Twenty-nine year old, G3P3003, Caucasian female presents for six week postpartum appointment. The interesting piece is she is a surrogate mother for a civilian couple. The gametes were fertilized outside the womb, in vitro. She came alone to the postpartum appointment because her husband is deployed. However, he did come for the delivery. Do you wonder what her depression scale score was? It was a three and she was in good spirits. She chose to breastfeed the baby while in the hospital and I thought it was a little odd. The baby left the hospital with the adopted parents. The patient receives almost daily texts with photos of the baby. This is her first time being a surrogate mother and she states she would do it again. She and her husband are happy and have two children of their own. Thoughts that come to my mind….. Tricare will not pay for in vitro but I bet the prenatal care is covered. So is it legal for an active duty member to be a surrogate? If the DoD is aware of the intent for surrogacy will Tricare cover the cost of prenatal care and the delivery? Also found it interesting that Tricare will not cover surrogacy as an infertility option.
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Was she a surrogate for another military member? Less conflict of interest or utilization of Tricare benefits issue. Did she say she was going to pump milk for the baby after? That was an interesting plan to start but she may have thought that was the best thing to do at the time for the baby's health. I'm guessing this was an open adoption situation. I searched the Tricare website to see if it addresses this issue but it does not. It only lists which infertility and maternity services are covered with no stipulations/exclusions listed for surrogacy.
ReplyDeleteThis issue has come up at Fort Belvior were the CNM have noticed a rise in Active Duty members being surrogate mothers. This is concerning to me b/c AD members get paid lots of money (some estimates are in the 80-100's), they use Tricare as a safety net for any medical problems the child may have (potentially saving the parents thousands of dollars in expenses that they would have to pay in the civilian world); an example of this happen at Belvior several years ago when a AD female gave birth to twins at 28 weeks, the parents refused to take the twins until they were discharged from the hospital several weeks later. Plus AD members also get their 6 weeks recovery time and stay off the deployment list. DoD and Tricare need to get updated to this fleecing of our scarce resources.
ReplyDeleteThe problem here is that there is no way to prove the intent of surrogacy nor that in the end the determination to adopt a child out ever involved a financial reward. Regardless of any monetary exchange, there is NO legal binding that the woman must adopt the child out to the biological parents upon birth. There are quite a few issues around childbearing that the military is vulnerable to especially "dependents" who go on to have several children under the premise of their parents AD status and deny their marital status or relationship status. No one ever checks the legitimacy of dependent status when it comes to prenatal care because the thought process is, the health of the mother and unborn child is more important than the details of eligiability...I think this goes along with the surrogate situation as well. The major concern is health of the soldier, first, for force readiness, stability and strength, and then the baby. The details, again, become somewhat obscure and irrelevant. It will be interestng to see, in the years to come, how DoD approaches this topic...is it fraud? You are entitled to health care as an AD soldier...and there is no policy out there that says you can not be a surrogate. I think that until that policy is put in place, then reinforced, you can expect to see more and more of this. Yup...same with dependents.
ReplyDeleteFrankly, I'm surprised that the DoD pays for surrogate pregnancies for civilian adoptive parents. I would think that if I were being a surrogate, I'd ask the biologic parents to "pony" up and pay for my medical care.
ReplyDeleteInteresting problem - one that I think the DoD should be closing the loophole on. Proving intent is a different story, however. I'm not sure how Tricare would go about asking pregnant women how they got pregnant, and what they're planning to do with the baby after discharge.