The Interplay Between Surrogacy & Counselling with Miranda Montrone
In this episode of the Family & Fertility Law Podcast, Stephen Page talks with Surrogacy Psychologist Miranda Montrone about her passion for surrogacy.
Intro: You’re listening to the Australian Family and Fertility Law Podcast. Here’s your host, Stephen Page.
Stephen Page: Welcome, everyone. Stephen Page from Page Provan Family and Fertility Lawyers. And I’m talking in our podcast about Australian family and fertility law. And today I’m joined by the wonderful Miranda Montrone, who I’ve known for quite a while and is a well-known fertility council psychologist from Sydney. She recently joined me in our webinar about surrogacy in New South Wales, which she knows absolutely buckets about. But I thought at this point I’ll actually hand over to Miranda and ask you say “Welcome. Hello.” Hi, Miranda. Welcome to the podcast today.
Miranda Montrone: Thank you, Stephen. Thank you for asking me to do this and dothe webinar. Thank you.
SP: And I just wanted to start with, how long have you been doing fertility council?
MM: When you mentioned that we were going to do this, I’ve been pondering. So it’s from the late 80s early 90s, so 30 years. So about 30 years or so, there was no formal training and there’s still no formal training in fertility council in Australia. And I was working on a relationship and family therapist as well as a psychologist. And I was working. I’ve always had a small private practise somewhere in there. I came across people who are having infertility problems and I wanted to refer them on to specialist help because they were talking about a world I didn’t know much about.
And that was pre-Internet days. Only the other day, pre-Internet days. So there was like newsletters. You could get newsletters and they told you about things and people through that. I saw her name in Melbourne, Jenny Blood, who was a social worker there and she referred me to a social work in Sydney, a lovely person, Felicity Dana, who is at North Shore Hospital. So I had a chat with Felicity, and that I I just chat what’s around the clinics for all sort of starting IVF. They were doing a lot of donor insemination, which is interesting in itself at the time.
That world has changed hugely. Felicity happens to be talking. This is how work happens. You know that the lovely Jeff Driskel, who is now dead, the head of a clinic that is now part of ODIs Australia. But he I was at Westmead and he was looking for a counsellor because they all had to have Council. This is a rambly version. Sorry.
SP: No, that’s alright. No, I was just reflecting on you saying that when you started, there was no Internet. And I had exactly the same problem back in 1988 when I had my first surrogacy client. And of course I had no Internet. I had to look at the Queensland Statutes, which were in a purple books back then and purple bound. And we would get the scissors out and cut and pasted with sticky tape and should work out what the law was as opposed to. Now we can just look it up online and there it is.
It’s easy to see. It was a different world and totally a different world.
SP: And there was no one you can ask what you’re saying about that know, you could ask. That was exactly right. There was no one I could ask.
MM: No. Well, that’s why when you heard of people that had a mutual interest, you went and saw them all, rang them up and there was no email. Well, email had just sort of started, but I think I wrote let up, you know. So Jeff said to Felicity was looking for somebody because the clinics were all being told. I had to have a counsellor. I think in the beginning the doctor for a bit unwilling, but whatever. So I was working at Westmead in Western Sydney and he was at Westmead.
I was doing relationship work at what has been Mary’s guidance. So I had a chat with Jess. He asked me to come work 3 hours a week and I said, sure, why not? Let’s do it. And there you go. So I started working with him. Lovely, lovely man and lovely people that I work with them. I worked with them for nine years, but I remember my first paper. I love it. God. It was ’92 of my first presentation at a fertility society conference as Secrets in Families.
It was about donor anonymous, donor insemination, which the world has changed again. Another thing now with the Internet. Amazing.
SP: Well, anything’s gone, it’s dead now. Isn’t it?
MM: No, no, it is. It’s a moot point. But it’s it has changed so drastically. It wasn’t that the people were bad then. I know that there is some real Cowboys and stories around the world. People weren’t bad people. They were just trying to cope in difficult situations. So it was then it was only heterosexual couples with significant sperm problems. That was the only with ecosexual couple not married and have to be married.
