Monday, January 25, 2016

My Sister Had a Baby We Didn't Keep: One Modern Family's Story



My sister Carol calls me around nine-thirty on a Wednesday morning. As always, her voice is cheerful and upbeat. In the background I hear the usual, accompanying sounds to her phone calls—the canned echo, the rush of cars outside. She lives in San Fernando Valley and commutes seventeen miles, every weekday, to her job at a non-profit in Los Angeles. During these drives to and from work, which can take from thirty to ninety minutes depending on traffic, she keeps in frequent contact with just about everyone in our family.

I ask her how the appointment went. This morning, she drove to Cedar Sinai for a twenty-week ultrasound.

“Everything’s on schedule,” she says. “Perfectly normal.”


Carol has three boys, the oldest born a few weeks shy of her first wedding anniversary. My nephew Jordan is thirteen now, five-feet-ten-inches tall. I remember sitting in the waiting room of her hospital in Santa Monica, waiting for his birth. His gender was supposed to be a surprise, but I was pretty sure it was a boy based on the ultrasound video I’d seen. Our first son, Diego, had been born ten months earlier. We’d tried to have him for several years and during that time, I’d amassed a stockpile of knowledge about pregnancy and babies. When you deal with infertility, you become an expert in reproduction in the same way, I assume, someone with cancer becomes versed in types and treatments. Suffice it to say, I’d seen lots of ultrasound videos.

Carol and I have always been close. As younger, child-free adults, we took trips together—a cruise to Mexico, a tour of Spain—and some of my best times have been with her. We’ve lived in different cities and states but have always stayed in touch. We've been there for each other’s celebrations and disappointments, and when we started our busy child-having years, we made every effort to know each other’s offspring, to have our kids know each other. As sisters do.

We come from a family of four children, which wasn’t unusual among the families we knew. At the Catholic school we attended, it seemed most had at least three. My youngest sister’s godparents had fifteen kids, and we knew several families that could fill an entire pew at Mass. Ours was a blended family, if you’re talking about different ways to have children. My mom has her own history with trying for children in the “natural” way, and being disappointed.

Our parents adopted our brother from a Catholic agency in Los Angeles and eighteen months later, me. Almost four years after that, they were surprised with a natural pregnancy: Carol. Eighteen months later, another surprise: Theresa. My parents always portrayed adoption as a wonderful gift, an answered prayer. I loved hearing about the phone call announcing my birth and the day they picked me up. When we children argued, my sisters would sometimes say, “Well, you’re adopted,” and my brother and I would laugh because we knew it was actually better. “We were chosen,” we’d say. “They weren’t even expecting you.”


My husband Jason and I had talked about having three or four children, but after months and then, years, passed, it seemed we’d be lucky to have even one. In the late 1990s we were living in Chicago, working full-time jobs and attending school at night. We went through the normal infertility processes. Lots of testing and probing, experimentation with different hormones, rounds of IUI (in uterine insemination), the eventual graduation to IVF (in vitro fertilization). The rollercoaster of hopes regained and dashed again and again. And then, bliss. Our first IVF worked and we were expecting.

Within two weeks of Diego’s birth, Carol flew to Chicago with my mom and spent some time getting to know him. When he was six weeks old, we moved back to California and for the next several years, Carol and I took turns being pregnant.


I brought Diego with me to visit Carol when Jordan was a baby and the following year, she came to the hospital the night our triplets were born. I made it to her hospital when Quincy was born ten months after that, although I’m sure I didn’t stay long with three babies back at home. Our kids spent lots of time together when they were young, and I’ll always be grateful that our kids are close to their cousins. Just when everyone seemed to be at an age to fend for themselves more, Carol and Jose decided to have my nephew Malcolm, who is seven now.

My sister was forty-two years old when she became pregnant this time. The baby is due in February, right around her birthday. And yes, after three boys, this one’s a girl. But we won’t be keeping her. Carol’s acting as a surrogate for a Chinese couple; this baby will be the first child for Jane and Jian Zhang (not their real names), who will fly in from their home in Beijing to be at the birth and take her home.
 

