In a ridiculous move, some Canadian hospitals have begun charging surrogate mothers and/or the intended parent(s) for medical bills. The National Post reports on a recent case in which Bethany, “a tax-paying Ontario resident,” was charged a $1,400 bill because she “was a surrogate carrying the infant for a couple from Italy.”

These unfair charges hurt both the growth of the industry as well as the relationship between the surrogate and the intended parent(s):

In one case, a Spanish couple took their premature twins home, but skipped out on the $58,000 hospital bill, leaving it to the surrogate to pay, said Sally Rhoads-Heinrich, a consultant and owner of Surrogacy in Canada Online.

“It’s pretty awful to carry babies for a couple and have a C-section and everything and have them just leave you with huge medical bills,” said Ms. Rhoads-Heinrch. “It has definitely destroyed some relationships.”

Often, the medical bill is more than the surrogate mother or the intended parent(s) can afford:

Ms. Flowerday said she had to negotiate with a hospital after it charged the foreign parents $700,000 to care for a baby carried by a Canadian mother.

The charge was eventually waived when the infant stayed long enough in Ontario to be considered a resident and eligible for medicare coverage, she said.

It seems that sometimes the only safe option is to “not [tell] the hospital the nature of [the] arrangement,” although withholding this option from a hospital is certainly not condoned.

It used to be that no Canadian hospital would charge for services provided in a surrogacy situation, said Ms. Rhoads-Heinrich. The fact that both pre-natal and post-natal care for Canadian surrogates is covered by medicare has actually made this country’s carriers more appealing to some foreign parents, at least in comparison with American carriers, whose medical costs must always be picked up by the intended parents, she said.

As surrogacy arrangements involving out-of-country and out-of-province couples have become more common, however, a few hospitals are now billing, said Ms. Rhoads-Heinrich.

At Quinte Health Care, which runs four hospitals in Belleville, Ont., and surrounding area, administrators developed a policy on the issue last summer after seeing increasing numbers of surrogate births, said Susan Rowe, a Quinte spokeswoman.

If the intended parents are from another province, their government plan will be billed $388 a day for basic post-natal care, she said. If the parents are from another country, the charge is $720 a day, a standard fee for foreign patients, said Ms. Rowe.

“We are a taxpayer-funded institution, and we have to make sure we maximize revenues,” she said.

The Grand River Hospital in Kitchener, Ont., will charge intended parents from outside the province unless the baby stays in Ontario for at least three months — the residency requirement to be covered under medicare, said spokesman Mark Karjaluoto.

If the delivery is straightforward and the baby healthy, the bill can be as little as a few hundred dollars, said Ms. Rhoads-Heinrich. But if the infant is born early, the woman has multiple babies or other complications occur, the charges quickly mount, she said.

Meanwhile, many facilities still absorb the costs in such situations, say lawyers and consultants, leading to what they called a legal grey area. “Sometimes there are massive bills and nothing happens,” said Nicole Kopping-Pavars, another Ontario fertility lawyer.

Still, she said she had a “frantic” call from a surrogate after another hospital handed her an invoice. The lawyer contacted the intended parents, who lived in Quebec, and asked them to take care of the bill.

In two other cases, parents from Quebec were also billed for services provided to babies born to surrogates in Ontario, said Ms. Kopping-Pavars.

Only time will tell if this practice will become policy for all Canadian hospitals.