Canadian surrogate eliminated baby from triplet pregnancy at urging of overseas couple

Kari Smith felt a real rapport with the overseas couple who commissioned her to have their child: they were about the same age, seemed to hold similar values and even shared a love of craft beer.

Then the Nova Scotia-based surrogate discovered she was pregnant with three babies, and things took a “horrible” turn.

Smith wanted to carry all three but, without hesitation, the would-be parents insisted the trio of fetuses be reduced surgically to just two. As non-citizens of their Caribbean home, they were all but barred from bringing home more than two children to the island nation.

A lawyer advised Smith that the couple could cut off expense payments if she insisted on keeping all the babies. Not wanting to upend the couple’s lives, the surrogate eventually agreed to the reduction, then one of the remaining two fetuses died, too. It was a traumatic experience.

I wasn’t even sure how I could look them in the eye after this

“I wasn’t even sure how I could look them in the eye after this,” says the Annapolis Valley resident. “It was horrible. I wasn’t sleeping, because it was on my mind all the time: ‘am I going to go through with it?’ ”

Weeks later, the 38-year-old says she now believes the reduction was for the best medically, given the risks around multiple births, and realizes the couple was not as coldly calculating about the decision as first appeared. They wept when the reduction occurred.

But the case underlines the moral dilemmas that can unexpectedly impose on women who lend out their wombs, as foreign demand for Canadian “carriers” surges.

“This is a heartbreaking situation for the woman,” said Juliet Guichon, a bioethics expert at the University of Calgary.

Darren Pittman for National PostDarren Pittman for National PostKari Smith poses in the backyard of her home in Somerset, Nova Scotia. Smith is serving as a surrogate for a couple who live in .

Participants in the increasingly common arrangements usually sign agreements that, among other issues, address abortion and selective reduction in certain circumstances. Surrogates ultimately can decide what to do, but may forgo expense payments if they do not follow the would-be parents’ desire to terminate.

That seems wrong, says Vardit Ravitsky, a bioethics professor at the University of Montreal. Contracts should let a surrogate reverse course — without financial repercussions — when she actually becomes pregnant, and warn the future parents that they can’t control every aspect of the pregnancy, she said.

“Termination of any kind, for any reason is something we often change our minds about,” said Ravitsky. “When it’s your own baby, it’s your own decision. When you’re carrying someone else’s baby, it’s extremely tricky … We’re putting all of this on the shoulder of the surrogate.”

Smith, a logistics expert at a Michelin tire factory and co-owner with her husband of the Bad Apple Brewhouse in Somerset, N.S., has already had five children of her own.

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She said she wanted to help those who were not able to have children naturally, and submitted her name to the Surrogacy in Canada Online consulting company. Surrogates here are barred from accepting commercial fees, but can be reimbursed for their expenses.

She and the overseas couple – Canadians originally from Halifax who had also signed up with the agency – hit it off when they made email contact. Under a confidentiality clause in the contract they eventually signed, Smith cannot identify the pair, making them unavailable for comment.

The agreement did allow for triplets to be reduced to twins if necessary. But Smith, currently in her 20th week of pregnancy, said the doctor never told her the two embryos placed in her womb could result in more than two babies and she gave the issue little thought.

In fact, one of the embryos split and developed into identical twins, the other resulted in pregnancy with a singleton.

That is when the parties’ paths diverged.

Darren Pittman for National PostDarren Pittman for National PostKari Smith poses under a tree near her home in Somerset, Nova Scotia. Smith is serving as a surrogate for a couple who live in Bermuda.

“Immediately, I was: ‘I’m going to do this, I’m going to carry all three,’ because I didn’t want to kill a baby,” Smith recalled. “(But) as soon as I sent (the couple) the email that there were three heartbeats, he said ‘We need to find out about reduction right away’ … They absolutely didn’t want three babies.”

Sally Rhoads-Heinrich, who runs the Surrogacy in Canada agency, says the husband told her by telephone that he would rather end up with no infants than three.

Reductions – where a drug is usually injected in the selected fetus to stop its heart – are sometimes recommended for multiple births to curb risk to the remaining babies. But just days before the procedure, Smith discovered another reason the couple was so adamant about eliminating one or more fetuses.

The country where the couple live will not allow foreign workers employed by private-sector employees to bring more than two children into the country, part of a tightly restricted immigration policy.

With triplets, the couple apparently would lose their jobs and have to leave the island, and Smith says she didn’t want that on her conscience.

The singleton was terminated and then, a week or so after the procedure, one of the identical twins died.

Despite the initial turmoil, Smith says she is reconciled with her decision, which she thinks has given the pregnancy a better chance overall of succeeding.

If there is an escape clause, I think what’s going to happen is, you’re going to see a lot more disputes

Meanwhile, surrogacy consultants say Canadian carriers like her are in increasing demand from people in other countries.

The emotional issues of abortion and reduction are always addressed in the contracts the parties sign, says Michelle Flowerday, a Toronto-based fertility lawyer.

The agreements typically leave the final decision to terminate a fetus to the surrogate but say she should follow the wishes of the intended parents or doctors – or risk losing expense payments.

Flowerday said she has never seen a conflict over the issues among her clients, and questions the value of giving surrogates the kind of no-penalty way-out that Ravitsky suggests.

“If there is an escape clause, I think what’s going to happen is, you’re going to see a lot more disputes,” she said.

About Tom Blackwell