Saturday, 5 March, 2011
Embryo swap mother of all mix-ups
Carolyn and Sean Savage were on their fourth round of IVF when they discovered she was pregnant - with another couple's child. Emma Brockes talks to them about what happened next.
In some US states, Carolyn Savage would be called the ''natural mother''. In others she is known as the ''birth mother''. The fertility industry generally refers to her as a ''gestational carrier'', a term she finds abhorrent. It's a complicated situation. In February 2009, while undergoing IVF, Savage was mistakenly implanted with the fertilised egg of another couple. She carried the baby to term and, after giving birth, handed him over to his ''genetic parents''. If she doesn't know exactly what she is to 18-month-old Logan, she does know this: ''I took him from 12 cells to a living, breathing human being.'' The 41-year-old pauses. ''That's a big deal.''
Since news of their situation got out, Sean and Carolyn Savage have been caught in a publicity whirlwind. They come from Sylvania, Ohio, where Sean works for a financial services firm and Carolyn was headteacher of a primary school. At the time of starting what they thought would be their last try at IVF, she had already undergone 20 ovarian stimulation cycles, three rounds of IVF, and had four miscarriages. So the first shock, on reading the book they have co-written, comes on page two, when the couple asserts that if treatment didn't work this time, ''We would thank God for our three beautiful, healthy children and move forward.''
The Savages were, by most standards, a complete family: they had two teenage boys, naturally conceived, and a one-year-old daughter conceived by IVF. Even to want four children in this age of dwindling birth rates is considered eccentric, and to pursue that aim across years of cost and turmoil has incurred rapid judgment, and the suggestion that, despite the uniquely dreadful circumstances in which they found themselves, they are less deserving of sympathy than they seem.
Today, in a Manhattan hotel room, they are braced for the onslaught. As a couple, Carolyn says, ''Sean's a type A and I'm like a B+. So we're swell together'' - though she is by far the more assertive in conversation.
Sean, a young-looking 40, was at work when he received a call from the couple's fertility doctor. That morning, Carolyn had gone into the clinic for a pregnancy test. Now, the doctor said: ''I have bad news, but not the type of bad news you'd expect. Carolyn is pregnant with another couple's genetic child.'' Sean drove home immediately to break the news to his wife. ''You are joking,'' she said. What else could she say? They both collapsed into tears.
So began nine months of unimaginable heartache, including, as they saw it, the thoughtlessness of the baby's genetic parents, the inadequacy of the clinic's response and the condemnation of the Catholic church, to which they belonged, for their use of IVF. Meanwhile, Carolyn struggled to figure out what it meant to carry another woman's child.
It would take a long investigation to discover exactly how the error occurred; the other woman, Shannon Morell, had registered for IVF under her maiden name, Savage. The two women's files were next to each other in the clinic and were mixed up, so when it came to locating Carolyn's fertilised eggs in cryopreservation, the wrong information was used. The mistake came to light only because of a small, unrelated error - Carolyn's birth year was wrong on her hospital wristband - which sent a technician back to the paperwork, where the bigger anomaly was discovered. By then it was too late; the eggs had already been transferred.
Technically, when the mistake was revealed, there was a decision to make, but the Savages say they had already made it. They had chosen their fertility doctor in part because he didn't believe in abortion. To their amazement, he urged them to consider a termination. They couldn't. They would have the child, they said, and after the birth, return it to its rightful parents. This decision was all the more extraordinary given Carolyn's pregnancy history: she had nearly died giving birth to their second son, Ryan, after suffering a rare form of pre-eclampsia, and Mary Kate had been born prematurely and spent a month in a neonatal unit.
The second question was: who were the other couple and how much interaction should they have with them? Sean urged caution. They might sell the story to the tabloids, he thought, or lobby for termination. A letter was sent through the Savages' lawyer, confirming that they would proceed with the pregnancy and keep the Morells informed but that, at this stage, they didn't wish to be in direct contact. The lawyer concluded: ''My clients do request that your clients understand how devastated they are by this situation.''
There is nothing like other people's child-bearing decisions to bring out any free-floating prejudices. Sean, the second youngest of nine children, and Carolyn, one of three, always wanted a large family. ''Yeah!'' says Carolyn, brightly. ''Well, I'm a teacher. I love kids. Sean was from a huge family. The idea just appealed to us. So we pursued that.''
''It's a personal choice,'' Sean says. ''We've seen some things out there [about us] - you know, why try to have four? It's tough to pass judgment on people. It's like looking at someone without a child and saying, why? But that's a personal choice.''
