A Surrogate Mom’s Guide to Medication Safety During Pregnancy

Introduction: Why Surrogate Mothers Must Strictly Control Medication Use During Pregnancy?

As a professional platform in the field of international surrogate motherhood, we understand that the health of surrogate mothers is directly related to the development of the fetus and the hope of the commissioning family. The use of medication during pregnancy not only involves complex medical ethics, but may also lead to legal disputes or risks to the health of mother and child due to improper use of medication. This article will combine global medical standards and clinical practice to provide detailed guidance on the use of medication for surrogate mothers and commissioned families to ensure the science and safety of the entire pregnancy.

the surrogate mother absolute contraindication list of drugs: these ingredients must be away from

1. High teratogenic risk drugs
   Isotretinoin (retinoic acid derivatives): even topical preparations may pass through the placenta and cause fetal craniofacial malformations or heart defects, with a significant increase in the risk of miscarriage with early pregnancy exposure.
   Methotrexate and cyclophosphamide: immunosuppressive drugs that may cause miscarriage in early pregnancy and fetal growth restriction or hematopoietic abnormalities in mid to late pregnancy.
   Reactivation (thalidomide): history warns that this type of neuroleptic has caused “seal limb deformities” and its use during pregnancy has been banned globally. 2.
2. Hormone-disrupting drugs
   Long-acting contraceptive injection (Depo-Provera): surrogate mothers need to be injected at least three months before preparing for pregnancy, otherwise it may interfere with the sexual development of the fetus.
   Estrogen replacement drugs: e.g. Hexenoestrol, may lead to increased risk of vaginal adenocarcinoma in female infants in adulthood.
3. Psychotropic and addictive substances
   SSRI antidepressants (e.g. paroxetine): use by surrogate mothers in late pregnancy may lead to neonatal withdrawal syndrome, manifested by tremors or respiratory distress.
   Benzodiazepine sedatives: increase the risk of fetal cleft palate and need to be contraindicated during breastfeeding.
   Recommendations for action: Surrogacy contracts need to specify the terms of drug contraindications for surrogate mothers, complete metabolic screening 3 months prior to conception, and bind surrogate mothers to liability for unauthorized use of medications through legal agreements.

the surrogate mother allowed to use drugs and standardized operation

1. Chronic disease management drugs
   Prednisone (glucocorticoid): safe to use in patients with lupus or asthma, but dose control (≤10 mg daily) is required to avoid fetal adrenal suppression.
   Hydroxychloroquine: base drug for SLE, continued use during pregnancy reduces risk of preterm labor.
2. Surrogate mother Infection and pain control
   Penicillin antibiotics: first choice for treatment of urinary tract infections, no evidence of teratogenicity, but need to be alert for allergic reactions.
   Acetaminophen: the only safe antipyretic and analgesic, daily dose should be ≤3g to prevent liver injury.
3. Nutritional supplements for surrogate mothers
   Folic acid (0.4-0.8mg/day): necessary from 3 months before pregnancy to early pregnancy, can reduce the rate of neural tube defects by 70%.
   Vitamin D (400-600IU/day): Deficiency may cause preeclampsia, it is recommended to adjust the dosage by blood test.
   Key Note: All medications need to be prescribed by a reproductive medicine specialist and communicated to the client in tandem with legal counsel. Cross-border surrogacy needs to ensure that the drugs comply with FDA or EMA certification, to avoid disputes arising from disputes over the source of the drugs.

Alternative therapies and natural medicine programs

1. Potential Risks of Herbal Medicine and Phytotherapy
   Black Cohosh and Angelica: may stimulate uterine contractions and increase the risk of miscarriage, and are absolutely contraindicated for surrogate mothers in early pregnancy.
   Echinacea: immunomodulatory effect or interference with embryo implantation, recommended to be avoided throughout the whole process.
2. surrogate mother physical therapy and lifestyle adjustment
   Acupuncture: Choose a qualified acupuncturist and avoid abdominal points (e.g. Guanyuan, Sanyinjiao).
   Gentle Exercise: A 30-minute walk daily or yoga during pregnancy can improve circulation and reduce the risk of gestational diabetes.
   Data support: Studies have shown that meditation and breathing exercises can reduce the incidence of anxiety during pregnancy by 40%, and it is recommended that families be entrusted with a counseling budget for surrogate mothers.

