[EO San Francisco] Creating Meaningful Surrogacy Journeys for Diverse Families With Brooke Kimbrough
John Corcoran: 13:15
And I, I don’t know if this is always still the case, but I saw on your LinkedIn you said that you try and attend every medical screening. How do you manage?
Brooke Kimbrough: 13:24
I cannot anymore. Yeah, I.
John Corcoran: 13:25
Can imagine.
Brooke Kimbrough: 13:26
You do. Definitely.
Brooke Kimbrough: 13:27
A long time ago. Yes. There are just not enough of me or my team to be able to do that anymore.
John Corcoran: 13:32
Let me ask a general question though about like, how do you manage these emotional interactions? You know, across, you know, not just attending. You know, whether whether you attend medical appointments or not, but but just being there for the clients and managing them through the process, both the because you have to manage the relationship with the surrogate and the relationship with the with the intended parents. And then they, you know, the relationship between the two of them.
Brooke Kimbrough: 13:58
Yeah.
Brooke Kimbrough: 13:58
So I have a very unique job in a very emotionally charged environment. Right. So high highs and low lows. I think obviously everybody thinks about high highs, babies, family building, family formation. The low parts are not generally what people think.
There aren’t a lot of like reality TV or people magazine where, you know, bad things are happening or surrogates are trying to abscond with the baby or anything. That’s all kind of movie type stuff. It doesn’t really happen in our space, but more so the science isn’t perfect, and we don’t know why perfect embryos don’t create babies. And so there is loss, there is miscarriage, there is grief. And that’s really challenging, especially in a hetero environment where that’s why they’re in surrogacy is that they had reoccurring loss.
And so it is generally the science which is the culprit of like the kind of low, low pieces of things. But overall, you know, I wake up every day and feel very grateful to be able to help families grow and to interact with a whole bunch of different kinds of people who really show the beauty of life and how much people are willing to give to one another to, you know, find happiness and joy.
John Corcoran: 15:14
How so of your client caseload. Now, let’s say over the last ten years, how many of them are, you know, l g b t q situation? How many of them are heterosexual situation where they just couldn’t conceive? How many of them are a single parent who needs to use a surrogate. Like, what’s the breakdown?
Brooke Kimbrough: 15:35
We split.
It’s very different agency to agency. And sometimes people have niches about where they they live in their space. Professionally, we’re about half and half. We do about half hetero half, half same sex and then singles on both sides. So it just depends year to year, but generally about half and half.
John Corcoran: 15:53
Got it. And talk to me a little bit about like how you find the surrogates.
Brooke Kimbrough: 15:58
It’s a very good question John.
Brooke Kimbrough: 16:00
And there is a massive surrogate shortage in the US right now. So it is extremely difficult. It has added a bunch of time and cost to an already really costly process. But surrogates are wonderful human beings who it’s actually not that people are not willing, excuse me, willing to carry babies for for other families. There’s so many people willing to do it.
It’s that it takes so much to qualify to be a surrogate. There’s so many different qualifications from the amount of pregnancies and health of pregnancies that you’ve had your age, your BMI willing to travel, your support system, the state in which you live, the legal parameters, your mental health, mental health diagnosis, mental health medication. So there’s all of these parameters that really limit the pool of people who can become surrogates. So we find surrogates all over the country. We only work in the United States.
There are definitely agencies that work in other countries, but we only work in the United States with surrogates. And and are really limited in population about surrogates that we’re willing to partner with in order to make sure that we are providing the the least legally risky proposition out there.
John Corcoran: 17:12
Yeah. And what has been the most unexpected element of being in this line of work?
Brooke Kimbrough: 17:20
That’s every day, John.
Every day. Every day is no day. Is the same unexpected?
I don’t. I don’t have a lot of unexpected days anymore. I think definitely when I was entering into the space, I didn’t expect the science to be as as complicated as it was, in the sense that I expected it to have a better success rate. We’re looking at embryos, successful embryos turning into live births somewhere between 40 and 60% of the time, even when we know a whole bunch about them. And so that’s kind of abysmal. If you look at, you know, a doctor who’s like, oh, I have a 50% success rate or a 60% success rate, that’s an F or a D in my world.
And so, you know, that’s that’s complicated for parents who are really looking to, to grow their family and, and are really, really struggling to get to baby. So that’s the most challenging part. I think I always from a positive standpoint, I am always surprised about how willing people are to share their lives and to share their stories and to be open and communicate really emotionally challenging things from a parent perspective. And then for surrogates obviously willing to carry babies for for families that can’t.
