Surrogacy Psychological Evaluation Explained: Emotional Readiness, Trust & What to Expect

Rebecca Deegan

Hi everyone, welcome back to the Surrog Buzz. Today we are going to be talking about the emotional readiness. and psychological support in surrogacy and we will be joined by Dr. Stephen Covaluzzi to help us understand this psych. situation in surrogacy and how to best advise on what to expect during that process. So but don't forget to like, subscribe, and comment Dr. Covaluzzi.

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Dr. Covelluzzi

Hi Rebecca.

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Rebecca Deegan

Thank you so much for joining us. You're welcome. This is such a hot topic.

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Dr. Covelluzzi

It sure is. A lot going on, that is for sure.

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Rebecca Deegan

And I feel like, you know, this is Uh obviously there's a lot of steps in the process, but I feel like sometimes this psych process is a little nerve-wracking for people.

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Dr. Covelluzzi

Overwhelming.

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Rebecca Deegan

It's scary to be told you need to meet with a s

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Dr. Covelluzzi

psychologist. I just want to have a baby. Like, why do I have to meet with this person? I get it.

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Rebecca Deegan

Yeah, but they're, you know, as we know, doing this every day, there is a lot that goes into the entire journey. And this is probably the first stepping stone that really um just makes a lot of sense and needs to be done.

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Dr. Covelluzzi

Yeah, I think it opens up a pathway of a conversation to have, you know, before you go through this process. because there's so many, I'd say, underlying emotions that people, you know, sometimes arrive with. And I think it's good to uncover that and to make sure that people are well aware before they move forward in that

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Rebecca Deegan

process for sure so before we kind of dive into all these fun questions about the psych process um can you share what drew you into this work Um and why psychological evaluations are so important for a third party.

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Dr. Covelluzzi

Yeah, it's a great question, you know. So I've been uh psychology, gosh, twenty-five years at this point. And so primarily um I specialize in children, adolescents, and families over the years. And so I've had the gamut of, you know, everything when it comes to children, families, etc. And then about 10 years or so ago, I decided to go through this process of having children through surrogacy. And so as a result of my own personal process, I decided to open my clinical practice up to helping other couples, surrogates, parents, et cetera, navigating this process. I thought, you know, at the time that I could really put my spin on, you know, my own experience, but also share all of my professional background to help uh other people, couples and surrogates. going through the process. So that's how I got um interested in it. And it's been almost what nine years at this point and I absolutely love every single day. I continue to learn something new every single day. Um, but I think that every person I meet from all over the world continues to teach me something. And it's It's just fascinating.

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Rebecca Deegan

Yeah. And did you get into it and switch your gears because you saw something that was needed or something that that was faulty?

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Dr. Covelluzzi

I did. I saw all of it. I definitely saw all of it. I think I saw, you know, and this is what almost nine years ago. So the field's changed a lot and it's evolved a lot. Technology's really caught up. But you know, as a person navigating it myself, I thought, you know, I see a little I I uh this can get cleaned up or yeah this could be sharpened or you know what I think we can really help parents with this. Not to infer my own, you know, personal experience, but you know, just broader brush strokes by allowing people to feel confident and comfortable um going through that process. process. And so yes, to answer your question, I saw areas of improvement, areas that were done really well, and areas that I think I wanted to help introduce, you know Something that we'll talk about a little bit later, like that group meeting that you were doing, I think is really important.

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Rebecca Deegan

So why do you think it's so important for us to do a psych evaluation for the third party process?

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Dr. Covelluzzi

Well, first of all, I'm so glad that you You have elected to do that. There are some, we'll say not not every parent goes through it. So I think it's really, really, really important to just emotionally prepare parents for the the landscape of what's about to happen, hopefully. You know, you know, some cases take a little bit longer, some a little bit shorter, but what we don't ultimately know is what parents are arriving to the surrogacy journey um width, you know, there's a presumably a lot of trauma, years of fertility loss, hurt. Sometimes obviously there's um miscarriage and then some people arrive with you know four five six children they just want to really expand their family so I never know that going into it so I think it's really important to assess where each person is but also um the other thing that I've learned over the years and um is you know a person's culture and their background really dictates how I think they're gonna handle the surrogacy journey too So it's a combination of assessing what their background is psychologically, but also what culture and how they communicate, all that sort of stuff at the beginning.

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Rebecca Deegan

Well yeah, I mean there's a lot of different factors that come into not just the surrogacy journey, why they're here, but also the cultural differences um which can arise as well with a match, right?

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Dr. Covelluzzi

Absolutely. There's nuance in culture. People, you know, some cultures are very quiet, some are a little bit more assertive. Yeah. Some don't talk about that. And so, you know, I come into the picture saying, hey guys Let's talk about everything in advance because I truly believe that the more you can bring to this first date when you're matching with your surrogate, you really can open up the pathways to uh create a cohesive experience. So I think the more the better.

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Rebecca Deegan

And that comes with the transparency up front, right? Hey, just lay it out on the line and tell us where why you're coming here and and what you what you have to give and maybe what the issues are that you come with, right?

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Dr. Covelluzzi

Or what you're you know, what you're scared of and what you're you're you know, you're maybe not even ashamed to talk about. But you know, it's like I say, it's like going on a first date and sometimes, you know, we Make ourselves look really pretty and we we don't talk about those things, but I'm here saying, Look, you know, yeah, you're going on that first date, but I really do want you to bring everything to the table and show everything because that's ultimately how your agency can help shine. That's how they can help match you with the perfect candidate so that that person can join with you and support you throughout the journey.

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Rebecca Deegan

Yeah, exactly. Um so what are the most common emotional themes that you hear from intended parents before they or when they're starting their match?

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Dr. Covelluzzi

Well There's a lot going on there. You know, there's a lot of different things, but I think obviously the commonality is they would love to have a family. They would love to have a child. So whatever that looks like, it looks like. And I think, you know, the themes of hope, you know, concern, i excitement. Um All of that is kind of there and then I think that it transitions to, well, how is this gonna go? You know, I've spoken to a friend who did it and they had this experience and they they said it's gonna go like this and I was like Okay, well it may not always go like that. Every experience is different. So the themes are, I'd say, hope, excitement, some being a little bit scared sometimes, but just um wanting to really match with the right person.

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Rebecca Deegan

So you're kind of managing expectations.

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Dr. Covelluzzi

A lot.

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Rebecca Deegan

Yeah.

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Dr. Covelluzzi

Yeah a lot.

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Rebecca Deegan

Where it's like, okay, because I feel like a lot of people do come into this journey. Maybe they got referred by somebody like you mentioned, or they know somebody who's gone through it, or maybe they are on social media and they've seen it, you know. And I think everybody hopes and prays that okay, it's gonna take on the first try, we're gonna get matched with this, you know, one surrogate and we're gonna have this, you know, beautiful rainbows of unicorns. Yeah Um, but it doesn't always happen like that. And so it kind of starts obviously with us as the agency kind of matching and things like that, but then it goes to you, right? As a psychologist, like, okay, hey, listen, we're, you know, gonna We're gonna see how this works. And we're gonna meet with you and we're gonna meet with your surrogate and then we're gonna meet all together.

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Dr. Covelluzzi

And it's hard because you know you're doing a lot of these really complex um processes at the very beginning, even before somebody's matched, really, right? And so Uh yeah to draw back on what you said, we are, you know, I'm helping parents manage their expectations, uh, to be psychologically resilient, to have, you know, the preparedness of, you know, anything's possible and some parents arrive with only one embryo or some parents only have you know, a couple and so there's a lot of uh fear. You know, there's a lot of fear associated is this gonna work? Oh my gosh, if it doesn't, is this my only and one and done? And so part of what I'm doing too is assessing, you know, why they're coming to surrogacine, what's happening? You know, has it been you know years of fertility trauma? Is it, you know, now is just the right time? And so it's more so about uh Assessing what they're coming to surrogacy with and then being able to help them uh navigate that pathway with that

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Rebecca Deegan

looks like forward. Right. Yeah. So I think whether you're on the IP or the surrogate side, I think the psychological evaluation is very stressful for people. Obviously for the intended parents, it's like, well, why do I need to be, you know, evaluated or why do we need this? Not Only does the IVF clinic require it, but so does the agency. Um and then on the surrogate side, it's like, okay, what are they gonna ask me? And so there's a lot of unknown.