***
Couples in China turn to surrogacy for the same reasons American couples do. As in many industrialized countries, the average age of first-time mothers has risen over the past few decades. In China, the average age is around thirty (twenty-seven in the U.S.). The financial pressures of urban living, the increase of women in the workforce, improvements in fertility treatments—all of it parallels the factors that affect U.S. couples. But in China, there are unique influences as well. The persistent cultural imperative to have children is perhaps stronger than anything we experience. Recent relaxations in the one-child-per-family policy have made it possible for affluent Chinese to find ways to have a second and in some cases, even a third or fourth child.

Surrogacy is illegal in China, as it is in Australia, France, Portugal, and many other countries. Not surprisingly, an underground surrogacy market has risen, employing usually low-income, rural young women by often questionable methods. Many Chinese couples travel to Thailand, India, or Ukraine to find a surrogate. And the wealthiest come to the United States. They can afford to pay the hefty penalties for violating the one-child policy; they have the means to travel back-and-forth throughout the process. Attracted by the professional and regulated U.S. surrogacy industry, by the clean air and yes, by the prospect of citizenship for the baby, Chinese couples often pay more than $100,000 to bring home a baby with their DNA, carried by an American surrogate. Like any system, you’ll hear of abuses and questionable intents. You’ll hear about requests for blonde, tall egg donors and about perfectly fertile couples paying top dollar for a made-in-America baby. But I have to believe that the vast majority come to this difficult decision with one basic desire and physical impediments to this goal. The same way my mom came to adoption, the same way I came to IVF. But how did Carol come to surrogacy?


The initial seed was planted, she tells me, at a family get-together several years ago. Relatives on her husband’s side were considering hiring a surrogate, and Carol jokingly said she’d do it. She came home that day and kept thinking about and discussing it with Jose, who was supportive. Nothing ever materialized with the relatives but a couple of years later, her son had a playdate with a school friend. The friend’s mother had recently had a baby for a gay couple from Turkey. Lights flashed; alarms sounded. That same evening, Carol began searching online for agencies. She was thirty-nine years old, but her youngest son was only three, so this made her womb a “fresh” one. Having that last child had qualified her to have one for someone else.

Fairly quickly, she found a surrogacy agency to work with. Things just fell into place after that, Carol says. She was matched almost immediately with a different Chinese couple from Hong Kong but did not become pregnant and both parties moved on. This is her second attempt with Jane and Jiang Zhang; the first ended in miscarriage at seven weeks. Carol’s journey to have this baby has taken more than three years. This included many doctor appointments and tests, psychological counseling, and the same ups and downs when anyone tries for a child. She has felt, all along, the pressure of wanting to keep the Zhangs from disappointment. And she also had to deal with reactions from family and friends, which weren’t always supportive.

“Actually,” she tells me over a recent lunch, “most of the reactions were positive. Some people said it seemed like something I would do.”

Carol is tall and curvaceous, with lovely, thick hair that grows much faster than mine and a wide smile that lights her whole face. She’s someone people like right away.

Skeptically, I can’t help thinking these reactions were only the ones she’d been present for.


“Even Mom was supportive at first,” she says. “Until she had some time to think about it.”

I confess to having several conversations with our mother about Carol’s surrogacy idea, and neither of us were exactly jumping over the moon about it. We worried about her health. She had recently lost quite a bit of weight, after years of being too heavy. She’d had her gall bladder removed; she got tonsillitis all the time but wouldn’t have the surgery her doctor kept recommending. Her life was incredibly hectic already; both she and Jose worked full-time and there were, of course, their three boys, the commute, teaching at her church on Sundays, and volunteer duties at her kids’ schools. You may have surmised by this list of activities that saying no is not one of Carol’s strengths, and you’d be right. My mom and I worried about her mental state in regards to the surrogacy. We thought maybe, in a strange way, she was doing it because she wanted more children. We worried about how she’d handle giving the baby away.

“In our first conversation,” I tell her now, “I think I said you were having a midlife crisis.”

“You did,” she says, laughing.