After the mistake was discovered, the first thing Sean did was start a giant filing system to deal with the paperwork. They had to find lawyers, a therapist - above all, a new physician. Their fertility doctor, utterly horrified by what had happened, made what they considered a bizarre suggestion: that they ''reverse surrogacy'', ie, transfer their embryos into the other woman and swap babies when they were born. As they write in the book, ''The idea sounded like it belonged in the circus.''
The next task was to tell friends and family. After reassuring everyone that no one had died and they weren't getting divorced, they called a meeting at the church hall - and warned those present that they detested the religious platitude that put their misfortune down to God's will. ''Ugh,'' Carolyn says. ''It got said a lot of times - 'It's God's plan' - and I thought, really? You think God did this to me? I don't believe in God's plan. I believe in God, but I think sometimes bad stuff happens.''
Early on, she had to decide how to consider the child she was carrying. Was it in any way hers? Could she possibly detach from it as it grew, so that come the handover, she was any less devastated?
No, she says. Even if she'd wanted to, her body wouldn't let her. ''I tried. I tried. In the first couple of days, I heard the term 'gestational carrier' thrown at me. And I just kept thinking, I'm not, I'm a mother. I tried to detach, but I couldn't.'' And it was, in some ways, her child. ''Obviously we kept our promise to return him to his genetic parents, but we made a decision to bring him into this world and I'll always feel responsibility towards him. It's just we don't get to raise him.''
Into the equation came the Morells, who'd been together for seven years and had twins conceived by IVF. Given the Savages' religious principles, would their decision not to fight for custody have been different if the Other Family had turned out, say, to be a divorced woman, having a child alone?
Carolyn says: ''We knew whoever was coming through that door was going to get this child. We knew that. So it didn't matter who they were. It was nice it was a family and a married couple. But we had already prepared ourselves for anything.''
What they didn't know was just how difficult interaction with the Morells would be. The most compelling part of the book is the terrible dance that takes place between the two families. When an introductory email from Shannon Morell arrived, the Savages' lawyer forwarded it with the warning: ''Think carefully before reading this, Carolyn.''
The letter had an incendiary effect. In it, Shannon complained about how she'd lose her privacy, how hard it would be to explain things to her co-workers and, in the line that inflamed Carolyn most, said, ''God for some reason decided another woman would carry this baby for me.''
Carolyn said to Sean: ''It's heartless.''
It was the beginning of a series of exchanges with the Morells, culminating in a very difficult meeting, which the Savages felt was characterised by the other family's insensitivity to their feelings; their failure to recognise the scale of what was being done for them. In that meeting, in the presence of lawyers, Carolyn was so distressed she couldn't look Shannon in the face, fixing instead on her necklace.
Shannon's husband Paul was, Sean thought, ''unbelievably uncomfortable''. Shannon is portrayed as flippant, pointing out the overlap between her maiden name and Sean's surname, and joking, ''Do you think you and I are related?'' She did express gratitude to the Savages for continuing with the pregnancy, but in a later phone call complained to Carolyn that her doctor had questioned her ultimate right to keep the child.
Carolyn says: ''It had never even occurred to her she might not be entitled to this child. I remember hearing that and thinking, OK, I feel a little bit vindicated because someone actually understands I am making a contribution. I didn't want to be looked at as an oven, or an incubator for this child.''
The Savages say they are on friendly enough terms with the Morells now, not least because they want to stay involved in Logan's life - something the Morells say they would also like. They have yet to see the book. Carolyn says: ''I offered to sit down with Shannon and go through some of the tougher moments, and she declined. That's their prerogative. We're not sugar-coating it; we experienced feelings we're not proud of and that aren't flattering to us. We all have those moments, right? We have weak moments and lose our patience; there's bitterness, resentment, anger, frustration. On the flip side, we're trying to show people if you keep focused, you can push that to the side and get to where you need to be. That's why we included those moments. We don't anticipate any...'' She hesitates. ''I hope they understand. Time will tell.''
All the Savages had left, after the birth, was the moral high ground, and you can hardly blame them if an air of condescension creeps into their references to the Morells. Their youngest son, Ryan, when told about the baby, asked of the Other Family: ''Do they smoke? What do they do for a living? Where do they live?''
The pregnancy continued and Sean and Carolyn talked about what they would do after it. Astonishingly, they decided to pursue having another child. Given Carolyn's age, they felt more IVF might not be ideal. So, as the birth approached, they found a surrogate. She was implanted with their remaining fertilised eggs and became pregnant.
