New Dads on the Block

Things are happening so fast that it’s hard to keep up with the blog.  This entry will be about the US Consulate and the passport application process.

After meeting with our lawyer, Urvi Rathod (who has done an amazing job in a record amount of time), we realized that we would have to return to Hiranandani Hospital to pick up a copy of a ‘no dues’ letter, explaining that all liabilities for the babies and for the surrogate have been satisfied.  Easy enough, right?  The front desk receptionist asked for a copy of our final bill, checked his records, and typed out the letter in roughly 5 minutes.  He also informed us that we were eligible for a small refund (2400 INR or about $46 USD) and that it would take a few minutes to process and be refunded in cash.  He filled out the form while Josh ran over to the hospital’s gift shop to purchase more preemie formula.  The few minutes turned into an hour and a half wait.  First, they could not locate the CFO of the hospital who was required to sign off on the refund, then we were told that he lost his cell phone, then we were told that he was just in a meeting, and finally, we were told that he was returning shortly.  I killed some time by returning to the records room in the basement to make sure that our birth certificate applications had been processed, and was told that we should expect them in just a few days.  When I returned to the counter, I was finally offered my refund after signing 2 forms, noting that the document had since been signed by the CFO, stamped, affixed with a physical stamp that was signed over, and photocopied.  If nothing else in our blog demonstrates Indian bureaucracy, this document should… all for 46 bucks.

The next day, I called a woman named Nita who owns a Priyanka Photography Studio in Hiranandani Gardens.  (Phone number +91 98 2030 8746)  She often works with our lawyer to help clients obtain passport photos for their newborn babies.  Rather than enduring another bumpy car trip with no car seats, I opted to pay a premium to have the photographer come to our hotel to take the pictures.  He spent about 30 minutes in total, wiggling the babies’ feet, trying to get them to smile, or at least to open their eyes.  Personally, I think the photos look more like mug shots than portraits, but they will work perfectly well at the consulate and the FRRO.  I do enjoy the idea of Julianne and Henry traveling for the next few years with a 5-day-old photo as their identification… I hope they stay that way forever.  The photographer was happy with his shots, and he returned about 6 hours later with the completed photos.  Total cost was 2800 INR ($54 USD), so Saturday’s refund basically took care of the photos.

We received the US consulate documents on late Monday evening.  These included our original birth certificates, a ‘no dues’ letter from the Rotunda clinic, an embryo cycle summary, a letter explaining the specifics of our surrogacy process signed by the medical director of the clinic, a signed and notarized copy of the ‘no dues’ letter from our surrogate, and a copy of our doctor’s medical license.  As soon as I had the birth certificates in hand, I logged onto the US Consulate website and registered for the next available appointment to process a CBRA (Consular Birth Report Abroad).  Thankfully, there was one appointment left for the following morning, Tuesday at 10:30 AM.  Knowing that I would require a DNA test for each child, I emailed the Fraud Prevention Unit at the US Consulate to schedule DNA testing following our 10:30 AM appointment.  Since it was so late at night, I wasn’t sure that I would be able to do the DNA portion on the same day, but in the morning, I received a telephone call from the FPU letting me know that they were able to contact the physician who would conduct the swabbing and he was available at 11:45 AM.  I was never told to fill in these forms by anyone, but after reading the link above, I prepared myself the night before by printing two copies of each form and filling out as much as possible in advance of the appointment.

We opted to take the Westin house car rather than a blue taxi because it was set at a flat rate for 3.5 hours of usage and the driver would stay outside of the consulate to wait for us.  Prior to arriving at the consulate, I asked the driver to stop at a bank in order to obtain a demand draft of 2000 INR, payable to the physician doing the swabbing, as he does not accept cash.  Alternatively, we could have made the payment directly to the cashier’s counter at the hospital where this physician works, but I thought it would be easier to just have the demand draft ready for him.  The first bank seemed very confused when I asked for a demand draft.  It’s essentially a cashier’s check, so I assumed (never do this in India) that any bank would charge me a small fee and accept cash in exchange for the draft.  Apparently this is only done at certain banks, and the one that I chose was not one of them.  I had wasted 15 minutes figuring this out, so I decided to head to the consulate in order to not be late for my appointment rather than showing up late with the draft.  A few metal detectors and passport checks later, we were through security and in a small room full of plastic chairs, the far wall lined with cashier windows.  Now this process is going to sound stressful, but honestly, the US Consulate was amazingly efficient and very comfortable.  Everyone was incredibly friendly and the entire CBRA/passport application process took less than 40 minutes.  First, I provided a copy of the appointment confirmation sheet that was emailed to me when I set up the appointment to the check-in window.  She proceeded to give me two stickers with numbers on them (602 and 603) and asked me to wait until my number was called.  A few minutes later, I was called to a second window where I provided the completed CBRA application, the application for a US passport, and all of my supporting documentation for each child.  The man reviewed each document, showed me how to correct a few things, handed me back the originals, and asked me to walk 2 windows over to the cashier in order to pay for the applications.  The total for 2 CBRAs, 2 passports, and expedited processing was $410.00 US and they accepted my credit card.  Lastly, I was called to the window of the consular officer.  She was amazingly sweet and asked to look at each of the babies to compare them with their passport photos.  Once this was done, mom held both of them while I stood at the window, held up my right hand, and swore 6 different oaths about providing financial care until the twins’ 18th birthday, the accuracy of the submitted applications, and my status as a US citizen.  Instant citizenship for Henry and Julianne.

