The Flavor of the Month - Written by Drew

The last eighteen months have been tough for international surrogacy facilitators and agents.  In the wake of several high profile cases, India has continued to tighten its restrictions on surrogacy.   Thailand closed its doors in 2014 although the case of Baby Carmen continues to highlight the danger of surrogacy in a place where the legal framework is evolving.  An earthquake in Nepal didn't slow them down, but the Supreme Court in Nepal has put a moratorium on surrogacy.  The news from Mexico has not been encouraging. 

Of all the possible locations on the planet to descend upon for surrogacy, where are the international facilitators and agencies going now?

Cambodia.

 As a wise man once said, I'm not making this up.

Let's see what the US State Department (link) has to say about traveling to Cambodia.


On Crime:
"Cambodia has a high crime rate, including street crime. Military weapons and explosives are readily available to criminals despite authorities’ efforts to collect and destroy such weapons. Armed robberies occur frequently, and foreign residents and visitors, including U.S. citizens, are among the victims. The Embassy has also received reports that hotel rooms of U.S. citizen visitors in Phnom Penh were burglarized while the occupants were asleep."
"Local police rarely investigate reports of crime against tourists, and travelers should not expect to recover stolen items. It has also been reported that some police stations charge foreigners between $20 and $100 to file a police report."

The concept of someone breaking into my hotel room while I'm sleeping is creepy to say the least, the idea of this happening in a room where my newborn infant is sleeping is horrifying.  That's saying nothing about the military-grade weapons that are easily accessible.

On LGBT Rights:
"While there are no legal restrictions on same-sex sexual relations or the organization of LGBT events in Cambodia, public attitudes remain negative towards LBGT individuals, and same sex marriage is generally not permitted. There have been no reports of arrests or violence related to LBGT travelers."

The fact that there have not been reports of arrests or violence related to LGBT travelers may seem encouraging, however the cultural climate of negativity towards the LGBT community is  concerning.  What is more concerning is that despite several cases of LGBT parents experiencing legal issues in non tolerant countries, that facilitators and agencies continue to bring their clients to places where their rights are not recognized and protected. 


Most importantly, this is what the US State Department says on on Health:

"Medical facilities and services in Cambodia do not meet international standards. Both Phnom Penh and Siem Reap have a limited number of internationally-run clinics and hospitals that can provide basic medical care and stabilization. Medical care outside of these two cities is almost non-existent. Local pharmacies provide a limited supply of prescription and over-the-counter medications, but because the quality of locally obtained medications can vary greatly, make sure to bring a supply of your medications that is adequate for the duration of your stay in Cambodia. You should be wary of purchasing local medication. Counterfeit medication is readily available, often indiscernible from authentic medication, and potentially lethal."

Even if we were to ignore everything else, what about the above paragraph indicates that Cambodia is a safe and appropriate place to conduct a surrogacy?   By definition, surrogate pregnancies are considered high risk.  The increased risk of multiple pregnancy and prematurity make access to high quality health care critical for the safety and wellbeing of babies.

Likely, if you point this out to one of the facilitators or agents currently touting Cambodia as the next great option  for international surrogacy they will  tell you that "their" doctors and clinics are state of the art.  Given that they make thousands of dollars from IPs with absolutely zero accountability for outcomes, I suppose it's not surprising that they would minimize the risk.   Disappointing, but not surprising.  I mean really.... who cares what the State Department has to say as long as the facilitators "feel" good about it. 

Families through Surrogacy's website has the following to say about surrogacy in Cambodia:

Note:  The Cambodian surrogate retains parental rights under the law.   While facilitators may feel comfortable minimizing the risk that this poses to intended parents, one only has to look at the current Baby Carmen case to see just how dangerous ignoring the legal rights of the surrogate is.  

As always, we urge all hopeful IPs to consider the risks to everyone involved when it comes to weighing your options, no matter how desperate you may feel.  As has been said here before, where your baby will be born is the first decision you will make that could have serious and/or long-lasting repercussions on your baby's health.  As the first anniversary of my twins' birth and my son's death quickly approaches, I remember how we were reassured repeatedly that our surrogate was receiving the absolute best care possible, and that my twins would have access to the same level of healthcare as they would in a regional medical center in the United States.  My wife and I believed what we had been told repeatedly by our facilitator, and it wasn't until we received conflicting information in the wake of the premature birth that our facilitator admitted that she wasn't a medical professional.

As a matter of fact, none of them are.

None of them are legal experts in any of the numerous countries they have churned through over the last almost two years, either.   There is no possible way any of them could become legal experts on surrogacy in country after country after country.  

None of them are fluent in the local language, and I find it implausible that any of them could have become experts in the local customs and cultural practices in the very limited amount of time that they spend there before declaring a program "open for business." 