John Corcoran: 18:37
Yeah. And related to that, you actually maintained a relationship with that first dad that you were a surrogate for. Can you tell that story?
Brooke Kimbrough: 18:49
Yeah.
He’s the best. I love him madly. I maintain a relationship with him and his daughters. He has a daughter who I carried, and then he. I was done with pregnancy, and he went on and had a second surrogate who had her, my surrogate baby’s sister.
And she did not choose to have a relationship with them going forward. And so when the girls got older and I was still in both of their lives, the little one asked if we could just pretend that I was her surrogate. And so now I just maintain a relationship with both of them and they are my pen pals and they send me glitter and stickers and such, and I send them care packages of crap their dad doesn’t want them to have. Noisemakers and lip glosses and such.
John Corcoran: 19:40
It strikes me that, you know, these sorts of relationships don’t fit squarely within a traditional box, do they?
Brooke Kimbrough: 19:49
No.
John Corcoran: 19:50
What is it like when you talk to people that don’t understand that or don’t have any experience with that world? Like, how do you explain to them what what your relationship is like with these, you know, children that you, you know, carried to term and then are being raised by someone else?
Brooke Kimbrough: 20:06
Yeah.
Brooke Kimbrough: 20:07
So one thing that I think is important to note is that almost all of surrogacy in the United States is now gestational carriers. It is not traditional surrogacy in which in whereby the embryo is not the egg of the carrier. right?
Brooke Kimbrough: 20:23
So there’s no.
Brooke Kimbrough: 20:24
Biological relationship between me and the baby that I carried. Or most surrogates. 98% of them. So that’s one component is like, you know, that you’re not carrying anything that’s biologically related to you.
John Corcoran: 20:36
Do you think that makes it a different type of really okay, because it’s not your biological.
Brooke Kimbrough: 20:41
Child, it’s not your biological child.
Brooke Kimbrough: 20:43
Right. And so you always you go enter into this space knowing that you’re carrying somebody else’s child. I think for me, the best way that I’ve been able to explain it to other people, and I do explain this a lot to my clients coming in who obviously are a little bit nervous about how the circuits going to feel and how she’s going to feel after, is that I have four kids of my own, and I have a bunch of nieces and nephews, all of whom I love endlessly, sometimes my nieces and nephews more than my own kids because they’re spoiled too. But I and I love them sort of all the same. Right?
And then I have I have coached kids over the course of my last ten years in a bunch of different sports, and. have nanny children. And I kind of feel like my surrogate babies, like I do about those kids, I love them. I’m so grateful to be a part of their family’s lives and their lives. I want them to be successful.
I want to see them grow. I always want to to celebrate their successes. But they are not my kids. And so I, you know, never have a problem where it’s like, oh, how did you we hear like, how did you give up the baby? I wasn’t giving up anything.
It was never mine to begin with. So I think most surrogates feel more like very grateful that they were able to care for this baby and allow somebody allowed them the responsibility of taking care of this baby for some period of time until we can give them back to their parents.
John Corcoran: 22:03
Yeah. And, you know, we don’t have to get a whole side discussion about the legality behind it. But I’m a recovering lawyer, so I think about this stuff all the time. I took a class in law school that was called Children’s Rights, which I remember we read a case. I can’t remember the name of it, but there were some foundational cases.
I want to say in like the 70s and 80s, before, this area of law was really settled. And it was kind of uncertain at the time. And there was some, you know, awkward situations where surrogates decided they wanted to keep the baby and stuff like that. You don’t hear that anymore. It seems like a lot of that stuff was was resolved and is kind of left in the past.
And it’s allowed this area to be, you know, the, the it’s allowed it to be the tool that it has become, which is allowing families to have children that wouldn’t otherwise be able to.
Brooke Kimbrough: 22:53
It’s an interesting legal landscape, and ultimately what has happened is that it is not federally regulated. The laws related to surrogacy are regulated by the state in which the baby is born, meaning where the surrogate lives, generally speaking. California has the longest withstanding laws protecting parents and surrogates. That does not mean that they are the only state that people should use. There’s been lots and lots of states who have followed suit and have become Equally.
Legally protective and great surrogate states where you can get a pre-birth order, meaning that you get parentage of the baby before the baby is born and you guys are the parents. You go on the birth certificate. So all those things happen. There’s lots and lots of states that provide those. Now, we have interesting states that were holdouts for a long time that you would think would not be.
Washington did not become a surrogate friendly state until 2019, whereby otherwise they are super, super liberal and you would think would be right in line with California. Another surprise is New York did not become surrogate friendly until 2021, so really late to the game. They actually put into place a whole surrogate bill of rights, which advocates for the for the rights of surrogates as well as parents. And then we are just April 2025 welcoming Michigan into surrogacy. So we’re all going.