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Dr. Covelluzzi

There's a lot of unknown.

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Rebecca Deegan

There's a lot of unknown, and I think that it's it Even more so than the medical piece, people are very um hesitant and maybe you know scared about that. So can you explain in simple terms what an evaluation in surrogacy looks like and what is Yeah.

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Dr. Covelluzzi

So that's an interesting. Yeah, no, no, it's a great question though. So that's a is that's the first word I try to pull back from. I think that, you know, because I'm not formally treating anybody, I don't call it an evaluation. I call it a consultation. Because you know, they're coming in and everyone says, did you fail? Did you pass it? It's like it's not a pass-fail situation. It's a let's come to see how educated you are about this process and how I can bring you up to speed about what may happen So it's an about it it's a consultation, is really what I say. And so what people can expect is just to have a conversation about the surrogacy process from start to finish. um and about, you know, creating uh a pathway to connect with your surrogate. Um, because I think, in my experience. Um I think that getting to know your surrogate even ahead of time can be really, really, really beneficial. To reducing that fear, anxiety, and ultimately what we're doing here um over the course of this meeting is is for me to assess can this couple, can this person trust another human and what that looks like for them and then allow them the opportunity to share that with their agency or with their surrogate so that they can choose the correct uh candidate for them.

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Rebecca Deegan

Because we really want everybody to feel supported. Mm-hmm. Yeah.

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Dr. Covelluzzi

And so they can only do that if they're open and share. So I you know, I start with gentle a gentle opening and then I kind of guide people through. The ASRM does have guidelines that I do touch on, of course. And so when I'm meeting with parents, I I tell them in advance, I kind of give them a syllabus. They say, this is what you can expect from the meeting. You know, you're not in school. I'm not formally assessing you. I'm gonna You know, talk with you about who you are as a person, just get to know you really quickly, and then we're gonna address some, you know, some psych questions. I'll have to kind of just you know do a little bit of poking and prodding and seeing, you know, what's going on over there, and then we'll get into the rest of your journey, depending on if you're working with Donor embryos or your own genetics, and then we'll spend them the bulk of our time talking about surrogacy and how to best prepare you for that process.

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Rebecca Deegan

Yeah And so I would think that during this process, the the openness that you need from both sides, right? I need to know a little bit of background. Is there anything that I need to be aware of? Um, you know, we do a pre-sec evaluation on an a on the agency side just to kind of, you know, obviously check for anything that would might arise. Um, but I think the common theme even as people go through this process, surrogate or intended parent, um, just being honest and open about your life, right? Because You know, medical records are being reviewed and things like that. So things do come up that you might not want to come up, but unfortunately during this process, um, you know, we do have to talk about it.

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Dr. Covelluzzi

Please don't forget about parts of your background or your lifestyle. because there's chances are it's gonna come back up. Yeah. You know, because I think that almost like when I was in grad school when I was writing my dissertation, somebody once told me, and I think That it's very applicable here. It's like when you know you're going through such a personal experience, it's really going to evoke a lot of insecurities. It's going to really bring up a lot of things that you, you know, you may want to want to talk about, but you're going to have to eventually talk about. So So I've learned over the years it's just I think more helpful for everybody to get it up and get it out and just be honest and straightforward with what your needs and wants are.

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Rebecca Deegan

Well and then that's the best way that we we as a whole, professionals, and match that we can move forward where there are no issues that might rise or the clinic might not, you know, request something.

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Dr. Covelluzzi

And I say to everybody, you know, we're all a team We're all joining this to do we we all want to get from point A to point B. We all want a healthy delivery. Surrogate wants to be healthy. Parents want to feel, you know, part of the process. And I just want to step in to make sure that everybody is communicating cooperatively and seeing us

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Rebecca Deegan

Yeah, and we're not here to pass judgment or, you know, fault you for something that may have happened in your past. It's more just Let's see what the issue is and how do we move on.

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Dr. Covelluzzi

Correct. And that's what I say, you know, everyone has a past. You know? Yeah. It's not a bad thing. Like it's just you know what have you done with it? How have you coped with it and how have you moved past it? Or is it still a thing for you? And if it is, then we will have to find a a way to work with that so that it doesn't become such a big um thing for you during that

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Rebecca Deegan

process. Right, exactly. So from your experience, how do consultations or evaluations benefit the intended parents emotionally, relationship? all of to encompass everything in the in the journey.

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Dr. Covelluzzi

Say that one question one more time. Sorry.

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Rebecca Deegan

How do you how do consultations and evaluations benefit the intended parents?

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Dr. Covelluzzi

I think it gives them the opportunity to to be raw, to be vulnerable if they can be, to be real, and to give them um the opportunity to say, oh my gosh, okay, so this is how it could go, this is my Like best case scenario, this is really what I don't want to happen. So I think that it allows the parents the opportunity to feel a little bit more comfortable with this process. You know, it's at the beginning. really even know who they're matched with. Yeah. They don't know what the process is going to look like. And so this is, I think, where a bit of my own personal experience having navigated a surrogate journey myself can be really beneficial. A lot of parents ask me, yeah, what is it like? Oh my gosh, and was it successful and this and that? And I, you know, I I don't talk about all of it. I just say that it it it can be successful you know with the right team and if you trust uh the process as you move forward. And I think that it it it it requires a lot of flexibility. It requires a lot of mental nimbleness. And it, you know, for some parents, I think that depending on their background and what they show up with, you know You know, it that can be a hard one to unlearn, right? You know, because I think parents are comfortable in their lives, they're comfortable being who they are, um, and then they come to a process where they have no community. control that can be really really tough and really really really challenging. So part of what I'm looking for and helping people with is getting comfortable with the slight discomfort that it might might evoke in you and what you're gonna do with that and how you're gonna cope with stress and how you're gonna cope with anxiety and we just certainly don't want that to come out onto your surrogate. So it's about creating, you know, pathways for you and your circumstances. so that your surrogate doesn't feel that. We don't want her to feel that at all. We want her to feel supported, whole, and well taken care of.

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Rebecca Deegan

Yeah, meeting with intended parents for the first time, I always Tell them like the trust and the control are gonna be very difficult for you. So you know, you're meeting with a surrogate for let's just say an hour, hour and a half, you've read her profile, um, and then you meet her, but You're in you're making a decision after meeting somebody like you're like it's like dating, right? You're like, okay, hey, um I talked to you on the phone for an hour.

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Dr. Covelluzzi

Let's go out and it's like getting married, getting pregnant, and then not being able to divorce. You're doing all of life's most ch challenging things within an hour sometimes, an hour and a half, and you're like, how am I going to make this choice and what's that going to feel like? And is it the right choice? And I don't know. And you know Couples have been together for years, right? And they've had lots of time to work through these things. And right now we're saying, okay, Rebecca, you're gonna, I'm gonna marry you, and you're gonna get pregnant with my kid, and I'm gonna trust you Uh I think I can I don't know. And so it's a lot, right?

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Rebecca Deegan

It's a lot, yeah.