There is a sense, in the book at least, that Carolyn is the driving force behind this relentless push to have more children. Earlier on in their marriage, Sean had said, ''Drew and Ryan are beautiful and healthy. Why can't this be our family?''
Carolyn replied, ''Sean, you don't understand. Our family is supposed to be bigger than this.''
To which her husband said, ''I am not opposed to more children. But at what cost?''
The cost was, of course, huge. There comes a point in the story when each scene seems more cruel than the last. Having invited Shannon along to an ultrasound, Carolyn is desperately upset when the technician directs all her comments to Shannon, handing her the scans at the end. And when, finally, she goes into labour, she is grief-stricken. ''I wasn't ready for this child to be born. I wasn't ready to say goodbye.'' She had suggested having the Morells in the delivery room, but Sean put his foot down. ''It will be like a birth and a death in the same room at the same time,'' he said.
They negotiated with the other family to have some private time with the baby after he was born. They introduced him to their other children, then, as a couple, spent a few moments with the baby they could not be sure they would ever see again. Sean took him from Carolyn to where the Morells were waiting and handed him over, in tears. The other couple shrieked and clapped. Sean said, ''Congratulations, you have a healthy baby boy. Five pounds, three ounces.'' They said they were calling him Logan, which means ''lucky'', and that his middle name would be Savage.
The hospital asked the Savages if they'd like a ''bereavement box'', given to families who lose a child at or after birth, containing, among other things, a photo and a footprint in clay. Carolyn said she would. A week after the birth, the surrogate mother pregnant with their own baby miscarried.
The couple have said their ability to withstand these experiences has come down in part to their faith. Yet the Catholic church called their use of IVF ''morally unacceptable''. It's hard to imagine how they dealt with such an unforgiving attitude.
Sean says, ''Our view is our church is a man-made institution, founded on the principles of an incredible God. But man-made institutions are flawed and they're going to make mistakes.''
They continue to seek fertility treatment of one kind or another, in the hopes of having a fourth child. (On the issue of adoption, Sean says, ''We have significant respect for people who adopt. We considered it. It's a very personal choice as well.'')
Isn't there a danger it has become an obsession?
''Oh, sure,'' says Carolyn. ''I can see that. I don't think it has, for us. We're in a pretty peaceful place right now. That said, we're not willing to slam the door on anything.''
If it hadn't been for the slip-up with her birth date in hospital, the mistake would never have been discovered. Do they ever wish that was the case?
''Oh, yes,'' says Carolyn. She laughs. ''Of course. Yeah. Sean and I are stronger and better people for what we've been through, OK? But I don't know how you wouldn't consider that... Logan - we would've never known. We just wouldn't have.''
Sean looks alarmed. ''In no way are we saying we wish the mistake wasn't discovered,'' he says. His wife turns to him as if he's taken leave of his senses. He continues, ''I don't think that's a fair -''
''Well, whatever,'' snaps Carolyn. ''OK. I would say it's fair to say there are moments when we wonder, hmmm. So.''
After the birth, the Morells sent out a card announcing Logan's arrival, with a photo of the family in which he was wearing an outfit given to them by the Savages. When he was three months old, the Morells brought him for a visit. Shannon let Carolyn change his nappy; while she was doing so, she murmured to him, ''Mamma loves you.''
''I said that to him all the time in utero - to all my babies. That's not saying I'm his mum. I'm saying when he was with me, he had my love, like he was my child; now - we had a great afternoon [with Shannon] - I've seen his mother loves him.''
It had a double meaning? ''It did.''
Sean says, ''I think you have to celebrate that. We have unconditional love for him. I don't know if there's a greater love.'' That they decided to ''embrace the gift'' by loving the baby is, says Sean, ''probably the way we survived it''.
They came to a settlement with the hospital, the size of which can't be disclosed. Some of it, along with proceeds from the book, will be tithed to a charitable foundation set up in their name.
They hope when Logan grows up and reads the story of his birth, he'll want to be part of their lives. But they know they will always be in a strange no man's land where he is concerned. ''We have three children. Or do we have four?'' they ask. During the pregnancy, Carolyn had an amniocentesis, to make absolutely sure the baby wasn't hers. A small part of her still hoped that, despite all evidence to the contrary, the error was in itself an error. The results came back: there was a zero per cent chance the baby was her genetic child. ''I thought, surely, a little bit of my soul had crept into him. But I guess the DNA test couldn't measure my contribution.''
Inconceivable by Carolyn and Sean Savage is published by HarperOne.