Ep 117: Demystifying Surrogacy with Mindy Berkson
Fertility Forward Episode 117:
Surrogacy gives people with fertility struggles the opportunity to have a biological child. However, the idea can feel daunting beyond measure. Today we are joined by the founder of Newborn Advantage Surrogacy, Mindy Berkson. Mindy married her venture capital background with her industry experience, as well as her personal experience as a secondary infertility patient, to help intended families grow their families. In this episode, we find out more about the mother-daughter duo offering well-rounded concierge services to both intended parents and surrogates and learn the ins and outs of surrogacy. Mindy explains everything from the most important criteria when choosing a surrogate and what makes for a strong surrogate candidate, to how surrogacy laws differ state-to-state. Tune in to hear the communication guidelines between intended parents and surrogates, Mindy’s advice for intended parents, and so much more!
Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
I am so excited to welcome to Fertility Forward today, Mindy Berkson who is the founder of Newborn Advantage Surrogacy. She founded the agency to help intended parents globally expand their families. With over 26 years industry experience, her own battle of secondary infertility, and having helped thousands of clients successfully bring a newborn into their lives, Mindy provides an insider's approach to the often challenging roadblocks present in conquering infertility. For the past nine years, Mindy has worked closely with her daughter, Courtney, to offer well-rounded concierge services to both clients and surrogates. Together this mother-daughter duo diligently guide intended parents through the surrogacy process with care, passion, and determination to meet the goal of a live, healthy birth. Berkson has been featured in numerous international, national business, health, and wellness publications, radio interviews, and keynote speaker panels related to the fertility industry. Thank you so much for coming on today, Mindy, it is a pleasure to have you.
Mindy: Well, thank you for having me. I appreciate it, Rena.
Rena: So when I was researching you and your agency, of course, the first thing that stuck out was that you do this with your daughter.
Mindy: Yes. We're the mother-daughter duo.
Rena: Yes. So tell us more about sort of your journey and and how that happened and how you founded this and it came to inception.
Mindy: Well, I actually started my career in venture capital and I had my daughter with no problems. But a year and a half later we tried to expand our family and I went through secondary infertility with no explanation. Now, of course, this was 27, 28 years ago. My twins are now 26. And it was during that, that period of time where I became very passionate about this industry. And after the twins were born, I started working in the industry. I was working for an agency, I learned what was onerous about their contracts. I worked for a fertility center, so I learned the medical side of the business. And then in 2005, I wrote the business plan and I actually married my venture capital background with my experience in the industry, my experience as a patient. And that was what made me successful in writing that business plan in 2005.
Rena: Wow. It is so wonderful. You know, Dara, my co-host, and I, she's not on today's episode, but we often talk with other women and we we're so lucky to meet other women that get into this field because of their own experience, just like you did.
Mindy: It's been very rewarding. And Courtney grew up watching me run the business, build the business. And after college she was very excited about joining me in the business. And so we've had a great nine year run with it and she's doing phenomenal. So I'm really excited to be working closely with her.
Rena: That's so wonderful. I love that. It's great to be able to love what you do.
Mindy: It is. It doesn't feel like you go to work every day when you work a passion.
Rena: Yes, exactly. Exactly. So tell us more about your agency and what exactly you know you do with surrogacy.
Mindy: So we're a very full service agency from beginning through birth. I start with the identification of surrogate piece and one of the things that I think distinguishes me most in the industry is that I always have a large pool of available surrogates. And the benefit to that is it allows my clients to be able to compare and contrast profiles of various surrogates. Most clients don't even know what a surrogate profile looks like or what they're looking for in a profile, but I think when you have the opportunity to compare and contrast profiles, you could really hone in on, oh, I never thought of that, but that's important to me. And that I think is what truly distinguishes Newborn Advantage from other agencies who, from what I understand, have waitlists that could be from 8 to 16 months.
Rena: So you're saying because you have a large pool of surrogates, your waitlist is shorter?
Mindy: I don't have a waitlist.
Rena: Oh, wow.
Mindy: So it's immediate match times, you know, of course, depending on what you're looking for in a surrogate. But I have surrogates all over the country and they all meet ASRM guidelines and you know, depending on what clients are looking for, and when I say what they're looking for, are they looking to transfer one or two embryos? Are they looking to have a surrogate willing to terminate for any chromosomal issues that may be identified in utero? So things like that kind of change criteria from client to client.
Rena: So is that something that intended parents and surrogates have to be on the same page about?
Mindy: Absolutely, because those are two topics that are woven into the legal agreement between surrogates and intended parents. So in my matching process, I wanna make sure everybody's on the same page so things don't blow up at the legal table.