I’m a few years older than she is, so I’d seen my share of people making questionable mid-life decisions. I advised Carol to consider a job change or maybe to become trained as a doula, if she really liked being around the childbirth process so much.

My mom and I worried about Carol’s boys, not that it was any of our business. How would they feel? How much time would be taken from them to help out these strangers? As I said, it was none of our business but these are the things we worried about, if I’m being honest. I imagine some of these questions and concerns may be similar to what people may have been saying about me when we went through our time-consuming fertility treatments. I distinctly remember someone telling me that if she hadn’t gotten pregnant “naturally” (which, of course, she had), she would’ve simply accepted that it wasn’t meant to be. 


Carol describes her call to surrogacy as a vocation. Matter-of-factly, she tells me it isn’t fair that some women can have children and some can’t. She’s looking forward to the golden moment when she’ll watch the Zhang family expand from two to three. This moment, the idea of witnessing the creation of a family, remains her main motivation. As for fitting in the doctor appointments, she says she’s accustomed to life lived at fever pitch, so it was just one more thing to schedule in. Because she’s delivered three babies already, she isn’t worried about potential health risks. When I ask her if there is anything she worries about, the only bad outcome she can imagine, at this point, is the baby not surviving. And she worries about that for the Zhangs’ sake, not her own.

“What do people say about the fact that the couple is Chinese?” I ask her.

She shrugs and takes a sip of her iced tea. “You get a variety of reactions.”

Carol has a support group online where she shares her experiences with other surrogates. She has the women at her job, who coddle and support her, her caseworker, who is a former surrogate herself, and she has the baby’s mother, Jane, with whom she keeps in regular contact.


We talk about birth size, and whether the baby will be on the large side, like Carol’s two younger sons. We laugh thinking about this petite Asian couple taking home a ten-pound baby. “I know several other surrogates who’ve had Chinese babies,” Carol says. “Eventually, the environment outside wins.”

***
Jane and Jian Zhang met during college in ­­1995 and married in 2007. After graduation, Jane took a job for a large, multinational computer corporation; now, she and Jian run their own educational tutoring company. They travel to the U.S. several times a year for business although for the past few years, Jane hasn’t been working. They make their home in Beijing, China’s capital and one of its largest cities, with population in the 20 million range. Jane is about five-feet-three-inches tall by my sister’s estimation. She is trim with shoulder-length black hair she has a habit of gathering and pulling to one side or the other while talking. She is expressive and outgoing, very similar to Carol’s personality. Both of the Zhangs are stylish in appearance and clothing. Jian is stockier and slightly taller; he is shy but has warmed up considerably over their meetings. In a letter the couple submitted for potential surrogates when beginning the process, they wrote: "We live in a happy life, both of us think that the most lucky thing in our life is to meet the other."

The Zhangs were married for two years when they started trying to have a baby, and they’ve been at it for five years. Early inventions included natural remedies: holistic herbs, teas and treatments, and during the last three years, they’ve attempted several IUIs in Beijing with no success. Because their efforts included miscarriages, they turned to surrogacy. A friend referred them to West Coast Surrogacy in Irvine, California, and after Jian did some initial research, Jane hopped on a plane and went directly to their offices. Jane is thirty-eight years old and Jian is thirty-seven.

Everything about a surrogacy is contracted, so matching a potential surrogate with parents requires, at first, a perusal of the requirements stated by each. Some surrogates, for example, will not agree to terminate a pregnancy no matter what. Others will agree to termination in cases of extreme defects. The contract stipulates every possible scenario. It requires the parents to designate beneficiaries, should something happen to them during the pregnancy and it prohibits certain activities for the surrogate: skydiving, consuming alcohol, anything that could put the baby at risk. Carol is banned from traveling toward the end of the pregnancy.

The demand for surrogates is high. I ask Carol what factors influenced her decision to work with the Zhangs, whether their story was important to her.

“Definitely,” she says. “I wanted to help a couple who couldn’t have their own baby. And I liked Jane’s honesty."

I ask her what she means.

