Rethinking reimbursements for reproductive donors and surrogates

  • January 28, 2019

Put five pregnant women in a room and chances are that each of the five will report a different experience with her pregnancy. Put one woman who’s had multiple pregnancies in a room and chances are she’ll tell you that each pregnancy was different from the other in ways large or small.

The issues and costs that can arise during the reproductive cycle, from the first attempts to become pregnant to post-partum care, are nearly impossible to quantify, and the government shouldn’t try, say the CBA’s Family Law, Health Law, and Sexual Orientation and Gender Identity Community Sections, in a submission to Health Canada.

The Sections were responding to proposed regulations under the Assisted Human Reproduction Act, with particular focus on how donors and surrogates are reimbursed for their out-of-pocket expenses.

While the regulations don’t put a cap on expenses, they do define an exhaustive list of allowable costs for those who donate eggs and sperm, and for surrogate mothers. But given the unpredictable nature of pregnancy, the Sections believe that list is problematic and unnecessarily restrictive, suggesting instead that the regulations allow all reasonable expenses to be reimbursed.

“The proposed exhaustive list of categories could leave some surrogates and donors ineligible for reimbursement, even for reasonable out-of-pocket expenses,” the submission says. “For surrogates, it is often impossible to predict every expense that will be reasonable, as every woman’s pregnancy can be different. Additionally, each surrogacy has its own unique circumstances as a result of the combination of intended parents, surrogate and, in many cases, a surrogate’s spouse and dependents.”

A restrictive list of allowable expenses could dissuade potential donors and surrogates, and thus limit the availability of assisted reproductive technologies, the Sections say.

While the Sections support a non -exhaustive list, they do say that any list provided should include a few additional things for surrogates. They say the list should explicitly include reimbursement for personal food consumption, given that many surrogates are asked to follow a particular diet during the pregnancy to ensure the health of the baby. Reasonable household help should be among any itemized expenses for surrogates, particularly in the final trimester, and communication costs, particularly where the surrogate and the intended parents live a distance from each other, should also be reimbursable.

The Sections note that the regulations don’t allow for ova and sperm donors to recover income they lose by taking time off work to undergo egg harvesting treatment, or to travel to the single sperm bank in Canada, which is located in Toronto, nor are surrogates reimbursed for lost wages after birth.

“Canadian laws seek to promote and support altruistic aspects of surrogacy, but the proposed regulations would actually penalize women for a reasonable period of post-partum recovery if they are unable to work.”

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