John Corcoran: 24:13
This is some bigger states that were not in the game for a long time. Wow.
Brooke Kimbrough: 24:17
So really happy to have those states entering into the space and protecting the rights of parents, surrogates and then ultimately babies in in getting them where they need to be and protecting the their identity as, as human beings and and where they came from.
John Corcoran: 24:36
I imagine given the landscape of the world we’re in in 2025, there are certain states that you don’t operate in.
Brooke Kimbrough: 24:43
Yes, sir.
John Corcoran: 24:44
Yeah.
Brooke Kimbrough: 24:45
I think, you know, from a legal standpoint, there’s still five states that we can’t operate in. That’s always been true. With the changing laws in Texas and not allowing people, our surrogates, our friends, our female counterparts to have access to healthcare there. We stay out of Texas. There are lots of agencies that still work there.
I think it’s legally risky. So we do not. And then, you know, on our watch list are places that are potentially dangerous from a standpoint of what direction are we headed? I think for the most part, we don’t really have elective terminations in surrogacy. We’re not accidentally getting our surrogates pregnant.
And so we’re not accessing termination as often or as frequently as the general population of the United States. But we still want to be able to have access if there was an ectopic pregnancy, that what should happen in an ectopic pregnancy is that there should be a DNC and that she should get medical care as soon as possible. That is not available in Texas and and seemingly may not be available in other states generally in the South in the next year or two. So we’re watching those states closely.
John Corcoran: 26:00
Yeah. I want to shift a little bit and ask you about the business of building a business like this. Talk to me a little bit about some of the challenges around, you know, hiring, getting, you know, Employees on board with with this, you know, what has that been like as you’ve grown the agency over the years?
Brooke Kimbrough: 26:19
I have been extremely lucky, fortunate and immensely grateful that we have only ever lost one employee. We hire with intention and and really, really protect our team about who is a good fit and a good community resource and a good advocate and and aligns with what we’re doing. It’s already a very emotional environment. There’s a lot of burnout in surrogacy. And so we’re really looking for specifically people who are really connected to our community, who want to be members here, who want to be a part of it.
Maybe surprising, maybe not. We get lots and lots of people who want to come work for us. I think agencies, generally speaking, if you’re a good agency, that happens. Lots of surrogates are like, hey, I can’t endlessly have babies, but I’d love to stay in this space. Can I work for you or with you?
But we have maintained we’ve grown, obviously, but we’ve maintained the same and grown up in a way that has been healthy for Roots. So we’ve not had a lot of turnover, we’ve not had a lot of burnout. We are so grateful for our team and they really are the ones that make the magic happen. But more complicated is sourcing intended parents and or surrogates just depending on the time. Right now, the supply and demand is completely off.
There’s so many parents and not enough surrogates. The exact opposite was true back in 2015, 2016, 2017.
John Corcoran: 27:44
So wow.
Brooke Kimbrough: 27:46
That is more complicated. Obviously they’re not my employees, but it is a complicated endeavor to try and find pieces that match and mix well together. And and that can also be like from a parent side, afford surrogacy. You want to be a part of it or not going through the adoptive space, whatever that that looks like for their families. And then from a surrogate side that are qualified to do this and want to carry a baby for another family.
John Corcoran: 28:08
And you mentioned there’s a whole list of things that they need to check off in order to be qualified. But if you could wave a magic wand, is there anything that could that could be done that could solve this imbalance of supply and demand?
Brooke Kimbrough: 28:25
Not, not not one thing in particular for sure. I wish the science was better. I wish that we knew more about embryos, so that we knew that if we had an embryo, it was going to create a live birth, so we wouldn’t have so many failed transfers, access to medical care in in communities that have kind of medical deserts and do not have great medical care would be really helpful. And that’s not just where people think, like in the Midwest or whatever. There are absolute communities within California itself that do not have great medical care and do not have access to, you know, like level two NICU, level three NICU.
There’s one OB to serve an entire population within 200 miles. So there’s definitely room for improvement in the medical community as it relates to helping support pregnancy, generally speaking.
John Corcoran: 29:19
Yeah. Now, given the imbalance in supply and demand, it must be hard to do this last part. But you got to match these people. You got to match the couples or the individual that are looking for a surrogate, and you have to figure out, okay, who’s a good pairing here? You say on your LinkedIn profile you don’t use computer pairing or Match.com model.
How do you make those determinations? Who’s a fit?
