I recently read an article in Newsweek addressing the lack of postpartum medical support for women following the birth of their child(ren). This is in stark contrast, as the article points out, to the planned and orchestrated “system of well-child care” that a baby receives in the days, months, and years after his or her birth. The article states:

Our fragmented health care system offers no bridge across the chasm that separates maternity care and ongoing primary care. This chasm harms many mothers; for Black and Indigenous people, the gap in care too often means the difference between life and death. The U.S. maternal mortality rate is the highest among affluent nations, and Black and Indigenous mothers are 3.5 times more likely to die from pregnancy-related causes than are white mothers. One-third of these deaths occur between one week and one year postpartum (in the chasm); and for every maternal death, there are at least 100 near misses. When complications, such as hypertension and diabetes, are not followed by primary care after pregnancy, chronic illness can develop. (emphasis mine)

The article raises valid points as well as obtainable solutions; increasing and lengthening doula and midwifery care after pregnancy, extending Medicaid following the birth of a child, changing the electronic medical system to facilitate continuity of communication and healthcare, and managing integration between maternity and primary care through insurers. 

I couldn’t help but think about one population of women that isn’t mentioned in the article: Surrogate mothers.  Oftentimes, the intended parent(s) are responsible for covering the costs of pregnancy and birth, including health care for the surrogate mother. Who would or should cover the cost of extended health care for these surrogate mothers? 

The article also accurately points out that “pregnancy is a stress test on women’s bodies, revealing clues about underlying and future health.”  Pregnancy complications like gestational diabetes, hypertensive disorders such as gestational hypertension or pre-eclampsia, depression and substance use disorder “affect up to a quarter of pregnant people.” I’ve written previously that new studies are showing that surrogate mothers are more likely to be diagnosed with gestational diabetes, hypertensive disorders, and depression making it all-the-more important, according to the Newsweek article, that these women receive extended post-partum care. Will they?  

These conditions don’t just come and go; they have the potential to cause serious long-term health risks and chronic health conditions. Did you know that hypertensive disorders in pregnancy double the risk for heart disease and stroke and that gestational diabetes significantly raises a woman’s likelihood of developing type 2 diabetes? I have had the opportunity to talk first-hand with many surrogate mothers that are struggling with health concerns that stemmed from their surrogate pregnancies. No doubt, these health burdens have impacted every sphere of their lives. 

Should fertility clinics, surrogacy agencies, or intended parents be responsible for the health of the surrogate mother throughout her lifetime? If she is diagnosed with any of these complications that have the capacity to change the trajectory of her health and life, how do we reconcile this? Can we? 

Author Profile

Kallie Fell, Executive Director
Kallie Fell, Executive Director
Kallie Fell, MS, BSN, RN, started her professional career as a scientist in the Department of Obstetrics and Gynecology at Vanderbilt University Medical Center utilizing a Master of Science degree in Animal Sciences with an emphasis on Reproductive Physiology and Molecular Biology from Purdue University. While assisting in the investigation of endometriosis and pre-term birth, Kallie simultaneously pursued a degree in nursing with hopes of working with women as a perinatal nurse. After meeting Jennifer at a conference, Kallie became interested in the work of the Center for Bioethics and Culture and started volunteering with the organization. It is obvious that Kallie is passionate about women’s health. She continues to work, as she has for the past 6 years, as a perinatal nurse and has worked with the CBC since 2018, first as a volunteer writer, then as our staff Research Associate, and now as the Executive Director. In 2021, Kallie co-directed the CBC’s newest documentary, Trans Mission: What’s the Rush to Reassign Gender? Kallie also hosts the popular podcast Venus Rising and is the Program Director for the Paul Ramsey Institute.