Next step, the DNA tests.  Since I was unsuccessful in obtaining a demand draft prior to the appointment, I asked Josh to leave the consulate with some cash and take the Westin car to find a bank that would process the draft.  He blazed a trail and returned just as we were leaving the building to head over to the FPU side.  The bank was located a few blocks away from the consulate, still within the ‘G’ block of the BKC, a massive complex of government buildings and international banks.  The bank that granted the demand draft is called Bank of Baroda and the address is C-26, G – Block, Bandra – Kurla Complex, Bandra (East), Mumbai-400051.  The demand draft should be made out to Dr. Jayant Rele and they charge 84 INR to print the draft.

Now it was time for the DNA testing, which took place within the same consulate, but we would first have to backtrack from the American Citizens Services (ACS) building to the main entrance of the consulate.  This meant that we were asked to leave the secure area, take the car around the block to the main entrance, and resubmit ourselves for security on the other side.  If you are reading this blog because you are interested in surrogacy in India, please remember to leave all cell phones and electronics (even your ipod ear buds) in the car, because this is non-negotiable.  A consulate employee was waiting for us at the main entrance, checked my passport against his list of DNA tests for the day, and granted us access to a waiting area off of a beautiful bench-lined courtyard.  The DNA testing went smoothly after I provided the original birth certificates, photocopies of these certificates, my passport and visa copies, and the demand draft for 2000 INR.  Each baby had both cheeks swabbed 4 times, the samples were sealed into envelopes, and shipped out directly from the consulate to our lab in Arizona.  As I sit here now, I’ve tracked the package from Mumbai to Dubai to Paris to Memphis.  It should arrive later today in Phoenix.  Once the DNA test is run and there is a match (crossing fingers!), the lab will email the US Consulate and the passports will be ready within 24 hours.

There is a lot of down time here in Mumbai.  Since the babies are so small and we do not have car seats, we are really stuck at the hotel for days on end.  The mall provides a brief respite, as two of us can go to dinner and bring back a meal for the ‘babysitter.’  Mom and I went to the British Brewing Company last night for some food, and it did not disappoint.  The menus are on iPads, so you click on whatever you want and press send to deliver the order to the kitchen.  It’s a cool concept, but seems so out of place when you think about the thousands of people living right next to the mall in the slums who barely have running water, let alone enough electricity to run an iPad.  Mumbai is a stark juxtaposition of incredible wealth and incredible poverty, and the interaction between them is often a few short footsteps.

I picked up a copy of the book ‘Behind the Beautiful Forevers‘ for mom to read, as Josh and I have already read it.  I highly recommend it if you are interested in learning more about the slums of Mumbai and the lives of their inhabitants.  The story is completely true, told by a journalist-turned-author, and it’s absolutely heartbreaking.  For my own guilty pleasure, I grabbed a copy of ‘Inferno’ by Dan Brown, and although the reviews have been pretty dismal, I’ll give it a shot.

Thank you to everyone for your words of support.  It has been difficult to respond to all of the Facebook messages, the emails, and the blog comments, but we appreciate all of them.  Now that buzzfeed and queerty have picked up the story, our video has been viewed over 75,000 times on multiple sources.  We made a video so that our friends could see the process, but having strangers support our decisions has made it all the more meaningful.  Thank you!

-Matt

So now I’m going to try to remember everything that took place at the hospital in detail… here we go.

We arrived before 9 am, and the first step was to meet with the social worker who would verify my identity, review the surrogacy contract documents, and make photocopies of these records for their own purposes.  For those who are following in our footsteps, I will try to provide locations.  The social worker’s office is located on the ground floor, directly behind the welcome desk.  If you walk to the right of the welcome desk and pass the Hindi statues on your right, look to your left for a small door.  The social worker got in around 9:15 am and immediately began to review our documents.  There was a small concern over my middle name being omitted from the surrogacy contract when compared to my passport, but it should not be a problem as long as the birth certificates match my passport name exactly.  A few minutes later, I was taken up to the 9th floor where the nursery was keeping our babies warm and cozy.

