Surrogate Pregnancy and COVID-19

How does COVID-19 Impact Surrogate Pregnancy?

COVID-19 has impacted the world and our lives in ways we never imagined. As the world has adapted, we know more about the virus’ impacts on pregnant women, and a vaccine is now available. Naturally, many of our parents and surrogates have questions about how to navigate decision making related to COVID-19 risks during pregnancy and whether they should consider being vaccinated. Growing Generations has partnered with a group of maternal-fetal medicine specialists at Mitera, a telehealth platform that specializes in pregnancy, to help our intended parents and surrogates understand their options and make informed decisions that they are comfortable with.

In early February of 2021, we sat down with Dr. Kathy Salari of Mitera to ask the questions folks are most curious about. Here are the highlights, and we hope you enjoy watching the full interview here!

What are COVID-19 Risks for Pregnant Surrogates?

A collection of data from the CDC compared 23,000 pregnant women with COVID-19 to non-pregnant women with COVID-19. In these findings, the rate of hospitalization, ICU admission, and risk of mortality were higher among pregnant women compared to their non-pregnant counterparts.

According to Dr. Salari, “in general, pregnant women are young and healthy and, even if I were to increase her risk by threefold or fivefold, the absolute risk — which is really the true risk a woman is interested in for a severe outcome from COVID-19 — or, for instance, the worst outcome (which is mortality from COVID-19) still remains relatively low.” In fact, the mortality rate of pregnant women with COVID-19 is still lower than the mortality rate of pregnant women with H1N1 Influenza back in 2009.

Should Surrogates be Vaccinated Before Attempting to Become Pregnant?

Due to the increased risk during pregnancy, it is recommended that anyone considering pregnancy, be vaccinated when the vaccine becomes available to them.

According to Dr. Salari, the medical recommendation from the CDC (Center for Disease Control) and ACOG (American College of Obstetrics and Gynecology), is for women to take the vaccine before becoming pregnant. The COVID-19 vaccine already has an excellent safety profile in non-pregnant adults, as well as being highly effective in preventing COVID-19. This will significantly lower the risk of COVID-19 during pregnancy.

Can Pregnant Surrogates Be Vaccinated?

But, what if you are already pregnant when the vaccination becomes available to you? As with most new medications and vaccines, pregnant women were excluded from the initial safety trials. At this time, there are no COVID-19 vaccine safety studies for pregnant women, though the CDC has announced that they plan to begin safety studies soon. However, Dr. Salari believes the risks are largely theoretical and says:

When it comes to vaccinations and pregnancy, pregnant women are not supposed to be given live viral vaccines. This is because pregnant women are immunocompromised, and the stands the risk of making them ill. However, some vaccines such as TDAP or the influenza vaccine, do not use live, viral particles and are safe for pregnant women.

The COVID-19 vaccine uses RNA based technology, genetic material from the virus rather than live, viral particles. This causes the body to generate proteins belonging to the virus which causes the immune system to develop antibodies. Although there have been no trials yet, this is not expected to be a cause for concern when it comes to pregnant women or the fetus.

In the case of COVID-19, the unfortunate situation here is that pregnant women are actually more vulnerable. They would benefit from vaccination more so than their non-pregnant counterparts.

The official stance is that the COVID-19 vaccine should not be withheld from someone who is pregnant. Still, there may be some concerns and hesitation among pregnant surrogates and parents. “When anyone expresses hesitation regarding vaccination, the first rule of the provider is to acknowledge that vaccine hesitancy,” says Dr. Salari.

Do Surrogates Have to Receive a COVID-19 Vaccine?

No. While many IVF doctors are strongly recommending vaccination prior to pregnancy, some surrogates and intended parents aren’t comfortable with the limited data, and that’s ok. Growing Generations aims to provide surrogates and intended parents with information from qualified medical professionals, so they can give informed consent or refusal. We work with each individual surrogate and intended parent to ensure they are matched with someone who is like minded.

Erica began her career at Growing Generations as a college intern in 2003. Like most people at the time, she had no direct experience with the fertility world, but she was immediately intrigued when she read an internship listing titled “marketing intern needed for gay surrogacy agency” (we have always helped all prospective parents but back in the early days you had to say it explicitly). As a queer woman and someone with a gay father, she already had a passion for LGBTQ+ people and families. She had a general idea of what surrogacy was but had never thought of the two coming together in such an intentional way. She at once knew she had to be a part of what Growing Generations was doing. When she reflects back, she says “I can vividly recall the moment I saw the internship posting, the moment I received a call for an interview, and the day of my interview-down to the clothes I was wearing and the excitement I felt. My most vivid memories highlight the most pivotal and influential moments in my life and beginning her career with Growing Generations was certainly one of those moments.”