Stop. Sit. Surrogate.

Inside The Surrogacy Journey With A Clinical Case Manager

• Kenedi & Ellen Smith • Season 5 • Episode 32

Share episode

What if one case manager guided both the surrogate and the intended parents—from the first profile exchange to baby photos years later? We sit down with Nina Simmons, case manager and clinical support manager at Northwest Surrogacy Center, to explore how a unified model reduces miscommunication, deepens trust, and creates a steadier surrogacy journey. Nina pulls back the curtain on the real work behind the scenes: coordinating clinics and legal timelines, keeping everyone informed, and offering trauma-informed support when emotions run high.

We talk about the head-and-heart balance that keeps a match on track: the administrative structure that provides safety and the relational care that builds confidence. Nina shares practical ways to set expectations early, from communication preferences to boundary setting, and explains how transparent group conversations help resolve friction before it grows. She also addresses common challenges—loss of control for intended parents, boundary fatigue for surrogates—and shows how predictability and clear options restore a sense of agency. IVF is powerful but not absolute; offering choice, clarity, and steady presence helps everyone breathe through the unknowns.

You’ll also hear how the pandemic reshaped matching and support—Zoom meetings, online groups, and a renewed desire for in-person connection—and why ethical guardrails matter when choosing an agency. Nina’s guidance on vetting compensation packages, reading the fine print on lost wages and insurance, and understanding state-by-state legal pathways is essential listening for anyone considering surrogacy. If you’re searching for a model that honors both people and process, this conversation delivers practical insights and real hope.

If the conversation resonates, follow the show, share it with someone who needs it, and leave a quick review to help others find honest, human-centered surrogacy stories.

Send us a text

https://stopsitsurrogate.com

SPEAKER_02:

Welcome. We are a mother-daughter podcast about all things surrogacy. Together, we have brought eight beautiful babies into this world, and we would like to share through education and knowledge about surrogacy with those who want to educate themselves on the topic. This is Stop, Sit, Surrogate.

SPEAKER_03:

Have you ever thought about growing your family but aren't sure what your options are? Or maybe you're someone who wants to help others experience the joy of parenthood? That's where Northwest Surrogacy Center comes in. Northwest Surrogacy Center is a full-service surrogacy agency that guides intended parents and surrogates through every step of the journey with compassion, transparency, and personalized care. From matching to legal support to emotional wellness, they make what can feel an overwhelming feeling immediately human and supported. Whether you're considering surrogacy to grow your family, or you're ready to become a surrogate yourself, the Northwest Surrogacy Center is there to walk beside you every step of the way. Visit the Northwest SurrogacyCenter.com and at NWSurrogacyCenter.com to learn more and to take the first step towards something truly life-changing. Northwest Surrogacy Center. Love makes families. Hi everybody. Welcome back to Stopsit Surrogate. We are here today with a very special guest. I'm very excited to speak with her. So would you like to introduce yourself?

SPEAKER_04:

Yes. Thank you so much. I'm so happy to be here. My name is Nina Simmons. I am a case manager and clinical support manager at Northwest Surrogacy Center.

SPEAKER_03:

Oh my gosh. Okay, so what is that?

SPEAKER_04:

Yes, sure. So as a case manager, our role is to walk alongside GCs and IPs. And I think I guess one thing that I should preface before we move forward with our conversation is I will use abbreviation. So GC is gestational carrier. You'll often hear me interchange that with surrogate. And then intend IPs is for intended parents. So just to get that out of the way. So case managers walk alongside GCs and intended parents from the time of a profile exchange through having a baby and oftentimes beyond. This includes things like navigating, outside monitoring appointments, travel, communication challenges, insurance, emotional support, and just providing a wealth of support through the surrogacy process.

unknown:

Wow.

SPEAKER_03:

Okay. So you're there from like get-go all the way through.

SPEAKER_04:

Yeah. Pretty much, yeah. So from the time that intended parents receive a profile, that's when they're assigned a case manager. Um oftentimes we're working with people for probably about 13 months, sometimes longer if things don't go as planned. And so case managers really develop like an in-depth relationship with people. And so that's when I say, like, and beyond, oftentimes we're receiving photos and milestone pictures of baby for years.

SPEAKER_03:

So fun.

SPEAKER_04:

What a like a fun perk.

unknown:

Yeah.

SPEAKER_04:

I love it. That's the best part. I'm like, if you have a baby and you're in Portland, please come see me so I can give all the snuggles that I can.

SPEAKER_03:

Um, I love that. Um, okay, so case so case manager, are you do you do both sides? Did you say that? Am I did I like miss that part? Sorry.

SPEAKER_04:

Yeah, no, that's okay. Like, but so yeah, so case managers at Northwest Surrogacy Center are this, you'll have the same the surrogate will have the same case managers as intended parents. Oh, and they know that that is different than some other agencies. Very different. Yes. Yes. And so the reason that we do that is for a holistic picture. Um, we believe that trust and communication is the foundation of surrogacy. And why not have the same person be your case manager through the whole process? Because um, we're working as a team.

SPEAKER_03:

Well, and I can speak from experience, it's very annoying when your case manager changes about 20 times during the journey.

SPEAKER_04:

It's tough. It can be so tough, and it can really impact um how the spheres of journey goes and how people feel supported through the process.

SPEAKER_03:

Yeah, absolutely. Now, I do have like a little side question because I know a lot of people are gonna be thinking this and being like, why aren't you asking this? Okay, so because it is a little different, right? To have one case manager for both sides rather than one for each individual side. And the the explanation I was always told is like, oh, you don't want any bias or case manager likes, you know, one person more than the other. Is there is there anything that like pulls you into one direction over the other, or like you're just like very neutral?