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Dr. Covelluzzi

And there's no divorce, by the way. There's no bailing out of this plane. So it's almost like part of the analogy that I used to. It's like getting on an airplane and it's like Rebecca's gonna be the pilot. I don't really know her, but she's gonna get me from point A to point B. Right. I hope you know, some some some pilots are gonna let me know when there's turbulence, some aren't. Some are gonna say, get ready, put on your seatbelt, it's gonna be a little bumpy, and others are just like get through it. So I you know I think that community really important. The other thing that I say, you know, to parents, like you said, it's almost like creating a movie, right? It's almost like, you know I'm coming in and I'm a director, right? And I I have a vision and I know what I want to do and I know how I want my movie to go. And I've hired Rebecca, my movie star. She looks great. She looks she she knows what she's doing But I really want to direct her really hard. And I can to some extent, but ultimately I've hired her because I trust her. I know she's gonna be able to really shine in in this movie. So I say to parents, step behind the scenes. Get behind the scenes. You're not in front of the cameras. Let your let your surrogate movie star do what she does. I think that's a really nice Way of giving her dignity and allowing her the ability to feel like, wow, I really trust this person. Yeah. But that's hard for some parents because it's a flip of power, right? There's a big power differential here. Because parents oftentimes will show up with a lot of education, big backgrounds, really high powered jobs, and just, you know, used to, you know, getting what they want when they work really hard. But this is an area in life where despite how hard they work, it just hasn't happened. Whether you know they're two men or whether it's a heterosexual couple, it just can't happen. So that's where that control comes in. And so I think it's about uh helping parents recognize that I don't want to say power, but for lack of a better word, there's a power differential here. And you're essentially relinquishing a lot of power and putting trust in somebody who you don't really know. Right. And so I think that's where the psychological consultation can be really helpful to help parents get a little bit more comfortable with that dynamic.

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Rebecca Deegan

Right. And so on the flip side of that, you have the surrogate. Oh yeah. And you know, you work with surrogates who are going through this for the first time who may be very timid. You know Education is happening on the background from the agency side, but they're still very new to this process. And then you have a surrogate who's a proven surrogate who who may be more like the intended parents, right? Very vocal. I know what I want This is the type of intended parents I have. So like how do you navigate uh you know when you meet the surrogate and you know manage her expectation as well, right?

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Dr. Covelluzzi

Yeah, no, it depends on the thing. Two parts. Right. It's a two-parts situation because sometimes like when I meet couples, they're not matched, right? So once after they're matched, we can have those kinds of conversations. But part of what I'm doing with parents is I'm saying, look, this is sometimes a process of managing um risk, right? You know, do you are you comfortable with risk or do you want to try to mitigate risk as much as you possibly can to some extent, right? Yeah. You know, and I think that, you know, for some couples, um, they're very risk averse. So I say you know something it might be worth your time, you might consider working with a surrogate who has um prior experience. Not that it's gonna buy the perfect un you know complicated pregnancy, but what it certainly can do is help open up the pathway for trust because She's done that. You know she's been there before, but however, there's a slight caveat. I do like to see that the surrogate has partnered with the same agency. has the same people in place because they're gonna know her very well. Like Rebecca, I've hired you, you've done this once or twice. So okay, all right, tell me what could I speak Speak to your intended parents, what was what was it like working with you? Yeah, that sort of stuff. But then there's some people who are comfortable with taking a little bit more risk. You know, second-time surrogates have to start somewhere, right? Yep, that's exactly what I said. They have to start somewhere. And honestly, sometimes first-time surrogates. are absolutely they're wonderful. Not one is better than the other, but it really depends on the parents. That's where that level of trust, trauma, cultural background, and nuance sometimes comes in. Yeah. And I think that as long as a parent is aware of that, they can then make uh informed decisions. And that's part of what the psych consultation is. It's really a a humongous opportunity to have informed consent about what is going to happen or what could potentially happen so that they can then say, okay, these are the choices I'm comfortable with. These are the ones I don't really not comfortable with and then that then allows them the ability to align really well with their agency and with their surrogate in my opinion.

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Rebecca Deegan

Yeah. And sometimes it's kind of cool when a first-time intended parent works with a first-time surrogate and they're all just kind of like moving through together. There's no like expectation or uh you know underlying like I know what I'm doing or I've done this before where maybe she's done it before but the lack of communication comes in because she's like, oh I've done this, it's okay, everything's fine. you know, where a first-time surrogate might be. So I think obviously on the agency side we look at that too, like okay, what is best for this in intended parent? A lot of times it's given also by the IBF doctor. But then you see it on your end after a lot of times after the match has already happened where it's like, okay, the here we here we are, here's together, here's how we manage they're gonna need a little bit more hand holding or a little bit more touch

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Dr. Covelluzzi

points along the way and again depending on their trauma depending on you know their grief and depending on all that sort of stuff too yeah um you know but I'd say the majority of surrogates that I've worked with over over the years are honestly they're very kind, giving, open people, and they just really want to produce a healthy child for a couple. However, how that looks and how that unfolds doesn't always align with what parents want because their expectations might be unrealistic. So that's another thing that you know I'm assessing for and looking for is it are your expectations realistic or are they, you know, can can anybody meet those expectations?

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Rebecca Deegan

Yeah. And I think a lot of times that comes in with also the agency having a relationship with the professionals, with the psychologists, where it's like, hey, I have this issue, or hey, I see this in this match, you know, can you how can we help can you help navigate that or how do we move forward or what what do you suggest? Um I think us being transparent as the agency with the psychologist Um and just so you know, you know, obviously going into the match kind of what to expect or you know maybe some issues that we see that may arise that maybe you can help mitigate.

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Dr. Covelluzzi

Absolutely, or at least bring it uh to the table in advance. Yeah. And you know, sometimes, you know, I'm sure you see this all the time too, you know, I'm not in a position to, you know, demise magic. However, you know, if that does in fact happen or if a couple or a surrogate just aren't seeing eye to eye, um I'd much rather know that at the first date and say, you know, thanks for the date, but you know, I think we're gonna date somebody else. You know, I'm gonna just, you know, and I say to parents all and I remember feeling this myself too. It was, you know, let's go, let's go, let's go, let's let's do this. Like we waited, we waited, I'm ready. Uh and then somebody once told me, I think a nurse, a fertility nurse, said, you know, Stephen, it's much better to take your time to wait it out and find the right thing. candidates for you so that you can feel much more secure in that process. And I didn't understand it at the time because I was just like go go go let's go let's go let's go. I need to get matched. I need to yeah I need to have a baby. Right, right. And then you know she was right She was a hundred percent right because there were things that happened that were out of my control that I couldn't control. Yeah. And they just had to happen. Yeah. And I think there's some beauty in that because it really opens up the ability for you to really understand what your needs

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Rebecca Deegan

Mm-hmm. We see it sometimes where things are meant to happen or not meant to happen, right? I I think there's sometimes in this process there are things that are just unexplainable, but You know, sometimes rushing the process or, you know, rushing to have a baby at a certain time or getting matched super quick, um, it does pose some problems because then we're rushing it and it's like Is this supposed to happen? Is this supposed to happen now or are we rushing something that's not meant to be rushed? I think, you know for intended parents going through so much for, you know, let's just say you've had failed transfers, miscarriages, you know, nine years, ten years and Like that has been some people's whole marriage. Marriage, right? Like just trying to have a baby. So I think the sooner the better. Absolutely. But there's certain things that Can be moved along and certain things you just kind of have to let play out.

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Dr. Covelluzzi

And I say there's a hurry a lot of hurry up and waiting. We're measuring time in months because of the cycles and you know things like that. Um and I think that, you know, I try to let everybody know that there's beauty in that and then there's space um to continue to grow and evolve and to figure out what exactly it is that you're gonna need want. But it's very hard, you know. As having been a former intended parent, it's hard to be told that. It's hard to be told it's going to take a little bit of time. But you know, having now being on the other side of it, um Yeah.

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Rebecca Deegan

Because you feel like you've already given up so much time not being a parent that you feel like you need to do.