Yet they routinely present themselves to desperate intended parents as being experts who are able to determine whether a hospital, clinic, or even an entire country is an appropriate and safe place to bring a newborn into the world.  

Commenting on this blog is not a right.

This is my blog.

I am not obligated to post abusive, inappropriate ugly comments.

I am not obliged to justify what I do and do not post here.

I am not obliged to give anyone a platform to attack and shame intended parents for speaking out about their experiences.

I am not obliged to promote anyone's business.

It is not my responsibility to promote international surrogacy.

If as an industry professional you feel that I am a big meanie head for demanding that people who charge thousands of dollars for their services be accountable?

Surrogacy in Mexico Resource

One of the few unbiased sources on the state of surrogacy in Mexico can be found on Facebook.  This page is managed by the only person I know of who talks about surrogacy in Mexico, but who does not make money off of doing so.   A few of her recent blog posts include discussions on:

Surrogacy Beyond Borders article

Additional article on Surrogacy Beyond Borders

The articles include information on how Mexican law has been violated (commercial surrogacy in Mexico is NOT legal no matter how many times people try to play semantic games like "recatagorizing income"), allegations of surrogate mistreatment and bribery.

This page has extensive information for intended parents regarding the evolving situation in Mexico.

"Everything is fine"

http://www.worldcrunch.com/culture-society/surrogate-mother-industry-carries-on-after-nepal-quake-/surrogacy-fertilization-modernity-poverty-trafficking/c3s18992/#.VXjw00Z8NKh

Surrogacy in Nepal: International Surrogacy Disaster

One of the families currently stranded in Nepal with their newborns

Today our thoughts and prayers are with the surrogates, babies and intended parents who have been impacted by the terrible earthquake in Nepal.   There are reports of several Israeli families with premature babies who are trying to get out of the country.   I can only imagine how scared and worried they are as they try to keep their fragile babies safe.

One of the primary reservations I had when people first began touting Nepal as the next location for international surrogacy was the fragility of  infrastructure in the country.  For years experts have been warning about the danger to the area from earthquake,   especially given that in recent years construction has been largely unregulated.   Even prior to the quake, Nepal's medical infrastructure was fragile, not a single hospital in the country was accredited by the International Joint Commission on patient safety.   Now those facilities are overcrowded and running short on emergency supplies, and morgues are running out of space. BIR hospital is reported to be treating people in the streets.

Hours after the quake, the death toll is already above 1500.   However, surviving the initial quake and its  aftershocks is only the first hurdle that must be overcome.   The country is highly dependent on hydroelectric power plants, it's not yet clear what damage they have sustained.  Interruptions to the power grid are not unusual in Katmandu,  so many people and businesses have generators, however, given the significant damage to roads moving fuel to where it is needed is going to be very difficult.

I doubt that fertility clinics are going to be given first priority for allocation of what is likely going to be a scarce commodity.  This could have grave consequences not only for surrogates in housing, but for the thousands of embryos imported there in recent months.  

Cholera is a regular problem in Nepal, one which could easily become epidemic given the difficulty in maintaining clean water and adequate sanitation after a disaster of this magnitude.

When people advertise they are experts at surrogacy in a third world country the implication they are giving to intended parents is that they are prepared for the worst.   Unfortunately, as has been seen repeatedly, many of the so called "experts" are little more than expensive glorified travel agents with little to know understanding of the challenges that may be faced even under the best of conditions.  I have zero faith have the ability to truly help intended parents under conditions like these.

Families Through Surrogacy: Consumer Advocacy Group or Trade Show?

"Families Through Surrogacy is a consumer-based non-profit organization focused on bringing together surrogates, intended parents and families through surrogacy to network, share their stories and stay informed about best practices in surrogacy arrangements" 

In March 2014, I spoke at the West Coast Families Through Surrogacy Conference held in San Francisco, California.  I was also a member of the conference committee from the fall of 2013 to the summer of 2014.

I was very excited when I first joined the FTS conference committee .  I felt honored to be part of a group that promoted transparency, ethics and best practices in international surrogacy.  It wasn't very long though before  I began questioning how the conference's policy on sponsorship could be reconciled with its mission statement.   

While I understand the financial reality of doing conferences around the world, I am disheartened by the way the financial need for sponsorship appears to be overshadowing FTS's stated mission.   When I was on the committee one of the very difficult conversations we had regarded a set of sponsors who had ties to a medical tourism company currently under FBI investigation.   When I expressed concern about promoting players with a history that was at the  least problematic,  Sam responded with something along the lines of "Well they are being investigated, but they aren't indicted yet."

Surely there is a better measure of best practices than "Not yet indicted." Allowing people with long histories of questionable behavior the opportunity to promote themselves at Families through Surrogacy conferences not only makes vulnerable IPs a captive audience to providers with known issues, it undermines the credibility that the conference has with the wider surrogacy community.  Whether the committee realizes it or not, allowing someone to present at the conference is an endorsement of their services.