SPEAKER_04:

No, I I um gosh, I know people ask that question, and I know listeners are probably wondering that question, but I I don't in the seven years that I've been doing this work, I don't feel pulled in one direction or another. I truly, from the get-go, like at profile exchange to moving through forward with the matchmating, um, we're very transparent about how this process is gonna go. And so it is so collaborative and um um like there is not one thing that an antenna parent knows that a surrogate doesn't know, etc. Like all the communication is wholesome and everyone's in the communication together.

SPEAKER_03:

Okay. That's the and I think that's a huge benefit. Again, speaking from my own experience, just there's a lot of things sometimes that are left out. And then, like, and it maybe not, maybe sometimes it's not even on purpose. It's just like, oh, we told them, you know, we told the IPs this. Oh, so sorry that we forgot to CCU on the email GC. Like, you know, like, and it just it's a lot of the times I know it's not intentional, but so it is nice. I do see the perk of having just like one home base and being like, hey, she has all the information. So just go straight to her. And she has a relationship with both sides. So if something go into another question, sorry, I do go out of a little order. I'm sorry. Totally fine. Normally it's my mom who goes out of order. Um so oh gosh, I just had a brain fart. Um, oh, so when a when a when a situation arises, if it does, where there's like a complication or a conflict, how does that work? Or do they come to you right away? Like I would assume they feel comfortable enough because it's you the whole time.

SPEAKER_04:

Yeah. So um early on, like I said, we we we start relationship building. And I think that creates safety for people. Um case managers oftentimes are doing regular check-ins. Like we are not, I think one of the misconceptions about case management is is that we're only there in the event of an emergency or crisis. And that's just not true. Um, so we're so doing these regular checks-in, check-ins with intended parents and surrogates, I think helps build rapport and trust and so it is more likely that people are gonna come to us when there is an issue. And being both sides case manager, oftentimes I'm like, let's talk about this as a group. What do both people need? What do you need to move past this? What do you need to feel supported? What do you need? And and and that helps strengthen intended parents and gestational carriers relationships with one another. That when that relationship gets really strong, like the whole is like you guys communicate and you don't need me as much because your relationship is so strong and you and you trust each other so much.

SPEAKER_03:

Does that make sense? No, that makes perfect sense. And I think that that's I think that's the beauty in this. Absolutely. Oh my gosh. All right. Gosh, I kind of wish I had an in-between. It would be nice. It's just, you know, to have both sides. You're you have both stories already. Nobody has to catch you up on anything. You're not like, oh, let's see the emails. Is that really what was that? Like you have already. Probably, I'm gonna assume, maybe therefore makes less complications and conflict.

SPEAKER_04:

Potentially. I wouldn't say that it I wouldn't say that it necessarily makes less complications or conflict, but what it does is creates um a strong sense of support.

SPEAKER_03:

Yeah.

SPEAKER_04:

For when those things arise. Yeah.

SPEAKER_03:

Yeah. That makes perfect sense. So now we'll just like kind of work back. So what led you to join Northwest Surrogacy Center back in 2019?

SPEAKER_04:

Yeah. So let's see, uh, previous to Northwest Surrogacy Center, so I'm a licensed clinical social worker. I um have a background in perenatal mental health and complex grief. And so um my work previous to Northwest Surrogacy Center was working with mothers who had lost children due to a violent occurrence. And I it was tough work. And in and in that work, I um kept hearing a pattern. And oftentimes women would talk about previous miscarriages that they had or early pregnancy loss when they were in therapy talking about like losing the recent child that they had just lost. And so I said, gosh, there has to be something um to like this loss of pregnancy and miscarriage. And then I got into perinatal mental health, and oddly enough, I was looking for um the happier side of things too, because in that like deep grief work there that I was doing, there was no like happy ending.

SPEAKER_06:

Oh god.

SPEAKER_04:

To move forward, I found surrogacy, and there was pregnancy loss still, there was miscarriage loss still, there was pregnancy grief wrapped around that. But the it was met with hope and a baby in happiness. And I was like, Oh, that's right up my alley, that's what I'm looking for. So in 2019, not knowing much about surrogacy, I applied to Northwest Surrogacy Center, and it has been a fun journey.

SPEAKER_03:

Oh my gosh, I have to pause and say, bless your heart. That's a lot. Like, I'm like over here immediately depressed because how sad, like I can't, I can't imagine. Like, oh my god, because you're absolutely right. Like you said it in the best way, right? What you were doing before. There was no, there was clearly no hopeful outcome.

SPEAKER_04:

Like, what do you know? Yeah, I was like, what do you do with that? Like, that's just met with complex grief and no, there's nothing I could do to fix that. Um yeah, and so that's that's what led me.

SPEAKER_03:

Oh god, bless your heart. I'm so happy you're on the happier side of things now. It's good. Yeah, no, that's what a leap, but also not kind of like goes in a little of the same path. But that's so amazing. Wow, you're such a good person.

SPEAKER_06:

Thank you.

unknown:

Um, okay.

SPEAKER_04:

So uh how would you describe your oh wait, we already did that. Don't oh, but you know what I didn't explain though, Kennedy, is like my other role as a clinical support manager. So I don't know. Oh my gosh, how fun! I was just gonna ask them.

SPEAKER_03:

I was like, wait, do we want to go over that? No, we've been awesome. Okay. Um, how would you describe your role as both a case manager and clinical support manager? Yes.