SP: They were the only people who only people treated.
MM: And over time it all changed. Sorry. Gassy, which is our mutual, really strong mutual connection. It was in the I like maybe about 96 or so. 97. Maybe they started doing it in Canberra. You know, they remember there was Berri. Remember the legislation stud in Canberra. So Jeff came to me one day and he said, we’re thinking of doing surrogacy and that’s a big one. We need to think about this. So from that, I developed protocols from books. As you say, I found information from books. How do they do it in America?
How do they do it in the UK? And it was also based on the fact that one of the things was that in Australia we do with our no no side donor counselling, which has started by them too. We saw all people to the surrogacy.
SP: So those who are in the industry, our sides are eggs, aren’t they?
MM: So sperm boys, our side girls, embryos both together and surrogacy are uterus. So it’s all called third party reproduction for those of us in the Dragon world. So it involves a third party in the creation of another human being. Interesting. Very interesting how that has all changed.
SP: Why did you feel the desire or the need to get into in this area? Because, of course, you are practising. I presume you’re practising. As a psychologist back there.
MM: I think maybe it is. I’m a person that says, oh, that’s interesting. I might find out more so that’s maybe something in my nature Interestingly. This is on the side, but with all of the world and the way the world’s changed everything, and maybe it’s because I’m getting older and really pondering life. I don’t know. I was in my twenties and I was doing psychology and economics, working in the bank. I was doing my degree at Knife. I was supposed to end up somewhere totally different. And nowadays I would do.
I went to a talk and this guy gave the talk and I bounced up to him and said, That’s really interesting. It was organisational development. That’s really interesting. I’m doing this. I’m doing that at and he said, Are you ready for it? Or our clients wouldn’t like a pretty blonde like you telling them what to do.
SP: Oh, my God.
MM: I got it. Okay. Okay. So not long after I do the economics. But look, if I look back, Stephen, I was obviously wrong. A total press. But have I done good work in another area? Have I developed expertise? Has my life been terrible, though? Have I felt challenged and interested in my work? Yes. And that’s the curiosity and the stuff. This is interesting. Surrogacy. Okay, let’s have a think about how we’re going to do that. There was also another thing that informed me at that time. And this is again, how you learn on the way from what you come across.
So there was there was a whole lot of publicity about four people for women who died having had treatment from human pituitary hormones. I try not to make it to go on too much, but it was when people first started hearing about Close York, a disease.
SP: This is a disease.
MM: That’S the BC. So the same sort of they’re all pre on disease. Interesting. Interesting stuff. Interesting. But they wanted somebody at Relationships Australia to head up a counselling service because the government wanted to fund because there was about 2000 people that have had either human Petruta hormones for women for fertility treatment. That’s the link. How come I got in or human growth hormone for a short stature? And that again, it wasn’t that the doctors or anything were bad people. They used the treatment that was available for time.
But there was a cooler to that treatment that it probably I don’t think they ever came down probably cause the death of these women. And I don’t know that any others died, but it’s that hindsight. So it was helping people manage their anxiety that they may get this dreadful disease, having had treatment to either have a baby or for their statue. So from that I learnt the importance of transparency and openness and honesty. This is the information we have at this time. So that informs my work all the way through a egacy.
SP: So why is it important for parents to be open, honest and transparent? Because sometimes I hear from parents. Well, look, this is our family. We might have a donor, we might have a surrogate, but this is us. This is us and that is them. And they are part of our family. They’ve helped create our family, but they’re not part of their family and we’re really the unit. Why do parents need to be open, honest and transparent about that?
MM: Now, as you said, it’s a totally moot point, because genetic stuff through online testing means you have to tell the truth. But even after everybody real counselling people about donor, like, I would look at people and I talk to them. Just go back to the fellows. Long time ago, they were poor fellows. This term was not good and they were just feeling guilty. So I would say them, when do you think you should tell your child the truth? And they would routinely say, when should I say I’m not the real father?
