A Raglan woman wanted to give her sister back in Ireland the ultimate gift - a baby. But first, the women had to overcome legal and Covid-19 hurdles in a case that challenged health authorities, Alanah Eriksen writes.
When Katie Richardson told her two children she was pregnant again, they asked, "Who's this baby for, Mummy?"
Raglan siblings Cooper and Eily know their seven-month-old cousin, Florence, back in Ireland is extra special as their mother carried her in her belly for their aunt and uncle.
The 33-year-old is now 22 weeks into in her fourth pregnancy and the children are excited they "get to keep this one".
The sisters' surrogacy journey wasn't easy as they navigated legal issues both here and in Ireland, where surrogacy is not recognised, to get three embryos flown 18,000km across the world.
It was a rare and complicated case, which Kiwi health officials say challenged them.
And then our borders closed as Covid-19 raged around the world. If the new parents hadn't left Dublin when they did, with just 24 hours notice, there's no telling whether they would have been allowed into the country to collect the child they had long hoped for.
"Get Amy a baby"
Written on Stuart Hamilton's wish list during his battle with cancer was "get Amy a baby".
The father of four didn't live long enough to meet his granddaughter Florence but when he died in March 2019, he knew the process to create her had started - his youngest child Katie had agreed to be a surrogate for his third-born, Amy White.
White, 38, had cervical cancer when she was 25. It was picked up late as regular smear testing for women in Ireland didn't start until age 25. She had to have a hysterectomy, which removes the uterus, rendering her unable to conceive naturally.
"It was always in the back of our mind that myself or my older sister would do this for her," Richardson tells the Weekend Herald.
"But at the time when Amy had her cancer, none of us were having our own children so we didn't really register that side of it. Whereas Mum and Dad did, they were just distraught for Amy.
"My dad battled eight years of cancer, and it was just his dream . . . he had this bucket list of things he wanted to do before he passed away and one of them was 'get Amy a baby'.
"He just missed it but he knew how far we were down the legal process and he knew that Blake and I were doing our best to make it happen."
Richardson moved from Ireland to Auckland in 2009 and met her future Kiwi husband, Blake. The pair moved to Raglan in 2013, where she is a physiotherapist and nutritionist, specialising in women's pelvic health.
In 2014, her sister started a relationship with her husband-to-be, Reggie, whom she had known for years and who knew about her cancer and the fact it would be difficult for them to conceive. But the couple both knew they wanted a family.
"There's never been a doubt I wanted children," White tells the Weekend Herald from Dublin where she was five weeks into Ireland's third lockdown.
"He's got six kids in his family, four kids in my family. Both our families are really close."
Over the years, White kept an eye on surrogacy and adoption in Europe but she says not a lot of countries' laws aligned with Irish ones. And the adoption process was lengthy.
Meanwhile, Richardson struggled with endometriosis and was told in her-mid 20s she may find it difficult to have her own children. But she had no problems and had Cooper in 2015.
The sisters' older sister, Gilly Staunton, suffered hyperemesis gravidarum - which causes severe nausea and vomiting - during pregnancy so it ruled her out of helping White.
"As Gilly and I were having our own children, we started to realise what Amy and Reggie were missing and how hard it was going to be for them," Richardson says.
The couple went back to Ireland in 2016 and told the Whites they were willing to carry a baby for them. Blake had been "amazing" in agreeing to support her through the process, Richardson says.
"It's a huge thing to ask him to do. When you're pregnant, your partner deals with a lot but at the end it's for their baby, but in this scenario, Blake's not getting anything out of it. It was really selfless of him to do.
"He just said, 'If this is what you want to do, I'll support you'. And he went along with it. He turned up to all the counselling, all the legal things we needed to do and didn't even bat an eyelid.
"If he wasn't my partner, would I have been able to do it?"
But the couple wanted another child before they started the process, and for Richardson to have finished breastfeeding. So the following year, Eily was conceived, with the couple becoming parents of two in February 2018.
Starting the process
Once the two couples decided on New Zealand as the best place to start their journey, the sisters got in touch with Fertility Associates and Auckland barrister Margaret Casey QC, who specialises in medical ethics, international family law issues and reproductive law.
Even though surrogacy was not an option in Ireland, White was able to have embryos extracted in a clinic there with a complicated IVF surgery.
"They had to do abdominal surgery because they couldn't get the eggs out because they couldn't go up through the cervix like they'd usually do," Richardson says.
"But because her case was so interesting people wanted to try to help her and take her on."
The sisters had to apply to New Zealand's Ethics Committee on Assisted Reproductive Technology (Ecart) to get permission for the embryos to be sent here.
