Whether it’s human nature, a basic human right or a means to propagate the “gay agenda”, the choice to have children in a homosexual family unit is wrought with contention and conflict. But on the other side of the rainbow, contention melts away and gay and lesbian families find that learning to redefine words like “family”, “parent” and “offspring” on their own terms is exhilarating and involves bringing up a new generation of children who will at once be our allies and forever our truest loves.

While some news accounts poke fun at the new “Gayby Boom”, the reality is that with technology becoming more affordable and available, our choice to be gay parents looms before us, persistent and enticing. While recent statistics show that gay and lesbian couples are not really part of a baby “boom” as such, they are making a loud enough noise in the courts and in the schools to help bring about changes that can only contribute to gay and lesbian equality in society at large.

When it comes to gay and lesbian parenting, you’ve read plenty on the who, the why and the whether-or-not. In honor of Mother’s Day, this article is all about the how: a nuts-and-bolts guide, if you will, to the process of lesbian pregnancy and motherhood.

While there are several other parenting options available – such as adoption (see the sidebar accompanying this feature), surrogacy, “step” parent adoption of children from a previous heterosexual relationship, single mother insemination and foster parenting – this article is a first-hand guide for lesbians on how to navigate all of the incredible technologies available through anonymous donor insemination, as well as being a guide to the whole process of lesbian pregnancy.

While the first alternative insemination was performed in 1784 on a dog, and the first human trial performed exactly 100 years later, it has only been in the last 10 to 20 years that open lesbians have been permitted to utilize these services. In fact, some statistics show that there are only about 40 percent of fertility doctors who are willing to knowingly inseminate a lesbian even today. A long path lies ahead of us, one that is much easier to walk with knowledge and understanding.

Before getting too far into the process of insemination, it’s useful to look at the types of donors that are available. Though most lesbians would like to consider themselves completely self-sufficient, it is in fact a requirement that egg and sperm meet in order to generate life. However, nature does not dictate how that egg and sperm must meet.

So: The first thing to decide is whether or not to use a known donor.

For some lesbian moms, a relationship with a donor that they know has been a wonderful, peaceful experience in which the donor has done a good deed for the mother(s) and the relationship ensues as established at the beginning, both emotionally and legally. But while some would prefer knowing who the donor is, what he looks like and what he is like as a person, the legal risks of enacting a relationship with a donor can be extremely difficult to manage.

Obviously, the decision is personal. There are other cases where men with the best intentions have offered their services to the lesbian or to the couple, under the impression that they never want children, only to change their mind once the child is born. Some of these donors who had signed off their rights as a parental unit prior to conception have later won custody of “alternatively inseminated” children. In other cases of lesbians using known donors, there have been lesbian couples that have promised the donor he would have no obligation to the child in any way, then sued the donor for child support. There are other cases where lesbian mothers-to-be have enlisted the help of trusted male friends and have shared in a co-parenting experience with these men, and the result has been happy and successful. Protection for the lesbian couple and the donor are fairly limited. For the most part, judges have decided on a case-by-case basis how these conflicts are resolved.

Anonymous donor sperm is the safest path legally for a lesbian or a lesbian couple to pursue. The legal documents signed during the application process explicitly state that the donor has no parental rights or claims to the offspring and that both parties are forbidden from knowing the other’s personal information. In most cases, the donor is never obligated to meet the child after the age of 18 and the lesbian parent(s) are not obligated to meet him. The courts have already ruled that because the procedure is done in a “clinical” manner, both biological parents are protected under the law. These laws were enacted to protect infertile heterosexual couples that chose to use an anonymous donor to impregnate the woman, so there would be no conflict over establishing paternity. These legal safeguards are extended to lesbian couples.

But there are also issues with this choice. The mother has no knowledge of what the donor looks like, what his personality is like or what his intentions are for donating the sperm. She must trust in the process and the doctors to choose carefully from the pool of applicants that offer to donate their sperm. If one day the child wants to meet this biological parent, there’s an extremely good chance that that will never occur.

Obviously both choices have their pros and cons and it’s best to investigate every possible angle. Prudence and resolve are needed at this crucial decision point, because parents will eventually have to defend their decision to the child.

Through careful contemplation, the hypothetical lesbian couple has decided to opt for the anonymous donor through the sperm bank.

What happens next?