“One item on the questionnaire asked whether they planned to tell the baby she was born via a surrogate. Jane answered that she didn’t know. She didn’t put what she thought a surrogate might want to hear.”
Gifts from the Zhangs
Jane and Carol stay in touch via email and text. They talk about how Carol is feeling, about plans for future visits, about what will happen when the baby is born. Jane occasionally sends Carol care packages—a supply of nutritional bars, a special oil for stretch marks. She once sent presents for Carol’s three boys. Perhaps because of the nature of the surrogacy arrangement, medical intervention is very conservative and thorough. Carol had to repeat the glucose screening test for gestational diabetes three times and she agreed to an amniocentesis. Jane flew in from Beijing, along with her mother and Jian’s mother. The women crowded into the room and watched the preliminary ultrasound. This was when they confirmed the baby was a girl. Jian’s mother whispered something to Jane, who explained: “She is worried you’ll want to keep the baby now that it’s a girl.” Carol laughed and assured them she did not.

I too wondered about Carol’s feelings, having no daughters of her own, and I worried about my admittedly stereotypical notions about gender preferences for Chinese couples. Were the Zhangs hoping for a boy? I spoke to Carol after she left the appointment and asked her about both of these issues. She told me it didn’t phase her at all that the baby was female; it made no difference whatsoever. From the beginning, she said, this pregnancy has been different from her others. She didn’t feel the bond she felt with her children, only the responsibility to keep healthy and provide nutrition for the baby. Basically, it felt like a job. A personally fulfilling job, but a job nonetheless.

As for the Zhangs’s feelings about their new daughter, Carol says everyone involved is thrilled. Jian is an only child so it is the first grandchild on his side; Jane has two brothers and each has one child, both girls. So, this baby will fit right in.

Carol’s husband Jose has been her partner in this endeavor. He had to undergo the same psychological evaluation she did and a complete physical, and he reviewed every page of the very long, very detailed contract and signed wherever Carol did. He has definitely stated his opinions from time to time. He was appalled by the idea of selective reduction and told Carol he didn’t want to hear anything about it. In the event of an emergency C-section, he insisted he would be the one to accompany Carol into the surgery and not Jane. And during the counseling screening, Jose was annoyed when the psychologist asked about Carol’s weight gain throughout a potential pregnancy and whether it would bother him. He made some brief, complimentary comments about pregnant women, which prompted the psychologist to write in the report: “Husband seems to be attracted to pregnant women.” Carol’s caseworker still brings this up from time to time to tease them.

Jose administered the nightly shots in Carol’s backside prior to the IVF; he and the boys have been making sure she doesn’t carry anything heavy or strain herself in any way. Her husband’s biggest concern, Carol says, was her attachment to the baby. But from the beginning, he’d noticed the ways this pregnancy was different from the others, and has been reassured.
***
Two months before the due date, Jane and Jian arrive in California for a visit. They meet Carol for several long lunches. They plan to come out for a few months when the baby is born; Carol has agreed to supply breast milk for up to four months. They talk about the logistics of picking up the milk. Carol would prefer limited contact after the birth and she tries to think of nice ways to say this. They talk about baby supplies and Carol offers suggestions and advice. Then, the Zhangs make a special request: they ask Carol to choose an American name for the baby. The birth certificate will show her Chinese name, but the American name is what they will call her. They want a simple moniker, something short and easy to pronounce. Carol thinks about it for a couple of days and the next time they meet, she tells them her choice: Mia. Jane immediately bends down, rubs Carol’s belly, and says “Hello, Mia. I’m your mommy.”
***
The financial arrangement between Carol and the Zhangs is detailed, broken down into a series of payments over the course of the surrogacy relationship. Specific amounts were paid to Carol at certain milestones, such as when she passed the initial physical, the completion of the embryo transfer, the confirmation of a positive pregnancy test, and the twelve-week mark. She was given a one-time payment for maternity clothes; there’s a monthly stipend to cover expenses such as food, vitamins, visits to a life coach, and parking fees at the doctor appointments. During the second trimester of the pregnancy, this monthly check increased, as did the assorted milestone payments. At that point, the payments began chipping away at the main, larger payout, the majority of which is paid at delivery and for a few months afterwards. All of the checks are drawn from a trust established by the Zhangs. Carol uses her regular, employer-provided medical insurance for doctor visits, but she is reimbursed the monthly amount deducted on each of her paychecks. She submits copays to the surrogate agency and gets that money back too. There will be a weekly fee for providing breastmilk after the delivery.