After navigating legal issues, mountains of paperwork and required counselling, in September 2019 the pair were granted approval and three embryos were shipped to New Zealand for just the price of a flight.
The embryos were then implanted in Richardson at Fertility Associates' clinic in Hamilton in November that year. Fortunately, Richardson did not need hormone injections and the transfer was done as part of her natural cycle. She became pregnant after implementation of the first embryo.
The science of it all amazes her, and it was even more amazing for the sisters' late grandmother Sheila Morrison.
"For her to comprehend what Amy and I were doing was just phenomenal. She knew when she passed away that I was pregnant with Amy's baby and she was 93 and able to accept that."
Once the sisters knew Richardson was pregnant, White sent over children's books for Cooper and Eily to help them understand what was happening.
"They say 'my mum is a surrogate,' And they talk about a kangaroo carrying a baby in the pouch," Richardson says.
"They're really useful to explain to kids but at the same time they were so young that they didn't really understand much about sex education anyway.
"When they see someone who is pregnant, they will often ask, who the baby's for? Who they are going to give it to? They don't really grasp it."
Richardson was sick most days until about 19 weeks into the pregnancy and believes it was because she was carrying someone else's child.
"I think the psychological aspects of what I was doing really impacted on how that pregnancy was for me.
"When people started to find out what I was doing, I was overwhelmed by it, people saying 'Oh, it's amazing'. I was so sick at the time and I just couldn't cope with people complimenting me all the time. If you're not that way inclined . . . it's like you walking down the street and people commenting on your dress all the time and you're just like, 'Stop'."
But she had help from counsellors as well as a doctor friend who was like her "rock".
"She said to me afterwards it was like I was so detached from Florence that I was . . . feeling the physical much more.
"When you're pregnant yourself, you're really engaging with your baby and how beautiful it's going to be but I was literally doing a job and I was putting one foot in front of the other to finish this job."
Covid rears its head
The Whites were due to come to New Zealand in March 2020 for a couple of weeks so they could accompany Richardson to her 20-week scan.
But closer to the date of the flight, Prime Minister Jacinda Ardern announced all travellers here would have to start isolating when they arrived; at this stage in their place of choice. Not knowing what other restrictions might be introduced, the Whites packed their bags and were in New Zealand 24 hours later - a split decision that may have changed the course of their and their newborn daughter's lives.
"I packed disastrously," White says.
"I bought one sweater with me, one pair of shoes, I did not think I'd be there for more than two or three weeks.
"We had washing in the washing machine, food in the fridge . . . we really weren't going for that long.
"If it had been a couple of days later, I don't know whether we would have got in. That stress on top of the emotional journey we were already on . . . working out how to get flights, let alone getting accepted into the country, the timing worked out so so well for us."
The couple self-isolated at a friend's home for two weeks.
"If we had arrived 10 hours before, we wouldn't have had to isolate.
"When we landed we had planned on meeting Katie at the airport and seeing her with a bump and obviously that didn't happen . . . we couldn't hug her."
Soon after, the borders closed to all non-residents and those who did get in had to go to managed isolation facilities.
Then, just as the couple were finishing their isolation period, New Zealand went into lockdown. They moved into the Richardsons' Raglan home.
"But what an amazing place to get stuck in. If we'd been in that situation in another country, it would have been very different.
"It was so nice spending so much time with Katie's community in Raglan, with her friends and family.
"We'd been in New Zealand over two months before we got a cup of coffee . . . before we could do anything bar go to the supermarket."
Richardson says the time together was great as they had a live-in chef, Reggie, as well as help with their children.
Because of lockdown, the couple were not allowed to go to the 20-week scan but White sat in the car outside the clinic. Many couples find out the sex of their baby at 20 weeks but after such a structured pregnancy process, the couple wanted to leave Florence's gender a surprise.
"We left that as one of the only unplanned parts," White says.
After lockdown, the couple rented another home in Raglan to play the waiting game; they did not know how long New Zealand's borders would be closed and did not want to risk not being able to get back in to get Florence.
White was able to work remotely for her job back in Ireland as a store manager at Lululemon. But it was only part-time, giving her plenty of time to research how she could bring on milk to breastfeed her daughter.
She started taking medication when her sister was about 25 weeks pregnant to start lactation. At about 34 weeks, she started pumping every three hours, including through the night, and was able to extract milk.
White's baby shower was a little different to what she imagined. It was held online with her friends and family in Ireland streaming in. The sisters also had an afternoon tea in Raglan with Richardson's friends. Richardson says the two experiences were surreal, and her feelings at the time were a sign of things to come.
