I need a bit of time to wrap my head around this before commenting as I am quite conflicted. While it certainly seems that Ms. Olafson is well intended and is owed an tremendous debt of gratitude for everything she has done, I am simultaneously bothered by the notion that she has spent almost her entire adult life as a gestational carrier for others and, in so doing, has put her own health at risk while sacrificing time she could otherwise spend with her own children. Serving as a gestational carrier should not be a career or vocation and I am surprised that any agency would accept a surrogate after more than 3-5 surrogate pregnancies. Further, Ms. Olafson even describes herself as an “incubator” which I would otherwise find demeaning if such a label was attached to any gestational carrier. I am curious as to how other surrogates feel about Ms. Olafson’s self-description.

More thoughts to follow in another post, but for now, here is Ms. Olafson’s story:

Meredith Olafson rubs her hands across her swollen belly and says this will be her last baby. “I am retiring after this one,” the 47-year-old Fargo woman says. “This uterus is closing shop.”

But whenever she says this, her family gently kids her that they’ve heard that claim before. Meredith has such a soft heart, explains her husband, Jay. And then his wife will hear the sad story of another couple who can’t conceive, and she’ll want to help them, he says.

In the past 13 years, Olafson has given birth to 10 children for couples who couldn’t have kids. That’s two sets of triplets, one set of twins and two single births in addition to her own four children. Now she is six months pregnant with her sixth pregnancy for someone else – a little girl she insists will be her last – for a South Dakota couple.

Olafson could be the mother of all gestational carriers. Unlike a surrogate mother, who donates her own egg and uterus to create a child, a gestational carrier has no biological link to the baby-to-be. The egg and sperm of the intended parents, or other donors, are fertilized in-vitro in a lab and then transferred to the carrier’s uterus for pregnancy and delivery. “You are literally a walking incubator,” she says.

Some women are motivated to become gestational carriers for financial reasons. In certain areas, a surrogate mother or gestational carrier can command a fee as much as $250,000 for one pregnancy. Olafson says she earns just a tiny fraction of that. “I would be a millionaire if I lived on the East Coast,” says Olafson, a friendly, open woman who lives in a modest home near Olivet Lutheran. “But we never went into this to make money. We did it so people who want a family can have a family.”

As a young wife, Olafson never dreamed she would someday give birth to 15 children. Yet the pregnancies and births of her own four children – Michelle, Jessica, Trevor and Krissy – were enviably easy. She barely gained weight. She golfed with Jay and worked her full-time job as a licensed practical nurse right up to her due dates. Her deliveries could be as short as 20 minutes.

Olafson’s unlabored labor became legendary. Her midwife and obstetrician asked if she’d ever considered being a surrogate mother. At that time, there weren’t any in the area, they said, but there was a growing national demand for healthy, willing surrogates. The Olafsons’ own kids were still young: ranging from age 2 to 10. But Olafson really wanted to help others who weren’t medically able to have children. She contacted a Denver agency that specialized in helping prospective parents find third-party reproductive services. The agency was also contacted by Jodie and Dan Wegge, a Cummings, N.D., couple looking for someone to carry their baby.

Jodie Wegge almost died while delivering their only child, Lindsey. “They lost me on the table for 32 seconds. I needed 48 pints of blood during surgery,” says Wegge. “In an attempt to stop the bleeding, the doctor removed my uterus.” The baby and her young mother pulled through, but Jodie’s child-carrying days were finished. The Wegges longed to give their young daughter some siblings. They considered adoption but were told the wait could take years.

Dan’s mother broached the subject of someone else carrying their baby. “At least they left your ovaries,” she reminded Jodie. Jodie got online and researched her options. She stumbled across the same agency that Olafson found. The business, located hundreds of miles away, told Jodie there was an interested gestational carrier in her own backyard. Through a little detective work, the Wegges found Olafson.

Jodie cold-called her, prefacing their conversation by saying, “This is kind of a crazy question.” While surprised at first, Olafson agreed to meet. The two families quickly bonded. “I liked the fact she was very open,” Jodie says of the initial meeting in 1998. “Our personalities just clicked.” In that moment, history was made.

Working through a lawyer, they drew up a gestational carrier contract – the first in North Dakota. The Wegges would pay a premium for a $250,000 life insurance policy for Meredith, in case anything happened to her. Provisions were made in case the pregnancy required bed rest and she had to quit work. That first contract has formed the basic framework for Olafson’s subsequent pregnancies. She says most parents pay anywhere from $100,000 to $125,000 for the complete process, including in-vitro costs. She receives “10 to 15 percent” of that, she says.

The gestational carrier concept was so new that state laws and insurance guidelines hadn’t caught up with it yet. The Wegges’ health insurance didn’t pay certain costs for surrogates, but the policy said nothing about gestational carriers. The company paid, but it immediately added a clause to exclude coverage of such pregnancies.

With the legal details hammered out, the medical process began. Olafson took drugs to prepare her uterus while Jodie took fertility stimulants to increase the size of her eggs. About a month later, the couple and Olafson traveled to Minneapolis for the in-vitro procedure. There, doctors transferred three of Jodie and Dan’s embryos into Olafson’s uterus. The embryologist said there was a 3 percent chance she would successfully have triplets.

