Products are independently selected by our editors. We may earn an affiliate commission from links.
I don’t remember if it was my husband or therapist who first floated the idea of surrogacy, but I do remember my response—an unequivocal no. I was 35 years old, healthy, financially secure, and married to a healthy, financially secure, and emotionally supportive partner. In the 12 years we’d been together, I’d never once tried to get pregnant, and I should at least have to try. Surrogacy was for those who had struggled for years with infertility, who had gone through countless rounds of IVF and failed implantations. Surrogacy was for those who had suffered. Who did I think I was to treat someone’s last resort as my first?
Then I did suffer, though it had nothing to do with my fertility.
I had just moved into my new house, and a friend asked for pictures. I stepped onto the fireplace hearth in the living room to get a better vantage. When I stepped off, I rolled my ankle and went down hard. I heard what sounded like a twig snapping.
It was a “good” break, in the fifth metatarsal bone of my foot, one that would heal cleanly in eight weeks. For that time I’d need to use crutches and wear a boot. I’d gotten a finger caught in a car door as a kid, but other than that, I’d never broken anything before. When I began experiencing pain in my calf, I tried to reassure myself that it was soreness from the boot. The dull ache flared hot at the lightest touch, not intolerable but also different than anything I’d felt before.
I emailed the doctor and described my symptoms. He emailed back that he could get me fitted for a different boot. “It’s super-unlikely,” he added, “but when we have calf pain in any immobilization, blood clots enter our thought process.”
I wrote back asking how I could schedule an appointment for the new boot, adding that I was on the pill so blood clots were always somewhat of a concern. He reiterated that it would be “really, really uncommon.”
I almost left it there. In the months that followed, I would obsess over the phantom version of myself who was too uncomfortable to nudge one last time, who closed her computer and carried on with her day. Who did not go to the hospital for an ultrasound, where the tech discovered a deep vein thrombosis (DVT) in her right calf. Who died because she hadn’t wanted to be pushy.
When I was little, my parents called me the what if kid. What if lightning strikes our house? What if there’s flesh-eating bacteria in that water? What if this bump on my shin isn’t a calcium deposit like my coach said but bone cancer? The subtext, never uttered out loud for fear it could manifest as true, what if I die?
At checkups, the nurses would remark on my sky-high blood pressure. White coat syndrome, I would brush off with a fake laugh and a pounding pulse. Various doctors over the years recommended antidepressants, but I simply didn’t identify as a person who needed medication. Panic was a room I was familiar with, sure, but I had always managed to find the door, slip back into regular life undetected by my husband, friends, the people who knew me as a successful novelist and screenwriter. But I could not escape the thought that it was my aggressive vigilance alone that had saved my life, that the only way to survive was to keep watch from within my four walls of terror.
I ended up back in my doctor’s office, worried the blood thinners I was taking to dissolve the clot had caused a brain bleed. My doctor kindly went through an assessment, then stepped back and stared at me with concern. I can see you’re very stressed, he said so gently I burst into tears. I remember the exam room table paper disintegrating beneath my sweating palms as I realized that what had been a hairline crack was now structural. Everyone could see I was buckling.
I scheduled a psychological assessment and learned that I wasn’t just dealing with anxiety and panic, but mild depression and OCD too. I had always associated OCD with repetitive behaviors, but obsessiveness also fuels anxiety, making people feel hounded by their worst thoughts and fears. Mine convinced me I would be the unicorn written about in medical texts who had a fatal reaction to Lexapro, so much so that I took my first dose in a public place, thinking, if I go into anaphylactic shock, at least someone will be around to call 911.
That was a Friday morning. By Monday, it was as though a velvet curtain had dropped between me and all my chronic what ifs. Like actors assuming their places before the start of a play, I knew they were back there, but I could no longer see or hear them. I could stop white knuckling my way through the day. I could relax. It was a remarkable kind of emancipation.
One that, in my mind, pregnancy expressly jeopardized.
At 35, most of my friends had carried children. One or two of them had enjoyed pregnancy, but the vast majority told me horror stories about how awful they felt and how traumatized they were by childbirth. And those were just the examples where no one died.
