Transcript
Speaker: I think people hear gatekeeper, they hear judgment, they hear looking for problems, like a test. It's a pass fail.
Speaker: You're not looking for a perfect individual that has had this perfect life. No, we've we've you actually used that term. Like, man, the survivor badass, like you're coming in with skills and resources and resiliency.
Speaker: If you've ever heard the words psychological evaluation and immediately felt your stomach drop, you're definitely not alone. For many intended parents and surrogates, this can feel like a very intimidating step in the surrogacy process.
Speaker: People worry they'll say the wrong thing, that their past will be held against them, or that they're being evaluated to see if they're quote, good enough. But that's not what this process is designed to do.
Speaker: Today, I'm joined by psychotherapists, Leslie and Kristen from Memorial Wellness to talk about how surrogacy psych evaluations really work, why fertility clinics require them, and what psychologists are actually looking for. Because when it comes to surrogacy, the goal isn't to find the perfect people.
Speaker: It's to understand the whole person and create the strongest possible foundation very healthy and successful journey. Enjoy.
Speaker: I'm so excited to have you back and I'm just even more excited that we get to have Kristin join us as well. I feel like it's a pretty common thing where you have a lot of intended parents and surrogates, they hear the phrase like psychological evaluation and immediately become super nervous. What do you think most people are just commonly misunderstanding about the purpose of the evaluation?
Speaker: So I think when we're talking about both intended parents and surrogates, there are two different types of sessions. And I think people hear gatekeeper, they hear judgment, they hear looking for problems, like a test. It's a pass fail. um And so I think if that if that's probably the most important thing that we could try to to change or augment with, it's really more about our role to help inform and guide and be a support and just make sure, you know,
Speaker: improve confidence and form consent, make sure that people are as ready as they can be to have a successful journey. And by successful, I think that that looks like relationship, that looks like and communication, that looks like getting their needs met from their team, from their intended parents, you know, that kind of thing.
Speaker: What is the evaluation actually designed to accomplish? So the evaluation, and I know that term sounds scary, but really, we like to call it more of just a time to chat, a communication time for both yeah the surrogate and her partner. So we ask them both to be able to participate. And that looks like um what we call a clinical interview, a clinical assessment. And that's going to be with them. It's usually about 60 to 90 minutes. And then in addition to that, we do a personality assessment. And that's typically with the carrier herself. And so both of those, um the the the interview plus the assessment are used to really help navigate and ah and identify um what are their strengths, what is their understanding, what are their expectations. It also is for us to look and clarify stability and emotional strengths and things that um that they want to kind of talk through to make sure that they are a good fit for this for in this time frame and for this particular match.
Speaker: Anything you want to Yeah, no, just making sure that this is this is as much of a good fit for them as it is for the intended parents and the clinic and the agency and everybody involved so that we we truly, we are assessing, but we also truly want them to feel supported as well. So... And and looking at looking at their coping resources, a lot of our surrogates coming in are the strongest women. And some of them have been through things in their life. And so we actually see that as a strength.
Speaker: right So while you're resourceful, resilient, resilient, and so. you already are this, you know, a mother to how many children she may already have. And so, so we want to draw on those strengths and that confidence. Um, we also, it's important that we are making sure that our carrier has, is able to use her voice. So if she has a preference or a need or whatever that might be that she, feels safe and she feels encouraged um to be able to express that, whether that's with her physician or her intended parent. um And so I think that's a big part yeah of our discussion is is that communication piece.
Speaker: Yeah, yeah, for sure. For sure. Well, like you said, right, like a successful evaluation, quote unquote, or successful journey is part of that is right that basis of the relationship. And so, right, like just discovering is this are all of the pieces here are all the ingredients here.
Speaker: Absolutely. Definitely. Yeah. can you help our listeners understand just what ASRM is and why their guidelines matter in the world third-party reproduction?
Speaker: Absolutely. So it sounds so formal, but ASRM is, right, American Society of Reproductive Medicine, and they are actually an international organization association so it's all countries across the world and they typically meet once a year and have a wonderful conference that brings together all disciplines involved in reproductive medicine and so it's been really cool about it over i mean I guess I've been a part of it almost 20 years and so over time
Speaker: The ASRM has developed these guidelines that are standard, that are kind of across the board. So it allows clinics, large clinics, small clinics to go back to these guidelines and say, hey, this is what we feel like is the...