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Dr. Covelluzzi

Or there's a sense of shame or that you know there's life happening around you or people, you know, having families are asking you why why aren't you having a child? You know, and it's shameful for some families, you know, it's shameful or it's embarrassing or it's hard to talk about. It's almost taboo. Why don't you have a kid? You know, that sort of stuff. Well, these are really personal choices that you know people don't know. You know, they mean well. Um and sometimes I see that coming up. I have sometimes the privilege of working with people who have been through a surrogacy journey and then And um, you know, it's good news, right? They have their baby and they're doing their they're living their life and they're on the playground and somebody, you know, unintentionally just Walks up to them and says, Well, where did you get that child? Like I didn't see you pregnant and w what happened here? And so then it becomes a different kind of conversation of is it a public service announcement about surrogacy or do I get into it or whatever it might be.

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Rebecca Deegan

Right.

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Dr. Covelluzzi

You know, so it's it's interesting, you know, because It's good news, right? They have their family, but sometimes parents don't want to think about it. They don't want to go backwards. They don't want to think about all the stuff they went through.

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Rebecca Deegan

Right.

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Dr. Covelluzzi

However, um, you know, I think for the child's mental health uh depending on your culture, your background, your views and wants, I think it's appropriate for a child to know uh about the use of a surrogate. Is there any shame and harm in um letting a child know, depending on your child Of course, getting to know your child position and all the things that you're talking about. When do I introduce it? I've got a lot of strategies for helping people with that too. And um, you know, I'd say most people are very comfortable and open about talking Yeah. Well look look at gay men, right? There's no hiding it. Like there's there's just just either you adopt it or you're, you know, you went through like what happened. People are very forthcoming and open about it. And I think You know, with heterosexual couples, obviously you can pat it a little bit, you can you know not talk about it as much. But you know, I say that we can learn a lot from everybody. Yeah. heterosexual gay couple, you know, and I think that most of the children that I know who have been uh brought into the world through surrogacy from um gay male couples are pretty well adjusted kids. Yeah. Because their families are fairly old

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Rebecca Deegan

Yeah, and we live in a great time right now where I think surrogacy is a topic that a lot of people are talking about, you know, social media and you know news, I mean all of it, right? Absolutely. And I feel like you're in a if you're an intended parent or even a surrogate, like you're in a good time to have the support of other people depending on where you live in the country.

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Dr. Covelluzzi

Correct. Yes. Yes. I agree with you. Yes whole there are there are pockets. There's definitely depending on where in the country or in this case the world, right? Yeah. It's not legal in some countries and so you know there's some shame. So I you know I say to everybody, you know, obviously adjust and do what is in the best interest of your family, your background, your circumstances. sense your culture because that's gonna dictate, you know, a bit. However, I believe that psychologically children generally are not harmed by hearing them about it. I almost view it as like, you know, like you go to the doctor if you needed a kidney transplant or if you needed a blood transfusion or if you just needed a little bit of help along the way, there's no harm. Yeah. It's like I don't have a uterus, but I wanted to have a child. And so, you know, going through surrogacy I'm not ashamed about it. And I think that, you know, the ethics of it sometimes come up for couples too. Yeah. You know, a bum p paying somebody for this service and I'll say, yeah, but you know what the surrogate's choosing to do it too. Yeah. You know, both parties are equally aligned and they both want the same common goal You know, and so I think that it's okay.

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Rebecca Deegan

Mm-hmm.

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Dr. Covelluzzi

I think it's okay.

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Rebecca Deegan

Yeah. Um, so evaluating a surrogate is more than just kind of a medical check, obviously it's needed for the medical evaluation. But like what emotional patterns are important for a surrogate to understand before moving forward?

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Dr. Covelluzzi

Yeah. the parents.

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Rebecca Deegan

Yeah, and like just to understand like emotionally and how the relationship is going to be affected. Like what does that look like on the surrogate side?

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Dr. Covelluzzi

I think there's so that's such a humongous question and there's a lot going into it. So as a psychologist, I'm looking at it from lots of different lenses. I'm looking at it obviously from, you know uh her background, where she's come from, her motivations, her, you know, psychology, her family unit, you know, her job, you know, there's so many different layers that I'm looking her age sometimes, you know, divorce, not divorce, you know uh supports us the community. You know, there's so many different factors that lead into this. And I think that ultimately no matter what surrogate I'm working with, I'm really looking for high amounts of empathy and dignity. And I think that, you know, if a surrogate shows up to meeting with me and I'm you know not quite seeing, you know, both on paper and through her background that there's gonna be this ability to treat another couple or a person with dignity, I think then that is a bit of a red flag for me and moving forward with surrogate and and it doesn't happen a lot, um, but you know, some are, and I think that that is a huge red flag because in the end, you know, in all the work that I've done over the years with couples and you know high conflict circumstances, it's really about treating somebody with Dignity, kindness, respect, empathy, and validation. I think that um not to make this a political conversation, but there are so many areas in the world where people aren't trying treated dignified and that creates conflict. Yeah. And I look at surrogacy to some extent as a mini conflict. And we don't want that. We don't want that at all. So what I try to do is to try to prevent that by saying, look, if we can work In this pattern, and if we can, you know, really lay these um we'll say tools on at the beginning, it can really reduce the potential conflict to come up later on in the your experience with your surrogate.

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Rebecca Deegan

Yeah, because I come from the surrogate side. Yeah. So for me, coming into this process, I felt that I had empathy and I felt like I wanted to do this for the right reason and um you know I felt like I had support and things like that. And I think a lot of people feel that way, right? You feel a certain way about yourself Um and then you come into this process and it's like, hey, how do we make sure that you have empathy and dignity and you have all and you're doing this for the right reasons and it's a lot to assess, it's a lot to look for, you know, and I and I look to their community and what you

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Dr. Covelluzzi

done with your life and you know where you're working you know and everyone has a story, right? And I think that as long as the surrogate and her family and her support system are well aligned, um then I think that Um people can generally progress forward. But you know, every so often things do pop up where I'm like, you know I think we push the pause for for now. Let's push the pause button. Let's maybe work on these couple of things in your background or circumstance. So So it's not a no, it's a let's defer for a little bit and then maybe come back.

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Rebecca Deegan

And then you give them the tools to kind of correct and say, hey, maybe work on this or maybe sharpen this or change that and then maybe we reassess in a little bit of time.

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Dr. Covelluzzi

Yeah. But maybe now's not the right time. And I look at it you know, not that I'm the end all be all here, but I I try to look at this experience as a safety measure for everybody. Yeah, no absolutely. I always begin by saying, look, I'm not here to judge. I am here though, however, to provide an assessment, but it's really uh for your safety. You know, try to look at it as a safety experience because nobody wants anyone to be put in a position position of feeling unsafe or you know to feel victimized or to feel like they're you know not able to succeed. So sometimes if somebody is unable to move forward at this time it's purely in my experience just A safety experience for everybody. We don't want anyone to feel um hurt or exposed.

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Rebecca Deegan

Yeah. Well, and it's more than just, okay, where do I come from and how do I feel about this process? It's like Also, how do I work with a couple and have their child, but this is their child who I'm allowing to make decisions for that child. So It's very deep, right? We don't think about it. I think when a surrogate comes into the process, it's I want to have a baby for someone. I've had great pregnancies. I've always wanted to help a couple. Um and then it starts to get real deep.

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Dr. Covelluzzi

Well so what I say is to parents and part of what I'm assessing for and what I'm looking for is you know I say to parents, look guys, we're in the theoretical stage of this. conversation. It's all theory. It's all, you know, we're talking the minute that your surrogate hopefully gets pregnant, it transitions to something very real. And for many couples, they've never experienced a pregnancy before. So everything gets really charged. Correct. Because it transitions from hypothetical to real. And oh my gosh, how do I f I don't know how I'm gonna feel and I don't know how I'm gonna cope with this and then now I'm anxious and correct. Well here's an example. You know sometimes there's uh uh an underlying distrust of the American medical system or just OB care or whatever it might be. And parents might arrive saying, I I don't want my child to have any exposure to anything in utero. Nothing. You know, eat this and don't do that. And you must have to it Okay. Or I I understand that. However, the surrogate does have autonomy to her body and she does have the ability to make choices for herself and sometimes that can be a minor conflict or a major conflict depending on the person, what their culture is, their background, or what they're arriving at the surrogacy journey. with so part of what I'm doing in the group experience is bringing up these things that I've learned over the years to help me uh manage that. Yeah. Or just like, hey, look, if a situation like this comes up, let's talk about it. What might we do?