Rena: Hmm, okay. And I think that's something that a lot of people, I mean, would have no idea about until they started this process, but that intended parents and surrogates need to be on the same page about nuances like that.
Rena: What other things, you know, as an intended parent do you think people should look for when looking for a surrogate or an agency?
Mindy: You know, often intended parents come to me and the first thing they say is, I need a surrogate in my backyard. You know, I wanna attend every single medical appointment. And I get that. But I ask clients to always think about – what does that picture look like for you after birth? Do you really want a surrogate in your backyard, or do you want some distance? And you know, how involved do you want the surrogate to be in the process and in your life? And secondarily, if you've been pregnant before, you know that the medical appointments, the monthly medical appointments aren't very exciting. They take your blood pressure, they measure your, your belly, and that's it. The most exciting appointment of all is the 20-week ultrasound because it's the most revealing of information. And oftentimes parents don't know if it's the sex of the child and they may be able to find out the sex at that point. But that's the appointment I encourage my clients to go to if they can't go to any or all of the appointments. So I would say when looking for a surrogate, the most important criteria is not location. The most important criteria is quality of candidate.
Rena: I think that's a great way to explain it. You know, I think, and I think that takes a lot of pressure off of intended parents to feel like they have to be involved with, you know, all the appointments and, and all the time.
Mindy: And with technology today – zoom, texting, FaceTime – there's so many ways to be at an appointment if you're not physically at an appointment.
Rena: And what about legalities or finances across state lines?
Mindy: Surrogates travel two times to intended parents’ fertility center. The first time is for medical clearance. The second time is for the actual embryo transfer. All other monitoring gets done at a local fertility center. So cost-wise, truly, the cost of two travels is the least expensive part of the entire surrogacy arrangement.
Rena: And then what about the birth? Is that dictated based on where the surrogate lives or the intended parents?
Mindy: Where the surrogate lives. For two reasons. We don't like surrogates to travel after about the seventh month of pregnancy, especially by plane as barometric pressure can lead to premature delivery. And secondly, the surrogate has been seeing her OB for this nine month period and we want her OB to be delivering her at a hospital near her. So intended parents travel to surrogate for the delivery. And thirdly, the delivery has to be in that, the state where the surrogate resides because that's the state we've done the contracts in, the state that's gonna dictate parentage – how we get intended parents names on the birth certificate.
Rena: And what about parents that are really nervous then about traveling back to where they live by plane with a newborn?
Mindy: You know, those are the parents that say criteria is, I want to be driving distance, but have my clientele is from Europe and they tell me it's the easiest thing to travel back with the baby who sleeps the entire flight.
Rena: Yeah. Very true. So how do you find, I mean, how do surrogates find you? How do intended parents find you? What do you kind of look for?
Mindy: Intended parents find me typically through the fertility doctors. They're the ones who refer to me with regard to surrogates. I recruit nationwide. But since I built the company in 2005, I've just developed pipelines of referral sources from other surrogates. I have surrogates who are repeat surrogates and they refer their friends, colleagues, relatives.
Rena: So word of mouth?
Mindy: Yeah, word of mouth, deep pipelines and advertising. Those are the main sources of recruitment.
Rena: What would you say, you know, makes a strong candidate for a surrogate and what may drive someone to wanna be a surrogate? I think that intended parents are always really curious about that.
Mindy: Yeah, Rena, that's a great question and here's why – most people think surrogates go through this just for financial gain. And I will tell you my best surrogates are those that have a healthy blend of altruism and financial gain. And I believe it's the financial gain that helps put a boundary on the surrogate being able to give up a baby after delivery. So it's, it's just a clear boundary, clear expectations, and then the altruism combined with that, I think makes the best surrogates.
Rena: Do you have guidelines or guidance for the relationship between surrogates and intended parents? You know, do you encourage, like, how much communication do you encourage while the surrogate is pregnant and then after the baby is born? What would you sort of advise for that communication?
Mindy: I think communication during the pregnancy is very important. And I would say the majority of my clients are in constant communication with the surrogate, especially after each doctor's appointment. I also make sure that the surrogate puts a HIPPA waiver in place with the OB. So if the intended parents had any questions, any medical questions related to her visits, they have freedom to speak with her OB regarding those medical issues. So I think that during the pregnancy it's important. After the pregnancy, hard to say. It depends how that relationship blossoms over time. But I would say the majority of my clients definitely keep in touch with surrogates. Maybe not so much on a regular basis, but certainly Christmas cards, birthday cards, photos of the baby, you know, couple times a year kind of thing.
Rena: And what about, you know, people that, you know, someone's told they need a surrogate and then, you know, they start to see the finances. How do you work with people on that sense? You know, a lot of times that's…cost is a real barrier to care.