SPEAKER_04:

Um, so my role as a clinical support manager is to provide a safe and non-judgmental space to um GCs to talk about the nuances and maybe the complexities of surrogacy. And so my colleague Veronica, who I know you know very well, um and has been featured on your podcast, created Beyond the Surface, um, which is a support group for the surrogate community. Um, it is inclusive to surrogates who have maybe graduated their surrogacy process and are no longer moving forward with surrogacy, to um women who are thinking about becoming a surrogate, to women who are like in the thick of it and pregnant and cycling. Um and in this group, we often talk about things like when surrogacy doesn't go as you expected. Um, we talk about loss and grief. We talk a little bit about self-care and stress management. Um, and the goal of these groups is to create a safe space for surrogates to share their stories and to share what's hard about surrogacy. And what we saw and what we continue to see with these groups is the community that's built within these groups of women connecting with other women who have been through it and get it. Um so that has just been um a really rewarding um part of the process to be in.

SPEAKER_03:

Yeah, absolutely. Oh my gosh. Gosh, you're just doing all the things. Jeez. Oh my goodness. Um, okay, so for people who may not understand nope, don't do that one. Oh, well, okay, maybe we'll ask it. Okay, so for people who may not understand what a case manager does, how would you explain your day-to-day work?

SPEAKER_04:

But I think you kind of already said that, no? Yeah, we can we can go through it and you can have me to answer. Um with case management, I would say that no two days are the same, which is I I love the that's probably part of why I love this job, is it kind of keeps me on my toes. Um, on any given day, we may be helping a surrogate navigate a difficult conversation with intended parents or checking on medical updates from blood work that was just completed to coordinating appointments to providing emotional support. Um, case managers are constantly problem solving, answering questions, and just keeping everybody on track. Um but I think the core of our work is just really about being consistent in a supportive presence to everyone involved.

SPEAKER_03:

Yeah, no, and I think clearly you do that very well. We hope that's the thing. I've only heard good things. Um, so how do you balance the administrative side of the role with the emotional and relational support aspects?

SPEAKER_04:

This I really think is a balance of head and heart.

unknown:

Okay.

SPEAKER_04:

And what I mean when I say that is the administrative side, I think, keeps the journey on track, and the relational side keeps people feeling supportive and understood. Um, balancing the administrative side of my role with the emotional and relational aspects is really about me staying grounded in the fact that they're both equally important to have in like a successful surrogacy journey. Um I think the administrative side of things, like when I'm thinking about timelines and documentations and communications with the clinics and making sure that everyone's meeting requirements creates uh structure and safety, but like the emotional support is what creates the trust, the connection, and the positive experience.

SPEAKER_06:

Okay.

SPEAKER_04:

And so um staying grounded in both of those things and knowing that both of those things is a job as a case manager, um, helps balance both of those.

SPEAKER_03:

Yeah, and you you definitely need to they're they're equally important.

SPEAKER_04:

Yes, absolutely.

SPEAKER_03:

Yeah, absolutely. Yeah, and so to balance them is is the key. I know sometimes it's hard for sure, probably, but definitely, definitely needed.

unknown:

Yeah.

SPEAKER_03:

Uh what are some of the most common challenges intended parents and surrogates face, and how does your team support them?

SPEAKER_04:

Um intended parents and surrogates, I think, face different challenges. Um, both groups are navigating something deeply emotional. Um, and so I guess each match we have to come at it with a different perspective and a unique perspective. I think oftentimes for intended parents, the challenge is the loss of control. Um they've often been through infertility loss or years of treatment, or same-sex couples have grown up with the belief system that they're never going to have biological children of their own. And so now they're trusting somebody with the most important part of their life. Um, and I think that not having that control, all of that control, creates anxiety and fear about the unknown and just a lot of questions. And so we support them by giving clear communication, um, preparing them for what to expect, offering emotional check-ins throughout the process, um, and just help them build a healthy relationship with their surrogate. Um for surrogates, I would say surrogates are helping people, right? And so they're oftentimes our nurses, our our teachers, and uh, you know, not all the time, but that is a that is a large population of the surrogates that we work with. And so helping them navigate boundaries and emotional expectations, um, because they are always wanting to connect, they're always wanting to make sure that they're doing what's right, they're always wanting to make sure that their intended parents are happy, and yet they're busy women with children and families of their own. And so helping them um just create those healthy boundaries, um, I feel like is what surrogates have challenges with.

SPEAKER_03:

I agree with that. Like I agree. It's very hard to uh navigate, especially the first-time surrogate. It's very hard to navigate things because you don't know what you don't know, right?

SPEAKER_04:

So there's so many appointments and um medication calendars and so many things that you're staying on top of, along with your children, your own children's sports and school and um family life and you know all the things.

SPEAKER_03:

Yeah, it's uh it's not to overwhelm people, but it it it can if you're not an organized person or like you're not like how do I how can I compartmentalize it?

SPEAKER_04:

It is very challenging, not impossible, just definitely not impossible, and that's why we have case managers to help people walk through the process, exactly.

SPEAKER_03:

Exactly. I know just beautiful souls like yourself. Yeah, I love it. Um, what misconceptions do people often have about the case management process? I have one. I can tell you what I think. I was gonna tell me. Okay. I think because like I know a little bit more now, now that I'm like been in this industry for so long, but I really was just like, why are you there? Like, I don't need you. My God, like right, like, because like as a first-time surrogate, I'm like, what are you doing? You're not doing anything. You're just you just text me, hello, how are you? I hope you're well. Like, you know, like I at first I was just like, what are you really doing? But I believe now it is, oh, it's a lot. You guys do a lot behind the scenes. Like it's a lot of the paperwork, the nitty-gritty, the tedious things. I mean, maybe I'm wrong, but I know that that definitely is part of it.