Carol and Jose decided early on to set aside each and every check received. They opened a special account for the fees she’d receive as a surrogate and plan to use the money for some sort of investment, maybe a rental property. I ask Carol to estimate what the whole process has cost the Zhangs and at first, it’s difficult for her to come up with a number. In addition to Carol’s fees and other medical expenses, there’s travel back and forth from China, the hotels and the rental house, assorted legal fees. She says the Zhangs are nearing $100,000 out of pocket, if she had to guess.

***
On February 23rd, four days after the baby’s due date, Carol meets Jane and Jian Zhang at her doctor’s office. She’s been in good health throughout the pregnancy although in recent days, her boss has sent her home twice to elevate her feet when she noticed how swollen Carol’s ankles were. Jian is in California for two weeks only, after which he needs to return to Beijing to work. Jane arrived at the beginning of the month, with her mother and one of her brothers. They’ve rented a house in Yorba Linda, forty miles from the hospital, and they’ll stay closer at a hotel when the time comes. Everyone is ready, but the baby is not cooperating. At thirty-eight weeks, she was positioned sideways. Carol spent a weekend perusing a website about “spinning your baby” and attempting the recommended techniques to get Mia into the proper head-down position. Her efforts succeeded and the doctor fitted her with an uncomfortable pregnancy girdle that she’s been wearing ever since. And now, the baby seems to be in no hurry to come out.

At the appointment, the parents and Carol discuss their options. Jane and Jian are inclined to let the delivery occur without intervention; the doctor is disinclined to let Carol go beyond seven days past the due date. They decide to induce labor in two days. Carol will go to the hospital in the late evening, and they’ll aim for delivery on February 26th, which is also Jian’s birthday. Carol has just turned forty-three on the 22nd, so it’s to be a week of birthdays.

The next day, the 24th, Carol meets the Zhangs for lunch at a Thai restaurant. She orders a dish with eggplant and tofu; she’s retained healthy habits throughout the pregnancy, which has been probably the healthiest of her four pregnancies. During the lunch, Jane and Jian tell her a little about Chinese astrology—yin and yang, the 12-year cycle of animal zodiac signs, and the five elements: metal, wood, water, fire, earth. Carol listens politely as they explain that under Chinese astrology, one’s fate and destiny can be computed using birthday, birth season and birth hours. She starts to get an inkling that this brief lesson might concern her. They tell her they’ve consulted with Chinese experts as to the perfect time for the baby’s birth on the 26th.

“Don’t they understand how this works?” I sputter into the phone when she tells me.

“I know,” she says, “but it’s a big deal to them. The experts gave two windows: 7:00 to 9:00 in the morning, or between 1:00 and 3:00 in the afternoon.”           

We talk about this for a few minutes, about all the ways it’s unrealistic and how many things could go against plan. The Zhangs pled their case to the doctor, though, who has moved back Carol’s admittance time to eight o’clock in the evening. Maybe they’d be able to catch that first, morning window, he said.
We both think the delivery, once began, will go very quickly. I’m planning to drive up to see her on Friday, the day after the birth. Jose will send group texts to update family while they’re at the hospital. We hash over all of the possibilities we can think of, and we joke about her ability to deliver during the peak astrology times. Good luck, I say before hanging up. It feels so different, even to me, from the other times, when we had our babies.
***
The labor and delivery, the eventual birth right in the middle of that first favorable Chinese astrological window, was a twelve-hour drama not unlike anyone else’s. Carol was expecting a quick and easy delivery. She’d been induced with all three of her boys and had delivered Malcolm, her youngest, easily in one big push.

