There are published guidelines in regards to practices with gestational carriers for mental health professionals that outline a standard of care. More specifically, these publications highlight the importance of psychological counseling, education, assessment, and support by a qualified fertility counselor of all participants as well as they provide for rejection or denial of participants. Counseling is an important part of medical care and should occur before treatment begins.
Fertility counselors traditionally meet separately with the intended parents; separately with the gestational carrier for psychological assessment and consultation (with husband/significant other, if applicable); and finally with both the intended parents and gestational carrier in a group session. Each of these sessions has different purposes and goals, yet all are components in building, planning, and navigating the family-building process with a gestational carrier.
A significant goal of preconception counseling with a potential gestational carrier is helping her decide if being a carrier will serve a positive purpose or have a negative impact on her life. Being a gestational carrier involves a wide array of ambiguity and potentially emotionally stressful situations, and assessing how a carrier will respond to and resolve such issues is key to protecting her and all parties involved. She needs to be able to provide informed consent, be able to relinquish the child, and, along with her family, exit the experience whole and unharmed.
In an effort to serve both parties, the fertility counselor must assess the candidate’s motivations, her ability to accurately perceive situations, her personality, and her intellectual competency. Assessing decision-making processes, social and family relationships and supports, manner of resolving problems and ability to take care of herself and others (e.g., her own children) is important.