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Rebecca Deegan

Yeah. And I think on the agency side, this is very important. At the beginning of a journey, let's just say matching, my suggestion is always to, you know what, if there's something you feel really strongly about, uh Something that's maybe not listed in the profile, maybe a question that just didn't get answered, um, that you just feel really strongly about, like you said. Um

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Dr. Covelluzzi

The political background.

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Rebecca Deegan

Yeah.

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Dr. Covelluzzi

That was a new one for me.

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Rebecca Deegan

Or like what do you eat? Yeah. Hey, we really want you to eat this. Oh, we don't like these cleaning products. We want to use these cleaning products.

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Dr. Covelluzzi

Nails, nail salons.

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Rebecca Deegan

I've heard people say, you know, would you be okay using all natural makeup? Absolutely. I think before you get into a match, because obviously the goal at the match in the match meeting is to make sure that you align, you can vibe We talk about very, you know, non-fun things like termination and um things like that, but I think These small things that come up, sometimes later down the line, like you mentioned, once a pregnancy is concerned where they don't think about it.

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Dr. Covelluzzi

So we want to try to reduce the amount of resentment and angst At the beginning. Yeah. And there's all these little things

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Rebecca Deegan

Yeah, and it's like just ask the question. Like I'm happy to copy and paste yeah, copy and paste the your hey, would you mind eating this? What kind of cleaning products you use? Things that Let's just envision that you're pregnant, you're that you're now having a baby. What does that look like? And I always I try to explain to also to the intended parents like 8020 rule for diet, you know, like because I think these things in your brain you could you could really start to snowball.

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Dr. Covelluzzi

From theoretical to real. And then it becomes I've never been pregnant. Then sometimes we struggle or parents struggle with, am I gonna bond with this child and how am I gonna feel the baby's not, you know, specifically in my body. And that's a real thing. I I get it. It's real. But you know, I I you know, ingest say, you know, something, I don't have a uterus. I'm never gonna have a uter. I'm never gonna know what it feels like, but it doesn't mean I'm gonna love my child any differently just because the child was in somebody else's body. Yeah. And oftentimes in my experience in psychology, um, attachment really begins afterward. You know, attachment's something that people work on and it's something that you feel and you know, attachment it's possible. It can begin in utero, but it's also possible. that it can begin once the baby is born too. And so I try to assess and work with families too. Yeah. Going back to what you asked earlier about parents, you know w how they're arriving and where they're at psychologically and how they're gonna feel about bonding and you know nurturing and creating a a sense of, you know I'm gonna be a parent now. Wow. When do I get excited? That's something that, you know, we talk about too. Do I get excited the minute she's pregnant or do I get excited once the baby is born and in my arms? Very personal question. You know, years of trauma, hurt, loss, and it's hard to predict when And you know, somebody might feel bonded or excited because they don't they're guarding, right? Absolutely. You know, and I think part of you know being a parent on the other side of it too, to to create rituals and to feel like you're experiencing this process too You know, but you know, culture sometimes plays a factor, superstition sometimes you know, when do I do that? You know, that's a it's a really hard question, you know, to answer. Yeah, it's so personal to every single couple and Yeah. I think that depending on how the consultation goes, sometimes I make the recommendation for, you know, I think you might benefit from having it An additional consultation, you know, either with me or with a different provider or somebody of your choosing. Yeah. Just so that you can begin to talk about these things so that as you're going through the process, it's not shocking or discomfort or uncomfortable. Comfortable for you. Yeah. Because remember, we want you to be whole and happy once the baby's here. And it's really, really hard to predict how it may come up.

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Rebecca Deegan

You know, and then the emotional or maybe non-emotional side, depending on the surrogate, at delivery.

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Dr. Covelluzzi

Absolutely

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Rebecca Deegan

So envision yourself we're, you know, about to deliver the baby and what does that look like for you? You know, is there you there?

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Dr. Covelluzzi

Are you not there? Do you prefer to be behind? surrogate wants you there.

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Rebecca Deegan

Or just the surrogate delivering. Like how does that look like for you as a surrogate? Like you're delivering the baby and like, okay, now you're giving the baby to the parents. Like are you

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Dr. Covelluzzi

Are you are preparing yourself for this gift? And you know what I say to all surrogate? You know, part of you know when I meet with surrogates, I'm like, this is my absolute new favorite way of viewing surrogacy. I have so many different things I'm like, you know, it's almost like you're serving as a kangaroo, a koala bear, an oven, a panda bear, the reverse of foster care. Where I really think it's important for a surrogate to tell herself at the beginning, look, this baby that I'm carrying already has a loving stable, supportive, nurturing home. I've been asked and tasked with being a foster parent, but it's in the reverse order. You know, the traditional foster care kids are, you know, born into challenging homes, right? And then they have to find But in this case it's just the opposite. This baby already has it, and the family is going through extreme measures in order for that family uh or that child to be introduced So I try to encourage surrogates to think about that. And I also say, you know, here's my new favorite one. Talk about you know the day and time in which we live I'm like, listen, you're acting as a 3D printer. You know, this family already has some feedback. They they're gonna say, here, take this, and you have got that 3D printer inside your body. Could you grow this for me? Yeah. I love that. Yeah. So surrogates usually like that one. Their kids like it, they have a good time with it too. But I also think, I mean you could probably speak more to this, but psychologically, I would assume For a surrogate, it can be a bit challenging, right? Once you deliver, there's a change of hormones and you know, and so what I say to surrogates, I think it's really important to go towards something after Yeah, but it's not for me, it well again, yeah. Because if it is a successful experience, I think that surrogates will miss all the support and the feedback and the nurturing relationships. that they've grown with the family if it's a good match, right? With their case manager, with the people that they've helped, and all of a sudden, oh, they're gone. I mean you want that, right? Right? You know, you want that family to be created. You want that family to be happy, but yet who am I? I'm in the I'm in the hospital and baby's gone, family's doing their thing, and how do I fit into that? Yeah. So I think it's really important for a surrogate to think about that and you tell me if I'm wrong.

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Rebecca Deegan

Yeah, no, exactly. I obviously didn't want the child and I think a lot of surrogates come into it. Like look, I don't want another baby. I'm done having my own kids. Like I don't want your baby. Right. Ex you know, but but I also love this experience. We've had this bond. I was actually s more sad to see not see my intended parents every day than I was at all being attached to the children. Like it was more like, gosh, I love my couple and I like have had this relationship with them for You dated a year and a half, 18 months. Yeah. And now it's like Now they're gonna go home and I'm gonna see them, you know, once a week to get breast give them breast milk and you know, so and and we still have a relationship to this day and that always doesn't happen, but I'm thankful for that, but I I would say that's probably why a third of surrogates come back and do another journey very quickly afterwards.

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Dr. Covelluzzi

But it's it's about the experience because it's It's so powerful and life-changing. And I say, no matter where you live in the world, you will be bonded to that. I mean, that person will have forever changed the world for you You know, I say to surrogates too, it's almost like, you know, it's not very often that you can change the world, but in this application, you literally are changing the world and opening the world. World up for that family. You legitimately there's no taking that away from you. And that's something that no one will ever be able to take away from you. Something that you can carry with with you for the rest of your life.

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Rebecca Deegan

Yeah. Even if your journey wasn't what you expected or it wasn't perfect or things like this, I always tell myself, you know what, I don't n need the validation of anybody else. I know that I did it and what I gave to the world is more than anybody can say thank you or gifts or any of it.

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Dr. Covelluzzi

Absolutely.

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Rebecca Deegan

And you just have to know in internally that you did such an amazing thing.