She arrived at Cedar Sinai around 8:00 p.m. and within an hour, was admitted and placed into her delivery room. Jose was there, from the start, along with Jane. Later in the evening, Carol’s boys came to visit with our mom. Jordan sat on the floor doing his homework, and Quincy asked when she was coming home. All three were happy to see her, yet about as interested as kids are in anything outside of their immediate world. After a short visit, they went home. It was a school day, after all. Around midnight, the nurse administered Pitocin to start labor, and contractions started right away. Jane’s mother and brother visited for a while. At 3:00 a.m., they broke her water. At 4:00, Jose texted to say they’d started an epidural. The rest of the early morning was hectic. There’d been meconium in the amniotic fluid, so there was concern about that. The baby’s heartrate had been fluctuating and she was not descending as she should. At some point, the night nurses thought that Carol should be prepped for a C-section. At 6:00 a.m., Jose texted to say that the veteran morning nurses had come in and taken over. The doctor wanted to administer more Pitocin and turn off the epidural.  “Are you sure that’s a good idea?” Carol had joked. At that time, the baby’s head was still high so they had Carol move into some challenging positions.

Jane and Jian were there all morning. Jane stayed near Carol’s head most of the time, but when the extreme positioning started, Carol says that Jian moseyed towards the door, behind a curtain. The doctor thought the umbilical cord may be wrapped around the baby. Carol started to push at 7:45 a.m. Those present: Jose, the Zhangs, the case manager for the surrogacy, and Jose’s mother, who hurried in before work, just in time. “I haven’t missed the birth of any of my grandchildren,” she announced, “and I wouldn’t miss this one, even if it’s a surrogate grandbaby.” Jose rubbed Carol’s forehead and told her to push from below, not with her face, something he’d said throughout all of their births, and his mother remarked about the baby’s thick hair, as she had for each of her grandsons. Jane and Jian were mostly quiet, although Carol remembers reading concern for her on Jane’s face. At 8:26 a.m., Mia was born.
I ask Carol about that golden moment she had anticipated, the one that sustained her throughout the pregnancy.

“It was different than I thought,” she says. “Because of the meconium, the nurses took Mia and spent about ten minutes cleaning and checking her. The cord was wrapped around her neck three times so there was a lot of activity, right after.” Carol explains that while the nurses were handling the baby, Jane was close by, watching everything they did, and Carol was a little distracted, what with delivering the placenta and all.

“But that moment,” she says, “when it finally came, was just as good as I imagined. Jane had been advised to hold the baby bare chest to bare chest, so she had a gown on. And when they handed her the baby, that look on her face, the way she just stared, and smiled a little smile, and kissed her, it just made me remember how strange it is to meet someone and fall in love immediately.”

The day Mia was born, it turned out I had to drive up to Los Angeles to pick up Jason from the airport. So we visited the hospital in the afternoon, about six hours after delivery. Cedar Sinai is a huge facility with lots of long hallways. After a few wrong turns, we found Carol’s room down a long corridor in what seemed like the furthest corner of the maternity wing. When we parted the curtain in the doorframe, bright sunlight streamed through a center window, under which the baby lay motionless, swaddled in a hospital blanket. The room had space for the bed and one chair, which Jane had placed next to the bassinet. I don’t think she used it much. In the short time we were there, she paced around the room, back and forth from the baby to the chair, up and down, to talk to the nurses, and back to the bassinet again. The baby slept soundlessly until she mewed a few faint cries and Jane jumped up to get her.

Carol was full of vigor and happy to see us. I hadn’t met Jane before and wasn’t sure what to expect—about her, about the whole situation. But I can only say that the brief visit touched me in unexpected ways, and felt absolutely, strangely “natural.” Carol seemed to have a certain pride about the baby and yet, it was obvious Jane was the one in charge of her. As we stood chatting with Carol in the cramped room, I looked over to see Jane holding Mia and looking at her in that ravenous way Carol and I both later recalled from having our own babies. The slight smile, the unwavering gaze, the quiet murmurs; it was incredibly touching. Jian arrived with Jane’s mother, who hadn’t seen the baby yet, and Jason and I hustled out of there to give them their space. It was their baby, their moment. I had no desire to hold Mia, as adorable as she was. I had concerns only for my sister.
***
The birth had been more difficult than Carol had anticipated, and the recovery was too. She was sick when she came home and had a deep, congested cough that made healing from a vaginal birth difficult. She was pretty much exhausted but rallied and was working from home within a few days. She returned to her office ten days after the delivery.

