The Psychological Challenges in the Surrogacy Process

(From an interview with psychologist Dr. Ilan Tabak Aviram)

Surrogacy is not only a medical procedure – it is a medical, emotional, and social journey. It is a complex journey, full of experiences, challenges, and unique human connections. On one hand, it requires professional guidance and support, and on the other – it allows the fulfillment of the dream of parenthood.

In Israel, unlike in many European countries where the process is completely forbidden, the law permits surrogacy both domestically and abroad, while recognizing children born through this path. Dr. Ilan Tabak Aviram, a clinical psychologist who has accompanied intended parents through Tammuz for many years, explains the challenges, emotional tension, and unique bonds that form along the way.

The Development of the Law and Expansion of the Process

The Surrogacy Law, enacted in 1996, was originally intended to help heterosexual couples struggling with fertility issues. Today, following social and legal changes, surrogacy is also available to LGBTQ couples and single parents – and sometimes it is the only way to realize the dream of parenthood.

Unique Challenges Along the Journey

The relationship between intended parents and the surrogate is delicate and complex. In modern surrogacy, there is no genetic link between the surrogate and the baby – which reduces attachment, but does not eliminate it. Birth and the return to routine pose emotional challenges for the surrogate, while the intended parents experience a “long-distance pregnancy,” sometimes in another country. The lack of control can trigger anxiety: some respond with emotional detachment as a defense mechanism, while others cling to their worries. The psychological work focuses on building trust, reconnecting to the process, and genuine preparation for parenthood.

Preparation and Setting Expectations

From the very beginning, it is crucial to set clear expectations – not only medically, but also emotionally and psychologically. Anxiety, stress, and sleepless nights will accompany parents even after birth, and they need to understand that these are an inseparable part of parenthood.

Another key aspect is the conversation with the child about the way they came into the world – and it is advisable to begin at an early age, using age-appropriate language, in order to prevent secrecy and to strengthen self-confidence.

The Relationship with the Surrogate

Should families maintain contact with the surrogate? This is a personal choice. Some families opt for close and friendly relationships, while others keep it formal and distant. In international surrogacy, as done through Tammuz, the relationship is usually conducted through digital means – allowing for both clear boundaries and a sense of security.

After the Birth

After the birth and the return home, parents face a wide range of new challenges. As part of the parenting preparation program developed over the years, Tammuz offers a unique workshop for intended parents, conducted by leading professionals, designed to provide tools for coping. (The workshop is free of charge and exclusively for Tammuz clients.)

Conclusion

Surrogacy is a challenging yet empowering journey that requires support, listening, and the ability to embrace complexity. Thanks to the vast experience of Tammuz, the largest surrogacy agency in Israel, intended parents receive professional and human support that enables them to go through the process with confidence – and fulfill their dream of becoming parents.