How Is Pregnancy Lived in Surrogacy Month by Month?

By MD (psychologist), (embryologist) and (babygest staff).
Last Update: 09/29/2017

Pregnancy is the biological process by which an embryo develops inside a woman’s womb to give rise, after childbirth, to a new being. In a surrogate pregnancy, through in vitro fertilization and subsequent transfer of the embryos to the surrogate, the embryo will implant in the endometrium and begin its evolution.

During the 9 months of pregnancy, the woman experiences a whole set of physical and emotional changes, unique to the state of pregnancy and caused mainly by hormonal alterations.

Changes and care during pregnancy.

Among the best known physical changes of pregnancy, there are some more obvious as weight gain or breast enlargement as a result of milk production, as well as other less visible: the creation of the umbilical cord, the softening of the uterus, skin stretching, etc.

New emotions are also produced due to hormone imbalance: increased sensitivity, worries or doubts, sexual desire, mood swings, alterations in self-esteem, etc. Hormonal changes are also responsible for the famous nausea, swelling or heaviness of various parts of the body such as feet or legs.

There are pregnancies in which these changes are lighter and others in which they become so intense that they imply a change in daily routines.

Periodic medical checkups throughout the nine months of pregnancy is very important to ensure that the changes are normal and the fetus develops normally. The woman must also change her diet and follow a proper diet to provide the baby with the nutrients needed for proper growth.

Medical care in pregnancy.

The surrogate should have a series of medical tests during her pregnancy to ensure her health and that of the baby. The most important are the following:

Ultrasounds
the usual frequency of ultrasounds monitoring is one for each trimester of pregnancy, specifically at weeks 12, 20 and 36, but additional ultrasounds may be requested as needed. Additional ultrasounds may be requested.
O’sullivan test
glucose test to detect gestational diabetes.
Fetal echocardiography
to check if the baby’s heart is beating properly.
Nuchal translucency test
evaluates the risk of Down syndrome and other chromosomal defects, as well as relevant congenital heart abnormalities.

A woman should keep scheduled medical appointments to follow up on her pregnancy. In the case of a surrogacy pregnancy, the future parents can follow the pregnancy through the ultrasounds sent by the agency or the surrogate herself. They will be informed about everything that happens during pregnancy and the medical tests that are done to the pregnant woman.

Although, as we have commented, pregnancy monitoring can be carried out through the information that the clinic gives to the parents, if there is a relationship between the intended parents and the surrogate, she will be able to give details of the evolution of the pregnancy day by day.

Food and other healthy habits in pregnancy

During pregnancy, good lifestyle habits are essential. It is important that you control aspects such as:

  • Food: now the woman must eat for two, as the fetus feeds and develops thanks to her meals. She should eat a balanced diet rich in nutrients, especially vitamins and calcium.
  • Physical exercise: moderate intensity physical exercise is recommended during pregnancy. Competitions or activities involving intense change should be avoided, especially as pregnancy progresses. Swimming, cycling or walking 20 to 40 minutes a day is highly recommended.
  • Toxic substances: completely avoid the use of toxic substances such as tobacco or alcohol, as they can increase the risk of complications in pregnancy and childbirth, in addition to causing harm to the fetus.

The doctor may order a number of dietary supplements during pregnancy to ensure that there is no shortage of essential minerals and nutrients.

Development of the fetus in the uterus month to month

Surrogacy is a reproductive method that many women, men and couples choose to have a child when they do not have the ability to carry it themselves. Although they are not the ones who carry the pregnancy to term, the interest in following the pregnancy is very great, because it is about the evolution of their future child. For that reason, even if it is in the distance, in the following sections we show a summary for future parents who want to know the changes that “suffers” the woman who is pregnant to his son, as well as the different steps of the embryonic development:

First months of pregnancy

Although the surrogate has already gone through a pregnancy and knows what she is facing, her nerves do not go unnoticed, although they may go unnoticed compared to the feelings of future parents.

It is the period of greatest risk of miscarriage and also when the most uncomfortable symptoms of pregnancy occur, such as nausea or vomiting.

