Ms Sara Cohen:

The Deputy asked about how we handle altruistic surrogacy in Canada. Under our legislation, we are not allowed to pay a surrogate and doing so is punishable by up to ten years in jail and-or a fine of $500,000. However, we have always been allowed to reimburse the surrogate for any expenses she incurs as a result of the surrogacy. A couple of years ago Health Canada provided a list of various categories for which we are allowed to reimburse the surrogate and they are actually quite generous. The idea behind that was not to have surrogates for whom only the very smallest things were covered but to treat them well and in a way that we would want to be treated ourselves. If I am eight months pregnant, for example, there is no way I am going to clean a bathroom floor on my hands and knees and neither should a surrogate, so we can help with things like housekeeping and so on, as long as it is reasonable. The surrogate must provide receipts and other documentary evidence showing what she has spent during the surrogacy within those categories. Sometimes there is oversight by her doctor, who will write off that something is necessary or recommended. That is how we handle it. No specific cap is imposed by the government. As long as the expense is reasonable and is related to the surrogacy, then people can go ahead and pay it. That is how we handle that and it works beautifully. Having that list is very helpful because we know what is payment and what is reimbursement. It is quite nice.

In terms of the benefit of using post-birth orders, I want to clarify a point I made earlier. When I said the surrogate provides her consent twice, what I meant is that she does it prior to transfer first by entering into the gestational surrogacy agreement. A big part of that is her consenting not to be a parent of this child and making sure that is very, very clear. We get her consent again that she does not want to be a parent of this child after the baby has been born. We think it is very important to have these orders for everybody, particularly for all of our international intended parents who engage in surrogacy in Canada. In the case of non-heteronormative family building, it is very helpful because people have questions, whether they ought to or not, about who is a parent in those situations.

In terms of whether it is necessary to do a pre-birth order or a post-birth order, our experience in Canada is that we have never had a gestational surrogate try to keep the baby. To some extent, while I do not want to call it a waste of time, it has not proven to be necessary to wait until after the baby is born because we do not have surrogates trying to keep the baby. It just puts everyone in a funny position, as we heard from the lovely women who had been surrogates in Ireland. It is a short delay time for us but in that delay time, while we are waiting for the post-birth order, it could be confusing and problematic. Honestly, my experience is that surrogates just want to go home. They are not a parent so they do not need to be there anymore. They want to go ahead. We only have post-birth orders in Canada and that makes sense to me. It gives comfort to those people who are a little less comfortable with the concept of surrogacy, who have less experience of it, who have not had the benefit of speaking to the amazing people who have been surrogates and who are concerned that a surrogate might want to keep a child. Having the post-birth order makes sense but do I actually think it is necessary? For us, it has not proven to be necessary to do post-birth as opposed to pre-birth orders.