Womb for rent:A heart to carry another woman's baby

Imagine a woman desperately trying to get pregnant, but so far every attempt is unsuccessful. Would you be brave enough to “get pregnant for her?” Aisha Nansereko did. She told her story to Cecilia Okoth

Aisha Nansereko is a surrogate mother. In 2012, a fertilised egg from a couple that had failed to conceive was implanted in Nansereko’s womb.

Baby Sheila was born.

Nansereko, 26, did not go to secondary school education.

Orphaned at a tender age, she struggled through life before being married off at the age of 16 and bore two children soon after.
Like many a marriage today, hers was not rosy.

The couple hit a rocky patch and eventually split.

Nansereko traces her interest in surrogacy to the time her aunt was desperately trying to get pregnant, ending up at the Women’s Hospital and Fertility Centre in Bukoto.

While the doctors were running tests on her aunt, curiosity got the better of Nansereko. She found herself in the doctor’s office inquiring about her aunt’s chances of giving birth seeing how desperate she was.

She was told that her aunt could give birth with assistance. That surrogacy would be another option if things came to the worst.


Offering to be a surrogate

“I was deeply hurt by the fact that some women were not able to give birth.

That is when I made the decision to help be a surrogate mother for anyone who needed help,” Nansereko says.


“I am an orphan and was the second to last of seven children, so life while growing up was difficult.

I only managed to complete P7 and thereafter became a shopkeeper,” she says.

“My aunt talked of how she had been told that she could only give birth through assistance.

I was very concerned.”

“I confided in my aunt that I wanted to help her.

But she turned down the offer, saying her husband would not give her the help she would need,” she says.

Nansereko’s aunt suggested that she becomes surrogate for someone else and she agreed.


Nansereko was subjected to a myriad of tests at the hospital. These included tests for HIV and sexually transmitted diseases, sickle cell anaemia and hormonal imbalances.


“I was also scanned to check if my eggs were okay. The doctors checked my blood pressure as well as group and whether I had diabetes.

I was perfectly fine and qualified to be a surrogate mother.”

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Aisha Nansereko, a mother of two, has been a surrogate once and donated her eggs once

Going through the pregnancy

The start was difficult.

Nansereko was put on medication for one-and-a-half months. Then came the egg donations and many failed attempts to get pregnant, prompting the doctors to give Nansereko a three-month break before resuming all over again.

With these failed attempts after getting 46 injections, came desperation.

Through all this, the intending parents remained extremely supportive.

“The woman took good care of me and gave me sh600,000 for upkeep,” Nansereko says.

“I got so disappointed that I had failed the lady who needed help,” she recalls.

“I was told never to use a bodaboda, not to take alcohol and not to have sex,” she says.

Then she resumed the treatment.

She recalls fondly the joy that swept through her when she finally got pregnant.

“The first time, the doctors gave me the two eggs, they did not work out.

Then the next time they put in one egg and I got pregnant.

Words cannot explain the way I felt,” she remembers, adding that she fed on a balanced diet of posho, rice, beans, fish, meat and juice.

The surrogate pregnancy was no different from the rest.

“It was normal.” Nansereko took care of herself throughout the pregnancy.


“I did not want to lose the child and was vibrant throughout the pregnancy.


I always prayed to God and I was in touch with the parents of the child I was carrying.

They lived in Belgium and we spoke often,” says Nansereko whose first child is seven years old and the second six.

Then came the labour pains and the delivery was normal.


“I did not want any damage to my womb so I made sure I delivered normally. So I pushed the baby,”
Nansereko says.


About how it felt carrying another woman’s child and not holding it, she says it felt normal.
“I was trained psychologically not to get attached to the child I was carrying.

I often felt the baby kick me but I did not get any other complications,” she says.

“My only issue was whether the parents would take good care of the baby,” Nansereko says.

She was finally paid sh13.2m which she used to purchase a plot of land.

She later sold off the land to start a restaurant business.

“Even after giving birth, I did not get to carry the baby and I did not feel bad about it. I only saw her and that was it. My work was done,” she says.


The parents of the child stayed in Uganda for a while before returning to Belgium. She is eternally grateful to the couple whom she says treated her so well, cementing her decision to be a surrogate.

“However, the hospital has a policy not to show the surrogate mother the child she has bore for the couple.”
Nansereko donated her eggs to another couple in 2012.