Unfortunately, the conference has been used by more than one provider in this manner.   Speaking at the conference legitimizes providers, allowing them to present themselves as recognized "authorities" when that is often not be the reality.  It grants them a veneer of respectability and allows them them not only a captive audience, but they can later refer to their "speaking engagement" as a way to recruit new clients.  

The year  I spoke at the West Coast Families through Surrogacy conference Kim Waters Hendrix of Complete Surrogacy Solutions also spoke.    It was very clear the conference was used as a platform  to promote her business.   This pattern was repeated later that same year in Australia, where many people complained of Kim's "grandstanding."  Kim  used the forum not only to promote her own services, but also to denigrate her competitors.

Last year, Megan Sainsbury was "banned" from the Families through Surrogacy conference in Australia.   This year, Kim Hendrix is banned while Megan is attending under the umbrella of the clinic she promotes in Mexico.  What changed during this time?  To my knowledge,  no one from Families Through Surrogacy has explained why Kim went from being actively promoted to being banned and what Meg did that resolved the issues that caused her to not be allowed at the conference one year and then allowed to return the next.

At the very least, if a concern is brought to a provider, and it's serious enough to warrant not allowing them to attend the conference,  and then they take the time and energy to resolve those issues so that you feel comfortable bringing them back, it seems like it would be in everyone's best interest to give them credit for making those changes.

If the conference wants to grant sponsorships to anyone willing to pay the fee,  in much the same way that vendors at a trade show are selected, that is clearly their prerogative.   However, it's my opinion that if you want to maintain credibility as a non profit IP focused advocacy group, "not yet indicted" and "not popular at this time" is an incredibly low standard for professional participants.

When Families through Surrogacy allows agents to abuse intended parents publicly and says nothing?  They are giving their tacit approval of the behavior.  They are in fact contributing to the climate of fear and intimidation that permeates the international surrogacy community.   When Families through Surrogacy is not transparent about how they choose sponsors, they are not modeling the transparency that intended parents should expect from ALL parties who work in this field.  

I know that I am not the first person, nor am I likely to be the last,  to bring these issues to their attention.

Consumer driven advocacy groups have a responsibility to advocate.   If they do not want to take on that responsibility then truth in advertising demands that they notify attendees that they are a trade group for agents and clinics.   This would all them to continue to provide information to consumers, but would give those intended parents the proper context for that information.

If you aren't part of the solution, you're part of the problem.  

Is this professional behavior? - by Drew

While we have always named specific people who have exhibited behavior with which we have grave concerns, it could still be possible that someone could read our blog and believe that we are against international surrogacy, and that it should be shut down.  This is not true.   Despite Johnny's death and what has transpired subsequently, without international surrogacy we would not have the delight that is our daughter.  However, we are disappointed by the sheer number of people in the international surrogacy community who seem committed to behaving in  unprofessional and/or questionable ways.

The most recent example of this:

Last night, I received this Facebook message from Catherine Moscarello, of IP Conceptions.

To put it (very) briefly, Ms Moscarello started out as a Planet Hospital employee.  Catherine and her husband seem to be the only ones to who materially benefited from its implosion.    While the rest of us lost thousands of dollars, Catherine Moscarello awalked away with a set of embryos and the entire Planet Hospital client file.  Catherine then launched IP Conceptions,  her own surrogacy facilitation business in Mexico.  In the beginning,  Catherine  consulted frequently with us as to our opinions on best practices, transparency, etc.   We wanted to believe that she had good intentions.  However,  when she began make decisions that appeared to put her interests above those of IPs  who had lost tens of thousands of dollars to Planet Hospital,  we spoke up.    On good days, she ignored the concerns we and others shared with her.  On other days, we and several other former Planet Hospital clients were viciously attacked.

Ultimately, we decided  there was no point continuing to engage with her, so we severed contact with her and considered the matter closed.

Putting aside the hubris that makes her think that we are required to publish any comment she were to write, let me point out that we have not "attacked" Megan Sainsbury.  While we have expressed disappointment at Meg's behavior towards friends of ours, we haven't made any posts that address her or her business.   I have no idea what comment Catherine is going on about.  Please keep this in mind as you read the conversation between Catherine and I.

The following is the screencap she linked me to:

 

 

And now these are my screencaps of the rest of our conversation:



Ms. Moscarello is correct that we have put things out there publicly.  If she would like to refute those things or address them, it's my understanding she has her own social media accounts that she can use to do so.  My wife has blocked Catherine on her telephone, on email,  on Facebook, has put her on ignore on BabyCenter and has repeatedly asked her to not contact us.   Despite that,  Ms. Moscarello  appears to believe she has the right to continue a barrage of unwanted and harassing contact. This does not seem like professional behavior.