Speaker: safest, most professional um criteria, yeah best practice that, that we want to see for our egg donors, our sperm donors, our surrogates, our intended parents. And so, um and typically it's a, it's a It's a panel or a group of people that come together and kind of create these ever so many years. And they're using updated data and research to add to that. So that it kind of gives us kind of a standard of care yeah that if this person went to New York or California or Denver, that they're using the same criteria for their cycle ah psychological evaluations. and intended parent consults. Are these guidelines, would you say, are requirements, recommendations, or kind of something in between?
Speaker: That's a very good yeah question. um They are, it's, it's, it's funny because people have asked like, is this the law? Is this against the law? So there's no law, there's no like formality. i think they are, I mean, I think you could say that they're requirements, but really they're strong recommendations. And, and I think, you know, going back to a discussion we had right before we started was These are recommendations across the board, but it is not a one-size-fits-all, right? And so our job, I mean, otherwise we just have them talk to fat, right, to do their avowl, but we're...
Speaker: We really want to hear their full full story, right? We want to hear, ah we we don't want to take something out of context of one, you know, this the surrogate was on medication at some point for depression. Oh, she's automatically excluded. So we don't want to be kind of a black and white. We want the whole story yeah of what does that look like and how long has she been on that or been off the context? Yeah.
Speaker: Yeah. So how do you balance, you know, those, those guidelines, but you are still evaluating each situation individually? That, that is a wonderful question. Do you want to answer that? Yeah. I think you have to go like every time you go in for an evaluation, I think it's a clean slate. You start fresh, right? You, you have that boundary of, you know, this is a new, a new person, a new surrogate, a new donor.
Speaker: You know, and I'm going to just, you know, start from ground zero and build the story from there. And so um so you just have to you have to each individual is unique and has their own journey and path that they've been on. And I think you just have to really lean into what what their story tells you about them.
Speaker: And I i think we're using a collection of data. Right. So we're using the personality assessment. We're using the interview process. We're talking to the agency or the nurse who's also had interactions with you know the with this candidate. And so it's not by by itself in a little silo that we're making um a recommendation. And and actually, mean, at the end of the day, we're we're ah we're making a recommendation of Does this, um, is this a good fit for, is this good time? Is this person in a good place mentally, physically, physically?
Speaker: ah is Do they give good informed consent? Do they understand? Do they have support? um Is there some unresolved trauma or crisis that maybe they need some more time to work through? What is their motivation? So these are the things that we look at. And sometimes we do a lot of collaboration with ourselves, with other mental health professionals, the team.
Speaker: Um, cause some, and sometimes it's, Hey, come back and let's talk some more, or maybe we need a little bit more time. Um, or they might need a little bit more time, um, depending on the scenario.
Speaker: Yeah. Can you like, How do you determine when a situation maybe requires just additional exploration, support, or you make the recommendation, now's maybe not the right time? How how do you, I guess, work within that gray area?
Speaker: Yeah, and I think that is a perfect example of when you would want to collaborate with the team and maybe do a consult with another professional. Luckily, you know Leslie and I can consult with each other, but we have other colleagues you know that have experience as well and have been doing this for a long time. So that's helpful. Pulling in the nurse from the clinic, pulling in the physician from the clinic as well, and sharing concerns. and and and And each of those teammates also really helps us to you know, sort paint the picture because they've had interactions, you know, with with the potential surrogate and they've had interactions with the intended parents. And so we can take all all dynamics into consideration. with these concerns and I can truly say that I do, everyone is is looking out for the but best interest of all parties involved and wanting to make sure that it's a good fit when we make when we do have to press pause. i I think that statement right there, like best interest of all, yeah is it it yeah it's challenging when things don't go as planned, whether it's for an egg donor cycle or or surrogacy, and And if we're making a recommendation, we're not ultimately the decision maker. We're just giving our recommendation of from from a mental health standpoint. And so people may not always love if we're saying, hey, we think this egg donor or um or this surrogate might need counseling or some counseling or something that is not a long-term issue, but maybe something and we might recommend ah a bit of a
Speaker: you know, six months or a year. And that's somewhat unusual. But again, we've looked at the whole picture and not just in a silo. And so while that may not be popular, it is in the best interest of both the parents and that the surrogate, right? Or donor. Yeah. Well, again, right. Like at the beginning you said, you know, sometimes people may look at this as, Oh, you're gatekeepers or you're, you know, keeping this. It is very much not a gatekeeping situation. it is a, we're looking at this from this perspective and the whole everything. And what you do with the recommendation is ultimately up to you, but yeah, Here it is. Right. No, no. Absolutely. yeah Right. Absolutely.