Mindy: Cost is a barrier, but I'm very transparent with fees and my first consultation with clients. We always discuss what is the overall cost of surrogacy and then I send out a detailed, you know, spreadsheet of estimated costs. Once they select a surrogate. It could be a little bit more specific about costs because each surrogate's compensation may vary, lost wages may vary, well lost wages do vary. And also cost to childcare varies. And all of those things are woven in the, the contract between the surrogate and the intended parent. So before I solidify any match, that transparency is very important to me.
Rena: And what about, you know, I know in New York, you know, we passed the Child Parent Security Act and we legalized surrogacy. What about, you know, different states vary with different regulations. How does that impact your work and your business?
Mindy: Well, I only recruit from states that obviously allow for surrogacy. While New York has passed that law and surrogacy is legal there, it's still not the most favorable state to do surrogacy in because the laws are so stringent. And the best example I could give you on that is, in New York, intended parents are required to maintain a health insurance policy on the surrogate one year post-delivery. And insurance tends to be one of the largest components of the overall surrogacy costs. So doing surrogacy in New York is a lot more expensive than doing surrogacy in other states that don't have that stipulation.
Rena: Oh wow. That's wild. So how would you, I mean, if someone lives in a state, you know, like that, are there ways to sort of navigate that to, you know, get around that?
Mindy: Well, if the intended parents live in New York and the surrogate lives in Pennsylvania, we're using Pennsylvania law. So we're not even dealing with the issues in New York.
Rena: Oh, so the law would side then with the state in which the surrogate resides.
Mindy: Correct. Correct. Because that's the state she's gonna deliver in. That's the court we use to get the birth certificates, post-delivery, et cetera.
Rena: Got it. I mean, so there are so many nuances and things to really understand when going down this path.
Mindy: There are, and it's important for me to understand my clients’ individual circumstances. Are they legally married? Are they using their own DNA? Are they using an egg donor or a sperm donor or both? And for example, in the non-biological connection, there are fewer states that will accommodate that legally as opposed to if they were using just an egg donor or a sperm donor or their own DNA.
Rena: Are there any fantastic resources you suggest to people that are just starting to think about this? You know, I know when my patients are first faced with this, they feel, you know, about the potential of having to use a surrogate. They feel very overwhelmed and don't know sort of what to start doing.
Mindy: Yeah. Well, and I think the, the most difficult thing in that scenario is giving up control and, and trusting a perfect stranger to carry your most prized possession. And I don't know how to make that easier for clients, but what I can tell you is that over time, each step of the process, clients gain more trust in the surrogate. So, for example, they meet her initially, we ask a lot of questions, we decide if this is a good match to solidify both legally and personality-wise, et cetera. But then after she passes medical clearance, after she passes psychological, after she starts taking her medications, like each step of the way, I think that's what really helps clients gain more control. And then that's when the relationship between surrogate and clients starts to blossom.
Rena: And do you have any advice for people that are worried about, you know, feeling an attachment to a baby that they didn't carry and you know, there's so much loss that I think people experience when they're told that they can't carry. Any advice for people that are feeling that way?
Mindy: The best advice I could give is try not to control every step of the process. And I know it's the hardest advice to give, but there's so many things that are so not controllable in surrogacy or, or just in IVF in general. You can't control a pregnancy. You can't make sure it's gonna take. So I, I think being able to ride out the storm is probably the best advice I could give. And the second best advice is finding an agency who knows how to pick up the pieces if God forbid something happened throughout the process. And that's very different than taking a surrogate from some chat room. And what I've experienced with those chat rooms is typically those surrogates that are going independent are going independent because they have been denied by an agency for some reason or another.
Rena: I think that's great advice. I mean, I would say, you know, from my experience in, you know, helping people navigate the mental health side of this, you know, I think it's really common for people to struggle with sort of a juxtaposition of emotions, right? You know, sort of excitement that, you know, they're able to pursue a path to parenthood, but also a lot of grief and loss about not being able to carry and not have that experience themselves.
Mindy: But if those patients can reframe that grief and loss and try to look at this from a positive experience as, oh my gosh, at least I have the opportunity to do something like this, to still have a biological child, I think reframing helps tremendously.
Rena: Absolutely. And that's, you know, a lot of what I do with people as well as encourage them to feel the emotions and be able to have the juxtaposing emotions. Like you can be sad and upset about the same thing that you're excited about too, and how to kind of navigate the togging back and forth of that.
Mindy: Yeah. And where I see most, see the difference is with heterosexual couples and gay couples. Gay couples come to my table and they're so ecstatic to be here because they have this option. In the heterosexual world, there's a little more of that grief that you just mentioned.