The first trimester of pregnancy is the moment of greatest embryonic evolution. In this first period, the gastrulation or formation of the three cellular layers that will form all the tissues of the future baby takes place:

  • Ectoderm
  • Mesoderm
  • Endoderm

During the second month, the spinal cord, brain, heart, intestine, and skin form. In addition, the eyes, ears, nose and upper lip of the mouth begin to evolve.

The embryo begins to take on human form. At one end the rounded head begins to form and at the other end we see a kind of tail.

In the third month, we move from the embryonic stage to the fetal stage, so the embryo becomes a fetus. At this time, although they are not fully developed, all the vital organs have already formed.

Fetal movement is quite intense, although it is not always detected by the pregnant woman. The future baby kicks, turns wrists, bends fingers, clenches fists, purses forehead or squeezes lip and other facial gestures.

Second trimester

The second trimester of pregnancy comprises the fourth, fifth and sixth months. At this stage, both the pregnant woman and the future parents are calmer, as the euphoria and anxiety from the beginning have passed.

The fetus continues to develop and completes its formation month by month as explained below:

Four months
lanugo, hair that covers the skin of the fetus to maintain heat, forms. The vocal cords are formed, the neck is separated from the face, and the eyes are particularly large. At this time, the fetus measures between 9 and 15 cm. It also begins to release urine.
Fifth months
the development of the organs is intensified, especially the heart, which already beats strongly. The movements of the fetus are more appreciated, especially when the pregnant woman lies down.
Sixth months
starting this month, the fetus already opens its eyes to perceive the light. It also begins to detect sounds, so it responds to external stimuli. Eyelashes, eyebrows and hair have formed. It can measure up to 32 cm and already has a shape increasingly similar to the one it will have at birth.

Preparation for delivery

The end of pregnancy is approaching and there is less to see the expected baby’s face.

In the seventh month, the lungs develop and the skeleton becomes more consistent. The fetus begins to be able to regulate body temperature, so the lanugo begins to disappear. Pigmentation of the eyes and skin also occurs.

The size of the fetus is increasing which makes its movements more limited. It puts more and more pressure on the bladder of the pregnant woman, which increases her desire to urinate.

In the eighth month of gestation, the future baby’s weight increases considerably. The brain continues to develop. It moves forcefully and sometimes even spasmodically due to episodes of hiccups caused by swallowing amniotic fluid.

It is common for the pregnant woman to feel tired and heavy. Widening of the uterus may even make it difficult to breathe at times.

Month 9 marks the beginning of the end. The fetus is characterized by the following:

  • Stomach and intestine are working
  • The skin stops being wrinkled and becomes softer
  • The head begins to fit into the pelvis
  • Less movement, although still noticeable and with abruptness

At the end of the ninth and beginning of the tenth month, the organs of the fetus are completely autonomous and ready to leave the placenta, that is, for birth.

For more details on the progression of pregnancy, see this full article: Pregnancy month by month.

In cases of surrogacy, it is usually calculated when the birth will take place to warn the future parents and are at that time with the surrogate and can see birth up close. However, childbirth is not always accurate and it is therefore possible for the baby to be brought forward and born earlier than planned.

It is very difficult to predict the exact date of delivery, however, it is possible to estimate approximately an interval of days on which delivery is expected to take place. Prospective parents should be prepared to travel to the appropriate place at the time notice is given.

Relationship between intended parents and surrogate

The relationship between the surrogate and the future parents will be as close as both parties wish. This is a very personal decision. Depending on how this relationship is, future parents will follow the pregnancy more or less closely.

Regardless of the degree of trust that exists, the clinic conducting the process will periodically inform the intented parents of the outcome of the ultrasounds, as well as possible complications.

There are couples who decide to have contact with the surrogate before, during and after pregnancy, and others who prefer to keep their distance. In general, the following cases usually occur:

  • Some couples consider that having contact with the woman who conceived their child can lead to emotional conflict and even to jealousy and complexes.
  • Other people believe that the surrogate is a very important woman in the life of her future child and, therefore, want to know her in depth, also think that maintaining an intimate relationship with the surrogate makes them more involved in the pregnancy and birth of their child.

In many cases, the bond created between the surrogate and the future parents is so strong that they continue to have contact with the passage of time. They continue to talk regularly, exchange photos, etc. There are even couples who have wanted to have a second child and have resorted to the same surrogate.