First, the lesbian who wishes to carry the child will have to go to her primary doctor. She will need to have a physical exam, a pap smear and several blood tests to ensure she is up to date on her immunizations. She will then send an application to any number of sperm banks (see the sidebar “Lesbian-friendly sperm banks”) across the nation, which will require she submit a notice from her doctor stating that she is healthy enough to have a baby.

In the past, many lesbians may have been stopped by this very piece of documentation because homophobic doctors had a legal right to declare the lesbian unfit for pregnancy. These days, doctors are more likely to sign this important piece of paperwork, out of respect for the diverse families in this country and quite possibly out of fear of a lawsuit.

After the sperm bank accepts the application, the lesbian and her partner get to choose the donor. Generally, the sperm banks offer a “short” and “long” list about the donor. The short list will show the donor’s ethnicity, religion, eye color, hair color, weight, height, profession and educational experience. Once the couple has narrowed the search down to a handful of donors, the sperm bank usually requires the mothers-to-be to submit payment for the “long list.”

The long list basically shows a detailed genetic history of the donor and a handwritten application of the donor’s interests and attitudes about certain issues. Generally, sperm shoppers are able to get a better idea of who the donor is, though it is rather two-dimensional. Some sperm banks have recently started offering baby pictures and voiced interviews of the donors for a small fee and other sperm banks have a list of donors who are willing to be contacted when the child turns 18. The sperm itself costs anywhere from $220-300 per vial. A vial consists of concentrated ejaculate. Generally, one would purchase two to three vials each menstrual cycle until conception is achieved.

There are two different types of insemination procedures. The first is called ICI, or Intra Cervical Insemination, in which the sperm is delivered in small vials via a tank filled with nitrogen oxide (dry ice) to the expectant consumers. The couple can take the tank home and inseminate with a small syringe-like device, which resembles a miniature turkey baster, or they can take it to the doctor’s office to have the procedure performed there.

The second procedure is called IUI, or Intra Uterine Insemination, and must be done at a physician’s office because it actually requires opening the cervix and inserting the washed specimen directly into the uterus with a special tool.

Again, at this stage our intrepid mothers-to-be are faced with a big decision. While some women find that they are able to get pregnant the first or second try, others find that insemination can actually take months and, in turn, thousands of dollars. There is no guarantee, obviously, that either procedure will work and so it’s up to the couple to decide which treatment is better.

Some couples opt to inseminate in the privacy of their home, playing romantic music, burning candles, and making love before or after the act. To be quite honest, it is pretty difficult to remain completely romantic in this act. The frozen sperm must be thawed for 15 minutes before insemination. It does not survive very well past this time. The specimen must then be carefully transferred without spilling from the vial into the syringe. Then the partner or the one being inseminated herself must insert the fairly cold plastic syringe into the vaginal canal and hoist her hips for 20 minutes or so, in order to help the sperm find the cervix. Still, however clinical the procedure, some find this method to be sweet, endearing and bonding.

The second method – going to the doctor’s office – puts the couple in an environment that can be impersonal, sterile and somewhat chilly. However, the IUI method has to take place at a doctor’s office.

Some women choose to use a combination of both – inseminate the first night after ovulation at home, then go for an IUI “injection” the next day at the doctor office.

The ICI method can be less expensive because the vials cost less and because it’s not necessary to pay a fertility doctor to do the insemination. If the couple chooses the IUI procedure, they will generally pay around $300 in doctor’s fees, and health insurance companies generally do not cover this procedure or the purchase of sperm. Also, most health insurance plans do not recognize lesbians as a couple or family unit and will not accept lesbianism as a reason for infertility. The venture can cost a small fortune, especially if it takes several months.

If a couple seeks the assistance of a fertility doctor, be warned that although the obvious fertility issue is that the inseminee is using frozen sperm, which has the potency and effectiveness at a fraction of fresh sperm, the mother-to-be will be treated as an infertility case even if fertility has not been a problem and, in the event of impregnation, she will probably be treated with extra care and blood tests because she is automatically scheduled into the routine treatment of infertility. However, for many couples, seeking the assistance of a fertility doctor is helpful for learning about hormonal issues, proper diet and other issues relevant to their own life and situation. Fertility drugs can also be very effective to help balance hormones and to release multiple eggs to increase the probability of conception.

As mentioned earlier, fresh sperm is more viable, though potentially not as safe. At the sperm bank, each specimen of sperm is quarantined for six months. The sperm donor undergoes several tests to determine if he has contracted any STDs, including HIV. If so, his sperm is discarded and he is no longer allowed to donate. This is another reason to have more than one donor in mind. Sometimes, supplies are depleted or sperm is being quarantined and unless the moms-to-be are willing to wait for the supply to become available again, they are at the mercy of this man’s own personal sexual risk history and availability to donate.