SPEAKER_04:

Yeah, absolutely. Yeah. Um, I'm so glad that you brought that up because I think many people come into the process thinking the same exact thing. Um and the the truth is that paperwork and like documentation is a part of it, but it's not the biggest part of it. Um, I don't think that people realize how much emotional guidance that case managers are there to provide and can provide to help prevent conflict, um, to help relationship build. Um, most people who have never done a surrogacy are like, hey, what do I talk to my intended parents about right now? Or intended parents are like, hey, I'm not really sure how to um talk to my surrogate about X, Y, or Z. Um, a lot of people say that the match meeting feels like a blind date. And so you go from like into a blind date to like moving forward together, and you know, and there there can be this sense of awkwardness. And so um case managers are here to like build that gap um and provide support. Um I think another misconception is that people only think that we're here for the big issues. I think I I talked about this a little bit earlier, but like medical emergencies or legal concerns. Um, but the day to day things matter just as much.

SPEAKER_03:

Um can you give an example of like what a day-to-day thing would be?

SPEAKER_04:

Yeah. Um I think supporting like intended parents through anxiety, um, or making sure that everyone feels informed or connected. So for example, like uh you you talked about this earlier in your own experience. Um, the clinic will write the intended parents an email and leave out the the surrogate.

SPEAKER_06:

Yeah.

SPEAKER_04:

As a case manager, that is something that I'm noticing and recognizing and bringing everyone together so that everyone feels included. Um I recently just had a surrogate who um had an emergency situation where she had to have surgery. Um, I've called and checked in on her almost daily, you know, and thinking about like what are her favorite snacks? What are things that she really enjoys? How can she, as an individual, feel most supportive? It's not the same through and through. And so as a case manager getting to know everybody individually, I get to know these like special things about people.

SPEAKER_03:

Yeah. Which is a really big that's like a big ask of you. And like, and not that anybody's not that anybody's like asking of you. You're just case managers have really big hearts. And if you're a good case manager, which clearly you are, but if you're a good one, you know, you definitely do put in that extra effort of like, let me get to know you as a person and like let me like show you I am here for you. I listen to you, I know I know you, like I'm here for you. And I think that that sometimes gets lost, sadly, in some places in this industry for sure. But um no, I I I it's a huge part to be hard.

SPEAKER_04:

And we try from the get-go to to really be human-centered, I would say. From the time that that people contact us and say, hey, we want to be a surrogate with your agency, walk us through the process, is um we try to be genuine about connecting with people and learning about who they are and learning about their families. And I can say that from like our screening team through our case management team is that strong relationships truly are built. And um I would say as important it is to me, I'm confident it's important to everyone else, like on our team.

SPEAKER_03:

Oh, yeah. I'm I mean, we've talked to several people from from Northwest. Yeah. And it's funny, we actually have had talked to several surrogates from Northwest. Oh yeah. Like I don't even know by the time they come on, and like when they're on, they're like, Oh yeah, can I mention my agency? I'm like, sure. And it's funny how many I should just like make like a little like a little thing because it's and I'm like, oh wow, this is amazing, like it's great. So definitely what you guys are doing is definitely like working for sure. Um and yeah. We'll be right back. But first, I want to take a quick moment to talk about something close to my heart, helping families grow through surrogacy. If you've ever thought about becoming a surrogate or if you're an intended parent ready to start your journey, Paying It Forward Surrogacy is here to guide you every step of the way. At Paying It Forward Surrogacy, you're not just a number, you're supported, celebrated, and connected with real people who've walked this path before. Whether you're just starting to explore or ready to take the next step, they'll make sure you feel informed, empowered, and cared for from day one. Visit Paying It Forward Surrogacy.com to learn more. That's Payingit Forward Surrogacy.com because every journey to parenthood deserves heart, honesty, and the right support. Now let's get back to the episode.

unknown:

Okay.

SPEAKER_01:

Like some of these are already talking about You're already making me feel comfortable.

SPEAKER_04:

Thanks. I just for like a general conversation. Even if you don't have like you not having the questions completely picked out, I'm like, oh yeah, no.

SPEAKER_03:

Because you know what? Like I said, it just kind of goes off, and then it's like, well, we already lumped those together. So scroll down. Uh let's see. Oh, that's interesting. Okay. What here's an interesting question. What trauma-informed approaches do you find most effective in your work? Does that apply?

SPEAKER_04:

Yeah. That's a great question. I think trauma-informed care is is huge in how I uh uh approach anything, any conversation, any any situation in my work. Um, many intended parents and even some surrogates have experienced at least some form of medical trauma or infertility trauma or just past loss of of some kind, right? And so the most effective strategies I use to come back um to like the core principles, I guess you would say, of trauma-informed care is safety, trust, and empowerment. And so what does that look like? Um slowing things down and giving people choice where I can. And so trauma, like not to get into the nitty-gritty of things, but trauma often leaves people feeling powerless. And so offering options that can be how do we communicate, how fast you want to move through a decision, or what kind of support you want gives people a sense of control. Um, another key approach that we work on as a case management team, we talk about this all the time, is predictability and transparency. Explain what's happening, why it's happening, what are the next steps are. Um, when people know what to expect, their nervous system can settle down and they can come in like more confidently and calmly into a conversation. Um the other thing is like when people are angry about something, oftentimes, like let's say uh there's a delay of some kind or um the outcome wasn't what they expected, and people are upset. I'm really listening for what is underneath that anger. Is it fear? Is it grief? Is it overwhelm? Is there a need that hasn't been met? And how can I meet that person where they are? And all of that is a trauma-informed approach, bringing back safety, trust, and empowerment.

SPEAKER_03:

Okay. No, it makes sense, yeah. No, it makes sense. That's no, that's amazing. That's safety, trust, and empowerment, right? That's what you said. Safety, trust, and empowerment. And I think that those are definitely things, especially when people feel anxiety. And I think trauma brings anxiety, right? Like it's definitely, it's all part of your nervous system. So yeah, when you have the safety, you can calm a little. When you can trust someone, you can calm a little. When you feel like you're in control a little, you can be like, hey, I wish I felt that every day.

