Becoming or working with a surrogate: surrogacy support counselling and your pre-surrogacy psychological assessment

So, you’ve found your Surrogate or perfect Intended Parent(s) and it feels a bit like you’ve hit the jackpot. Then it dawns on you. You now have to navigate all of the medical, psychological, and legal checks to finally get to that glorious moment of transfer. More time, energy and money will be lost, you think to yourself… Can’t I just get a baby already? 

Well, the best things in life take time and how you and the team come out on the other side depends on a number of things:

  • Making sure that you are keeping within the law
  • Looking after your body
  • Looking after your mind as you travel through surrogacy

How you cope with the journey can be a great indicator of how you will manage the ongoing relationships that surrogacy brings. Not only with your teammates but also with the wonderful bub that is brought forth from your team.

Surrogacy and the importance of mental health

For Intended Parents, your mental health will have a dramatic impact on your baby’s brain development. That’s in addition to the bond that you build with your baby. This will affect your baby for the rest of their life. Not to mention your grandchildren and your grandchildren’s children (and so on) through intergenerational transmission (no pressure!).

For Surrogates, coping with not just the pregnancy itself but also the postpartum fourth trimester can be tricky. Taking your mental health in hand can help increase coping skills and will hold you steady for your own family.

Counselling for Surrogates and Intended Parents

If it’s your first time seeing a reproductive psychologist or infertility counsellor, it can be daunting. When the phrase ‘pre-surrogacy psychological assessment’ is attached to the meeting you may feel a sudden desire to run to the hills.

The word ‘assessment’ is a weird one to apply to psychology – it can sound like someone is going to judge you.

Psychologists (like myself) who conduct these assessments are looking at how ready you are for this journey. Plus, we’re looking at whether or not any psychological harm may come to either the Surrogate, the Intended Parents, or any child associated with the surrogacy. This includes the one who will be born.

So, yes, it’s called an assessment, but it’s not personal. It’s to make sure that everyone has thought it through, is capable of giving consent, and won’t be harmed by the intended surrogacy. Think of it as protection from harm, rather than assessing you as a person.

Common questions that arise before and during surrogacy counselling

A common question for teams coming into psychological counselling for surrogacy is whether it is possible to ‘fail’ the psychological assessment.

  • What if we are simply not cut out for this?
  • What about that postnatal depression I suffered? Does that preclude me as a surrogate? 
  • And what about the anxiety that has plagued me since my teenage years. Will that mean I am somehow not suitable to have my dream baby? 

To answer these questions, it’s important to understand: things are rarely so cut and dried.

Your infertility counsellor’s job is to assist you to work through the implications of what you are getting yourself into. Additionally, they will get an understanding of what might get in your way. This is important as it often means you can create a plan to help.

It’s common to see teams where someone has suffered from anxiety or depression, and many surrogates have experienced postnatal depression in the past.

During the assessment, it’s important to consider:

  • What might trigger a relapse
  • What plans can be put in place to manage symptoms
  • To think about how these issues will be managed once the baby is here

So, what is recommended when it comes to counselling in surrogacy? Let’s cover the core minimum below.

Mandatory counselling for surrogacy participants

Firstly, it is important to make sure that you are working with a psychologist or infertility counsellor who is registered with the Australian New Zealand Infertility Counsellors Association (ANZICA).

Psychologists or fertility counsellors who are registered with ANZICA must follow guidelines that ensure they are abreast of the legislation for each state. They also cover the important considerations in surrogacy. 

There is a mandatory counselling process built into the surrogacy legislation and, confusingly, the requirements vary from state to state.

In Victoria, for example, your ‘implications counselling’ (think of it as a space to consider the ramifications of surrogacy and to understand what it all means) is completed by your clinic before an application is made to the Patient Review Panel (PRP) to approve your surrogacy. This is when an Independent Pre-Surrogacy Psychological Assessment is recommended to bolster the panel’s understanding that clinics have covered everything necessary in the implications counselling. At Happy Minds Psychology, these assessments involve three separate sessions with me either face to face or – thanks to Covid –via telehealth video link. 

In NSW, the ACT, South Australia, and Queensland, the implications counselling and the assessment can all be completed externally from the clinic. Due to the use of telehealth, you can get your surrogacy counselling completed with Happy Minds Psychology from wherever you are in Australia. 

If your eyes have begun to glaze over at this point, you are not alone!

Hopefully, you will find a practitioner who is a good fit with your team and who can guide you, step by step, through the counselling and assessment process.

Teams often tell me that they are initially nervous about working on the counselling component of their surrogacy. However, later on, they find it to be an enlightening and supportive process. Plus most importantly, a safe place to voice their fears and work on their plans. 

The process of pre-surrogacy implications counselling and assessment

Australian surrogacy law requires that ALL parties to the surrogacy arrangement must participate in counselling. Therefore, all partners of Intended Parents and Surrogates must attend the sessions.

Essentially, if you are in a relationship with someone involved in surrogacy then you are part of the team! 

Which state you reside in will determine the length of time necessary to complete the counselling and assessment.

Prior to the first session, all members of the team will need to complete a questionnaire that captures each individual’s story. Plus, it will grab some basic details and personal history. With this questionnaire is a consent form that explains the limitations of confidentiality in surrogacy. These privacy limitations are necessary as questions can be used to form a report for the Court, Ethics Comittee at the fertility clinic or the PRP (if the IP(s) live in Victoria). 

Once the questionnaire and consent forms are completed, three sessions are scheduled. Easch session normally lasts 1-2 hours.

  1. Session one is with the Intended Parent(s)
  2. Session two is with the Surrogate and her partner (if applicable)
  3. The final session is with the whole team. Any children of an appropriate age will also be involved in these sessions. 

When the sessions are complete, each team member will need to complete an online personality assessment. It will look at:

  • Any psychopathology (psych speak for mental illness)
  • Personality factors that might be indicated.

The results of these tests will be fed back to you if anything of note is found. Most people are anxious about these tests; however, it is important to note that they form a relatively small part of the overall picture. Any issues will be thoroughly discussed with you prior to being included in the report. 

All reports are completed in draft form within a two-week deadline unless previously agreed with your team. A draft copy will be sent out to each team member at the same time. The report is then finalised and sent to your clinic or lawyers depending on the state in which you live. 

Further surrogacy information and counselling

At Happy Minds Psychology we enthusiastically advocate for Surrogates and Intended Parents in Australia. Our experienced, ANZICA-registered counsellors can assist with your independent pre-surrogacy psychological assessment or with surrogacy support counselling.

For appointments face-to-face in our Ocean Grove office, or remotely via Telehealth, fill out our contact form or give the team a call on 0431 666 050 today.

Share this post