The 9th floor of the hospital contains the nursery, a few private ‘hotel’ rooms, and the snack bar.  A row of chairs in the nursery waiting room is where Josh and my mom spent most of the day waiting to see the babies.  I spent 20 minutes sitting there before they allowed me access into the tiny nursery.  Eight babies were in individual carts and ours were in the two closest to the door.  Julianne was born first and barely weighed 4 lbs.  She was under a blue-ish lamp due to slight jaundice and she had eye covers to protect her baby blues.  Henry was just laying there, staring up at the ceiling.  I couldn’t breathe because I was so happy.  The nurses asked me to put on a mask, a hairnet, and some scrubs in order to hold the babies.  A series of forms had to be signed, giving permission for the photo light therapy, the formula feeding, etc.  I was able to hold each of them for just a few minutes before heading back down to the ground floor to meet with a friend who brought a local SIM card for my blackberry.  At this point, mom and Josh had been sitting patiently downstairs, waiting for any word.  They clearly were anxious to meet the babies, so I was able to convince the social worker to allow all of us up to the 9th floor waiting area until a private room could be made available.  About five hours in, we were finally given our room, just a few doors down from the nursery.  We spent the next hour waiting for the babies to be wheeled into the room.  If you’ve seen the video, you know how amazing that moment was for us.  Josh was speechless and mom did not want to let them go once they were in her arms.

The nursing staff came in with bottles, formula, and hand sanitizer and gave us a brief lesson in feeding schedules, burping, and swaddling.  While the doctors can communicate in English pretty well, the nurses struggle to understand some more complicated requests.  Nevertheless, we were able to keep the babies in our room until discharge the next afternoon without any further medical intervention.

While Josh and mom were feeding the twins, I was able to pop down to the 2nd floor, where the NICU and the birthing suites reside.  I found a nurse in the NICU and requested two copies of the form that needs to be filled out to begin the birth certificate process.  These forms need to be filled out perfectly, making sure that the names are spelled correctly, the location of birth explicitly stated as Dr. L H Hiranandani Hospital (you would assume that they would just do that part for you, but most of the babies born in the area are born at home and only brought to the NICU if needed).  I was then asked if I had changed the baby names from I and II in their computer system to their actual names.  Since I had never been told to do this, I had to return to the welcome desk on the ground floor and fill out two ‘information change’ forms that were immediately received and updated by the representative.  Once the babies were named in the computer system, I returned to the NICU with proof of the name change and the previously mentioned forms were filed.  Finally, I took the elevator down to the basement to find the records room.  One of the records room employees stated that it was too early to see if the birth certificate forms had been properly submitted and suggested that I return the following day.

At this point, I returned to the 9th floor to our room.  Josh and mom decided to return to the hotel for the night, with a stop at a baby store to check out the availability of portable bassinets.  I spent the rest of the night feeding, burping, and sleeping.   I think the babies did that too.

At 9 pm the pediatrician, Dr. Ahuja, popped in to check on the twins.  He listened to their hearts, checked their jaundice, and told me that we would most likely be discharged by Friday afternoon (2 days later).  The next morning, mom and Josh returned and we waited for a few hours for the morning rounds to speak with the doctor again.  When he did not show, I called down to the clinic where he treats patients and asked to be discharged.  He readily agreed, which makes me think that we would probably still be sitting there if I hadn’t been more demanding.  Clearly, the babies were healthy, feeding well, and needed no extra care that a hospital would provide.  He asked the nurse to wheel the babies down to his clinic to weigh them one last time.  I joined this caravan from the 9th floor to the ground floor, smiling happily as all of the other patients and staff stared at the two carts, trying to figure out exactly what was going on.  Both babies had lost a little weight, which is normal after they transition from placenta feeding to bottle feeding.  Dr. Ahuja explained that we should allow the babies to be in direct sunlight for a small amount of time each day to help with the jaundice and asked us to return this coming Friday for a checkup.  I popped back down to the records room and the clerk informed me that the paperwork was in place and that the certificates would be available in a week.

From there, I returned back to our room, signed a bunch of discharge forms, and we got the babies wrapped up for their first road trip.  Finally, I had to settle the hospital bill for the babies as well as our surrogate.  The billing office is also on the 9th floor, right next to the elevators.  The billing manager spoke with the nursing station on the 5th floor where our surrogate had been recovering from her c-section.  Our surrogate was also being discharged, so her final bill was settled pretty quickly.  One note about costs: every single item brought to your hospital room is charged to your account.  While in our parenting classes, we were told to stock up on free diapers, wipes, formula, etc., but I guess that things work differently in US hospitals.  I requested wipes and was told that I would have to go downstairs to the convenience store to purchase them.  Every diaper was billed to our account.

We plan on writing an entry about the total costs of surrogacy, but for now, I’ll just provide the hospital expenses.  After an initial wired deposit of 102,000 rupees (about US $1800), the final bill was for another 158,000 rupees, for a grand total of 260,000 rupees (US $4800).  While this is a lot of money, it included a full 4 weeks of admission for our surrogate prior to the birth, the entire delivery of the twins, the anesthesia and follow-up care, the accommodations, all consumables, all drugs, the daily consultations, and all of the lab tests.

Now the babies are back at the hotel with us.  We have fallen into a pretty routine schedule of feedings, and we couldn’t be happier.

-Matt