Rena: Sure. I think because if you're a, a hetero couple, that wasn't something that you thought was going to be, you know, happening, right? And so it's reframing that and coming up with a new picture of how you're going to get to where you wanna go, which is, you know, again, this path to parenthood because it's gonna look different than you had envisioned. And that's really hard.
Mindy: Really hard. Again, going back to trusting the perfect stranger.
Rena: Yeah. And I, and I think, you know, as you spoke about, you know, giving up control, you know, that starts so much in just fertility treatment in general, right? You know, whether, you know you're coming in for an IUI or you've done multiple rounds of IVF and you have to move on towards, you know, surrogacy that's so much about feeling a loss of control, learning how to reframe, how to deal with uncertainty. And it's extremely stressful and, and so difficult.
Mindy: Yes, I agree. So finding the right surrogate doesn't have to be in your backyard, but just finding a, a quality candidate that you feel a connection to that you can trust. I think that paves the way, it's like building a house. You wouldn't build it on a shaky foundation. So it's the same analogy here.
Rena: Exactly. Yeah. I mean obviously you know, you're a reputable agency. How can people find you if this is something that they need to pursue?
Mindy: Mostly through the fertility centers, but also Google searches. I'm headquartered in Texas. I have an office in Tampa as well, and my daughter lives out in California. So we have a wide range of business hours during the day.
Rena: Oh wow. And so do people need to live in one of those states to work with you?
Mindy: Not at all. Not at all. I meet the majority of my clients, international and domestic over Zoom. And I work with fertility centers all over the country and I recruit all over the country. So all the surrogates are in the US but the clients are global.
Rena: Okay. And where do you see your business going? Do you have any sort of, like, future plans or visions for the business?
Mindy: Right now I'm just so enjoying working with my daughter that we just plan to keep going. We intentionally keep things small. We do about 60, 65 cases a year because that's what the two of us can handle. And I have no intention of hiring additional help. So we're happy just keeping it tiny and very concierge services and working with fertility centers that we just really love working with.
Rena: Oh, that's so wonderful. What would you say, what's the best part of your job?
Mindy: You know, I've had such a blessed career being able to help people and fulfill a passion. At the same time. I consider myself very lucky.
Rena: That's fantastic. And you get to work with your daughter. And you know, again, I think it sounds like you turned your own struggle and difficulty into, you know, a beautiful thing.
Mindy: I did. It was a lot of reframing, Rena.
Rena: Reframing. It makes a huge difference.
Mindy: It does.
Rena: You know, I love the phrase, every passing minute is another chance to turn it all around.
Mindy: That's a beautiful phrase.
Rena: You know, we can kind of sit and suffer or just pick up your dream. Keep moving. Exactly. Exactly. And it sounds like you are another wonderful, strong woman who has done that and it's so inspiring to meet you and have you on.
Mindy: Thank you very much.
Rena: So any parting words that you know, or advice or guidance, anything about you or your agency that you wanna share with listeners that you think they should know?
Mindy: My consultations are complementary, so I am happy to meet with everyone. They're, my consultations are very individualized. Most agencies ask people to fill out all this paperwork. I don't. For me, it's getting to know the person, it's getting to know the personality, and that's how I can best help match with surrogates.
Rena: Wonderful. And I think you know, your info, how to contact you, how to find you, your website, everything will be listed in our show notes so people can look you up right away.
Mindy: That's wonderful. Thank you so much.
Rena: Of course. And how we like to wrap up our podcast is by sharing a gratitude. So something that you are grateful for today.
Mindy: Oh wow. I'm grateful to so many people who helped me in start in the business. I'm grateful for the life that I have built since starting the business. And I'm grateful to all my clients all over the world, so many of them who have become dear friends of mine.
Rena: Oh, that's so beautiful. Oh, I love that. That is so nice. I will say, I get in a similar vein, you know, I'm grateful for my work also and being able to do what I love and really care about and you know, the support of RMA to do this podcast and, you know, just give listeners the opportunity to hear wonderful people like you, reputable information. So I am very grateful for being able to do what I love and you know, having turned my own story into my work now.
Mindy: It's beautiful.
Rena: So thank you so much for coming on and you know, again, we'll list all of your contact information, everything. This was, I think, so helpful for people. I, I, you know, see so many clients and patients get so overwhelmed with the process and idea of surrogacy. And I think this was a really great sort of like surrogacy 101 tutorial for people to help it feel less daunting and, and like they can, you know, work with someone to make it a, a really streamlined and positive experience.
Mindy: Yes. And I'm happy to help.
Rena: Thank you so much.
Mindy: Thank you. Have a great day.
Dara: Thank you so much for listening today and always remember: practice gratitude, give a little love to someone else and yourself, and remember – you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.