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Dr. Covelluzzi

You've given the gift of all gifts basically. Yeah. That 3D printer was a very powerful gift that you gave to some somebody the ability for you to use that selflessly. You know, absolutely. And it's a good idea. But you know, whether you have a relationship or not with the child or the family afterward, you know, that's a bonus. That's, you know An amazing thing. It really is. It doesn't often happen that way. Yeah. But it does. Yeah. But again, no one will ever take that away from you. It's like going getting a degree. No one could ever take that away from you. It's something that you've earned. You put your hard work in. Yeah, it's the other thing, you know, with surrogacy, and I say to parents too, I'm like, this is a marathon. It's not a sprint. It's an everyday, you know, we're gonna show up every day, we're gonna, you know, work collaboratively for the surrogates too. And I I try to, um, when I'm meeting with surrogates, I try to help them create the realistic expectation of, look, we really have no control over what's going to happen and how the pregnancy is going to unfold Well, we hope that it's healthy and we hope that you deliver. But on honestly, what you full have control over is yourself, your choices, your stress levels, and your ability to, you know, show up every single day and live your life to the best of your ability and make good health. smart, rational choices. That is what surrogacy is about. And I really think that, I hope at least it helps surrogates in preparation for, you know, if there were to be a miscarriage. or some medical complications or challenges that can happen because I think psychologically it's more important for her to know that, you know, every day that I showed up, I made a good choice. Yeah. I made a smart, healthy choice. I did my job. I did what I I did what I came to do, and ultimately it's hard because you want to sort of detach from you know the delivery, right? But everyone's doing it for that, but yet the realistic You know, application of surgery my experiences just every day. Yeah. Make healthy smart choices every day. Did I do this?

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Rebecca Deegan

Did I you know that sort of stuff. Yeah, it's a job.

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Dr. Covelluzzi

So it's it's it's a it's a beautiful meshing of your job and your personal and it's gonna feel and that's what I say to parents too, you know, and I and I think about parents and I'm meeting with them and I'm like, okay Are they in charge of their lives? Like what do they do? It's gonna feel a little like a twisted combination of both work and personal at the same time and the way that you mitigate solve problems. It's gonna uh sort of emulate either what you do in your personal life or in your work life and it's gonna feel twisted You know, because you're trusting, you know, your movie star here with a child that you can't do on your own for whatever reason. Yet she I don't want to say is in charge, but ultimately she is the one who's leading the pathway here, right? And or again for many parents that can be a very big power differential.

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Rebecca Deegan

Yeah. So let's kind of go into um The stressors of surrogacy. So what patterns do you often see that create tension and stress Between intended parents and surrogates if not addressed early on. So obviously you're going through the process. There are things that come up that you're not Maybe you probably weren't thinking about, right? But then something happens and the stress or the tension at you know, comes up. What could we have done maybe early on to help address those things that come up later on life? Because we we talk about communication. That's like the you know foundation, but you are obviously seeing it on You know, it's a complex question.

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Dr. Covelluzzi

It's a complex question because you know we don't have a crystal ball, right? You know, nobody can predict whose lifestyle is going to take twists and turns and job losses and job insecurities or how you know there's a kids get sick. There's so many different factors that can come up, right? You know, it's a person's life, you know, it's another human being. And so hard question to answer, but I think that drawing on all of the experiences from either the psychologist side or the agency side and saying, look, parents These are the different areas of potentially we've touched on some of them. Communications humongous, absolutely. You know, diet, lifestyle. uh religion, culture, background. I think that complex medical choices sometimes doesn't really get talked about on your first date because who wants to talk about them? that.

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Rebecca Deegan

Well and we don't know, right? It's that hypothetical situation. Am I gonna have an issue where I go on bed rest?

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Dr. Covelluzzi

You know, so these are Or do I have to take this medication? Should I take it without telling the parents or do I just do it on my own and then tell the parents? And I honestly In that specific application, I think that it's about when a parent doesn't feel consulted, they're just fear. It's just it's fear, it's concern. And you know, I try to mitigate that with the parents by saying, look. You know, the OBs are gonna, I hope, you know, do what is in the best interest of not only the surrogate's body, but your child as well. It may not align with what your needs and wants are, but they're in the business of a healthy delivery and a healthy baby right? Yeah. And it it may look different. And that's where that cultural piece sometimes comes in or a distrust um for the American system of medical uh Um care. Especially if an IP is in another part of the world. That sometimes can pop in or vaccines, another big one.

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Rebecca Deegan

And a lot of times it still comes you know, it just still comes up obviously for ones further down the line. Absolutely. Not so much anymore, COVID, but yeah, I think Just anything. Yeah, exactly. Any medication you're gonna take, Tylenol now is a huge one.

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Dr. Covelluzzi

Drink water from you know the the mountains of Iceland in glass. And that's fine as long as it's addressed. But I think that You know, diet, lifestyle, exercise, access to food, you know, for some families, you know, eating a particular style or way is very important, you know, and I try to work with parents, I say, look. I think that's appropriate to talk about. However, please don't set your surrogate up for a power struggle. You know, if you yourself wouldn't keep that particular lifestyle, I think it's unreasonable. And it's setting her up for a struggle that she may not be able to keep. But if you personally do it and you live that lifestyle, align with her. Talk to her about it. She may not be the right candidate for you. And you'd much rather know that at the beginning. Um and then, you know, sometimes in local matches it's interesting because that's where this power differential sometimes comes up where parents want to have access and get in there and get in there and you know be to every single and that's great, right? But Ah, surrogate's a patient. She's the one who's in charge, right? She's got her HIPAA right. She can say no, you're not allowed in there. So we try to talk about that too. You know, who's gonna have access to, you know to seeing what's going on in those. You know, is it gonna be her feeding you the information or are you gonna allow the parents to have access directly to the doctor if the doctor, you know, if you sign off on the release of information for the communication to happen.

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Rebecca Deegan

And so for at on the agency side, I see the stressors and the tension. Um you know that situation obviously to try to help mitigate that we do make sure that every single match has a group session. Yes. Which we really haven't chatted about yet. It's really individual at this point, but um a group session is key to for Both sides to me.

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Dr. Covelluzzi

I believe, yes.

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Rebecca Deegan

I believe too. I think I think really um you know this is something that has um evolved in the industry over the last few years of um you know Before it was East Coast, West Coast, East Coast clinics, it was mandatory, um, not so much on the West Coast. Um and then, you know, we just kind of adopted the group session as being critical and making sure the surrogate and the intended parent can come together in a group session with a professional to say, okay, here's here's me and here's me and how do we successfully move forward.

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Dr. Covelluzzi

Yeah. You know, it's almost like you know when I when I do these group sessions Which by the way I absolutely love doing. I find them to be incredibly beneficial, useful for every person. And in most of the sessions I've had at the end, people have said, you know something? That was really, really, really useful. I'm hopeful that you have the same experience.

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Rebecca Deegan

Yeah, nobody nobody's ever said anything negative or that they didn't get out what they thought. You know, I just think you're meeting for an hour and a half, you're moving forward with a match. Um, she your surrogate comes from somewhere and you come from somewhere. How do we meet in the middle for this to be successful? And I think those stressors and tension that come up throughout the journey, you know, maybe you go back to that and you say, you know what, I know that this is who she is and this is where she came from.

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Dr. Covelluzzi

And I put people not Intention I I I I I I lay these little like bombs and just to say, hey, if this were to happen, how are you gonna manage that or what's this gonna look like And then we kind of work our way through you know baby scenarios, baby little like conflicts to see what happens. You know, the goal is to not undo a match, of course. However, you know, if that does occur, it's much better obviously to know about it and advanced, but ultimately, you know, the framework is to you know set the framework at the beginning. I use almost like a round robin style check-in, kind of draw back to my group therapy days of like, okay, and how did you feel at that? And what did that make you feel? And we really revisit all of those things. We talk about shared values and the logistics of what the pregnancy is going to be. Okay. Um to say, hey, you know, these things could come up, this could trigger anxiety, this could make you feel underappreciated, overappreciated. What does communication look like? in these moments. And then we spoke about this, but trying to normalize the power asymmetry here, I think that's really, really important too, because you're each very much in charge. Charge, right? You know, no one's leading the charge here. You're both on the same team. So it's about trying to normalize sometimes that unspoken tension.