Speaker: Yeah. So obvious, I mean, anxiety, postpartum, mental health, medication, i mean, post 2020, right? Like it feels like everybody at some point has been on some form of antidepressant or anti-anxiety, um you know, but seeing that history can make people concerned or nervous as to whether or not, you know, they'll be quote unquote, like cleared.
Speaker: we've kind of touched on it in various ways, but how do psychologists, like how do you determine or just doing distinguish, I guess, between like a quote unquote normal human experience in situ versus maybe situations that are, that do require additional support or just caution.
Speaker: Okay. yeah Um, yeah, Okay, so first I want to say what i what I would really recommend is, as as we're talking about a surrogate candidate who's nervous, like, oh my gosh, I have to go.
Speaker: the The most important thing that she can do is come be herself, share openly, not hide, not um be defensive of things that have happened because we are so not judgmental, right? Like we we are not judging if she's had postpartum or if she's had.
Speaker: So if she can come in and be, have a honest forthcoming approach, then that helps set the tone for everything. It also helps as she's taking her personality assessment to to not be as defensive or not feel the need to look good or be good or do her best.
Speaker: We really just want honest honesty and introspection. intertrospection and so so with that, what we really look at is risk.
Speaker: If she's had um if she had three children and she had postpartum with one, what we're looking at is pattern.
Speaker: We're looking at what was helpful. Coping. Coping. Did she seek resources? Did she seek support? um how long ago, how long was she on the medication? um is this situational? What was going on in her marriage and her life at that time? So again, it's not just check the box, postpartum depression, and we're not going to see you. The criteria says that the surrogate cannot have
Speaker: any active anxiety, depression, um any mental health, major struggles. and and and And it's a little more vague about the history. And so that's what that's where our skills come in of really looking at What is that history? And so again, this person's come in and said, I had this, but it was my first marriage and my husband wasn't around or my or or we had just moved and I didn't have any family. And if there's more of a situational versus I've been on medication for 10 years and I've just gotten off to do this.
Speaker: That's a w risk. yeah Because the risk is we don't know how the surrogate will be off medication. We never want someone to go off of medication just to be a surrogate. yeah We want them go off your medication if you no longer need it but not just to apply. or Or they're on their medication and... and they decide through the evaluation that they're willing to go off of it during the surrogacy, which is another, you know, to your point, you know, not something that we would recommend either.
Speaker: yeah because again, it's best interest, right? Right. So if someone said I had some postpartum for a couple of months with my second child, I talked to a counselor or I took, you know, so loft for three months and then I felt better. i went back to work. I, the one recently we had was, she was going back to work and her She was trying to pump and she was had a lot of stress about returning to work and that added to some of the postpartum. But once, you know, I think she took surgery in for a few months and then was in a better space. So then we look at, okay, well then how's the last year been? How's the last two years been?
Speaker: What we look, I mean, i we see that as a strength that we have someone who reached out to her OB-GYN, right? Like, Hey, I'm struggling. and I might need some help because that's what we want from our surrogates when they are in an IVF transfer, when they are in and in a pregnancy, if they're struggling with God forbid, a COVID situation. We were busy during that. like Sure. um Or, i believe it you know, the craziness of the world, it may have nothing to do with pregnancy, but we always say, hey, life happens. And so you, you cannot, you cannot assume full responsibility for getting support, whether that's your agency whether that is your intended parents. um
Speaker: and it's And it's hard because Chris and I always recommend an agency. Sometimes we get an intended parent who comes in who's like, oh, I met this person online. And, you know, sometimes that works great. I'm not saying that doesn't work. But again, we're looking at risks. And one of the great the great things about working with with you guys is that We know that these, when you, you have educated your candidates, you have. Yes, ma'am. you right I know, right? Yes, ma'am. I mean, they come in so prepared and informed.
