Couples who choose to use a surrogate mother to help them realize their dream of becoming parents receive a great gift. But what makes a woman decide to give so very much of herself -- and what does she get in return?

Surrogate Lucy described her relationship with the couple whose son she carried, nurtured and gave birth to in glowing terms. "In time, we became friends, and it seemed when I wasn't looking, somewhere along the way we became family," she says. "In the end, the parents have a wonderful son and a new lifetime of hopes and dreams. I, on the other hand, feel like I got so much more. I have ... a sense of self worth that few can ever even imagine. Because of me, Lucy -- your stereotypical suburban mother -- there is a family who lives half way around the world. [They] can now pass down the family name to yet another generation. Without my help, the family name would have died out, because [the parents] were both only children who couldn't have children on their own.

"I made a difference in a life. How many people can say that?"

The feeling of family goes both ways. Like Lucy and the family for whom she was a surrogate, Lynn and her husband grew close to their surrogate, whom they first met over the Internet. "We were total strangers who met and became an extended family. Our surrogate and her family are now part of our family, and we expect to remain close to them over the years. We refer to our surrogate as 'Auntie' -- as a matter of fact, when I first went back to work, she was our daycare provider for Nichole." Lynn's surrogate is pregnant again, carrying another child for Lynn and her husband.

For Suzie, 32, and her husband Ed, of Lincoln University, Penn., the feeling of their surrogate being family didn't happen as a result of the surrogate carrying their child -- their surrogate, Tara, already was family; she is Ed's younger sister.

Suzie and her husband, Ed, had been married for two years when their daughter Emily was born prematurely. Suzie was just 20 weeks pregnant when her water broke; she was in the hospital on bedrest when she went into labor at 28 weeks. Emily weighed just over two pounds and lived for only three hours. Five weeks later, Suzie began hemorrhaging. During surgery, her doctor discovered that during pregnancy, the placenta had perforated the wall of her uterus. An emergency hysterectomy had to be performed to save Suzie's life.

About a year after Emily's birth and death, Suzie and Ed had just started the adoption process when they received a letter from Ed's younger sister, Tara. Tara enclosed a copy of a newspaper article about two sisters, one of whom acted as surrogate for the others. "She finished her letter with a P.S., 'I am interested in this if you are.'"

After coming to an agreement with Tara and her husband, Chris, Suzie and Ed moved from Arizona to Delaware, where Tara and her family lived, and Tara became their surrogate. Since Suzie still has her ovaries, her eggs were used in the IVF procedure. Suzie's and Ed's son, Keegan, who grew in his Aunt Tara's womb, is now a healthy, happy 6-year-old.

Suzie's and Ed's experience of having a loved one act as surrogate is not unique. Sharon, 36, of Rochester, NY, is currently pregnant with twins in an independent gestational surrogate arrangement. Sharon has been married for 15 years and has a son who is 13 and a daughter who is 4. The couple whose twins she is carrying are family friends. The intended mother could not carry another pregnancy. Sharon's decision to act as surrogate is supported by her husband, Joe. "His feelings seem to be that we are helping create a complete family for another couple. What could be better than that?" Sharon also enjoys the support of friends and family. "After answering questions about my health and procedures and explaining exactly what surrogacy is, I have had a very supportive reaction and feel lucky that my friends and family understand my motives."

Suzie, whose sister-in-law carried her son for her, feels that this kind of support is crucial to making a surrogacy arrangement work. "I think it is very important that all parties involved are in full support of this. It was crucial to us that Tara's husband agreed with this plan. Our doctor required that we all attend one session with a psychologist before agreeing to this procedure."

Like Sharon and Tara, Lucy had her husband's full support for her surrogate pregnancy. Though Lucy's husband initially had reservations about the arrangement, after he met with a surrogate counselor, he was not only reassured, but became "as active as possible in my surrogacy journey. He was the surrogate father," giving her shots, accompanying her to the doctor when the intended parents couldn't, and ultimately became her Lamaze coach.

What of the fears, generated through stories like that of Mary Beth Whitehead and "Baby M," that the surrogate will want to keep the child? Surrogates Sharon and Lucy, who both have children of their own, agree that a surrogate pregnancy is different from being pregnant with their own child. "When you are carrying your own children you have hopes and plans for them. You wonder whom they are going to look like and what their personality is going to be like. Your extended family is excited and everyone is planning for the new addition. This is not the way of carrying a surrogate baby. As a surrogate, I mainly focus on how happy the parents are going to be and how their family will be completed because I could be there to help them achieve their dreams."

Lucy, who has just embarked on her second surrogacy, feels the same way. "From the very beginning, even before I got pregnant with my first surro-baby, I knew he was not mine. I knew that once I gave birth, I would be seeing a stranger. Yes, I would know his kicks and his hiccups, I would know his sleeping pattern and his movements, but I wouldn't recognize whose ears he had, or whose nose. He would never have my mouth or my husband's eyes." She adds, "When I got pregnant, the first person I called was my Intended Mother, not my husband. When I felt his first kick, I called her, not my husband. When I found out it was a boy, again, I called her first. Yes, this child grows inside you and you love and nurture it. My daughters called me 'the baby sitter.' To be honest, that's all I was. I took care of this wonderful baby, until it was time for the parents to come back.

"I will always have a special place in my heart for him, but not the place I save for my own children."

Want to see more?

• Building a Family Through Surrogate Parenting Part I: Financial and Legal Implications
• Surrogacy Discussion Board