"I was in such protection mode, detaching from Florence, that I think I found it all a bit strange.
"I didn't let myself get the warm and fuzzies over anything. I was there to do my job."
Richardson says she had wanted a c-section but you can't elect for one in New Zealand.
"I knew deep down that I was so detached from Florence that I was going to find it really hard to deliver her."
"A shell of myself"
Richardson's waters broke at 36 weeks and the sisters again counted themselves lucky the Whites had come early. They had been planning to come back to New Zealand after 36 weeks and even if they had been granted an exemption to come in, they would have had to isolate for two weeks, missing the birth of their baby.
But despite the early action, she didn't go into labour.
Both couples stayed at Blake's parents home in Hamilton - about a 45-minute drive from Raglan - to be closer to Waikato hospital. White says the waiting for contractions to start was intense.
"It was like having three husbands . . . me, Reggie and Blake. Katie was like, 'Would you just all back off'. There's not much you can do when you're on the waiting side."
Richardson was induced a week later and contracted all day but still didn't go into active labour. The next day she was induced again.
"I was drawing strength from corners of my soul I didn't even know existed," she says.
"I was just broken . . . just a shell of myself."
After two days, she was still only 3cm dilated.
"I was beyond gutted. Am I surprised? No. I was trying to disconnect from the baby I was trying to deliver."
Then Florence's heart rate dropped and Richardson was rushed into theatre for an emergency c-section. White was allowed in the room with her sister while her husband "peered through a crack in the door."
On July 16, 2020, Florence Katie Hamilton White was born, weighing seven pounds, two ounces.
After she was checked over, White got the first skin to skin contact with her daughter. Richardson says it was always going to be that way despite suggestions during counselling sessions that it would be good for Richardson to hold her first.
"I just couldn't, I was like, 'Absolutely no, that's just pushing my boundaries too much. I need Florence to go straight to Amy'."
White then was able to breastfeed straight away and continued to do so for three months.
"It was amazing to be able to feed her . . . but if I had bottle fed her, I feel like I was so connected to her as well that I hope [it wouldn't matter] if I hadn't."
Meanwhile Richardson felt a sense of overwhelming relief.
"I'd done my job, I'd handed over the baby and everybody was safe.
"That's what keeps you going, that idea of seeing them with their baby and what you're giving them. It was everything I'd imagined it would be."
She says her husband was concerned with how she would fare mentally.
"But I was fine. I was so prepared with the idea that this wasn't my baby. I probably enjoyed the surrogacy the most in that post-natal period because I could see them with their baby."
She held Florence in the hospital but it was only for about 10 seconds before she vomited into a bowl because of all the medication she was on after her c-section.
"I didn't particularly want to hold her. I wanted to see them hold her. That meant more to me."
Richardson stayed an extra night in hospital to recover and says she was never put in a room with the baby, which she says "was really considerate" of hospital staff.
Florence also stayed longer as she had jaundice and the Whites were allowed to stay with her. Everybody was discharged together.
Florence's parents brought her home to their rented Raglan home.
The new family unit stayed in New Zealand about six weeks before flying back to Dublin.
"It was so bizarre arriving in a Covid country and leaving such a Covid-free country," White says.
"When we arrived at the airport and . . . for my mum to meet the baby that is her grandchild but her daughter carried her for her other daughter . . . it's such a huge thing.
"It's the part I probably dreamed of forever."
Fertility Associates group medical director Dr Mary Birdsall says in her 25 years with the company she can't recall a previous case where embryos were flown from Ireland.
"Wherever people are based off shore, that has some challenges around, how do our psychologists have the appropriate meetings when it isn't face-to-face. And also Ireland has it's own set of laws around adoption issues so that just made things a little bit more challenging than for many people.
"We were all delighted that it all worked out well. It was a really wonderful thing for one sister to do for another sister."
Due to Covid, inquiries for embryos to be shipped between countries had increased as people weren't able to travel overseas for treatments, Birdsall says.
But the process had become challenging. Prior to Covid, specialised companies had a staffer fly with the embryo in a freezing device to the other country. Now, they couldn't do so unless granted an exemption by our Government and unless they pay to stay in managed isolation.
Fertility Associates undertakes about 80 per cent of all surrogacy in New Zealand - in 2015 they carried out five, and that grew to 17 in 2019.
Last year, the company filed 25 applications to Ecart for surrogacy. All were approved, with one deferred.
