In a few weeks, Sheila Gump will give birth to her grandchildren.
The twins, a boy and a girl, were conceived through in vitro fertilization because Gump’s daughter, Micaela Johnson, is unable to get pregnant.
Johnson, 26, was diagnosed in 2015 with a rare and aggressive small cell cervical cancer.
At the time, Micaela and Brandon Johnson were trying for a second baby to follow son Aidyn, who was born in 2012. Doctors found a tumor on Johnson’s cervix during a routine exam. The only treatment option was a hysterectomy, followed by chemotherapy and radiation. The treatment would thrust the young woman into menopause and render her infertile.
Johnson wanted to start treatment immediately, but after consulting with doctors she decided along with her husband to wait long enough to freeze their embryos.
She would need a surrogate to carry any future children. She didn’t have to look far.
“I just want her to have everything she wants,” Gump said. “As a mother, don’t you want to see your child happy?”
Gump, 43, said her heart was ripped out when Johnson got the cancer diagnosis. The two, who live about an hour apart in Southern Illinois, describe themselves as best friends. Gump was a single mom for much of Johnson’s life. Strangers commonly mistake them for sisters.
Gump reunited with Johnson’s father, David Gump, when their daughter was a teenager. The family still vacations together, with the Gumps even accompanying their daughter and son-in-law on their Florida honeymoon. Mother and daughter took a pre-planned cruise vacation to celebrate Johnson’s birthday soon after her cancer diagnosis.
When they returned from the trip, Johnson started hormone therapy that led to the retrieval of 19 eggs. Ultimately, Micaela and Brandon Johnson were able to freeze nine of their embryos for future use.
Then the cancer treatments started. A radical hysterectomy followed by radiation and chemotherapy. Gump accompanied her daughter to every appointment, holding her hand through the fear and sickness.
Knowing the embryos were waiting “gave me something to look forward to,” Johnson said. “I could make my life pick up where it left off.”
About 15 percent to 20 percent of Dr. Premal Thaker’s cancer patients are young enough to discuss preserving their fertility before undergoing chemotherapy or radiation that can damage the reproductive organs. The oncologists work with fertility specialists to expedite the egg retrieval process so cancer treatment can start as soon as possible.
“Women should know they have options, and should see a gynecological oncologist who can offer them cutting-edge treatments to assist them with hopefully a future life beyond cancer,” said Thaker, of Washington University.
A year after the initial fertility treatments, the family returned to Dr. Kenan Omurtag of Washington University to discuss their options. Insurance generally does not cover fertility treatments, but women with a cancer diagnosis can get grants through the Livestrong Foundation to offset the cost. Omurtag told the family about all the health and psychological screenings necessary to start the surrogacy process.
Gump reassured her daughter: “I’ll carry the baby, if it comes to that. I will carry your children if I can.”
Because she is younger than 45 and already had three healthy pregnancies, Gump was a good candidate for surrogacy. She was a teenager when she gave birth to Johnson, her oldest. Hunter, her son, is now 13, and Brianna is 10.
Gump received hormone treatments to prepare her uterus for implantation of two embryos.
“You can put an embryo into any uterus, and as long as the mechanisms are working properly, it should implant,” Omurtag said. “The risks to the baby follow the age of the egg.”
Now the mother-daughter roles have reversed. Johnson takes her mom to her pregnancy appointments. Gump needs insulin for gestational diabetes and blood thinners to prevent clots after an experience with deep vein thrombosis a few years ago. When she got lightheaded during a recent ultrasound at St. Louis Children’s Hospital, Johnson held a cold washcloth to her mother’s forehead.
Gump said she is quick to tell anyone, even strangers, that the babies are not hers because she wants to stay in the grandmother role.
“I’m looking forward to spoiling them and sending them home,” she said.
The family tells Johnson’s 6-year-old son Aidyn that “Mawmaw is growing your babies.” They plan to be open with his little brother and sister about how they were conceived and carried.
“She gave me something microscopic, and I’m giving her something to hold,” as Gump explains their story.
There were 3,432 gestational surrogates who became pregnant through in vitro fertilization in the U.S. in 2013, the latest figures available from the Centers for Disease Control and Prevention.
Although details on the surrogates are not available, most are believed to be unrelated to the child’s parents. Those who are related tend to be sisters or cousins of similar age. There are only a few reports of mothers like Gump who have served as surrogates for their own children.
Gump and the Johnsons have avoided many of the legal and financial complications of surrogacy, including the average $50,000 payment to the surrogate. Gump’s health insurance from her job at a Walgreens distribution center covers the costs of the pregnancy. The Johnsons paid attorney fees on both sides for the contract required by law, although mother and daughter both said they didn’t need one.
Johnson has been cancer-free for two years, but she still needs PET scans every six months. She helped start a nonprofit, Sisters Against Rare Cervical Cancers, to educate and raise money for research and treatments. She wants to share her story to give women hope.
She said she is jealous of her mother for the experience of being pregnant with the twins. She’ll also miss breastfeeding this time around. Gump will not breastfeed the babies but will use a pump initially to provide some milk. Johnson has also lined up breast milk donors for the first couple months.
Gump plans to deliver the twins at Good Samaritan Hospital in Mount Vernon. As soon as the babies are born, they will be placed in the arms of their mother.
The babies’ grandmother said that is exactly as it should be.
“What wouldn’t you do for your grandchildren? I’ll bring them into the world.”