SPEAKER_04:

And let's be honest, like the the the process of like IVF in general has little room for control. You know, there's a medication counter there, um, there's like, where are you at on your cycle? Where's your lining at? Like we don't have control of a lot of these things. And so gaining options or gaining control when we can is so helpful in the process.

SPEAKER_03:

Yes, I completely agree. Yeah, IVF is IVF is great, but it's definitely uh I always hate I maybe I'll get a backlash for this, but it it is a how I've always looked at it as like a gamble. Like you can do everything that you possibly can, but like at the same time, science is science, it can only go so far. And everything that you can do can only go so far. And unfortunately, it's just not the hundred percent that everybody hopes and dreams about. Yeah. I think it's I think it's well above 60%, maybe.

SPEAKER_04:

Yes, I mean, medicine has come a really long way, especially when it comes to IVF. Um, and and like we're thankful for that. And at at the same time, I the way that I always explain this to people is um while medicine is great and there is a lot of control that we do have in medicine, surrogacy and IVF also includes a human part of the process. And and that's the piece that like oftentimes we don't have control of. Um we just do the best that we can. And oftentimes that leads to success. And we love that. But there are times when that that isn't the outcome that we'd hoped for. Exactly.

SPEAKER_03:

Exactly. And and that's okay. Yes, okay. Yeah. And to try again. I like I really do like what you said in the beginning, is that surrogacy has the ending of hope. Yeah, it's just like it's I love I love that you said that. I'm like, that that's very true. And there's always hope in surrogacy.

SPEAKER_04:

And I there's always hope in surrogacy. I mean, I think this sounds so cheesy, but I think about this all the time. Um, but when I think about surrogacy, I often am thinking about like there is profound grief. Surrogacy is not the first choice that people have of being a baby, right? Like people didn't come here as option one.

SPEAKER_03:

Be that louder.

SPEAKER_04:

Be it louder. Um, and so so the so the grief at some point is a part of surrogacy, but it collides with hope. And it creates um it creates such a beautiful process. It's part of what keeps me in this job. I think it is so rewarding and so um, I I don't know. Oftentimes it leaves me speechless because I don't think we have enough words for like you two strangers are meeting. Someone who can't have a baby, and someone who's saying, Hey, I'm here to help you. And that's like incredible. Um yes, like that just sorry, that goes back and I got fired up. It goes back to Oh, you're good. Uh, there's always hope in surrogacy.

SPEAKER_03:

Yes. I new new tagline. I love it. How has Northwest surrogacy center evolved since you joined in 2019?

SPEAKER_04:

Oh, this is a fun question because I measured this by pre-pandemic and post-pandemic because I've I've gotten the the um the ability to be with Northwest Surrogacy Center before the pandemic happened during and after. And I think that that has uh changed so many things. I I think and that's true for everywhere and for everybody. Um one of the things that I noticed is like in early 2020s, um there the online growth demand has continued to increase. And so we've created like these online online support groups. We've created um online webinars with with special specialists for intended parents or for surrogates or meet a surrogate online. All the this online presence has really grown um versus where it was when I first started with the agency. And then after the pandemic, we saw this increase of like human connection again and people wanting to meet in person. And so we moved forward with like meetups in person and um support groups in person and doing match meetings in person, which doesn't match meetings in person was the only way that we did things prior to the pandemic.

SPEAKER_01:

Really?

SPEAKER_04:

Oh yeah. People would fly, fly to like do the we would fly surrogates and antenna parents and the case manager, and everyone would do their match meeting in person. So that's an example.

SPEAKER_03:

That's so fun and old school, just like side note, that's the only way my mom ever matched too was in person. But my all three of my journeys, one of them was mid-COVID, but the other two weren't. They were but they were international. So that is the difference. But I uh I was only ever online with people.

SPEAKER_04:

That is I'm happy that you said that, Kenny, because caveat international has always typically has been online, but for the most part now, even if we have uh a survey pretty close by, and intended parents are close by, we're often doing match meetings still via Zoom. Like I thought you were gonna say in person. Still Zoom. So that that was a change from like when I first started to where we are now. Yeah, okay.

SPEAKER_03:

You know, it just makes it easier and people are more comfortable in their homes, kind of thing, maybe, right? Like so, but I do think it's cool. I do I do think it's cool to like meet them in person.

SPEAKER_04:

Yeah, I mean, old school times where we didn't meet in person, it was really funny because people who get along so well had look out in the parking lot and they would still be out there chatting with long after the match meeting.

SPEAKER_03:

Yeah, just hanging out, yeah. So funny when my mom matched with her triplet journey, they like went out to lunch after. Like the agency was just like, see you guys later, like whatever. And they like bestest of best friends to this day. And I'm like, maybe I should have met someone in person. Maybe this is where I went wrong. It's fun. We live and we learn. Oh my gosh. No, that that that is a huge change. And I think a lot of benefits came with COVID. I I hate to say it like that, but like you know what I mean. Like in the sense of the way that the industry kind of does things now.

SPEAKER_04:

Yeah, when I think about home visits, like home visits get done much quicker and through the screening process because social workers do, I don't do home visits for Northwest Sergio Center, but um so social workers outside the organization are able to do it over Zoom and just it helps with the screening process.

SPEAKER_03:

Side note, Nina, I never had a home visit.

unknown:

Wow.

SPEAKER_03:

I don't know why. I never in all of your journeys? Never. Never. They didn't ask me to walk around my house, they didn't ask for pictures, they didn't come to the house, like nothing. And my mom was like, that's not normal. I'm like, it's normal for me.

