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Friendship as the foundation of surrogacy

Couple turns to a close friend, rather than a stranger, to serve as surrogate in pregnancy

From left: Meghan Hukowicz, her son, Brady Zoll, and friend Diane Kieras-Ciolkos, who acted as gestational carrier.

Matthew Cavanaugh for The Boston Globe

From left: Meghan Hukowicz, her son, Brady Zoll, and friend Diane Kieras-Ciolkos, who acted as gestational carrier.

There is one voice, other than his parents’, that makes 10-month-old Brady Zoll’s eyes grow wide.

“Hi big boy,” coos Diane Kieras-Ciolkos. “Do your teeth hurt?” She holds the fussy baby while his mother, Meghan Hukowicz, looks for Tylenol.

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It’s not surprising that Brady is comforted by Kieras-Ciolkos’s voice. After all, he heard it for nine months, from deep inside her belly, up until the moment Kieras-Ciolkos handed him over to her best friend, who would raise him.

Kieras-Ciolkos, a tall and gregarious 41-year-old, was Brady’s gestational carrier; Hukowicz, 36, blond and petite, is his biological mother. A surrogate pregnancy between friends is unusual in the world of reproductive technology, but for these women, it’s a natural extension of the bond they have shared since childhood, when they built forts and played kickball together in the farmlands of Hadley.

Back then, Hukowicz was not a healthy child. She was diagnosed at 5 weeks old with cystic fibrosis, a chronic disease that causes dangerous mucus buildup in the lungs, and which used to all but assure a shortened life span. Her aunt, who also had the disease, died shortly after childbirth. “I always thought I couldn’t have children,” said Hukowicz.

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So when they were adolescents, Kieras-Ciolkos first made the offer — to carry a baby for Hukowicz. At that point, Hukowicz didn’t take the proposal seriously. But Kieras-Ciolkos kept offering — even as she got married and bore two children of her own. Only after Hukowicz got married did she and her husband, Frank Zoll, consider their options for a family.

Although Hukowicz coughs frequently and speaks in a raspy voice, she has kept her cystic fibrosis under control. But doctors confirmed that a pregnancy could be life-threatening — and that the medication she takes could harm a fetus.

So, with considerable trepidation, Hukowicz accepted Kieras-Ciolkos’s offer to become a gestational carrier — a type of surrogate pregnancy in which the biological parents provide the egg and sperm.

“She is really important to me, so my first concern was her health, and how it would affect her family,” Hukowicz said. But Kieras-Ciolkos’s enthusiasm — and the support of her husband and children — convinced her it could work. “She’s got such an amazing attitude, and I knew she could handle it.”

The American Society of Reproductive Medicine estimates that 1,400 babies a year are born through a gestational carrier in the United States. In most cases, a commercial agency brokers the arrangement between a couple who can’t have a baby and a woman they pay to carry one. Only a small percentage of such pregnancies are between close friends, according to Julianne Zweifel, a psychologist with the society.

Zweifel said the trust between friends can be comforting in an otherwise nerve-wracking process, but that familiarity can also create complications. For instance, in a strictly commercial arrangement, agencies try to match carrier and parents according to their views on such sticky topics as abortion or natural childbirth, but friends may find it awkward to acknowledge deep-seated differences.

“That’s a much harder bridge to cross than with someone you don’t have a prior relationship with,” Zweifel said. “Friends might feel, ‘I should [agree to] whatever you want because I really love you and want this to work for you.’ ”

Kieras-Ciolkos and Hukowicz say they were aware of the pitfalls, so they started with a legal contract.

Kieras-Ciolkos relinquished all parental rights to the baby; only Hukowicz and Zoll would be listed on the birth certificate, as stipulated in Massachusetts law. Hukowicz and Zoll agreed to pay all pregnancy-related expenses — which came to about $30,000 ­— but no surrogacy fee.

Their fertility clinic also required the four spouses to answer questions about worst-case contingencies. For instance, what if the pregnancy or birth went horribly wrong and only one life could be saved?

“Meghan and Frank said, ‘you have a family, it’s your life first,’ ” Kieras-Ciolkos said, “which is a very hard thing to even fathom and talk about, but everything needs to be talked about.”

Hukowicz said she felt guilty as Kieras-Ciolkos endured 14 weeks of hormone injections to prepare her body for embryo implantation. To everyone’s relief, it worked on the first try. From that point on, Hukowicz attended most of Kieras-Ciolkos’s obstetrician visits, where they pored over grainy ultrasound images together and listened to the baby’s heartbeat.

On occasion, Kieras-Ciolkos also brought along her 10-year-old daughter and 5-year-old son, to make sure they not only felt involved with the pregnancy, but understood the baby would not be living with them afterward.

Her children got it quickly, but not everyone did. Hukowicz would announce she was expecting a baby, then have to explain her flat belly. “It’s not the most comfortable thing to tell someone, ‘well, I’m having a child but my friend is carrying it,’ ” she said. “Some people look at me like I have five heads and they just don’t get it.”

Brady was born last August at Cooley Dickinson Hospital in Northampton, with both couples in the delivery room. As Kieras-Ciolkos labored for 10 hours, she deferred to Hukowicz and Zoll on key medical decisions, including how quickly to induce birth. Both women still tear up as they recall Brady being delivered with the umbilical cord wrapped around his neck. Once doctors made sure he was fine, Kieras-Ciolkos held him briefly then gave him to Zoll, who cut the cord.

Since that moment, Kieras-Ciolkos – Brady’s godmother — has been unsentimental about her role in his birth. “He’s a very special part of our lives, but there’s a very clear point when we moved on,” she said.

Zweifel says moving on can be hard for friends after sharing a pregnancy — will the new mother’s sense of indebtedness create an awkward power dynamic? Will she feel judged every time she gets impatient with the baby? But Hukowicz and Kieras-Ciolkos say they have returned to an uncomplicated friendship.

“I’ll always be grateful,” said Hukowicz, “but I just think everything is well balanced. It just feels right.”

Aside from teething pain, Brady is a healthy, plump baby. He does not have cystic fibrosis — something they checked for during the pregnancy — but his birth has forced Hukowicz to think carefully about her future. She says her prognosis depends on how well she manages her illness, so she stopped working and makes sure to get enough rest and exercise.

One day, Hukowicz and Kieras-Ciolkos will tell Brady his creation story, but they’re in no hurry. “It’s kind of like, he’s here, and it doesn’t matter how he got here,” Kieras-Ciolkos said.

And rather than dwell on the technical side of his conception, she said, it’s more important for Brady to know the value of their friendship.

Karen Brown can be reached at karen@
karenbrownreports.org. An audio version of this story is available on nepr.net.
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