Many fertility doctors recommend a basic plan toward fertility awareness. Websites are saturated with information about fads, diets and exercise plans to increase fertility; however, there is no exact science and no one way on how to improve the possibility of pregnancy. Part of it comes from knowing one’s body and part comes from not putting too much stress on success. Obviously, this is easier said than done.

Most clinicians recommend that a woman who wishes to become pregnant monitor her body for three to six months prior to attempting conception. Some recommend that she take her temperature every morning at the same time before rising from bed to track her fertile time. At the moment of ovulation, the woman will find that her body temperature rises and stays elevated until her first day of bleeding, wherein it will drop again. She is to monitor her temperature from day one of her cycle, which is defined as the first day she bleeds. After following this procedure for a few months, she will begin to notice a pattern in her body temperature.

Clinicians also recommend that women use an ovulation kit. These can be purchased at the drug store for $10-100 and help to determine when the lutenizing hormone (LH) surges in the body. At the onset of this surge, a woman will likely ovulate. Tracking this hormonal surge will help her to determine the two days she is most fertile.

Clinicians recommend that women keep track of their cervical fluid. Fertile fluid is thin and stretchy and clear. It looks like raw egg white and should be fairly abundant. It is only present at the time when the woman is most fertile. When these three ingredients line up, the woman is for the most part fertile. She will inseminate at this juncture and hope for the best.

Paying this much attention to your body can be draining and emotionally exhausting. It is imperative that a mother-to-be not put too much pressure on herself. Pregnancy is a mystery and will continue to be, no matter how developed technology becomes.

Our hypothetical lesbian couple has at last been successful in conceiving!

Now what?

At this point, lawyers recommend several courses of action for lesbian couples living in California. Because lesbians are not permitted to marry under California law, obtaining the same legal protections as heterosexual parents (biological or not) can be extremely grueling and, again, expensive.

Currently, California law allows domestic partners to register with the Department of State. The law allows hospital visitation rights and some decision-making rights in the case of death or disability of one partner. While some lesbians may not be interested in anything less than marriage, filing for a domestic partnership may be an act of good planning. Lesbian partners are still not classified as “family” members and can still be thrown out of the hospital delivery room, especially if complications present themselves. Without this legal protection, it is literally up to the hospital staff whether or not a nonbiological mother is allowed to witness the birth of her child.

Also, there is still some question about what happens to a baby if the biological mother dies in childbirth, or afterward, and who is entitled to make decisions about the biological mother if something goes horribly wrong during the birth process.

It’s wise to secure a Living Will, a Last Will and Testament, an Appointment of Guardianship and, to be extra safe, a Power of Attorney naming the nonbiological mother as the decision-maker over medical, mental and financial matters. Though the domestic partnership law is in place, it only grants a small handful of rights. Remember, the law does not automatically see the second mother of this child as a legal parent, as is the case in heterosexual couples where both parents are biologically related to the child.

In order to secure these documents, a person can go directly to a lawyer and file the above-mentioned documents or one can go to the Internet to find several companies that offer these services for a nominal fee. Having these documents in place early in the pregnancy will help to ensure a better peace of mind.

The baby is born and it appears to be healthy and happy. It loves its two mommies and trusts that the world will care for it.

Since the issue of the establishment of the nonbiological mother as a legal guardian is still open, it is imperative to seek legal counsel about successfully adopting the child. (See the accompanying sidebar “Stepparent adoption”.) In a nutshell, an adoption will cost from $800 to $2000 and will take nine months to a year to complete. The domestic-partner registry allows a lesbian couple to file under stepparent adoption, a right that had previously been reserved for heterosexual couples. The adoption process can begin once the baby is born.

Most pregnant women involved in a loving, committed relationship are concerned about what color or pattern to decorate the nursery, whether to use cloth or disposable diapers, whether to breast or bottle feed, which doctor they would like to use and how to pay for the birth and whether or not they or their partner will take time off from work to raise the child.

For a loving, lesbian couple, after undergoing the emotional and physical stress of having to get sperm, get pregnant, deal with homophobia, protect the nonbiological mother legally and, in turn, protect the child’s best interest – little matters like morning sickness, nursery patterns, diapers and financial concerns seem like mere child’s play!

To mothers everywhere: Happy Mother’s Day.