Maintaining a more or less strong relationship with the surrogate is neither better nor worse. From here we recommend that in the first appointment the preferences of both parts in relation to this matter are agreed. It is important that everyone involved feel comfortable with the decision made about the personal relationship before, during, and after the birth of the baby.

FAQs from users

What are the psychological effects of pregnancy?

By Amalia Bayonas MD (psychologist).

There are, you cannot deny it. To see your body transformed, to notice the development of the foetus, to feel yourself as the source of life necessarily implies a sensation of fullness, of femininity, in addition to the feeling of participating in the cycle of life: to be born, to live and to give birth.

All this creates an intimate feeling of belonging, of “biological well-being” in the sense of being well, of biology functioning well. That makes us feel very good. Obviously, I am talking about desired and longed dreamed pregnancies, not of unplanned pregnancies or with complications that compromise the well-being of the woman.

What kind of food is important during pregnancy?

By Andrea Rodrigo (embryologist).

It is very important to eat a variety of foods and to have a balanced diet. It is necessary to ensure that the necessary supply of minerals such as calcium, iron and iodine is obtained, as well as vitamins such as folic acid. It is important to keep in mind that, in pregnancy, nutritional needs increase.

Foods such as milk and other dairy products, vegetables, fruits, meats and low-calorie fish are recommended. These foods should be eaten mostly cooked to ensure the health of the pregnant woman.

Is exercising during pregnancy bad?

By Andrea Rodrigo (embryologist).

No, in fact it is recommended to do mild or moderate exercise. Walking, cycling (up to the fifth month of pregnancy), swimming, yoga or pilates are recommended. If in doubt, consult your doctor.

Is it good to take vitamin supplements during pregnancy? Should the surrogate take them?

By Andrea Rodrigo (embryologist).

Doctors and gynaecologists generally advise taking food supplements during pregnancy. The pregnant woman needs more iron, folic acid, calcium and iodine mainly. Therefore, it is most likely that the specialist will prescribe these supplements to the surrogate.

What care should be taken in twin pregnancies?

By Andrea Rodrigo (embryologist).

A multiple pregnancy has a higher risk than a single pregnancy, so the surrogate will receive a more comprehensive medical check. The surrogate will have to go to the clinic more times to check the correct fetal development and assess the risk of premature birth. The doctor will indicate how to proceed in each case.

In addition, the surrogate should rest properly to prevent uterine contractions and reduce her physical activity as the pregnancy progresses. It is also essential to follow an adequate diet with daily supplements of folic acid and iron.

The surrogate must acquire the appropriate weight for a twin pregnancy, as otherwise there will be a risk that the babies will have low birth weight. This situation could endanger the survival of babies, so it is vitally important that they reach a minimum weight.

Suggested for you

Care and good habits during pregnancy are essential in all cases, but in surrogacy special attention should be paid to this aspect, in order to reduce the risks for both the surrogate and the future baby and ensure their welfare. If you want to learn more about the medical follow up, you can read this post: Surrogate Medical Follow-Up Before and During Pregnancy.

If you are going to have a child thanks to surrogacy, you must know about how to proceed once the 9 months of gestation have passed and the baby is finally born. It is important to know how does surrogacy work in your country, you can read it here for the United States: Surrogacy in the USA – Is It Legal in All 50 States? and here for the United Kingdom: How Does Surrogacy Work in the UK? – Law, Cost & FAQs.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Amalia Bayonas
Amalia Bayonas
MD
Psychologist
Bachelor's Degree in Psychology from the University of Miami, Florida, with over 20 years experience in the treatment of psychological aspects associated with assisted reproduction patients. Organization of workshops and talks addressed to both infertile patients and professionals. Several research projects and campaigns for the prevention and emotional well-being. Head of Psychology Unit at clinic FIV Valencia (Spain). More information about Amalia Bayonas
License: PV 3734
 Andrea Rodrigo
Andrea Rodrigo
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information about Andrea Rodrigo
Adapted into english by:
 Marie Tusseau
Marie Tusseau
Babygest Staff
Editorial Director of Babygest magazine in French and English. More information about Marie Tusseau

Find the latest news on assisted reproduction in our channels.