Speaker: Um, you've done your own part of the kind of screening. Is this a good fit? I feel like they're very well matched. And so it's hard when they don't have, when there's a crisis or something happens and they don't have that agency, um And I promise everyone, um we're not getting paid by y'all to say this. I truly y'all. I truly believe. I've seen this over the years. I mean, it's just, and I know it costs more to use an agency. I know all of that. I know people try to cut corners, the economy, um but you get what you pay for, right? so So that, we usually spend a lot more time and energy with some of those other matches where because there sometimes are some issues. So yeah that I went way off. I don't know. Did I even answer question?
Speaker: no, I really love, think the thing that I am just loving so much that you've over and over again is you're not looking for a perfect individual that has had this perfect life, you are looking at, you know, how did they respond to those natural things and bumps in the road that have happened? And, you know, that, and I love that you're saying like, that is a strength. That is, that is a strength that we are, you know, like,
Speaker: Talk about like judgment free zone. In fact, it's more like, hello, celebration, you're a badass. Like, yeah. No, we've, we've actually used that term. Like, man, that survivor badass, like you're coming in with skills and resources and resiliency. um And I think that's because I do think it can be challenging for a surrogate to come in who's had two perfect, normal pregnancies. I got pregnant like that. We had a pregnancy a delivery. Everything was great. Yeah.
Speaker: And then doesn't always go that way. Even if everyone's done everything correctly, that's just... Sure. Can't control it. No, can't control this. No, that's the nature of this industry. The science is great, but it's not perfect. It's not everything. Yeah. That's one of our jobs in the evaluation and in the joint session that we can also talk about is really about expectations.
Speaker: And it's interesting because I had a surrogate a while back that I think I was coming back for another match. And we had a ah an updated evaluation. and she And she said that. She goes, I remember you saying in our first that,
Speaker: things don't, that but you know, I say expect the unexpected, right? Like things don't always, and that's not your fault or that's not clinic. That just, and so that had stayed with her because I think it didn't maybe take the first time. And so that's our job is just really to kind of help. And, and, and we will, we always say like, we're here throughout. We meet this one time and then we do our joint session and then,
Speaker: We may be available ongoing, you know, so. Yeah, yeah. No, I know I took advantage of some of the ongoing when I was a, you know, when I was a surrogate, which full disclosure, Leslie was the person who did my evaluations for both of my journeys. um And yeah, no, it's, ah I think,
Speaker: That is why i feel like it is so important to not view the psychological clearance and, you know, evaluation and the session as just another box that needs to be checked before, you know, we get to get into the medical aspect of it. Like it is so valuable and so, so important.
Speaker: I think one of the, I think it can be a frustration, um you know, for intended parents when we say to them, you know, hey, you're going to need another psychological consultation for surrogacy because maybe they already had one um whenever they first started down the IVF road. Why might a repeat consultation still be recommended? I think, again, with that perception of why are we here?
Speaker: Like, nothing's wrong with us. We, you know, we already made this decision. um and so we often will just say, look, you, because it's recommended, your clinic, almost every clinic we, well, all the clinics we work with, you know,
Speaker: We'll recommend that because it's for the clinic's best interest too that this person is informed and has the resources, right? so So we usually just lay it out at the beginning like, hey, we're here as a resource. Again, we're not judging or we want to make the best use of your time.
Speaker: I would say people we've already met with that are coming back it's is usually ah is more of a positive, right? It's, oh yeah, we talked about this and we had we have our embryos and you helped us with that with the donor piece, but now we're moving to this next piece and it's a different level of grief. yeah It's a different, there was grief about losing the genetic aspect, but now there's a different level of grief of not being able to carry. And so we're really there to address the grief for that intended parent.
Speaker: We're there to help talk with them about their preferences for when they are matched and what is important to them. What is their expectation? So again, just like with the surrogate, we want the intended parent to feel also that they have a voice, that they are able to ask questions.
Speaker: oh, i I can go to all the appointments if I want, or or I just had an IP consult last week, and and they were both saying, well, if, well, I don't want to, you know, if she doesn't want us in the room, you know, they're so um considerate about the surrogate, like her privacy, right? And so helping them to understand they have preferences and a voice and that they're going to be well matched on what both parties prefer.
