Surrogacy Termination and Selective Reduction

As a woman interested in becoming a surrogate, also known as a gestational carrier, you have likely seen mentions of “selective reduction” on agency applications or online research. Perhaps you have strong beliefs about termination and selective reduction and want to know if this excludes you from becoming a surrogate. Or perhaps you are simply interested in learning more about how selective reduction and termination could be relevant to your surrogacy journey. In this blog post, we will explore these concepts in more detail and how they could impact your choices moving forward.

What is selective reduction?

Selective reduction is best defined as the act of reducing one or more fetuses in a multi-fetal pregnancy - for example, opting to selectively reduce quadruplets to twins or a singleton pregnancy. Selective reduction is the most commonly used term for this process, but it can also be referred to as selective termination or multifetal pregnancy reduction (MFPR).

Is termination possible in a surrogacy pregnancy?

It’s important to be aware that medical need for selective reduction or termination may arise with any pregnancy, surrogate pregnancies included. In an ideal world, every surrogacy journey would follow the path of implanting a healthy embryo which develops into a healthy fetus and results in a beautiful bouncing baby. Unfortunately, this isn’t always the case. No amount of medical screening can completely eliminate the chance of an unforeseen health risk to the surrogate or the fetus, and selective reduction or termination will at times be the best solution to ensure the health of all parties or promote the best chance of carrying a healthy baby to term.

When might termination be considered?

Regardless of the circumstances, selective reduction is only used in a surrogate pregnancy after being recommended by the doctor overseeing the pregnancy. This is not an option that is casually available.

Two situations where termination might be considered include:

• When a fetus is found to have a condition that is not compatible with life and could result in fetal demise
• When a fetus is found to have a condition that is compatible with life, but not of optimal health for long term survival

Surrogate beliefs around termination

It should be stated that in most cases, the beliefs you have as an applicant will not exclude you from becoming a surrogate. They should certainly not dissuade you from applying. ConceiveAbilities works with surrogates with a wide range of backgrounds, personal values, and belief systems, all of which are considered when we match surrogates with intended parents. If you are considering gestational surrogacy and would not be comfortable with selective reduction or termination under any circumstances, the fact is that it simply might be more difficult to find an intended parent to work with. You may need to wait longer to be matched, but if you feel strongly about surrogacy it is still worth pursuing.

Due to beliefs, cultural sensitivities and existing family dynamics, intended parents have their own values when it comes to termination and reduction. Just as surrogates had during their pregnancies with their own children, intended parents have decision making authority over their family building. It’s why our Matching Matters® protocol very carefully examines these delicate topics between intended parents and surrogates to be sure they have a like-minded match.

How to discuss the topic of termination

Selective reduction and termination are topics which are necessary but sometimes difficult to discuss. It is the role of your agency to facilitate these conversations so that a true consensus can be reached and all parties feel heard. At ConceiveAbilities, we ask surrogate applicants to explore their viewpoints and feelings early on in their applications. Our surrogate match experts then take great care to ensure that surrogates are matched with intended parents whose views and comfort levels regarding termination are aligned.

How can a surrogacy agency help in these situations?

Surrogacy agencies provide support through every step of your process to becoming a gestational carrier or intended parent. Agencies recognize the importance of matching the right surrogate with the right intended parents to build a foundation for a successful surrogacy. As part of the matching process, they focus on bringing together gestational carriers and intended parents who share similar beliefs about selective reduction and termination. A good surrogacy agency will also advocate for you and help you understand your rights. They will ensure that your rights, specifically in regards to selective reduction and termination, are clearly defined in your surrogacy contract. Working with an agency gives you the peace of mind.

Before suggesting a match, ConceiveAbilities has already ensured that both parties are on the same page. By the time your match reaches the legal phase, there will be no surprises and the language in your surrogacy contract will reflect the unified position between intended parents and surrogate.

If you’ve weighed your beliefs about surrogacy termination and selective reduction and feel confident that you’re ready to move forward, contact us to learn more. Our team is here to support you every step of the way.