She has no regrets about doing so.

“There are very many people who try but do not get lucky. I made worthy friends during the venture and up to now, I am still friends with the couple.”

Would she do it again?

“Yes, I can do it again.

I separated with the father of my children and since then, I did not think that my life would pick up.”
What about breast milk production? “I took tablets.

Breast milk is supplied on demand (it is the baby to trigger the breast milk) therefore, when you do not breastfeed, it dries up,” Nansereko says.

When she was pregnant, she moved from where she was staying to avoid nosy neighbours and relatives.


“My new neighbours were not concerned. By the time I relocated, my pregnancy was already showing so it worked in my favour.”

After delivering, she moved to another neighbourhood to avoid suspicion. “Only my aunt and sister knew about this,” Nansereko says.

There are no available aggregated records of gestational surrogates in Uganda because all the centres currently providing IVF are privately owned and do not share information.

However, we have formed the Uganda Fertility Society and one of our objectives is to have a central database on all IVF activities.

In the near future, this information will be available.

Choosing a surrogate is a complex issue and involves interaction between doctor and intended parents, and the doctor with the surrogate.

Some intended parents choose their own surrogates and others leave it to the doctor/centre to provide a surrogate.
 

These surrogates are thoroughly screened for any diseases which might be detrimental for the growing foetus.

Preparation of a surrogate involves ongoing counselling way before and after the procedure.

We call this “informed written consent”.

All surrogates are given detailed information about what surrogacy entails, including the delivery process, before they consent to participate. It is important to continue to provide them with emotional support even after the delivery.

Post-natal depression can occur even in women carrying their own pregnancies, but so far, we have no records of any surrogates suffering.

However, if post-natal depression occurs, it can be medically managed.

Dr. Mark Muyingo,
Gynaecologist/Obstetrician
Mulago Hospital

Expert view

What is surrogacy?

Surrogacy, according to Dr. Gilbert Ahimbisibwe at the Women’s Hospital International and Fertility Centre, involves the use of another woman’s womb to carry a baby for a couple who cannot have a child.

He says the types of surrogacy include:

Gestational surrogacy: The sperm and egg of the parents are fertilized outside the body in the laboratory using the IVF in vitro fertilization technique and the resulting embryo is put into the surrogate’s womb.

In this case, there is no genetic link between the surrogate and the baby. Ahimbisibwe says this is the most common type of surrogacy.

The surrogate only provides nutrients, food, oxygen and shelter for the baby.

The other type is traditional surrogacy in which the surrogate’s eggs are used.


The surrogate conceives either through insemination or in vitro fertilisation. In this case, the surrogate has a genetic link with the baby.

IVF is a major method of treatment for infertility when other methods of assisted reproductive technology have failed.


The process involves monitoring and stimulating a woman’s ovulation process, removing ova from the ovaries and letting sperm fertilise them in a fluid medium in a laboratory.


The fertilised egg (zygote) is cultured for a period of days in a growth medium and then transferred to the woman’s uterus with the intention of establishing a pregnancy.


Before embarking on surrogacy, Ahimbisibwe says, the hospitals normally sign contracts with both parties.


Why would one need a surrogate mother?

Dr Ahimbisibwe says surrogacy is open for a woman who has failed to get pregnant for a number of reasons.

Some of the factors that would stop a woman from getting pregnant include, but are not limited to:

• Uterine rapture (uterus tearing during childbirth)
• Severe scars
• Multiple abortions
• Previous uterine surgery
• Fibroids
• Severe uterine infections
• Others include conditions which may limit the ability of a woman to carry a pregnancy to full term successfully, for example; high blood pressure, uncontrolled diabetes, clotting conditions, severe disability, sickle cell anaemia and repeated miscarriages.

Ahimbisibwe, however, notes that on rare occasions, some women use surrogates because of their demanding careers.
Can anyone be a surrogate?

“No. For one to become a surrogate, she must meet certain standards and is subjected to rigorous tests.
These include blood tests and general health.

The person must be between 20 and 35 years and must have been pregnant before and devoid of any
illnesses that can be transmitted to the child.”


Ahimbisibwe says about 30 surrogates have delivered from Women’s Hospital International and Fertility Centre over six years.
“However it became more popular in the past four years.”
 

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