You’re the real father. But when you should discuss it, there has been somebody help genetically. They would then answer the other 115. I don’t pick 15 bad time. They already hate you. Don’t pick that time. Don’t give them a reason. But it’s why. Why should people tell the truth? It’s the most important relationship in the child life. It shouldn’t be based on a lie. And it’s it’s not a bad thing to tell people that you have had help to you have a child. It’s not something.
And for example, say, for example, back to the men. How do they go about discussing sex with their children if they themselves have a terrible sperm problem? Big secret in their past. I mean, the research does show up the people from that era that the the parenting is just as good, if not better for me in that situation that the children don’t damage. There’s some stunning studies by Susan Golan back and her team in the UK, Cambridge.
MM: Yeah, brilliant stuff, but they had to stop at 18 and probably I actually only recently saw a young 1 minute that she found out at 35 through online testing, all her family thought they would just all do it and see what their genetic pass was. Well, hers was a huge surprise because it was a different genetic group altogether in her world and she had anticipated and it’s thrown her world into a spin. But why should people tell the truth? I just think it’s so much easier, so much easier.
SP: I sometimes say the clients in that at that time I tell them a story. I think it was somewhere out ten or 20 years ago. The problem is, when I’ve been practising so long at one year seems to go under the next. But I was acting for the husband. You know, we probably now say the father in family law litigation, parenting relegation. And it was just ugly. That’s really ugly. The wife, the mother of the kids head, reacted to something small in the relationship. I can’t remember what it was, but it was something fairly small.
And you look at any other relationship and you think I just would have got a little bump and kept going. But this one rendered their relationship overall, their marriage over, and they ended up in litigation in family court. And it was just so ugly. And when you look back at what the underlying reason that it all fell apart, it all happened well and truly before they got together, which is pretty common because you have a problem with the childhood and then that could impact you, as we know, a lifelong.
But hers happened on the night before her 21st birthday, what her parents said. And God is your 15 year rule that you’re just describing to describe the 15 year old, but not before the 21st. Mum said to her, Now, Darling, is something got to tell you. Please sit down. You’ve been adopted.
MM: I was adoption wasn’t okay. That was then that whole generation of a whole generation.
SP: No one was told. And and of course, she took the view. Quite simply, my parents have lied to me about the most fundamental thing about who I am.
SP: And if they’re going low to me about that, how are going to trust anyone with anything else?
MM: Exactly. Exactly. I now talk to people. I tell them to when again, sorry, as they should chat while they’re changing the baby’s nappy. And with same sex parents, it’s like two boys can’t make a baby chat, chat, chat, chat. And then this person help them. Then that person help. And basically it’s the adults have to get past the words. The children are totally cool. Totally cool. No trouble at all. I’ve met three year olds, but totally get it. So I say it’s. The reason for doing it that way is that to chat while they’re changing the nappy is they get past the words.
So then if they’re out shopping or somebody and somebody says something that presses a button for them, they can answer without getting that terrible stab in their heart.
SP: It’s not a cover up.
MM: Yeah, exactly. Or just an awful feeling that button being pressed. It’s also good for the children’s vocalisation skills because which are nowadays going down with the use of devices, their skills or sounding up things. But it’s more just. I mean, I’ve had lovely, lovely three year olds. People tell me stories about three year olds, how they’ve told people. Oh, no. I live with my two dads. My Mum and my brother live in data as they walk out of the room. Children are totally fine. It’s the emotional pain of the adults, and they need to address that pain.
And one way to do it is to just chat and there’s lots of books and things like that, as you know. Well, books and podcasts and everything nowadays and bluntly nowadays, you can’t lie. It’s stupid.
SP: Well, I think when we look at the rise of databases like ancestry dot com, the amount of information that is there is just enormous.