Legal Compliance and Medical Liability

1. Core terms of the international surrogacy agreement
   Medication authorization: the commissioning party needs to sign a document allowing the surrogate mother to use specific medications (e.g. progesterone injection) in case of emergency.
   Health Monitoring Clause: It is clear that the surrogate mother needs to submit medication records and maternity reports every two weeks, and breach of contract will trigger the compensation mechanism.
2. Cross-border drug transportation regulations
   Original packaging and customs declaration: surrogacy agencies need to assist in providing drug instructions, prescriptions and proof of ingredients to prevent international logistics seizure.
   Insurance Coverage: It is recommended to purchase “Surrogacy Medical Liability Insurance” to cover additional costs due to drug allergies or complications.
   Case reference: In a surrogacy case in California in 2023, the client was awarded $120,000 due to delayed embryo transfer caused by undeclared progesterone injection.

Efficient collaboration with the medical team

1. Composition of multidisciplinary medical team
   Core members: reproductive endocrinologist, obstetrician, pharmacist and psychologist.
   Communication mechanism: bi-weekly cross-team meetings to synchronize key data such as fetal NT screening and non-invasive DNA.
2. Digital health management tools
   Medication tracking app: recommend “Medisafe” to record the time of taking medication and set up automatic reminder function.
   Remote fetal heartbeat monitoring: Wearable devices such as “Bloomlife” can transmit data to the client in real time.
   User feedback: 85% of the surrogate mothers believe that the electronic health record improves medication compliance and reduces the risk of missing doses.

Nutritional fortification and dietary taboos for surrogate mothers

1. Necessary nutrient intake standard for surrogate mothers
   DHA (200-300mg/day): Prioritize intake from deep-sea fish (e.g. salmon) to support fetal brain development.
   Iron (27mg/day): Vegetarians need to pair with Vitamin C to improve absorption and avoid taking with calcium.
2. List of high-risk foods for surrogate mothers
   Raw food and unpasteurized dairy products: may carry Listeria monocytogenes and cause miscarriage or stillbirth.
   High-mercury fish (e.g. tuna): intake needs to be limited to 170g per month.
   Surrogate’s Kitchen Program: Provide customized meal menu service, with recipes designed by a nutritionist according to the characteristics of drug metabolism (e.g., avoiding grapefruit to affect the metabolism of anticoagulant drugs).

Psychological support and long-term health tracking for surrogate mothers

1. Drug-related emotional management of surrogate mothers
   Side effects of hormonal drugs: progesterone may lead to mood fluctuations, requiring monthly screening of PHQ-9 depression scale.
   Psychological counseling intervention: Cognitive Behavioral Therapy (CBT) is recommended at least once every two weeks to relieve surrogate separation anxiety.
2. Postnatal drug metabolism monitoring
   Breastfeeding contraindication: if using radiopharmaceuticals (e.g., iodine-131), breastfeeding needs to be suspended for at least 6 weeks.
   Bone densitometry: Long-term heparin users should undergo DXA scanning at 6 months postpartum.
   Statistical findings: systematic health tracking can reduce the risk of long-term chronic diseases of surrogate mothers by 35%.

Conclusion: Building a safe and transparent medication ecology

Surrogacy is not only a medical act, but also a profound practice of bioethics. We call on the industry to establish a globally unified database on medication use during pregnancy, promote insurance companies to develop surrogacy-specific medical liability insurance, and realize the traceability of the drug distribution process through blockchain technology. Only by combining scientific norms with humanistic care can surrogacy truly become a path of hope for creating life.