Angel Howard, 32, lay motionless on an examining table in a La Jolla fertility clinic last Mother's Day, her delicate features bathed in the blue-gray glow of an ultrasound screen as she watched a doctor try to impregnate her with someone else's embryos.
For the last month, Howard had been injecting herself with daily hormone shots that made her so sore she could barely sleep. The mother of six was tired. She had to handle becoming a surrogate without her husband, Brian, 34, at her side: The Navy Seabee had deployed to Iraq for six months.
FOR THE RECORD:
Surrogates: An article in Wednesday's Section A about military wives working as surrogate mothers reported that Chula Vista-based Surrogate Alternatives offers a $5,000 bonus to surrogates with Tricare military medical insurance. The company stopped offering that bonus within the last year. —
If Howard delivered a healthy baby, she would receive between $20,000 and $25,000 from the parents, plus an allowance for food and maternity clothes. If she had twins, she could be paid an extra $5,000.
The stay-at-home mother did not like to admit it, but she could use the money. Howard stretched every dollar of Brian's $56,000 yearly income, wearing old clothes, clipping coupons, shopping for sales at Wal-Mart and occasionally tapping the food pantry at the Armed Services YMCA. She had worked part time at a clothing store in the local mall, but quit when her husband was sent back to the Middle East. Surrogacy money would provide a much-needed safety net for her children, Maria, 14, Anthony, 12, Ezekiel, 10, Tacina, 8, Chaeli, 4, and Izaac, 16 months. Howard first seriously considered surrogacy after a chance meeting at a local pet store six years before.
She had just suffered a miscarriage, and found herself watching pregnant women in stores and restaurants, envious. Howard liked the feeling of being pregnant, the center of attention, bringing life into the world. When she spotted a pregnant stranger at PetSmart, she approached to ask when the woman was due.
The woman, who turned out to be a military wife, explained that she was a surrogate. She told Howard about the contract she had signed with a childless couple, including a breast lift after she gave birth, which the woman had insisted on.
Howard thought demanding plastic surgery was a bit much, but soon began investigating surrogacy online and through friends.
Young military wives make popular surrogates, especially in California where, unlike other states, surrogacy is legal and case law protects parents' rights to hire women to carry their babies.
"Military wives, they don't cry, they don't complain at the drop of a hat. They're organized. They're efficient. They handle everything when their husbands are gone," said Howard's surrogacy agent, Stephanie Caballero. "A few shots during the first few months is not going to bother them, and they don't need to be told to be polite and professional and show up on time."
Just as important to the would-be parents, military wives have access to military medical insurance called Tricare, which includes comprehensive prenatal care worth as much as $10,000. The coverage is such a draw that some surrogacy agencies, such as Chula Vista-based Surrogate Alternatives, offer surrogates who have it a $5,000 bonus.
Last February, Howard registered with Caballero's agency, Extraordinary Conceptions. Two months later, she was matched with a gay couple in France. The couple would buy eggs from a donor, pay a doctor to fertilize them with their sperm and transfer the embryos to Howard's uterus. Under their contract, she would have three tries to get pregnant.
If she failed to get pregnant, she would only receive about $1,000. If she became pregnant, Howard would start receiving monthly payments; to get the full amount, she would have to carry the baby for at least 35 weeks.
On that Mother's Day, Howard watched the doctor prepare two embryos that would be transferred inside her. With the room dimmed to protect the light-sensitive embryos, he brought in a spindly catheter that looked like a giant Q-Tip and inserted it. Howard said she could barely feel the catheter. When the doctor was done, she could see a tiny white dot shining inside her on the ultrasound screen -- the embryos.
In 11 days, she would return for a blood test to see if she was pregnant.
Howard had always enjoyed being pregnant, ever since she dropped out of high school at 17 to marry her boyfriend and have Maria. Raised in a dozen foster homes, Howard had been a runaway and a self-described party girl. Pregnancy changed everything.
She still liked to streak her black bob blue on occasion and wear a nose ring, but motherhood transformed her into a homemaker determined to build the family she never had.
She met Brian at a Charleston, S.C., dance club in 1998, soon after she left her first husband, who had joined the military without asking her. Brian was different: He asked her before he enlisted, just as she would later ask him before becoming a surrogate. They married in 1999 and settled in San Diego.
At the Murphy Canyon military housing complex in northern San Diego County, Howard's family grew to include a network of military wives she met at YMCA barbecues and on Craigslist. Once she started considering surrogacy, Howard found like-minded military wives on surrogate websites, where they gathered to vent and debate.
Her neighbor, Jennifer Loveless, 33, who hosts weekly bread giveaways for military families on her lawn, also hoped to become a surrogate. Loveless planned to spend the money on a Caribbean vacation.
"All my bills will be paid except the car payment," Loveless said over lunch with Howard at a mall in El Cajon.
Howard frowned. She could not understand how women could carry babies just for the money.
"You can't depend on it," she said of surrogacy money.
Loveless shrugged and turned back to her French fries.
