Pregnancy methodology linked to greater charges of dangerous childbirth in mothers

An increasingly popular pregnancy method used by celebrities including Jimmy Fallon and Kim Kardashian is associated with an increased risk of complications and death.

A new study found surrogates, women who carry and deliver a pregnancy for someone else, are more likely to experience life-threatening complications and death during pregnancy than women who give birth to their own children.

By looking at data from more than 800,000 pregnancies in Canada, researchers determined surrogates were likely to develop preeclampsia, a potentially fatal condition that causes high blood pressure, nausea and vomiting. 

It’s also been linked to an increased risk of heart disease and stroke later in life. 

The rate of life threatening health issues that can occur during or after childbirth was eight percent in the surrogates, compared with two percent of people who carried their own babies. 

People choose to use a surrogate for a number of reasons – be it complicated previous pregnancies or infertility. Jimmy Fallon has spoken about he and his wife’s decision to use a surrogate. Kim Kardashian has also shared her experience with surrogacy, using two different women to have children with Kanye West

Study Author Dr Maria Velez, an obstetrician at Queen’s University in Canada, said these risks need to be considered by people interested in paying other people to carry their babies. 

Dr Velez said: ‘Clinicians involved in the care of individuals and couples who need a gestational carrier to build their family should counsel their patients and the gestational carriers about the potential risk during pregnancy and early postpartum.’

Surrogacy, when the embryos from one couple are implanted into the womb of another woman who carries the baby to term, has become more popular with increasing medical advances.

The researchers analyzed 863,017 pregnancies from 2012 to 2021, 806 of which were surrogacies, and published their findings in the journal Annals of Internal Medicine. 

Though the topic remains controversial, the authors note, few studies had actually been performed to see what the safety of surrogate pregnancies were compared to normal childbirth. 

Dr Velez said: ‘The study was prompted by an increased in the use of gestational carriers worldwide and a lack of information about the impact of this reproductive modality on pregnancy outcomes, for the gestational carrier and the offspring.’

Childbirth is inherently risky. When giving birth, new mothers risk massive blood loss, tissue tears and changes to blood pressure. 

One well-known complication is a condition is preeclampsia – a sudden and dangerous change in a mother’s blood pressure during pregnancy or child birth that can lead to premature birth, liver damage, seizure, comas, cardiovascular disease and death.

It affects about five to eight percent of all pregnancies in the US, and is more common in women who are obese, over age 35 or have autoimmune disorders. 

The study found that eight percent of surrogate births had some sort of life-threatening complications, particularly preeclampsia and massive bleeding. 

This was four times the rate of the natural birth group – where two percent of pregnancies resulted in complications at birth. 

Also, surrogates were more likely to give birth prematurely – before 37 weeks gestation – than other women. Still, on the whole, the babies born to them were as healthy as the babies born to their biological mothers. 

The authors note that screening guidelines for surrogates should weed out existing health conditions that would make them more likely to have a complicated pregnancy. But, Dr Velez said: ‘these guidelines are not always strictly followed.’

On the whole, surrogacy is still a relatively rare situation. 

This is likely because it costs a lot of money to support a surrogate  – it can cost more than $200,000 according to American Surrogacy – making it the stuff of the wealthy. 

Researchers found risks were outsized in women who opted to be surrogates than in women who gave birth to their own biological children

The paycheck is a reason some surrogates opt into this contract. Others say they agree to be a surrogate just to help couples who can’t conceive on their own. 

The people who seek out a surrogate likewise have a number of motivations. Some had previous risky pregnancies. Others are infertile, or are in a same-sex partnership where it’s not possible to carry a baby yourself.  

One of the factors that complicates surrogacy in the US is that it’s not legal in every state. Nebraska and Louisiana currently prohibit paid surrogacy.

Paid surrogacy was brought to the spotlight in the 1980’s by a controversial legal case wherein a surrogate who was paid to carry the pregnancy of a couple in New Jersey had a change of heart after giving birth, and decided she wanted to keep the baby. 

The couple who paid the woman to carry the child sued, and were eventually granted custody. In response, New Jersey, New York and other states instated a ban on paid surrogacy that lasted years. 

The case, known popularly as ‘baby M’  – made surrogacy a national controversial topic, with people questioning the ethics of wealthy couples paying surrogates, who are sometimes substantially poorer – for the temporary use of their womb. 

In Canada, where the study was performed, surrogacy is largely legal, with some restrictions.