MM: Absolutely. But even then, it’s I think nowadays people do know that. So there’s that whole cohort from about there’s still a group of people there that don’t know and the poor parents, you know, I love that people pick terrible to to tell their children things. And the other thing about it is too, by the way, not just in infertility in the system, reproduction. People have affairs, remember, Stephen, and, you know, so they have this Christmas idea. Somebody decided to give everybody a test and the mother doesn’t want to do it.
MM: And maybe even her husband knows that the child is not her genetically. Oh, my God. Really, this is not the way to go.
SP: I think one of the law cases that I regularly site, which deals with citizenship concerns, a 30 year old woman born in Fiji to an Australian day and the Fiji and Mum, and they had sex and as a result of which she was born. So he thought and just to make sure, he said to Mum at the time, well, how about we get a blood test done? They got a blood test done. This is the days before DNA tests were done. Everyone did blood tests and the daughter had the same blood type as the Aussie.
And Mum had a different blood types. So he acknowledged Paternity, he bought her a house, he paid a child support. He went home to his wife in Melbourne and told her about all this, and somehow they remain together. And anyway, he continued to provide for this child and they would go and visit her and she’d go and visit them. And so the age of 30, she says, okay, I’m gonna apply for Australian citizenship so that I could leave with my step mum and dad and my siblings.
And the first DNA test came back. He’s not dead. There must be an arrow. So that is a second DNA test. He’s still not dead. And it was at that point that Mum said there was the other man and named him, believed to be an Australian who had since died. And so the issue was whether the first man was apparent and he was found in citizenship. But that 30 years after the event.
MM: Well, he was an Honourable man and well done him and he and well done the young woman. But in finding out news like that, but people do find in families but, I mean, nowadays with assisted reproduction, it’s plainly not going to happen because it’s just so foolish and it’s so common now. So the world has changed in terms of surrogacy. I remember in the is there no, we’re not going to do surrogacy. And now we do yoga. We do donor. They’re talking about mitochondrial donation so that they can, which is wonderful.
So they cannot have two women eggs, like have a donor mitochondria so that the disease doesn’t carry down their terrible diseases. That just goes through the generations of the women. It’s about transparency. You ask me about what’s important that we learn from all of this openness transparency consideration of the needs of all, including offspring of donors and surrogates and families and partners. It worries me when people rush. Worries me terribly. When people rush, it’s like, can we just slow down everybody? Everybody has normal human needs.
The donor maybe maybe have a lot of things on their plate at the moment. Maybe now is not a good time or a surrogate. Now it’s not a good time to do it. People have normal human needs. So it’s not rushing openness transparency, respect all those very straightforward value stated.
SP: But what’s the old line? I think I’m angling it, but it goes something like acting, act in haste, repent at leisure.
MM: Absolutely. Exactly. But it’s also just respecting the needs, treating other people the way in which you would like to be treated yourself. We’re all normal sales human beings, and we all make errors and we all do things that perhaps we shouldn’t do. But the aim is to minimise the long term impact, and particularly with regard to children who didn’t have a say in all of this.
SP: Given that you’ve been counselling surrogacy, I would guess probably longer than anyone who’s practising now in Australia. What are the things about it that you love doing?
MM: Yeah, I do. I really like it. I meet really nice people doing very special things for other people. What a lovely thing to offer to help create a new human life for people that otherwise will not be able to do that. I think we do a surrogacy better in Australia than anywhere else. That sounds terribly, I don’t know, maybe nationalistic or something, but we do so in America that I don’t think America does it bad, by the way, but I think that’s great language. I’m just us there.
I don’t think they’ve done it.
SP: No, I understand it’s a different way that occurs in the US.
MM: Yeah. But I think the fact that they don’t counsel their intended parents, it’s their emotional pain that is underneath it.
SP: Back to that people now some places to I can’t say it’s the norm. It seems very much the norm in the sort agency that some agencies definitely do that.