Speaker: and that typically most surrogates are like, come on in. And then, yeah, and I have lot of, um and then yeah so and i have a lot of A lot of moms I still see that use the surrogate and they, they're, they're not coming in about the surrogacy role. They're coming in because they're managing work life stress or they've got a two year old or they're, you know, just dealing with life, you know? So, um, so yeah, I've got anything you to I mean, i just always like to share with the intended parents that the purpose, in addition to what Leslie said, is that we want to provide support and education. so
Speaker: Again, working through any other, you know, a different layer of grief and making sure that, and some of the things that we talk about in those sessions are really far away and feel really weird to even be talking about, like thinking about the delivery experience. and And some of them will vocalize that, you know, they're more they're kind of more guarded because they've maybe been through a lot already and they don't really want to think about that delivery experience that we're just going to wait and see if we get there, you know. So we do have to kind of, you know, walk them through that, even though it might be uncomfortable or they're feeling like they're getting their hopes up in that moment. But we always explain, yes, we're available for, you know, at any point in this journey, but this is definitely our time to sit down and talk about those expectations that you have too. And so I always, i like that part of it because I feel like you you can, even though there might be some gardeness, you do kind of see their their eyes brighten up and getting to think about like, you know, getting to see their baby and holding that precious baby. So I feel like that's a really good part of the conversation to talk about as well that I like.
Speaker: Yeah, i I love that. And I think that's, that's true. It can be overwhelming because we're literally, well, and don't know, do you want us to talk about the joint session piece? or Yes, I would love to. I was gonna say, because I think the joint session, i know, at least at Ag General and Surrogate Solutions is a requirement for us. We, we, even if it's not a clinic requirement, it's a requirement for our agency because yes, we Thank you. Thank you. But again, right. Like as a coordinator, i know I have loved the fact that there has been one more just reiteration of let's make sure everybody's on the same page. Let's make sure we all start off on the right foot. So yeah, ah please dive into that joint session because I do find it so valuable.
Speaker: typically we are doing that joint session if we've done the initial consult. Um, and ideally we would do all three, but sometimes yeah it that doesn't work. We, we haven't done the eval for whatever reason. So then we do the joint session and the joint session is both parties. So that's,
Speaker: surrogate, her partner, if partnered, and then um and intended parents. And sometimes the surrogate has come in from out of town and her husband's at home with the kids and he's joined via telehealth. So I mean, again, we're pretty, but but we want him ah him or her to be a part of that, right? yeah So then the joint session is really walking through Kind of like Kristen said, everything from today transfer, appointments, delivery, and beyond. beyond yeah
Speaker: And so again, it's a lot about communication, preferences, expectations, and someone's idea of, you know, even just being able to ask, like, could we come to every appointment or I think we could probably only come twice to the involvement of the surrogate's children. how do they feel about that? If the intended parents already have kids, you know, how open. So it's a ah lot about how open the involvement of others.
Speaker: A lot of times our intended parents have families that want to maybe come to an ultrasound. um maybe come after delivery. And so even though it seems really early to talk about a lot of this, what I say is this is just the framework.
Speaker: And once we get through this and legal, and a lot of times it's nice because we're talking about a lot of the things that are are going to be addressed in the legal contract. And then...
Speaker: And then when they walk out, I usually say, okay, forget everything we said and just go back to yeah one week at a time. and yeah And we're you know we're not focused on delivery. We're not focused on pregnancy transfer. but were What's the next step? Because it like k Chris said, it can be really overwhelming. So we really want to help them just manage that.
Speaker: What? Okay. Oh, okay. Call legal. Okay. Meds for your surrogate. Okay. What's the, you know, and so one step at a time and that I think, but at least we have a format of everyone knows that.
Speaker: They're they really want this doctor or this hospital in Oklahoma. And OK, everyone knows that. And they can pull back on the conversations that we've had in the joint session when other stuff comes up or when they're doing the legal and all those things. It's like, oh, yeah, we talked about that. I kind of know what we want to do here. And that really helps, I think. Mm hmm.
Speaker: Yeah, yeah, absolutely. You've kind of touched on it. ASRM and then just the general requirement of clinics are for surrogates, you have to have had an evaluation within the year of your journey. Yes. for So that's the like the actual evaluation, MMPI, PAI, all of that.
Speaker: For intended parents, I know you said, you know, like you you have seen a surrogate again. is there still value in an intended parent coming in for a consultation, say this is their second journey with maybe even the same surrogate? Like, do you still, do there, is there still value in them coming in and having their own individual conversation?
