Karma Daigle of Waterbury, Conn., loved being pregnant with her son Gabriel, who is now 9, but after her divorce in 2004, she longed to have another child and knew that without a husband, it might not ever happen.
So she turned to gestational surrogacy, giving birth to four more children -- first Zoe in 2006, then her twin siblings Sebastiaan and Lukas in 2008 for a American couple living in Romania, and then Lucas Tomas in 2010 for a Chicago family.
Both couples were gay men who used their own sperm and donor eggs for in vitro fertilization.
They paid her $19,000 to $25,000 a pregnancy, and she signed legal papers giving away all rights to the children and holding the couples harmless for any potential medical problems, including her possible death.
But being a surrogate mother can be risky. Daigle developed preeclampsia in the final pregnancy that has left her with heart damage.
Though she might never be able to safely have another pregnancy and give her biological son Gabriel the siblings he longs for, Daigle said she would do it all again.
Daigle, now 32 and married for a second time, appreciated the money, buying a house and paying for her wedding, but most of all she wanted to help others who couldn't carry their own child.
"I am not particularly religious, but I consider myself spiritually oriented," said Daigle, who works as a legal secretary for the State of Connecticut and is currently majoring in public policy and management at a local college.
"I can't run off to Africa and save the children there," she said. "But I can sacrifice my own life and body to be a surrogate and give someone else something that changed my life. I cannot imagine not having my own biological children and for these same-sex couples, this has become a reality."
In fact, Daigle was worried about what her own parents might think about her decision. Her grandparents, who are opposed to same-sex marriage, still don't know about the four babies she carried for two gay couples.
"I didn't know if my family would support me," she said. "I didn't want to be the next Octomom. I just wanted to help someone become a family."
Emotionally, parting with her babies was not a problem, according to Daigle.
"Everybody goes through the baby blues and for every pregnancy that lasted three days. It was hard on my body but it didn't traumatize me. I knew what I was getting in to."
"With Zoe, I carried her and my body fed her," she said. "For those nine months, she belonged to me. But do I feel like her parent, no. I have a child."
Surrogate mothers have been used since the 1970s, but the first highly publicized case -- "Baby M" -- was in 1976.
Mary Beth Whitehead gave birth to a girl she had agreed to carry for an infertile couple. But as the biological mother, she changed her mind. She sued for custody, but was denied.
The American Society for Reproductive Medicine estimates that there were 400 to 600 surrogate births annually from 2003 to 2007, the last year for which data is available.
Support groups and agencies say the total number since 1976 may exceed 30,000.
"Honestly, no one knows," said Karen Synesiou, director of the Center for Surrogate Parenting, which has facilities in California and Maryland.