When Kaitlyn Munoz was growing up, she and her seven siblings often talked about what they wanted to do when they were older. “All she wanted to be was a mom,” remembers Munoz’s mother, Chalise Smith.
But as an 18-year-old newlywed, Munoz had trouble getting pregnant. After years of trying to conceive without success, a fertility specialist recommended that she and her husband try in vitro fertilization (IVF). The process resulted in four viable embryos. After being implanted with two of those embryos, Munoz became pregnant. Her joy was short-lived, however; about 30 weeks into the pregnancy she was diagnosed with Sjogren's syndrome, an autoimmune disorder that was causing damage to her kidneys. After developing hypertension, Munoz was rushed into an emergency C-section, delivering her son Callahan at 33 weeks.
When Callahan was a year old, Munoz and her husband looked into implanting their remaining embryos in hopes of having a second baby, but were told that she “wouldn’t survive” another pregnancy. “She was not at peace with doctors telling her 'no,'" says Smith. When her daughter turned her attention to finding a surrogate to carry her two remaining embryos, Smith wondered if she — then a 49-year-old grandmother — could go through the pregnancy herself. After getting the all-clear from her own doctors, Smith offered to act as her daughter's gestational carrier, and gave birth to her granddaughter Alayna in May 2022.
The appeal of keeping it in the family
Although grandmothers acting as surrogates for their own grandchildren is unusual, Smith's case is not unique. It often makes headlines when a so-called "surrograndma" carries a baby when their own child is struggling with infertility, or is gay and in need of a gestational carrier. But fertility specialists say the set-up can be a good option for some families.
“The main benefit is comfort with intimately knowing the person who is carrying your child," says Dr. Alex Robles, an ob-gyn with the Columbia University Fertility Center. "Similarly, the grandmother may feel a deep emotional connection to the baby and feel more invested in having the healthiest pregnancy possible."
Gina, who asked to not use her real name in order to protect her child’s privacy, found that to be true when her mother stepped in as her surrogate. “It was an amazing experience, and if the grandmother is healthy, passes all the tests and is a good candidate, it’s an amazing way [to have a baby]," she says. "Who else will love your baby as much as you, other than a selfless grandmother?"
From a practical standpoint, having a grandmother or other family member act as a surrogate is also more cost-effective than going through an agency, adds Dr. Deepika Garg, a Yale Medicine ob-gyn and reproductive endocrinologist, who notes that, "for most people, it is hard to afford a gestational carrier.” (According to a new survey, the average base salary for compensated gestational surrogacy has risen to $61,000, which doesn't include other financial benefits like new maternity clothes, bonuses and so on.) Garg adds that, per the American Society of Reproductive Medicine, grandmothers acting as surrogates is “generally ethically acceptable when all participants are fully informed and counseled.”
The age factor
Older women can act as surrogates “if a fertility clinic medically clears them,” according to Garg. He notes that while some fertility clinics set age limits, others do not. And being post-menopausal is not necessarily a barrier to acting as a surrogate. “Due to advancements in medical technology, even women who have undergone menopause are able to become pregnant,” Garg says. Dr. John Norian, a reproductive endocrinologist with HRC Fertility, explains that the process involves “waking up” the woman’s uterus with the hormone estradiol and progesterone therapy.
However, Robles says that older women, particularly those over 45, face an “increased risk of miscarriage, preeclampsia, gestational diabetes, C-section, low birth weight babies, stillbirth and more.” Nevertheless, he says that older women can act as surrogates “as long as all parties are cognizant of and accept the risks.”
Taking the leap
In the case of Munoz and Smith, the younger woman wanted to make sure that her mother knew exactly what the surrogacy process would entail. Prepping her body for an embryo transfer required Smith to get daily hormone shots for 10 weeks, in addition to the physical strain of carrying a pregnancy. Smith wanted Munoz and her husband to fully accept the risks as well. Because Smith was older and implantations don’t always result in pregnancies, she didn’t want her daughter to blame her if the procedure didn't work, or if she couldn't carry a pregnancy to term. They underwent counseling before signing a contract, which is a necessary step in the surrogacy process.
At the time of their surrogacy journey, Smith lived in Utah while her daughter was based in Texas. Munoz went to as many of her mom's appointments as she could in person, and joined the rest over FaceTime. One of the two embryos successfully implanted, and after the risky first 15 weeks of pregnancy, Smith and Munoz told friends and family. “People were amazed,” says Smith. “They had tears in their eyes.”
Smith turned 50 — which she celebrated with a trip to Disneyland — about six months into her mostly uneventful pregnancy. “She was a rock star the whole nine months,” says Munoz, who was by her mom's side when Smith gave birth to her granddaughter. Right after Alayna was born Smith thought, “That’s my granddaughter” and handed the baby over to her grateful and ecstatic parents.
From the beginning of the surrogacy process, Smith says she imagined “the joy and happiness” she would give her daughter. “My heart was overflowing with love to be able to give her this beautiful gift,” she says, adding that “everything felt right” when she saw Munoz holding Alayna for the first time. Big brother Callahan told Smith that Alayna is his “best friend.” Hearing that, Smith says she knew she helped bring Alayna into the world for him, too.
Alayna is now a year old and Smith visits her as often as she can. “I look into Alayna’s eyes and her soul connects to mine,” the proud "nana" says.
“My relationship with my mom has always been strong. She is one of my best friends,” Munoz shares. “I am so grateful.”
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