Ecart – which works to the principles of the Human Assisted Reproductive Technology Act 2004 - considers applications made by fertility clinics for a range of assisted reproductive procedures, including clinic-assisted surrogacy, donation of eggs or sperm and embryo donation.
It is still calculating the number of surrogacies approved overall for last year but a spokeswoman says there were 15 in the year to June 2016 and 14 in the year to June 2019.
Birdsall describes the sisters' application as "highly unusual".
"From time to time, people will have fertility treatment overseas, or will import or export sperm, eggs or embryos. However exporting an embryo, gestating and birthing the child in one country, and then having the child adopted in another country is uncommon in New Zealand."
She says the biggest growing surrogacy trend in New Zealand is same-sex men wishing to have a baby using a surrogate and an egg donor.
In cases involving an intended mother, the surrogate is often related to her but there is an increasing number of people finding donors online, Birdsall says. Some pairs come to a clinic for the transfer, while others do the insemination themselves.
By law, a surrogate is the legal parent of the child they are carrying even if it isn't genetically theirs so intended parents must adopt after they are born. New Zealand doesn't allow non-residents to adopt here.
"That's a difficult process for couples, having to go through an adoption process which involves going to court to adopt your biological baby," Birdsall says.
"Most couples find that difficult and expensive."
But changes are afoot.
Minister of Health Andrew Little has referred the Law Commission to undertake a review of the country's surrogacy laws.
And Labour MP Tamati Coffey, who had his son via surrogate in 2009, has filed a members' bill, which includes reform of birth certificate and providing a way to enforce surrogacy arrangements, in case an intending parent chooses not to take custody of the child.
The sisters' barrister, Margaret Casey, has acted for intended parents involving the births of more than 100 children born through surrogacy in the past few years, domestically and internationally.
She tells the Weekend Herald that European counties are slowly becoming more accepting of surrogacy as a way of creating a family so she expects the situation to improve in the near future.
"Covid added an extra layer of complexity for this family and continues to do so because I imagine that but for travel restrictions, there would have been plans made for celebrations to be shared in Ireland. Not being able to participate in those rituals does make it hard for everyone because it is a life-time relationship that continues to be celebrated and should be."
In Ecart-approved cases where embryos are flown here from overseas, Australia and the UK are the most common origins.
But for cases where an embryo transfer takes place overseas and a baby is born there - the most popular country remains the United States, where commercial surrogacy is legal.
In 2015, Ireland legalised gay marriage and White says laws needed to be updated to reflect that.
"I'm not the only person in this situation, it would be lovely if people had more options to create more family in whatever way they need to.
"I do think the Kiwis are so forward and I feel like it's really amazing the diversity and openness of different types of families . . . how not just birth family can be family there. It's very traditional here."
A new bundle of joy
"Special Aunty Katie's" face is the first thing Florence sees when she wakes up. In her Dublin nursery, a mobile with pictures of her aunt hangs over her cot.
"We talk to her about it every day," her mother says.
"All of her cousins know that Aunty Katie carried her. It's a conversation that is very much constant in our house. It always will be."
There are also several photos in the house of Richardson holding Florence in the hospital.
"It's a huge part of who she is."
White can barely put into words how she and her husband feel toward her sister after they were given the ultimate gift of a child.
"It's something that I think about all the time . . . For them to go through all of that . . . there's no words that can explain what they've done.
"It's one of those things that will kind of always give you a lump in your throat every time you really think about it. Even seeing Florence's little belly button and knowing that was attached to Katie's placenta . . . it blows my mind. It's probably something I will never fully put my head around because it's such a big thing."
The couple's friends and family are also emotional.
"They are just blown away by Katie. And all that she gained was seeing us as parents. It's unbelievably kind."
She says it would be lovely if Florence had a sibling but they will see "how life pans out".
Richardson adds: "My kids certainly understand that Amy wasn't able to have kids so mummy had a baby in her tummy instead so I think it will be that way for Florence."
White says she wants to raise awareness about cervical cancer and the importance of getting regular smear tests.
"We need to be open to having that conversation with friends."
Her sister adds: "I think one of the things that surprises people is that Amy was so young."
The Richardson family are now excited for their new bundle of joy due in July.
Richardson was at Cooper's school recently and a little girl said to her "You've got a baby in your tummy, who are you giving this one to?"
"So he obviously chats about it, explains it to his friends. They get it and they know that Florence is really special and they love to see videos of her and understand where she is.
"When we tried to tell them this time that I was pregnant, I was like "I'm having a baby', and they were like, 'Oh, you're going to give it to Amy and Reggie?', 'No we're not, we're going to keep this one for ourselves'."