 She and Jane have been in contact regularly, mostly via email. Carol has been pumping breastmilk around the clock and sometimes, Jane comes to her workplace to pick it up. Three times since the birth, Carol has seen Mia, usually strapped into her infant carseat. She’s an adorable baby, of course, with creamy skin and bright features. She strongly favors her father, with whom she shares a birthday.

***
I remember saying to my mom during one of our discussions before the surrogacy, something like, “Who knows, maybe a year from now, it’ll all be over and everything will be fine and we’ll say, well, that was such a nice thing she did.” And that’s pretty much where we are. It’s over and everything was fine. Except it was so much more than a nice thing, and sharing the whole experience with my sister has affected me in ways I couldn’t have predicted. She now understands intimately what we went through to have our children, and I feel that has drawn us even closer. In the course of our conversations during the pregnancy and in exchanges I had with other people, I’ve been continually surprised by people’s reactions, particularly women. While it may be true at the beginning that some were reacting to my own reservations, many were hesitant to voice support and in some cases, were downright disapproving. Several times I’ve been questioned as to why the Zhangs didn’t just adopt one of the many orphans in their country. I can’t answer that. I can’t answer exactly why my parents chose to adopt and some families do not, why some women undergo fertility treatments and others will not, why some choose surrogacy or sperm donation or foreign adoption, or have ten children, or two, or none. These are personal choices and sometimes, I’m surprised by how judgmental women can be and at other times, how empathetic. Of course, now that Carol’s experience is over and everything seems to have turned out swimmingly, everyone is much more relaxed about it. As I was/am, I guess. Maybe we women just worry about each other, that’s all.

Carol, Jose and their boys

As for Carol, she is healthy, happy, and as busy as ever. As I type this on a Sunday morning, she is at a work-sponsored charity run, manning one of the water stations with her eldest son. She spent yesterday at the boys’ track meet . There’s been no lull for her; she remains a productive, working mom and maybe, from time to time, she thinks ahead to the eventful weekends the Zhangs can now anticipate. She’ll always carry the knowledge of the tremendous gift she gave them.

***
Mia is an American citizen. China doesn’t have dual citizenship, so she’ll never be a citizen of her home country. At the age of twenty-one, Mia will be able to apply for U.S. green cards for both of her parents. When Carol asks Jane if she and Jian would ever move to America—for example in the case that Mia attends university here and ends up staying—Jane says she would never leave China. It’s her home, she says.

Near the end of April, Jane asks to meet Carol for coffee on a weekday morning. She arrives at Carol’s office with the baby, her brother and the nanny she has hired to help her. Mia is almost two months old. For the past several weeks, Jane has been seeing the same reproductive endocrinologist they used for the surrogacy, in the hopes of attempting their first IVF before returning to Beijing. But arriving home with an infant and another on the way is not in the cards. She tells Carol that neither of the egg retrievals yielded good results and she’s booked her flight home for the coming Sunday. Carol holds the baby and they snap a final photograph together. Carol agrees to continue to send breast milk for the rest of the week but that night, she’s only able to get about a quarter of the usual amount. She thinks her body somehow intuitively knows it’s time to stop. I ask her if she’s sad about them leaving and in her usual, upbeat voice she says, “Not really, no.”

We text each other the morning after Jane leaves with Mia. We talk briefly about this essay, about other things. Carol tells me the Zhangs have asked her to have another baby for them. “I’m ignoring that last part for now LOL,” I text. And she sends me an LOL back.

UPDATE, ONE YEAR LATER 


Jane was recently back in California with Mia. She arrived Thanksgiving week to start treatment for baby number two. The results of her egg retrievals were disappointing, so she went home and plans to return in a couple of months. If all goes well then, they’ll attempt an embryo transfer in March or April. My sister has agreed to be their surrogate.