MM: Yeah. And it’s really good. But, you know, that adopted where they told the young woman at the age of 21, they probably had that thing hanging over their head for years and years. Well, we’ll have to tell her now. We’ve always probably said, well, tell her before she’s an adult, but it was such a big thing to admit to that pain of their infertility. And then it comes to time when we should have told her we when can you tell her? So it’s it’s that sort of thing, considering people’s lives and eat into them a bit.
So it’s that taking time and considering the needs of all is really, really important and respect, definitely respect for all.
SP: I think what I get about surrogacy is that it’s just it can be such a magical process where someone is stepping forward and saying, I’m going to give you the gift of life. So with Diners, exactly.
MM: Lena way donor is way bigger. The amount of information at the same time as the whole treatment of assisted reproduction has changed. Genetics has changed drastically, hugely massively. So 2030 years, it’s been massive. So it always was big that people sort of they’d say things in the beginning. When I started in the early nine, you’d read things through just like blood. It’s patently not just like blood. It’s half of the genetic material of a person. But Don don’t sorry.
SP: Is that what they said? It’s just like blood.
MM: The people would say it not doctors, but just there was that sort of sense. It’s just like blood. No, they did. I remember reading a wonderful book about an American fellow who said, if it is such if it is such a big thing that we can’t tell our child, then we shouldn’t be doing it. And that was a man that was in fertile coming from his heart. But with the genetics and the donor, that’s lifetime, whereas sorry, because I think big, big for a couple of years.
It’s big for the year beforehand. It’s big for the pregnancy, is big for a number of months after the birth. But by the time the child’s 15, Norman will go, oh, yeah. You know, if the chance. So I was doing so they’re doing something for PD and HPA at school or something about their birth. And they say, can I get a photo? I want to do this to show who was my birth mother or my story at birth mother and the personal. Oh, yeah. The charge.
Where is it? 15, whereas the child is going through the whole differentiation is very psychology type stuff. But who am I? How am I the same as different from my parents? Who am I going to be when I be an adult person? That hole. Who am I typing that’s when the genetic material becomes hugely important. And the surrogacy. So it’s you and I both know we meet the surrogate, they say, and they’re not in Australia. They’re not uneducated or unsuccessful women in any way. They are confident, successful women who have careers and wealth.
Yet there’s a huge worldwide study there. If looking at the different patterns and different things related to the cultural and the society, more of the culture in which she orography is existing. I’m not doing that the search, but there’s a huge study there. But the women we meet are women. They say, yes, I can do it. Other women who can’t do it, the majority of women say, That’s amazing. I couldn’t do it. They can do it. But it’s still a huge and, you know, I talk about it, that’s their head talking.
And then we’ve got to talk about the body and how the body reacts. My research that I’ve done on well, it’s now 200 cases of surrogacy cases, but I haven’t published that yet. There’s no major psychological difference from the testing I use. There is a difference. And I’m trying to look, it doesn’t really matter what the difference is. It’s just that there is a group of women there who say they can do it and they do. They mean us and, you know, they mean it. But it’s also helping them manage something that is a huge life event in their life and the life of the child and intended parents.
SP: Wow. And so for anyone who is contemplating having a child through donation of some kind through Eagle sperm or even embryo donation, or thinking of undertaking SRC, what would be your top tip as to how they would go about it or what they should reflect upon one?
MM: I think on the one hand, it’s huge. On the other hand, it’s not. And that sounds great. I think parents can just love any little possible that they have the absolute privilege to raise.
SP: In a way, it’s a possum that sometimes goes into my ceiling than the ones that live at my house here.
MM: Do you want more?
SP: We had now turn up. And despite all our efforts to possible proof our house, the post still kept getting in. But once the all turned out, no more possum.
MM: No, I have a dog. There’s a stand off on that. Sorry, people who are listening. But anyway, we have a tribe of possums. I like the rules in New Zealand where they’re not seen as a species that needs protecting a they’re very much protected now. They live here. They live here. We’re allowed to live in this space even though they run it. But now a lovely little possum that we’re all privileged to raise. In a way, it’s liberating, you know, if it’s not yours genetically, if it’s yours genetically, you can have beliefs about how back to what happened to you when you were young.