Speaker: i mean, I think we're always going to see a value in that. If they are having a sibling journey with the same ah with the same surrogate and everything went great and nothing there, everything went smoothly and there were no issues. Then a lot of times we see that that's waived like, oh, it's the same person. Everything went great. Um, so sometimes we're not getting those and for, you know, and, and they are in a good place.
Speaker: But sometimes we've had a couple and they had a surrogate for whatever reason, there there wasn't success or so there was a medical or something happened and they're moving either for a sibling journey or for a new surrogate for this journey. Absolutely. Because yeah we're just want to help again, kind of process what emotions happen, um that disappointment.
Speaker: And now maybe they're a little more guarded because now, oh gosh, doing this again. And What if it, you know, in some of that or, my gosh, the first surrogate was so great. Now we have this new one. You know, I'm sure she is, but we're nervous. Every journey is different, even sibling journeys. And so just being that support, we do a support group at CCRM. That's for any intended parent, whether they're doing
Speaker: IVF or egg donor or surrogacy, but just as a support. And there's some online groups as well. So I think them feeling like they have a community if of people is also helpful. I always say, you know, for something that is one in six, it has, it always feels like they're the only one. And it's having, having that reminder of, you know, that, that support group and sitting in a room with the same people who under, I mean, if or anything, at least understand the language and how you're talking and what that means without having to explain it is something so wonderful and so valuable. Oh, it's so, it is so great. And it's, it's really cool too, because what we'll see is once couples are at that decision of, okay, it's been recommended that we use a surrogate for whatever reason.
Speaker: the minute that they might share that with their coworker or their friend, someone saying, Oh my gosh, my sister was a surrogate or my aunt used a surrogate. And so we see a lot of community that way. And so again, i think we really, this goes back to what I said about being open and honest. And I just feel like,
Speaker: So that this podcast, social media has completely normalized that. And have to tell you a quick story. So my first client this morning,
Speaker: um met, like she has this whole friend group and they all used surrogate and they met, two of them met in our group and the kids are like, I don't know, eight.
Speaker: I mean, it's pretty full. And so then they have this whole group and, um I love it. And I might still see some of them again, not for even anything surrogacy, but removing or, or changing schools, or a health crisis. and so But it's really cool because they've they've kind of connected, and now they all have children. And now it's not about surrogacy, it's about...
Speaker: whatever, schools and potty training and- Sure, sure. The typical like mom and parent stuff. And yeah, yeah. Oh, I love that. I love that. It's so fun. Yeah, I remember i i it was i had two clients, intended moms, who are it were are in Houston and we all figured out that they were still seeing you, Leslie. And then we became- like a mini fan. Then they met, I think at a, either a support group or maybe i gave one a phone number. I can't quite remember, but anyway, like they met and their kiddos, I think are a couple months apart and it's, so it yeah, it's just so fine. that It's so fun to just see that connection and it's so valuable.
Speaker: and And let me, let us just say like as a reassurance that These families, these parents yeah use this amazing person who gave the gift to carry their child and they have their child.
Speaker: And whether they see that surrogate again or they keep up with her at Christmas or, or every month, what I think what's cool for us is we get to see them after. And so we get to go back to the clinic too and say, we met the baby or we, and yeah,
Speaker: they're not coming in for those issues, right? they're And some aren't coming in at all. but they're And so just, I guess, a reassurance that they're, you use the word normal, they're typical. They move forward. they yeah forward And that's yeah I'm not saying that that hasn't impacted them and they're not bringing a part of that. And they'll often talk about course you know how they're sharing the story with their child and maybe the child has continued to see the surrogate or knows of her But it's it that part of them that they they become parents and they are the parent and they are the mother and um or if the two dads or whatever it is, because we see it all. Yeah.
Speaker: Yeah. How can intended parents and surrogates approach the psychological? i keep I keep saying evaluation, but I just want to like the psychological step in this process. the Yes.
Speaker: how can they approach that in a way that helps them get the most value from it?