SPEAKER_04:

Yeah, I mean, I guess if you don't know, you don't know.

SPEAKER_03:

Yeah, but I didn't realize that that was a thing until this this last journey of mine. But I don't even know if I did it then. I might have. I don't remember now, but wow, but yeah. Again, I um things change. Yes. Even within the past 10 years, things have changed.

unknown:

Yeah.

SPEAKER_04:

Um, I would say home, I mean, since I've been with Northwest Target Center, home home visits are a standard part of our screening process.

SPEAKER_03:

Can we can I can I kind of like go off a little and just ask? Because I I know home visits scare a lot of people, especially first-time sargists. So, like, what do I need to like spot clean my house? Like, what are you like there's no rats, I promise. Like, you know, like you know, there's like a dirty pile of laundry in the corner because you know, my kid was sick last week. Like, you know, all these things. And I do know the anxiety that comes wanting to like be like, look at my house is immaculate. Um, what is the purpose of a home visit?

SPEAKER_04:

Yes, I can rest assured it is not to make sure that your house is the cleanest house on the block. Um, so if you're if your house is messy and lived in the understood, what really we're looking for is is your home a safe place to carry a pregnancy? Do you have hot running water? Do you have heat? Do you um oftentimes social workers want everybody who lives in the home to be in the home to see how everyone interacts with one another? Um, do you have guns? And if you have guns, are they spin a safe? Are they locked up? You know, um these are things that a social worker is looking for.

SPEAKER_03:

Okay. And it's normally a social worker who does the home. Yeah. Okay. That would make sense. They know they know what to look for. I never thought of the gun thing because I don't have any. Interesting. Good. I'm glad that that's glad that's on the checklist. Um let's see. Oh, how do you train or mentor new staff or case managers? Do you have and how many case managers are we? Let me think. Hold on. Put you on the spot.

SPEAKER_04:

I know. There's seven of us. I should know this. Like, wow. We're very close and at tame.

SPEAKER_03:

How many cases do you take on?

SPEAKER_04:

Typically, an average caseload right now, I think, is like 35 to 40.

SPEAKER_03:

Oh my gosh, 35 times like four, right?

SPEAKER_04:

Yeah, you you're the first person that has like acknowledged that or noticed it. Yeah, I mean, because we're the case manager for the surrogate, for the intended parents, partners, you know, everyone that that's involved in the process plus the clinics. Um oh my god.

SPEAKER_03:

But I I was a case manager, I think, for like a week. And then I but I was still doing like a full-time job, and they were like, Oh yeah, maybe it's for you.

SPEAKER_01:

And I was like, No, it's not for me. Yeah, that would that would be that would be tough.

SPEAKER_03:

Yeah, yeah. Wow, that's that's a lot. 35 cases, that's that's 35 pregnant women at I know they're not all pregnant at the same time. I know there's different like essentially you're still dealing with 35 different hormonal emotions, flip IPs at times.

SPEAKER_04:

Yes. So so you have people going through the contract process where there's not a whole lot of one-on-one that's happening, about six to eight weeks, it takes people to complete a contract. Okay. Some people you may have cycling, some people just found out they're pregnant, and then some people are pregnant. And oftentimes when when people are pregnant and everything is healthy and going as it should, um, there's not a whole lot to do in that in that moment until somebody has a baby. So these different parts of the process help guide having that many matches or caseloads. Yeah.

SPEAKER_01:

Okay.

SPEAKER_04:

Um, and then I think you had asked about like training. Um, yes. Do you think wants to say like we throw them into the fire and to slurp? No. Um, so I think one of the you so there's seven case managers on our team. I think the newest, the newest case manager um was hired three or four years ago. So the retention on our team is really strong. Um it is is it is incredible. I think we have some really good working relationships and also friendships that just are arise. Um, but the one when someone new does come on, the way that we train them is they walk through every department in Northwest Surrogacy Center. So we have four departments. We have the legal team, we have the finance team, we have the case management team, and we have the surrogate screening team. Um, they will sit with people at each of those teams just to get a holistic approach of how we work as an agency and what our process is. Um they also will spend lots of time shadowing um each case manager. I think we all have a different work style, different personalities, different ways of doing the things that we do. And so it's good just to see how people do their match meetings, how people um do their check-ins or their 30-week calls, things like that. And so they sit and they shadow for months and months and months before they are given their own their own caseload.

SPEAKER_03:

Okay. All right, well, that's fair then.

SPEAKER_04:

They're they're they're they're lukewarm water. Lukewarm water. You're not thrown into the fire. Um we also haven't we also haven't had a new case manager in some time.

SPEAKER_03:

That's crazy. That's amazing though. Like truly, it's amazing because you hear how fast others cycle through.

SPEAKER_04:

So yeah, I think that that um attests for like the internal support that we receive.

SPEAKER_03:

Yeah.

SPEAKER_04:

Oh, for sure. Like from management. Um I I think that the care that we provide the people that we work with, we also provide the people that are internal. And I think it makes all the difference.

SPEAKER_03:

Yeah you got well, you gotta treat in surrogacy, it's really a family. Like everybody involved, it's like a big family. Everybody that you come in contact through the process, you gotta all have the same heart, the same mindset, the same love. Like it's so yeah, if you're if your home base is family, then it's gonna feel it's gonna feel warm. It's gonna feel good.

SPEAKER_04:

You're not gonna This work's not meant to do alone. That is for sure. For sure.

SPEAKER_03:

For sure. Um what do you think families and surrogates need more education and support around?