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Rebecca Deegan

And just being respectful. You know, just like what I want someone what I want to feel like this, or if someone said this to me, how would I react to that? Everything is Uh I would say a lot of communication happens by text, which is good and bad, right? It's good because it's a quick message where you get a response, but it's also very black and white and can be taken out of context.

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Dr. Covelluzzi

people infer their stuff on tick tech so I say to everybody look for just very April fifth, that's my appointment, ten o'clock. Wonderful. But if you have to communicate more nuanced information Please pick up the phone. Exactly. Yeah. You will get so much more from the inflections and the tones. So yeah, it's about talking about those power asymmetries and trying to talk about sometimes that unspoken tension You know, because again, part of what we don't quite know is has this couple and this person, this family really, really come to a place of acceptance of working with a surrogate. So sometimes we're still dealing with um you know that trauma. Baby's not gonna be in my body. How am I gonna feel about this? And so it's about in my experience the the further along a person or a couple isn't accepting either due to medical reasons or you know whatever else comes on I don't have a uterus, whatever. It's about have I fully accepted this? And I think that alone can set a a foundational um a strong house, right? If you will because they will say, well there's no other way for me to do this besides adoption. I try this or you know we make the choice to not have children. And that's okay too. Yeah. Um but I think when people are struggling with that I should have done more, I could have done more, and why didn't I do enough? And my body failed me and it let me down and I'm a disappointment. That's the Those are very real, valid feelings. If you want to honor that, um though I would say to a couple, you know, if you're still actively struggling with that, I might encourage you to take a little bit of time um to process that before you choose to work with us surrogate because those are the those are the I think the the like like the tinder that could cause yeah tension.

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Rebecca Deegan

Um and s and so let's just say maybe a journey isn't going yeah well right um in one of those But well, I don't want to say worst case scenarios, but you know, harder situations. What is your role or a psychologist's role further down the line? Like is that something, you know, you're You're available. They can, you know, have one on one sessions. Maybe we regroup and and you know at the twenty week mark, let's have another group session and see how we get through to delivery.

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Dr. Covelluzzi

Absolutely. You know, and every couple, every match is very different, you know. You know, I think that part of what, you know, I sometimes struggle with in surrogacy or just, you know, being in this industry is that there's a lot of work done at the beginning and then we hope for smooth sailing. Yeah. We hope, right? And so, you know, I feel like as the industry continues to evolve and as we learn more about and as it becomes more talked about, um I think that whether it's a psychologist or uh an agency, I think there needs to be more touch points throughout this journey. And I think that whether it's, you know, on a curated basis, a case by case basis or what agencies see where the general stress levels are. Uh-huh. You say, hey, you know what, we're going to invite you in to have a meeting with a mental health provider or come into our off whatever it might be. I think I don't think there could be any harm, you know, absolutely not in touching along the way. So to answer your question, I think you specifically asked what was your question?

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Rebecca Deegan

Like down the line, like how does a psychology like what's your role?

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Dr. Covelluzzi

The role would ultimately to continue to make sure that everyone's seeing eye to eye, communicating clearly, feeling that you're need Needs are being validated and heard and respected. And if you need more from your surrogate or even less of, first of all, I've never heard a parent say need less. I've never heard I've never heard that. I've only ever heard, you know, so when I'm meeting with surrogates, I say In the a lot of cases I've ever worked, I've never once heard a parent say, My surrogate's talking to me too much. What does she want? Never. Never. So never. So I say to surrogates, lay it on, the more the merrier, the more you can do. You know, obviously. do it. I think that the parents would really appreciate that and that gets into that well of reducing anxiety and it makes the parent in my experience feel a lot more confident and comfortable with the surrogate that they've chosen. Yeah. Aside from the pregnancy, just as a person. Right. You know, I think that's the other hard part that we're, you know, it's like you're trusting her as a person, but as a as a professional pregnant person, and what does that look like? Right. Everyone has a different lifestyle. People We're gonna make different choices. But again, we're all trying to get from point A to point B as healthy as possible as long as she's daily making healthy choices, then this process, I hope, um will understand unfold the way that everyone most desires in healthy delivery.

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Rebecca Deegan

Right. And on the agency side too, sometimes, you know, the agency is the one who's managing the cases, right? So I think sometimes there are situations that arise where, you know, maybe it's a suggestion, you know what, I really think you should, you know, speak to the psychologist to try to manage this, right? Because sometimes it's a little out of the scope of the agencies.

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Dr. Covelluzzi

And it's oftentimes conflict. It's really it's what we've been talking about. It's oftentimes conflict or just not feeling heard or validated that, you know, my needs are important here, or I don't really appreciate that the surrogate, you know, is is I don't know, having a cheeseburger, for example, you know, and I Oh okay, well we can talk about that and maybe she absolutely you know her kids were starving and she had to stop somewhere and she was you know maybe it's not an everyday thing because we just don't know, you know, where people's mindsets go as well. Yeah. You know, and so

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Rebecca Deegan

Yeah, for sure. And so if you meet with somebody that does that is maybe higher anxiety, things like that, do you suggest, you know, maybe regular sessions?

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Dr. Covelluzzi

I say, you know, something I think that, you know, ultimately it's your choice, you know. I'm you know I'm not mandating or saying you must do this, I say, but you know, I think that might you be open to the possibility um um of additional support, whether it's with me or a person of your choosing or uh you know, somebody that you trust or f some anybody I think that you know for some couples and some for some peoples it's shameful and they don't talk about it or it's very insulated just to them right and they don't have a big support system so that's another thing you know that I'm considering when I'm working with couples is Do they have people to talk to? Do they want to talk about it? Is it shameful? Is it are they open about it? Um and so obviously, you know, if I have a meeting with somebody and you know know they're struggling and you know I hear a lot of psychiatric stuff and traumas that they've been through and they're crying and their you know their expectations are we'll say not realistic then absolutely I will say Hey, you know something, let me let me talk to the agency or let me let me reach out, you know, on your behalf. Let's create a plan for you here so that we make sure that you are well taken care of. Or, you know, maybe we push the pause button just for a little bit. And you know, get this handled a little bit better. Again, safety, right? Right. Safety for the family, safety for the surrogate as well, because we don't want the surrogate to be exposed either, you know, to a family's unrealistic um hopes or expectations either.

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Rebecca Deegan

Right.

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Dr. Covelluzzi

So that that can be really hard for a surrogate too. She's she's coming in blind, right? Saying, well, I'm doing this, I want to have a baby for them, but I don't want to be, you know, subject Stuff, right?

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Rebecca Deegan

Yeah. Well the surrogate is coming in is I want to give someone a baby and doesn't usually have very many questions and um, you know, is pretty open um to who she's willing to carry for for the most part. That, you know, um, you know, denying an intended parent profile is is is not not fairly common, you know, because they're just like, no, I love everybody, I want to help do you know, family have have a baby but on the intended parent side it's obviously much much more detailed yeah so yeah I think the I think it's just the difference in your mental just thoughts coming into this and where everybody stands, where one is very low and one is very high. And it's hard.

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Dr. Covelluzzi

It's hard to make those assessments, you know, early on. And it You know, and things evolve, right? Like I said, once it goes from theory to real, things really start to kick in. Yeah. You know, the hope here though Is that you know a parent has some time to get to know that surrogate, get to know that person, get to know a little bit of their background, their lifestyle, all that kind of stuff. And those are questions that I think are important for parents to consider You know, some parents are very busy, right? Some are super busy and they're like, look, I don't I don't have a whole lot of time to create that kind of relationship, and that's okay. Yeah. As long as they're aware of that and they know that at the beginning and they're like, okay, I can get that through this nine months of fine. Yeah. Great. And some surrogates are like, look, I want to have a best friend. I want, you know, to get really get to know that I want to feel like I'm making a meaningful difference, an impactful difference. difference in this person's life. And so for their mental health, I think it's important for them to match with the right couple too.