Speaker: You know, i think just looking at it openly and again, assuming, you know, taking positive, a positive intent, um, stance and ah to kind of what Leslie said, um you know, you're, you're spending your, this is an investment in the process, right? You've already,
Speaker: invested so much time and emotional, you know, um, stamina and your physical health and everything else. Um, and so this is just adding to that, right. And, and is a form of protection for them, of course, for everybody, but especially, you know, for the intended parents so that Leslie always always says this, we don't turn a beautiful, you know, a beautiful thing into a mess, right. We want the, we want the journey to be, to be beautiful as much as we can along the way. um and just,
Speaker: look at it as being more proactive rather than reactive. Um, which lots of situations where, you know, it's in hindsight, you know, this could have been talked about, you know, if if there had been some more information and things like that. And sure. Going into it with that, like we want to get all the information that we can to the, not again, not to to say that that's a negative about a surrogate or, you know, or their partner, but to say, how can, is this a strength? How did, you know, how can we, then look at this as a positive and they're able to do this for us so that they're not, you know, just wanting to like check the box and, and move forward and really fully like, you know, be all in, in this. And I like what you said about investment. Like they're investing a lot of money.
Speaker: yeah Time. um Hurt, pain, risk, all of that. And so yeah i look at our role, if they can look at it more as preparedness versus judgment, right like we're preparing them for judgment.
Speaker: I mean, and and it may not always be success. We're preparing them to navigate. This next step. The next step. yeah and um And so that, instead of just check the box, because we can check the box. We can go through and talk about disclosure and sharing and expectations. But, you know, what what we hope is that they keep having conversations with themselves, with their agency, with their surrogate and vice versa. Right. And, um and I think, I think it's also i wanted to add if we've had an intended parent or a surrogate come in for a second journey, that's not with the same group.
Speaker: I always want to know what yeah what went well. what What went well? How did things go according to the plan and the script and the expectations? And what would you do differently this time? yeah Would you do anything differently? Yeah. And I encourage even surrogates who are matching again, especially if it's with first time IPs, to share, this is what I offered or this is what I did, not to make it a copycat or a cookie cutter, but
Speaker: i you know I kept a journal or I took photos or I played your voices night, all those things. And then i really like them offering all of that to the intended mother because as if she's never been pregnant or had that experience, a lot of times she doesn't really know what to ask for or she doesn't want to be intrusive. And so that way that gives her an option to say,
Speaker: no, thank you. I don't care for that. Or, oh my gosh, yes, I love that idea. So it yeah it just fosters more of them having those conversations and the relationship. yeah Yeah. Well, again, I think it's, I think one of the experiences that we have had i think with all of our clients is everyone is so conscientious of the other party. Oh, whatever they want. we want to make sure they're comfortable. And I know, you know, I've always, whenever I was, you know, interviewing potential surrogates, I was always like, that is so nice of you. And i love that. but I need to know what you want, because at the end of the day, it's not a great match. If you know, you say, Oh, whatever you want, but you're feeling uncomfortable. And so it's worth it to have these in-depth conversations. And again, right, this is judgment-free. I need to know what it is that you're comfortable with. Because if you're not comfortable with, you know, having like the dog plus grandma at the ultrasound, then let's talk about it. like
Speaker: No, and I think that's so true. And I think it's it's really sweet because a lot of times the intended parents will even ask permission of of the of the husband and the spouse. Like, hey man, are are you okay with me being in there? I mean, it's really sweet and um yeah um respectful, right? Like again, there's just so much value in not viewing this as checking a box, but really viewing this as a, this is a great place to reflect and to really think about some of these questions. And like you said, Kristen, not be in a scenario where now you're having to react, but you already kind of have a blueprint for if this happened, this is, you know, kind of the general guideline of how we would respond.
Speaker: If you could leave intended parents and surrogates with one message just about the psychological evaluations um or just any words of wisdom as they start a journey or maybe they're even in the middle of one, what would it be?
Speaker: I think one of the things i that I was thinking about and and and spoke about a little earlier that it that And not so much the evaluation itself, but the whole process of little bites at a time, just one step at a time and not borrowing trouble, not going into the future and worrying about how will I do on this test? You know, we don't use the word test, but how will I do here? Or or what if, or you know, and, you know, what if things don't work out or what if. And so just to, yeah to come back to being grounded and mindful of being in the moment.
Speaker: The other part of that that goes into is the loss of control for intended parents. so one thing we can help with is some just counseling and coping skills being on the on the trust, because so much of this is about blind faith and trust on both sides. absolutely um And so how to help both sides gain trust and feel that trust. and so if so especially for intended parents who are feeling so out of control that what what they may have done for their bodies and their selves during pregnancy, that that might look different with the surrogate. And and how can they let go
Speaker: and trust, but focus on the things they can control, like communication and taking care of themselves and garnering support. And so I think that would be the other part specifically for that group is, um,
Speaker: Like, don't think of this as a check. Come in and and let us let us help you. Let us help you yeah navigate and and and so that you you just can find joy. you know, there's this whole saying about foreboding joy.