Pregnancy has been politicized for the entirety of my child-bearing years. Obsessive hypochondriacs like me tend to catalog grim statistics—years before I ever considered having children, I’d already logged that the U.S. has the highest maternal death rate of any first world nation, that black women are three times more likely to die in childbirth than white women, that the rate is increasing nearly twice as fast in states with abortion bans. Pregnant women are five times more likely to develop a blood clot; I wasn’t about to go nine long months at this elevated risk without the Lexapro to keep the curtains down on my demons. It is generally not recommended to take Lexapro while pregnant (unless the benefits outweigh the risks—an impossible calculus), and although there are other antidepressants you can more confidently take, I felt a fiery kind of indignation at the idea of playing roulette with my mental health, a rage I now know was masking the familiar contours of an earlier trauma.
As I’ve written about before, I am a survivor of a sexual assault that was packaged to my high school classmates as something I willingly participated in, someone who deserved the scorn and social ostracization that followed. I endured that period of my life with as much stoicism as I could muster. And I could not shake the sense that pregnancy would be another violation of my body and mind that I would have to grin and bear as well. And for what? Motherhood had been billed as a thankless slog that would cannibalize my career and rot my identity. I was an editor at Cosmopolitan when Anne Marie Slaughter’s “Why Women Still Can’t Have it All” made the cover of The Atlantic and the article hit our hyper-pink-feminist offices like a lightning rod. I was not just the target audience for the lean-in, girlbossing era that followed, but part architect too. I trawled Pew statistics to anchor pitches about why more young, ambitious women were putting off having children and crowdsourced my friends for anecdotes that proved there are so many more ways to be a bad mother than a good father. It was an act of confirmation bias in its purest form.
But for all the contempt I had manufactured around motherhood, I could not bring myself to reject the choice to have kids outright.
In theory, I knew not everyone had to have the same experiences in life. But I had only understood it in the binary sense—either you are a person who wants children or a person who does not. As I worked through my ambivalent feelings in therapy, I had a profound revelation that may seem laughably rudimentary to those who have always been clear-eyed in this arena. I realized that I got to have a say in how I wanted to parent, that I was not destined to become martyred by motherhood just because a Pew statistic about unequal child-rearing responsibilities between men and women said I was. I had an egalitarian partner. I had developed self-awareness and found deeper sources of compassion and empathy that I wanted to share, thanks to the work I continue to do on myself in therapy. Most of all, I had the means to afford surrogacy. I had purposed the pain of my assault into a best-selling novel, and there was something harmonious about using my royalty money to protect myself from what I viewed as another trauma.
The decision did not happen overnight. I’d seen famous women who chose surrogacy take a battering online. Their Instagram birth announcements were littered with accusations that they’d bought a baby to preserve their bodies, to offload the hard work to someone else. Surrogacy when you didn’t need surrogacy was a vain and selfish choice made by vain and selfish women, and as someone who has always struggled to see herself as a good person, my ear was sharply tuned to the criticism. It took nearly a year for me to come around to the idea that the extraordinary women who sign up to be surrogates do so because, unlike me, they view pregnancy as a positive experience. I was not a bad person for not wanting to feel afraid again.
At 36, I completed a round of IVF. My hands trembled every time I gave myself a shot. But I made it through, and my husband and I ended up with four healthy embryos. While the surrogacy agency assumed we wanted to start the search immediately, I had other plans. I had adapted my first novel into a screenplay, and production was finally moving forward after seven years of rewrites and attempts to cast the lead. I wanted to feel free and young and unencumbered for every minute of this dream coming true, which entailed being on set for four months, flying to New York for the year of post that followed, picking out exciting outfits to wear for all the press opportunities in the month leading up to the premiere. This was another dignity that surrogacy restored for
me. I got to say when. Finally, I started to see my choice not as the easy way out but the most
loving gift I could give my 15-year-old self, whose agency and boundaries had been
devastated before she was old enough to drive.
When we finally pulled the trigger on the surrogate search, our liaison at the agency spoke to me as though I were a desperate woman broken down by years of trying and waiting for a baby. Every time she called, she would assure me in soft tones that she knew how anxious I was, how long I’d wanted this. I knew she meant well, and so I didn’t correct her. I did not know how to
explain the incongruity of my decision, that I came around to surrogacy not in my darkest
hour but in the sunlight. What kind of woman would I be if I told her that actually, I’d never felt better?
We call people who stray from the bounds of the traditional family structure childless cat ladies who are miserable with the choices they’ve made. But the only thing that would have made me miserable is the inability to make this choice. Now that my daughter is here, now that I catch
myself cooing to her that she’s my favorite person in the whole entire world, I know what kind of woman I am. I’m the kind who puts her life jacket on before I put on anyone else’s.
I’m the kind who will teach her daughter she is a good person for taking care of herself first.
Jessica Knoll is the author of Bright Young Women, now out in paperback.