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Rebecca Deegan

Yeah, that comes in the in the early stages of of matching to make sure that everybody aligns on that.

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Dr. Covelluzzi

Yeah. And things shift and evolve, right?

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Rebecca Deegan

Well and and you don't know sometimes if you want to be a best friend because you don't even know these people. Correct. And they don't know you. And so it's a very hypothetical I can I can understand being in the middle of like, I want to vibe naturally and if it becomes a best friend, great, and if it doesn't, that's okay too. We're respectful of each other. We all came in for one end goal of a baby and we're making go our separate.

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Dr. Covelluzzi

I've hired my movie star, we'll direct, you'd star and Great, and then we'll revisit that movie every so often because we enjoyed it or we won't. That was not a very good movie. And so I it's uh you know, I I talk to parents about that and they usually can get Behind that and say, oh, okay, all right, I get that. Yeah, cool.

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Rebecca Deegan

Yeah, that way there's not like a very high expectation of what to expect after.

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Dr. Covelluzzi

Yeah. It's like it's just it's kind of lowering those expectations, but creating a realistic expectation.

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Rebecca Deegan

Yeah. So if there were three things that you'd want every intended parent to know about the emotional side of this journey, what would they be?

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Dr. Covelluzzi

Oh boy.

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Rebecca Deegan

Just three. Just three. I know there's so many.

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Dr. Covelluzzi

Take your time at the beginning. I think that really curating the kind of experience that you think you want at the beginning can be really helpful. So I want you to think about all those factors of dating, you know. What what kind of lifestyle and personality and where she lives and how you know, I want you to think about who you want to date and if it takes a little bit of time, great. And if you're a couple, I want you to really You know, go in separate rooms and I want you to jot down all these characteristics that are important for you and then come back together and then try to have that conversation and then say these are the things that really looking for in a surrogate. So I'd say take your time at the beginning is the first one. Just take your time. And we talked about, you know, people are ang and they want to do it quick quick. Take your time time I think that like choosing a life partner, right? You you know some people make choices really quickly and some and some are a little bit slower. Sometimes it works, sometimes it doesn't. Correct. So in this case we want to take a little bit more time. Okay, so take time. The next thing I'd say is to be psychologically flexible and to have psychological nimbleness. and to you know expect that things aren't gonna evolve and unfold exactly curated to the way that you want them to be, but that's not bad. As long as it's falling within, we'll say, you know, it's like driving. You know, you're gonna you're gonna swerve a little bit, but as long as you're staying within the lines, be flexible. Try to be flexible. I think the more you can be flexible with your surrogate, the process and adept. I think it's gonna help create um a feeling of um say safety. Yeah. And the last one I think you can have fun and and and I think that you know, creating I say this to a lot of couples. I I really want you to keep a journal. I think it's important to chronicle and to journal the experience. Good, bad, not so good, because you know what I think it does? I think that it it's a beautiful love letter that you're essentially writing to your child. And I think that you can revisit it in a year, two, three years from now, and then share it with them. Because sometimes what we haven't talked about is some parents ask me, well, do I talk to my my child about surrogate and what do I do and do I not? And I think that if you put a little therapeutically I think it's one it's really a good to keep this journal and to write thoughts and questions about what you think your child's gonna ask you why you're doing what you anyway all that so I think it's good for the parent but secondly I think it's just a it's a it's a it's a love letter it's a book it's something that you've put together and you can revisit it and your child will go say, great, I want pizza. I don't really care. It doesn't really matter. But more importantly, it's the ritual. I think that's what I'm trying to ground people toward is the ritual going through it and feeling like you have some attachment. And then not only will you have, I hope, a healthy baby, but you have this other document that you and it's a live document that you can share with your child later on. Whether you use it or not, it's irrelevant, but the fact that you've done it, I think already steps into, you know, the role of being a parent.

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Rebecca Deegan

Yeah, I love that. No, those are great. Those three are great. I mean there's so many. It's hard to choose. I know that's why I was like, okay, he's gonna be like all yeah.

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Dr. Covelluzzi

It's hard to choose.

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Rebecca Deegan

I will say um journaling I think in general, even on the surrogate side, I would I journaled during my surrogate journey, um, even just to go back and look and be like the emotions that I felt and things like that. I think sometimes, you know, life can feel overwhelming. You're dealing with your own life and and whatnot. But just to like just to touch on that a little bit, I think it's good for both sides just to, you know, get out your feelings. Um, you know, you're taking meds and you're doing all these things. And so I did it kind of started it for like a med journal. And then it kind of just like evolved and said, oh, you know what? I'm just gonna write all my feelings down and, you know, just You know, putting it out into the universe of this is gonna work.

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Dr. Covelluzzi

you know, culture these days and that's fine. If you'd rather type it, fine. But I think that there's something therapeutic about picking something up and writing it down. I don't care if you start drawing a picture. Yeah. It's just something that you can do. I think it's

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Rebecca Deegan

It just gets it out of here and on here and then you can just, you know, release it.

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Dr. Covelluzzi

Absolutely. Or revisit it later. Yeah. If you're having an anxious day Be like, you know what I say to people in therapy? It's like, you know, try to get that thought out, write it down, look at it for about 10 minutes and then put it away, say that is gone now, and go to the next activity and then maybe you revisit it in an hour or two and oftentimes. what you might find is that that thought isn't as big or scary or as uncomfortable. So I think it can really just reduce it and create a little bit of sense of control over something that

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Rebecca Deegan

can feel it out of the Yeah. I love that. Yeah.

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Dr. Covelluzzi

I mean there's so many I could talk all day.

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Rebecca Deegan

I know, I know. Okay, so just to conclude. What would you say to somebody who's about to go through this process that's feeling anxious or maybe, you know, emotion emotional or, you know, just the complexities of this journey? What would you say to them?

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Dr. Covelluzzi

Boy, I would I would say, you know, thr really revisit why you're choosing to do this and trust this process. Trust that, you know, people have been there ahead of you. People you're hiring a team. Trust that that team is going to get you from point A to point B. as safely and as quickly and as as to the best it as as best they can um and that you know accept whatever is going to happen in advance is what I'd say. I think that that alone can provide a lot of grounding uh throughout this process. I think that not losing sight of your lifestyle, your choices, your social relationship relationships and trying to still live your life is incredibly important because I I think that many couples, because there's such a vast amount of money, um hope, fear, excitement, hurt, want, I mean you name it as a gamut of emotions, it's all kind of laying on this. And that's a lot for a surrogate. know to take on too right. And I hope that that can reduce some of the anxiety and then reach out You're not alone. You know, there's people who've been there, they've done that. Um there's psychologists uh who have been there, done that themselves, or you know, family members or friends or people in your agency oftentimes. can really help you. Yeah. But you don't have to do it alone. I think for some couples the shame is pretty significant and they're afraid to talk about it. You know, based on where they live or whatever it might be. And it's okay to have a trusted person to talk to. Somebody who's neutral, who's not gonna judge you and just allow you the ability to get it out And you know, maybe it's just, I don't like the shoelaces she's wearing. It's making me uncomfortable. Okay, well, it doesn't matter. It's whatever. But as long as it gets out, I think it can make somebody feel really grounded and and supported. Yeah. So I mean there's so many.

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Rebecca Deegan

I love that. Okay, well with that, Dr. Kovalisi, thank you so much for joining us today. Thank you all for joining us on the Surrogate Buzz today and chatting with Dr. Covaluzzi about the psych process. This has been very educational. I hope you guys feel the same. Don't forget, like, subscribe, and comment, and we will look forward to seeing you next time.

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