SPEAKER_04:

Um I I don't know if I I have like I feel like I'm like repeating myself here. So if I if I feel redundant, I'm sorry. Um but I think surrogates and intended parents get plenty of information around like the medical and logistic pieces of surrogacy and often are less prepared for the emotional and relational side of the experience. Um and so when when I say that, like I'm meaning like how to communicate, how to navigate conflict, how to cope with grief or guilt, how to stay connected when making incredibly different difficult conversation or difficult decisions, sorry. Um and also like the joyous parts of the process, like um how to celebrate together, or is it is it is it safe to let intendant parents know that I just had a positive home pregnancy test, or you know, so um there is such an emotional relational piece of this process that I wish people were just more prepared for.

SPEAKER_03:

I think that's very fair, and you know, each I can definitely attest to this is that each match or each journey is definitely different in communication style and like and I do know I do think that it's very important, and you guys probably do this, that you talk about it like pre-match or even in match. Is like this is how I like to communicate. And I know that's like a really weird thing to like bring up sometimes, like in a match meeting, but trust me, there's weirder things to talk about.

SPEAKER_04:

It is not it is not the most weird thing we're gonna talk about. I promise that.

SPEAKER_03:

It's like this is how I text. I like me myself, I am really, really bad at text messages. But if you email me, I will I'm like an old person. Like if you email me, I will email you. But texting me, I'm gonna read it, forget that it's there, and then like reply to you in like two weeks.

unknown:

Yes.

SPEAKER_04:

Kennedy, so happy that you're saying this because it is something we talk about. Like, what are your communication preferences? Do you prefer to get on FaceTime or do something like this? Are you or you person likes phone calls, or you like never call me, only text me, only email me. Um and then we talk a lot about like in the the pre-match calls and in the match meetings. How do you envision or hope your relationship is going to be um uh because setting those expectations earlier just helps the process in the beginning? Um and when I think about like uh you said something that um you were talking about communication differences, there's also like cultural differences that that people are navigating through and working through. So yeah.

SPEAKER_03:

Yep. And it's really important to not say that you have to like match, maybe maybe you don't have to match with somebody that has like the same communication style, right? But like to be very transp the more transparent you are up front, being like I'm an email person, I'm a call person. Okay, well, could we do something in between or do this or do that? Like it's everybody can be great people and like you can it can be your perfect match, and communication can always be worked out, but like it's important that you know how to like do it early on for sure.

SPEAKER_04:

Yeah, I agree.

SPEAKER_03:

Sure. I've been in conundrums because of communication, so and I will I will die on this hill.

SPEAKER_04:

Communication is the foundation of surrogacy.

SPEAKER_01:

Yes, preach it preach it because it's so true. Yeah, yeah.

SPEAKER_03:

The more you talk, the more detail you give in the conversation, the better. You don't have to talk every day, but the more detail is beneficial for everyone. I agree. Absolutely. Um, what advice would you give to someone considering becoming a surrogate or starting a surrogacy journey? Let's go there.

SPEAKER_04:

Uh, I think that there's a lot of agencies out there that have really attractive benefit compensation packages. I think I know where we're going. And and so and I say this, I and I say this like truly. I I would never persuade anyone from moving away from additional compensation. But I think it's important to read the small print. And when I say read the small print, are there caps on lost wages? If a surrogate ends up on bed rest, I need to make sure we she should make sure that she's fully financially protected and not subjected to use her own-based compensation to make sure that she can continue to live. If you see a very high compensation number that's higher than other agencies that you've interviewed, ask why. Right. Ask what that entails. Um, do you have to go through a catastrophic event to get all of that compensation?

SPEAKER_03:

Right. Does that include multiples? Are you not including insurance with that? Like what is are you is that including that you're covering my insurance? So really I'm not getting that. It's yeah, it's there's a there's a lot to look into for sure. Yeah. Okay. Okay. Well, what keeps you passionate about this work after all these years?

SPEAKER_04:

Um, I think what we talked about earlier, it is so rewarding to just see two strangers come together and create beautiful relationships. Um, oftentimes, not all the time, but oftentimes, most of the time. Um, even long after the surrogacy journey is done, people still remain in contact. Um surrogates will tell me that their nickname is um that's my belly bud, or that's my auntie, or you know, there's always these cute nicknames for surrogates who remain in touch with their intended parents and syrupes. Um and I just think that that's really beautiful. Um like I said, it doesn't happen all the time, but like the surrogacy journey in general is just a beautiful thing to sit and witness and support people through.

SPEAKER_03:

Yeah, I agree. I envy your job.

SPEAKER_04:

Um I envy your job getting to talk to people in the industry all day long about this.

SPEAKER_03:

Well, thank you. It is fun. It is fun to like get my little hour of like information and be like, winner now.

SPEAKER_04:

Yeah, absolutely.

SPEAKER_03:

And I'm always the civilian. I'm always just like, I'm gonna ask the stupid questions. I'm so sorry, everyone, but like, I don't understand what that is.

SPEAKER_04:

Like, but you have the unique experience of going through surrogacy journeys. Yeah, it yeah, this is true. That's cool.

SPEAKER_03:

Plus and plus and minuses, right? Okay, well, Nina, how can listeners stay connected with you or learn more about the work with Northwest Surrogacy Center?

SPEAKER_04:

Stay connected on socials, follow us on that. TikTok, on our Instagram, on our website. Um, we oftentimes have events for people who for potential surrogates, for potential intended parents, um, to meet with people who have been through the process. Um, so come to these events. I think it's a great place to start. Um and I believe our website does have an events page.

SPEAKER_03:

Okay. And are you guys in um you guys are located in Portland, right?

SPEAKER_04:

Yeah, we're located. We have an office in Portland and we have an office in Seattle and an office in San Francisco.

SPEAKER_03:

Oh my gosh. Okay. So are your events all just like West? Well, obviously it'd be West Coast, but like is it all just like even those three?