So, for example, you want your child to be a really good sports, personal. You want your child to be good academically, or you think they’re going to be like, I remember, you know, just looking at a child one day thinking, oh, my God, just like, just like the mother, just like the mother. And it’s that sort of the parent looking at the bad behaviour and looking at one thing. I wish I wish that my child was not showing the world the behaviour that I got under control.
Whereas if you have a child that is not yours genetically, like angst, one is an angst person and then one has a teenager that does angst with a capital A. It really you can look at yourself in the mirror. She’s like that one hidden or say you wanted to be a top sports person to go to the Olympics. I say, what are you got to do? An expectation of your child whereas it’s not yours genetically, it’s liberating in a way. Wonder what this little possum is all about.
I wonder what they’re going to do. What are they interested? You can sort of see it as a way in which it’s a creative thing and it is still amazingly wonderful. It’s not a substitute. It’s just a different way of being a mum and dad. And I.
SP: Just reflect on one thing and that that is that a friend in the US had undertaken research which indicated that surrogates would rather be surrogates to gay couples than to straight couples. And to me that seemed counterintuitive because I would have thought that a woman who can easily have children will help another woman who can’t. But I started to reflect on it and think about how a woman who might have been frustrated and had her car shredded because she can’t have a child might be tempted to micro manage the surrogate as opposed to a gay couple to come along and say, oh, you can have a child them at any times.
We try, we can’t will worship you.
MM: But there’s truth in that, Stephen. In the study of 160 couples, sorry to cases of which it’s now gate gay guys because it covers the period from more than when the guy guys were able to do it. New South Wales. It does include people from all over Australia. But anyway, in that study I think about about of the people I recommended that they do something that I approved. I gave it the suitability pass that I need to do, but I also recommended something else. And most of those were intended mums who had had so many of them have had really tough, tough stories, like dead babies and reproductive loss or being born without a uterus or cancer.
SP: They have is in the highest I ever heard was 38.
MM: No, but it’s the pain, the emotional pain of that being a mum. I think what happens is that they can panic. There have been situations that went pear shaped, not particularly in my cases, but I have hypothesised that it was the intended mother. Panicking about the behaviour of the surrogate who’s had no trouble having babies doesn’t know it. So I will refer the intended mothers on just say you need to do therapeutic supportive therapy. Counselling, while you’re having the surrogacy go and talk about your worry with that person and let the surrogate manage it.
So it’s that managing the pain rather than saying it’s a reason not to do it, because it’s not it’s an integral part of often of these lives of these women, but also managing it so that when the baby spawn, they can just. Okay, fine. We’re on now. We’re onto a good stage now. But that’s probably why I think it’s that also most sorry when you said about that research I’ve seen I’ve heard that said about so I just wanted to do it with guys. Mostly I’ve heard that said with regard to people who met through the Internet and stuff and maybe not sung.
SP: Not family members, not families.
MM: Were close friends in the any study were sisters or sisters in law. And the biggest group, though, now is increased. And the next I’d say now about maximum now. People meeting through the Internet is this massive group of friends, friends, work, colleagues. That’s the big group going up now. So that was like in my study, which ended in ten. But it is I think it’s that a lot of people it’s a relationship like this said, sorry hits me waving my hand. We’re not filming. I think there is that thing called the sisterhood.
And I have done a study. But again, I haven’t tomised, it the values and attitudes of people. Women will say the surge will say how terrible she can’t have children, and they show it back day guys, too. So they will say how terrible they should all have children. I love my children, and they’re not soppy about it. They’re practical women. I love my children. But this is something I can do to help that person. I can’t imagine my life without children, and I can help them have children.
They should be able to be dads and mums, too. So that sort of basic value that you’re referred to.
SP: But I think on that wonderful note, we’ll leave it today. Thank you for your time, Miranda, a pleasure.
Outro: Thanks for listening. If you have any questions, please don’t hesitate reaching out to Stephen at page proven com ou.