Later, as Howard loaded her youngest son into the car, she said the conversation reminded her of her miscarriage.
"If it doesn't survive, you lost a child and you're destroying the couple's hopes," she said. "It's not just dollar signs."
Military wives have been criticized in recent years for using their military insurance to make money as surrogates. But military brass who have tried to end the practice have had little success. Although Pentagon officials dismissed surrogacy as an "income-producing enterprise" they failed to eliminate surrogate medical coverage from recent defense spending bills.
Tricare, the military insurer, requires paid surrogates to pay for prenatal care but has had a hard time getting women to admit it. Medical privacy laws prevent the company from compelling women to disclose that information. Last year, in the western Tricare region that includes California and 20 other states, only two surrogates paid, both in San Diego. Tricare officials said they suspect there are many more.
Howard said she and other military wives pay their premiums and have earned their benefits.
"If our husbands are putting their necks on the line in Iraq or wherever they happen to be at that point in time, we should be able to do what we want with our insurance," she said as she sat in her living room, with Brian staring down at her from the family portrait in his dress whites. "We're going through a lot here and if we're trying to do something for our families and other families, there shouldn't be anything wrong with that."
At first, Howard had not been sure she wanted to carry the French couple's baby, no matter what they paid. If she signed the contract, she felt she would be inviting them into her life. She had to trust them.
It was decided during their first meeting in April, over lunch at an Italian restaurant near her house. She brought Izaac and some family snapshots. An assistant from the surrogacy agency came to translate, since Howard did not speak French.
Esteban, 46, the taller of the two with a short gray-black beard, was a child psychiatrist. His partner, Jean Michel, 50, tan and lean with gray hair, worked for the French government. (It is legal for French couples to hire surrogates overseas, adopt their babies and return home with them even though surrogacy is illegal in France. But due to the controversy surrounding surrogacy in Europe, the men asked to be identified by their first names only).
To Howard, they seemed professional, even preppy in their Polo sweaters, poring over her photos.
Esteban kept eyeing Izaac, with his untamable brown curls, chubby cheeks and impish grin. Unable to resist, he lifted the baby out of his high chair and held him close.
That's when Howard knew she could trust them.
A month after that meeting, Howard was waiting to find out if she was pregnant with Esteban and Jean Michel's baby. The morning of the blood test, she was in and out of the clinic in a flash, swishing past a wall of smiling surrogate baby photos.
At 2:20 p.m., the phone rang. Howard picked up quickly, thinking it was the doctor. It was her husband, calling from Iraq.
He had just started telling her about the slow pace of construction in Ramadi when her other line started ringing. "Hold on real quick," Howard said.
The doctor was brief: She was not pregnant. They would have to wait two months to try again.
She clicked back to Brian, who reassured her: "It will take next time, don't worry. You'll end up making them a family."
During her second attempt Aug. 1, Howard was more nervous than ever. She hadn't talked to Brian in days, not since he had moved to a desert outpost so remote, he did not even have running water. And Esteban and Jean Michel had flown in to join her.
As they took their places beside her at the examining table, she saw Esteban point to his heart.
"They may not be carrying the child," Howard remembered thinking, "but they're going through all the emotions with me."
A few days later, Howard took two digital home pregnancy tests and checked the tiny screens.
There it was, spelled out: "Pregnant."
She alerted the couple, who were ecstatic. The blood test would be a formality.
But when the doctor reviewed her results, he had bad news. A second test confirmed it. Howard had miscarried.
She could not bring herself to tell Esteban and Jean Michel. She asked the doctor to make the call.
On Jan. 27, Howard returned to the fertility clinic for one last try.
Once again, she was alone. Brian had returned from Iraq at the end of October, but was stationed nearly 200 miles north at Port Hueneme near Oxnard.
Howard went through the familiar routine on the examining table as the doctor transferred two of what he called the healthiest embryos he had ever seen. The French couple had hired a new egg donor.
Later that day, crippling cramps started, so powerful Howard could hardly walk. Then came the cravings: caramel turtles from See's Candies. She'd had similar cravings when she was pregnant with Ezekiel.
Howard bought five home pregnancy tests, and they all told her the same thing: pregnant. This time, she did not tell Esteban and Jean Michel. She could not bear to disappoint them.
She would wait until after the blood test Feb. 9.
The day dawned overcast. By the time Howard drove to the clinic for the test, at 9 a.m., it was raining. The doctor promised to call with the results as soon as he could.
At 1:34 p.m., her cellphone rang as she waited on her living room sofa.
"Congratulations," the doctor said.
The test showed she was probably carrying twins. (Later tests would show they were fraternal twins, due Oct. 15).
With the help of the doctor's assistant, Howard called Esteban with the news.
They laughed together. Then he said something she did not understand.
"He wants to thank you so much for being so strong through the whole thing and sticking with it," the assistant said.
"Thank him for being there for me," Howard said.
Outside, it had stopped raining. Sunbeams peeked through the clouds.