SPEAKER_04:

Question. Yeah. So we have events that that are in Oregon, Washington, and California, but we also host events where all of our surrogates are. So that is in uh Colorado and Nevada and um some on the East Coast. So we we are kind of a little bit everywhere and we try to make our presence in all the places that our surrogates live.

SPEAKER_03:

Amazing. Yeah. Okay, well, um I have one more question. So, what makes Northwest Surrogacy Center different from everyone else? Yeah.

SPEAKER_04:

Um, I think what makes our team unique is a combination of the expertise and the care and our intentional structure. Um, I think I mentioned this earlier, but we are founded by attorneys 31 years ago. And so risk management and compliance are just built into everything that we do. Um, and this also goes back to the question of what should surrogates look for when they're finding an ethically sound agency. Um we want to make sure that that clients can trust that the process is safe and ethical and thoughtfully managed. And so the ways that we do that is we only work in 13 states. A lot of surrogacy agencies that are around work in a lot more than 13 states because the truth is that surrogacy law is good in more than um 13 states. But the two things that is true in the states that we work in is that there's a clear and legal pathway to establishing parental rights and there's federal access to abortion care. And um termination is rare in surrogacy. That's like the absolute worst case scenario, but we want to make sure that our families um have access to the services if they're needed.

SPEAKER_06:

Right.

SPEAKER_04:

The one other thing that I'll say that is becoming a trend in surrogacy agencies that are coming up is um we're a family-owned business. Uh, there's we do not have any private um equity or venture capital backing. And we are seeing investors pop up more in the surrogacy agency space, I would say. Um, and so what this means is that um remaining privately owned just allows us to prioritize family over profits and make decisions based on what feels right and not what investors expect.

SPEAKER_03:

Does that make sense? Yeah, no, I love that. That makes a lot of sense.

SPEAKER_04:

Yeah. So yeah, when I think about trends in this in surrogacy and the things that are happening um just in the field in general, those are other things that I would be looking out for.

SPEAKER_03:

Yeah. No, that's great advice because it's becoming sadly hard to find um good agencies to trust on both sides, and and just yeah, it's a very interesting time in the Sarucia world. But they're out there. They are, they are they're out there, right? I think the frustrating part is that there's like you just said, right, so many are just popping up left and right, and it's like okay, but like and and and it I don't even know how to say this, but there's so many that are popping up left and right, and it's just it becomes overwhelming to be like, okay, how do I break this down? Because like we talked about earlier, right? Oh, well, the compensation, look what I get there. But there are caveats in in things. There, what you know, what's what's the catch in a lot of things? And not everybody has a catch in a lot of things, some of them are genuine for sure, but absolutely it is you do have to do your research on it, right? You really have to ask the questions, yeah. You gotta call, you gotta talk. You you gotta talk to someone, not automated machine, not an email.

SPEAKER_04:

Hopefully, no automated machines, hopefully no email. So it yeah, it's talking to a live person, talking to multiple agencies, yeah, figuring out what's important to you, figuring out why you are choosing to be a surrogate, and does that agency meet your same values and belief systems?

SPEAKER_03:

You know, I want to ask one question real quick. Um, promise is the last one, but I have been seeing this question be asked a lot, and it is is it okay for me to interview several agencies? Yes. Sorry. No, I love it. She said it like that. She's like, yes, don't even question it.

SPEAKER_04:

Yeah. If I was talking to my best friend or my sister or, you know, someone who is pursuing surrogacy, one of my advice would be interview multiple agencies.

SPEAKER_03:

Now, when you interview them, are you telling them that you're interviewing several, or are you just like, oh, you know what? Like, I'm I'm just getting my bearings. I'm just trying to understand a bit, like of what's going on, what you guys have to offer.

SPEAKER_04:

Yeah, I think it's completely up to you. Yes. I think I think you can leave it up. I think it's up to you. I think that you can let someone know that you're interviewing other agencies. Um, I think that there should be no pushback in that. I think it should be encouraged.

SPEAKER_03:

I think so too. And I think if you do get pushback, maybe we just hang up the phone and we call someone else. I'm asking why. Yes. We talk to someone else. Oh my gosh, how funny. Oh, well, this has been lovely. Thank you so much for taking the time to talk with me.

SPEAKER_04:

Thank you, Kennedy. It's been so good. Uh, I appreciate you and all that you're doing. And it's been just nice spending the last hour with you.

SPEAKER_03:

I know staying here. Well, thank you so much.

SPEAKER_04:

Thank you so much for all that you do. And um, tell your mom I said hi. Veronica says you guys are just talk so suck so highly of you two, which is part of why I was like, Veronica, you're setting the bar really high.

SPEAKER_03:

That's very sweet. Oh, well, tell her hello and thank you. Yes, we um we love her. She's very sweet. We yeah, she's a great talk.

SPEAKER_04:

Well, cheers. Have a good rest of your night. Thanks, you too. Bye-bye.

SPEAKER_03:

Oh my gosh. Well, that was amazing. Thank you so much, Nina, um, and Northwest Surrogacy Center. This has been wonderful insight to so many things. If anybody has any questions or stories that they would like to share, please feel free to reach out to us on Instagram at StopPeriodsit Period Surrogate, or you can email us at stop periodsitperiod surrogate at gmail.com. And this has been another episode of Stopsit Surrogate. See you next time. Bye. Before we wrap up, we want to give a huge thank you to our sponsors, Northwest Surrogacy Center, New York Surrogacy Center, Paying It Forward Surrogacy. Their continued support helps us share real stories to educate our community and connect families through the incredible journey of surrogacy. Thanks so much for tuning in to Stopsit Surrogate, where every story matters and every journey is worth sharing. We'll see you next time.