By Dawn MacKeen, Staff Writer, Newsday, NY, January 12, 2003

Isabella came into this world three weeks ago much like Delores Hughes’ own children. She let out a long yawning cry, with the full might of her tiny lungs.

From her hospital bed in Port Jefferson, 54-year-old Hughes focused on the 7-pound, 9-ounce baby with the shot of black hair and high cheekbones, arms flailing about. Those features reminded her of her youngest, Lori, whom she had given birth to – 30 years earlier.

Delores Hughes holds her granddaughter Isabella, whom she gave birth to last month. Hughes, 54, acted as surrogate for her daughter.
The resemblance made sense, since Lori is the biological mother of Isabella. Because Lori couldn’t become pregnant, Hughes carried Lori and her husband’s child for them. Doctors did this by extracting Lori’s eggs, fertilizing them with her husband’s sperm, and then transferring the embryos into Hughes’ uterus.

“If she needed a kidney, I would gladly give it to her,” Hughes said last week. “But she needed my uterus for nine months. Who else but a mother could do this? It’s unconditional love.”

Ever since Lori was 16, she knew she could never carry a child. As the years passed, Hughes said her heart slowly broke watching Lori care for her sister’s and brother’s children, knowing that Lori so longed for one of her own. Three years ago, Hughes, a Manorville resident, consulted her husband, Tom, and a doctor about the possibility of becoming a gestational carrier for Lori and her husband. And then she made the offer.

“It’s been so many years of talking about this and dreaming about it,” said Lori, who didn’t want her last name or her husband’s name used for privacy reasons. “It’s hard to believe that she’s finally here.”

Hughes, a youthful woman with shoulder-length brown hair and hazel eyes belongs to a small but growing class of women who are pregnant in their early 50s. There were 239 of them in 2001 alone, a 66 percent increase from only four years earlier, according to the National Center for Health Statistics. And she is part of an even more select group of those carrying their own grandchildren.

A recent study in the Journal of the American Medical Association found that there’s no medical reason to exclude women in Hughes’ age demographic from pregnancy. Although there is an increased risk of pregnancy-associated diabetes and high blood pressure, which could compromise the blood flow to the fetus, most babies and mothers – or gestational carriers – are fine. And that was certainly the case with Hughes and Isabella.

“Twenty or 30 years ago, a 50-year-old was clearly middle-aged ad now clearly that’s not the case,” said Dr. Richard Paulson, lead author of the November JAMA study and director of University of Southern California’s fertility program, where a 63-year-old underwent a procedure that led to the birth of a girl in 1997. “Harrison Ford is in his 50s and wasn’t he the “Sexiest Man Alive”? We are not seeing 50-year-olds ready to retire and watching TV.”

Hughes and Lori are thankful not just for the baby, but also for the way their doctors and the staff at St. Charles Hospital & Rehabilitation Center treated them when Isabella was born. They say they respected the unique relationships, and the importance of acknowledging that Lori was the mother, not Hughes. They have heard of what they call ‘horror stories’ of other biological mothers not being able to hold the baby after delivery, or who weren’t treated with much respect.

Shortly after the birth on Dec. 21, doctors placed Isabella in Lori’s arms. Then she was passed to Hughes, who whispered, “Merry Christmas.” Dad was next. Grandpa Tom, Delores’ husband was rolling the video camera on the child they call “baby Bella.”

But the one thing that upsets this family is that under New York State law, Isabella is not Lori’s child. She is technically her sister. On the birth certificate, Hughes is listed as the mother until an adoption is finalized.

Isabella in a recent family photo.

“It’s bizarre,” Hughes said on a recent afternoon, sitting in her living room in a pair of overalls and matching blue cotton shirt, looking much younger than a grandmother of five children. She is taking time off from her job as a social worker to recover from the birth, which required a cesarean section. Behind her, family photos of three generations of the Hughes family hang on the wall, and decorate the tops of the end tables, showing her other two adult kids, ages 34 and 32, and their children as well.

Lori shuttles in and out of the room, tending her child, changing her and feeding her. Lori brings Isabella to visit grandma at least once a week.

“If it was something between a mother and daughter, why does New York make it so complicated?” Hughes said. “It just seems odd that this is their child and that they have to go through this.”