Speaker: where you're not allowing yourself to enjoy pregnancy, the moment, the pregnancy test, because you're so, you know, guarded, your heart is guarded or you're not, you haven't told anybody or you're waiting for that shoe to fall or that negative. And so really helping them to be in that moment of respecting that they're not ready to announce it from the rooftops, but can they feel a moment of joy?
Speaker: with each little step, right? If we can break it down. oh no I'll know. I'll know. No, I mean, i no, I think that's, that's on point. And just, you know, not being, you know, being open to the possibilities that can, that can come in and not being, you know, there's a balance between preferences and expectations and being, you know, you know, too rigid and, you know, and not being flexible enough, right. To on both sides. so I think, yeah. So I think we've seen that from both the IP perspective and the surrogate's perspective. So, in different you know scenarios. So it's just you sure being flexible, being fluid you know for both parties I think is important.
Speaker: But also not being people-pleasers. Right, exactly. right Like that balance between yeah being a people-pleaser, like I've got to please and do exactly whatever they want, like you said, yeah to having the boundary or having, you know. yeah Speaking up and and putting their needs up there too. Yeah, for them, yeah.
Speaker: Yeah, well, right. I mean, as much as our brains so want this to be a black and white process, it's not. It's great. Even, you know, going back to right like ASRM guidelines. It's a guideline.
Speaker: We have to look at the whole picture. We're looking at these people individually. We're looking at this match, you know, on a case by case basis. And yeah, everything's fluid. Yes. everything's flu okay And gray. Fluid and gray. Yes, for sure. For sure. Well, again, thank you both so much just for ah your time, your expertise, everything you do for our shared clients. um I have one last question for you. And Leslie, I know you know this about me, but um Coffee and i we are never far from each other. And so i always love to ask the question. what has filled your cup lately, literally or figuratively?
Speaker: What's been the thing that's filled your cup? Gosh, okay. um Well, many may know that i I have twins through IVF who are now 23 years old. um And I was able, and one lives in another state So i was able to see her and have a great visit with her. And then the other one came home this weekend for Father's Day. So I think that just from a personal like personal perspective, yeah I mean, oh my gosh, totally, just completely fills me and fills my cup. And the one that came home is getting her master's in social work as we speak. And so that's so exciting. Double exciting. Double exciting. Pretty cool. Yeah. no Yeah. yeah
Speaker: How about for you? Personally, just um just time with friends and kids at the pool. i was on an IVF journey as well and in full transparency, went through egg donor solutions um to have my kiddos. So um love that. And so so then being in in this role professionally, really not to sound cliche, it truly does it truly does fill my cup professionally and even into the personal side because It was such an isolating experience going through it. You know, no none of my family or friends had. And so the fact that I get to have this opportunity to to do this for others and help people and walk alongside them, it it truly does. Like, you know, It it really does fill makeup. It's so like full circle. Yeah, full circle. Right? Yeah. It's yeah like it's pretty amazing. Like, this is so cliche, right? like But it is, like, amazing what we get to witness every And hear the intimate stories and all the... yeah I mean, it is a gift. Yeah. That we naturally...
Speaker: yeah No, I completely understand. i think, you know, every every transfer day, every baby picture, it all, like, it never gets old. It never gets, like, yeah it's yeah amazing every time. It's pretty, yeah yeahp keeps us coming back every day. Every day. i held a sick one last week during my entire session, and I was like, this is...
Speaker: fabulous. Yes. Yes. Oh, I love that. I love that. Well, again, thank you both so much. And we are going to have it in our show notes. But if people were to look for you, where should they go?
Speaker: Oh yeah, they can come to our website at memorialwell.com and we're both on there. um They can fill out information. Our phone numbers are on there. They can text us. Text is really the easiest. Our our personal our work cell phones are on there. yeah But yeah, absolutely. and we have an office at CCRM and we have an office here at Memorial. and But we also we work all throughout the state virtually with all the all the other clinics too. So we love it. Perfect. Yeah.
Speaker: Perfect. Awesome. Well, thank you both so much again. Thank you.