Brooke Kimbrough: 29:45
Yeah. So a lot of it is. Well here’s what we look at. So we look at the parents personality. We look at the parents expectations.
We look at the surrogates personality, the surrogates expectations. We look at the expectation of the reproductive endocrinologist or the doctor in clinic where they’re going to create the embryos, and then ultimately the geography of the parent and the surrogate, which is the least important part assuming that the surrogate lives in a surrogate friendly state. So after we do all those things and think that it may be a good fit, we’re also looking for generally how are people coming into this space? People if a parent is very, very nervous, a really laid back surrogate who is like kind of go with the flow may not be the best fit. They may need a more go getter, a type personality who’s going to be really not that the other surrogate wouldn’t be on top of things, but really needs to kind of cross all the T’s, maybe twice.
So we are looking at that and a lot of it is just we’ve been doing this a long time, right. We’ve made hundreds and hundreds and hundreds of matches. I did 375 parent calls educating about surrogacy last year alone. So I have a really good understanding about, you know, what people need, even if they may not understand that themselves. And then from a surrogate perspective, same thing.
You know, our team is spending a lot of time vetting these surrogates. We never put a surrogate in front of a parent before four months where we’re really understanding who she is, who her support system is, and then getting all this information about her and doing background checks and psychological evaluations and medical screening checks. And so all those things too. But really getting to know the people that you’re helping is very helpful in being able to make good connections, because we’re building teams and that’s really what it is. It’s a team of people working together on a project.
This project just happens to be Project Baby, but it does, you know, it does take a connection and it does take the right fit.
John Corcoran: 31:45
You mentioned that ten years ago it was much more common that it was everyone was geographically closer together. And you in the meantime, during this ten years, you moved from Southern California to Northern California, moved your family, those kids, those teens we were talking about. How has that changed the dynamics of this, you know, business, both with the family move and also the fact that surrogates might be further away from the the parents?
Brooke Kimbrough: 32:13
It actually doesn’t matter where the agency is. So agencies are all over the country and we have always. So since 2015 we’ve always been remote. All of our employees have been remote. We’ve always worked remotely.
And in fact, back in 2016 and 2017, we were using zoom. So when everybody was having this zoom crisis in 2020 about how to use zoom and how their kids were going to be on zoom, we were like, oh, please. Like, let me tell you, we’ve been using zoom for years. So I think from that standpoint, it hasn’t changed that much. I think it’s more that a couple of things have happened in the landscape which have changed the game.
San Francisco, shout out to you. Lots of big tech companies started adding fertility benefits to their to their benefits package, and that has allowed people a lot more access to build their families later in different ways, and in entering into third party family formation. So that changed a lot about the way people were accessing it. China’s one child law was lifted back in 2018 or 2019, and so lots of Chinese parents have come here and and started to grow their families through American surrogacy, which remains illegal in China. And, and then just a general knowledge of the American population about surrogacy.
Right. It’s become much more a topic of conversation. People access surrogacy more frequently and more often. I think lots of times people thought about surrogacy early on as either, you know, gay couple. And it was like done with a surrogate that they knew and most likely used her eggs.
Or it was, you know, somebody’s sister that carried for them because she couldn’t carry something along those lines. So I think it’s just a matter of like all things about people talking about it in big formats, small formats, and really being open and honest about the way that they struggled or may or may not have, but the way that they made their decision to form their family and in this case, through surrogacy.
John Corcoran: 34:21
Well, it’s really amazing and inspiring, Brooke, you know, especially with your backstory, the all the families you’ve been around to see you pouring yourself into, helping, you know, future families be formed. And it makes sense. Also, I was going to mention, you know, you were saying, you know, the science has evolved so, so much. IVF is so much further along today than it was, you know, 10, 15, 20 years ago. So it makes sense that this area, this kind of follow on industry would be evolving and changing as well, and that new opportunities would come for creating families.
Brooke Kimbrough: 34:55
Yeah, Absolutely. And I can’t wait. One of my kids wants to be a doctor. I hope she goes into reproductive endocrinology and changes the world in in much better ways than I have, and can allow access for our next generation to continue forward with surrogacy, egg donation, embryo donation, any way that parents and families want to grow their family.
John Corcoran: 35:15
Yeah. Brooke, this has been really interesting. Where can people go to learn more about you and learn more about Roots Surrogacy?
Brooke Kimbrough: 35:22
Yeah, you can check out our website www.rootssurrogacy.com. You can learn all about us and about surrogacy, and you can follow us on all of our socials. Same name.
John Corcoran: 35:38
Great Brooke, thanks so much.
Brooke Kimbrough: 35:40
Thank you.
Outro: 35:41
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