New York State has one of the strictest statues regarding surrogacy in the Northeast, said Melissa Brisman, an attorney specializing in reproductive law who is based in Park Ridge, N.J. Since 1992, it has been illegal in New York to compensate a gestational carrier, except for medical expenses and other pregnancy-related costs, such as maternity clothes.

But even for those who can have the procedure done in the state – because no money is changing hands – they still have to adopt the child if the baby is born here. And that can only be done after the baby’s birth. It’s a process that can take several months and it is costing Lori and her husband about $7,500.

In Connecticut, Massachusetts, Rhode Island, and Maine, biological parents have been able to petition the court prior to the delivery to be listed on the birth certificate instead of the carrier, Brisman said.

“New York politicians have fixed it so that New York couples have to jump through excessive amounts of hoops and also absorb tremendous costs to get this process done,” said Shirley Zagar, volunteer director of the Organization of Parents Through Surrogacy. “To do what other couples do by just getting into bed and having a baby.”

New York was just one of the states to pass restrictive surrogacy laws in the years following the case of Baby M. A surrogate mother, Mary Beth Whitehead-Gould, gave birth in 1986 to a baby girl, who became known as Baby M. Only Whitehead-Gould, who now lives on Long Island, had grown attached to the child and didn’t want to give her up to the New Jersey couple who had contracted with her to have the baby. In court, she won visitation rights but lost the legal battle to keep Baby M. At the time, there were other tragic stories of surrogates swindling money out of couples, or dying during pregnancy.

State Sen. John J. Marchi (R-Staten Island) sponsored New York’s 1992 surrogacy bill, which became law. “His legislation was intended to address abuses,” said Jerry McLaughlin, his spokesman. “He had obviously received word through either official sources or anecdotally of the situation where people were carrying babies and doing it in a totally commercial basis.”

But now, the traditional surrogacy procedure that led to Baby M.’s birth is not that common anymore. That was done by taking Whitehead-Gould’s eggs and fertilizing them with the sperm of the intended father. In the gestational carrier procedure Hughes underwent, Hughes’ relation to Bella is different – it is solely that of grandmother.

Many of New York’s infertile now leave the state and go to clinics in Pennsylvania, California, Connecticut and Massachusetts for the gestational carrier procedure, as well as to find the appropriate person to carry the child. Though there are no statistics, Brisman estimates that there are several hundred births each year from New York couples who are using carriers in other states. The New York State Department of Health doesn’t keep numbers of how many born to gestational carriers, either.   

“This was unique for having a mother who was willing to do this,” said Dr. Merle J. Berger, co-founder of Boston-IVF and associate clinical professor of OB-GYN and reproductive medicine at Harvard Medical School. “Most couples who need surrogacy do not have the convenience of having a relative or friend who are willing to do this for them. So the [New York] law has excluded the vast majority of people from dong this.” Berger estimates that about a third of his patients come from out of state, including New York, or even other countries.

Because of New York’s restrictions, Lori and Hughes thought they had no choice but to go out of state, too. But they could have stayed if they found a place that would treat Hughes – a challenge since many clinics don’t take anyone older than 50.

So when Hughes was 52, they drove to Wayne, Pa., to the Reproductive Science Institute of Suburban Philadelphia to start the procedure. Their cutoff was exactly her age. She underwent consultation, which included a psychological and a medical screening. In a two-year period, they made five trips there. They kept the cost down by clipping coupons for the Holiday Inn, but it still added up.

Dr. Michael Sobel, left, of reproductive Science Institute of Suburban Philadelphia, performed the procedure that impregnated Hughes.
“The impulse and drive to carry on family is ultimately one of the strongest desires we have in life,” said Dr. Michael Sobel, who is clinical director of RSI and did the procedure for Lori and Hughes. “This was a very loving and caring family, dedicated to continue until their efforts prevailed.”

Ten days after the fourth embryo transfer, Hughes woke up at 5:30 in the morning and took a home-pregnancy test.

When the stick started to change to light pink, she kept thinking that she was imagining it. Since her husband wasn’t home, she called Lori, but no one answered. A few moments later, Lori phoned back. By then, the color had changed to a dark pink.

“When I answered the phone,” Hughes recalled, “I said, ‘Congratulations! You’re pregnant.’”