Three weeks later, an ultrasound picked up three beating hearts. Doctors warned the Wegges not to get too attached. The chance all three would survive was slim. But the babies thrived. Olafson made it just past 36 weeks and then gave birth to three of the biggest triplets the hospital had ever seen. Nicholas weighed 5 pounds, 1½ ounces, Brooke weighed 4 pounds, 11 ounces, and Megan tipped the scales at 5 pounds, 3½ ounces.

Jodie was at Olafson’s side during the delivery. “I would have to say I felt so connected to her at that moment,” Wegge says. “I was just overjoyed. The emotions were just spilling out of me. I just loved her, and I couldn’t believe someone would do what she was doing for us.” Olafson was thrilled to see the Wegges so happy and bounced back with her usual resilience. “It’s kind of a fun thing,” she says. “I have a wristband and I can hold the baby and feed the baby. But psychologically, you go into it knowing it’s not your child.”

Even so, the Olafsons and Wegges have kept in touch. The Wegges have always been open with their children about Meredith’s role. When the triplets asked the usual questions about where they came from, the Wegges told them they rented an apartment in Meredith’s tummy for them to grow. When Nicholas turned 4, he brought a photo of a very pregnant Meredith – or “Marrydriff,” as he called her – to show-and-tell. The photo caused some bewildered questions among school staff, which Jodie cheerfully fielded. The important point to them is that their children understand Meredith’s role and accept it. “It’s not weird to them at all,” Jodie says. “They’ve met her a few times, and they just loved her.”

For Olafson, it was the beginning of a new vocation. “Little did I know that I would be pregnant for the next 13 years,” she jokes. She gave birth to twins in 2002, triplets again in 2003, a little girl in 2006 and a baby boy in 2008. The couples often heard about her through word of mouth. Some of the parents came from as far away as Seattle and flew her to a clinic in San Francisco for in-vitro procedures. Every Christmas, a hutch in the Olafson’s living room displays holiday photos of families she helped.

Through it all, Olafson stayed active. She worked, golfed, rollerbladed and raised her own kids. If her children’s friends needed help, she invited them to move in with her. “I have a big heart,” Olafson says. “Sometimes it’s too big, according to my husband.”

Yet this has not been a hazard-free occupation. After her second set of triplets, she developed pre-eclampsia (pregnancy-related hypertension). Her blood pressure soared to 210 over 180 and she developed blurred vision. “That took its toll on me,” she admits.

Her last delivery, in 2008, also was tough. In the middle of the Olafson’s 25th wedding anniversary, the baby arrived five weeks early. Olafson also had placenta previa, which can cause severe bleeding before and during delivery. It was a nightmarish time. Olafson’s oldest daughter, Michelle, was due to be married in a month, and one of her children’s friends, who was staying with the Olafsons, had just given birth to a child with birth defects. Olafson also was sad to learn that the little boy she had carried was diagnosed with Down syndrome.

Last year, Olafson learned more hard news: Megan, one of the Wegge triplets, was diagnosed with a rare form of liver cancer. Now living in Sturgeon Lake, Minn., with her family, she has completed chemotherapy treatments and received experimental proton therapy – all before her 13th birthday. “It’s been a bad year for the triplets,” Olafson says.

Now that Olafson is older – and since her last two deliveries weren’t textbook perfect – her family does worry about her health sometimes. Her youngest daughter, Krissy, who attends Fargo South, sometimes says: “Mom, you shouldn’t do this. Remember what you went through last time?” Oldest daughter, Michelle Lass, says she worries about the toll that her mother’s selflessness could take on her own body. “She’s always willing to give of herself to anyone else, yet she never expects anything back in return,” she says.

The concerns have basis. Michele Goodwin, a law professor and medical ethicist at the University of Minnesota, says there are multiple complex issues linked to surrogacy or gestational carriers, especially if the carrier is older. “It does raise health questions,” Goodwin says. “The older the person is, the more likely that there will be a multiple gestation and the more likely there may also be some health problems for the person who is carrying, and also for the fetuses,” she says.

Goodwin says we’ve become more accepting of older women having babies because, socially, a 40-something woman lives a much more active life than her mother did. Even so, Goodwin adds, a 47-year-old’s biology is the same. “Women over 35 have a much more difficult time of being pregnant. That hasn’t changed,” she says.

But Olafson insists her latest pregnancy has gone well, her obstetrician is pleased, and every ultrasound has been perfect. She’s not worried. “Not really,” she says, “just because I do pregnancies so well. I’ve had a couple of bleeps in there, but nothing that would stop me from being pregnant again. I’m healthy. We’re going to be OK.”

Her husband, a Hornbacher’s produce manager, supports whatever his wife wants to do. “She’s good at it; she likes it and she’s happy,” he says. “She’s helping another family, and she’s big on that, too.” And for Olafson, that’s what it’s all about. She says it’s worth it to see the look on her parents’ faces as they see a baby on an ultrasound or hold that infant for the first time.

“Their faces just light up. That’s what makes it so much easier to come back time and time again,” she says. “When they’re just born and these parents are holding them in their arms and saying I never dreamed we would be able to have our own child – you can’t get anything better than that. Those are the greatest things in the world you can give to someone.”

My colleague, Stephanie Caballero has pointed out that there must be a typographical error as we have never heard of a surrogate being paid $250,000.00.00 for an arrangement. Generally a surrogate will receive a tenth of that amount and any suggestion that gestational carriers earn a quarter of a million dollars per arrangement is abjectly false.