Are you considering becoming a surrogate? If so, you may be wondering what it’s really like to carry someone else’s baby. We can assure you, it’s a rewarding experience unlike anything else in this world!
At Family Inceptions, we have helped hundreds of surrogates connect with hopeful parents, guiding them along their own unique surrogacy journey.
Not just that, but many of us have been surrogates ourselves (including our founder and CEO), so we have firsthand knowledge about how surrogacy works.
We have compiled this guide to help you understand what it’s like to carry someone else’s baby as a surrogate. Of course, everyone’s experience is different, and this is only a general overview. If you have any questions about what surrogacy could be like for you, please reach out to our team!
How Is It Possible To Carry A Baby For Someone Else?
Modern assisted reproduction technology gives us more options for family building than ever before. Today, it is possible to carry a baby for someone else, helping them achieve their dreams of having a baby.
Gestational surrogacy is a widely accepted and increasingly common pathway to parenthood for people who struggle with infertility or who need reproductive assistance for other reasons.
A gestational carrier, also called a surrogate, is a woman who agrees to carry and deliver a baby for another person or couple (known as the intended parents, or IPs).
The embryo carried by a gestational surrogate is not genetically related to the surrogate. Someone else’s egg (that of the intended mother or a donor), is combined with sperm (either that of the intended father or a donor) to form an embryo.
It is then implanted using IVF (in vitro fertilization) technology. If the transfer is successful, the surrogate will then carry the baby for the intended parent(s), with the expectation that she will have no parental rights or obligations once the child is born.
Requirements To Become A Gestational Surrogate
There are several requirements a person must meet in order to become a gestational carrier. These qualifications are in place to ensure the health and wellbeing of everyone involved: the surrogate, the intended parents, and the future child.
The American Society for Reproductive Medicine sets broad guidelines for who may qualify as a surrogate. However, certain clinics, agencies, or fertility doctors may have more stringent guidelines.
At Family Inceptions, our minimum requirements are among the highest in the industry. Our surrogate requirements are as follows:
- Between the age of 23-39 years old
- Having a Body Mass Index (BMI) between 19-30
- Must be a non-smoker for at least 2 years + living in a non-smoking home
- Clean criminal background (surrogate + spouse)
- Surrogate and partner must undergo psychological screening
- Have adequate family & social support
- Must be a US Citizen or a Permanent Resident living in a surrogacy legal state
- Has given birth to at least one child of their own
- No more than 4 deliveries and 2 c-sections. (Minimum Gestation: Singleton – 37 weeks / Multiples – 33 weeks)
- Must have uncomplicated pregnancies and deliveries (including but not limited to preterm labor, toxemia, incompetent cervix, pre-eclampsia, and pregnancy-induced hypertension)
- No recent history of mental health illnesses or taking medications (anxiety, depression, bi-polar, postpartum depression)
- Not currently receiving government assistance (cash aid, state funded insurance, or food stamps)
- Financially stable and able to support your family
Remember that the fertility clinic staff will give the ultimate approval. They want to do everything possible to facilitate a healthy, successful pregnancy. If they identify any red flags, you may be disqualified as a surrogate.
Applying To Become A Surrogate
Once a surrogate agrees to carry a baby for someone else, she begins an extensive medical, psychological, and legal process to prepare for the surrogacy journey.
First, you should know that whether you are applying to become a surrogate with an agency or if you are volunteering to carry for a family member or friend, there are still many steps you must take to prepare.
One of the first steps you must take is obtaining medical clearance. Start by discussing your plans with your primary care physician and/or OB/GYN. Your doctor can help you weigh the potential risks based on your health history. You will need a letter of medical clearance to share with your agency and/or the IPs fertility clinic.
Before you continue on in the process, you’ll also be screened for infectious diseases like syphilis, HIV, hepatitis B & C, and others. Psychological evaluation is also required to ensure you are mentally stable and able to understand the potential risks and commitment involved in becoming a surrogate.
You will need to gather all appropriate documentation, including medical records, family medical history, information for background and credit checks, and anything else required by your agency or the fertility clinic.
Be sure to discuss your decision with friends and family members before you fully commit. You will need a strong support system to lean on throughout the long surrogacy journey, both for emotional needs and more practical ones like helping out with chores around the house.
You should also be sure you are able to commit to the entire, lengthy process. If you have any moves, changes in relationship status, or other major life transitions in the foreseeable future, you should hold off until you have more stability.
It can be extremely disruptive for a surrogate to move to a different state, go through a divorce, or care for an ailing parent, for example. Of course, no one is able to anticipate everything, so if a major disruption does arise during your journey as a surrogate, be sure to communicate fully and transparently with your agency and your intended parents.
Ethical And Emotional Factors You Should Take Into Account
There are many emotionally and ethically complicated decisions you will need to make as a potential surrogate. Each of these topics needs to be discussed and agreed upon (in writing!) prior to committing to carry a baby for someone.
We encourage all potential surrogates to carefully reflect on the following issues:
Embryo Reduction And Termination
Before you agree to become a surrogate for someone, you must be in agreement about embryo reduction and termination.
Consider how you feel about selective embryo reduction (also called multifetal reduction). Multiples are always possible in any pregnancy, but the risk is higher for IVF pregnancies.
Although current guidelines recommend only implanting one embryo at a time, many clinics continue to implant 2 or more embryos if the IPs make that request and the surrogate agrees. Even if only one embryo is implanted, there is still a change the embryo will split to form twins or triplets.
In the case of multiples, the doctor may recommend selective reduction to lessen health risks for the surrogate and/or to increase the chance of survival for the other embryo(s).
You and your IPs must agree to this, including your mutual decision in your written surrogacy contract.
Likewise, you must consider the question of termination. If your life as a surrogate is at risk due to pregnancy complications, will you consider termination? Or will you agree to a “no-term” surrogacy, meaning no termination at any time, for any reason, even if your life is at risk?
These are tough questions, but you must be in full alignment with your intended parents prior to committing to surrogacy.
Medical Decisions
Next, you must consider how important medical decisions will be handled. As a surrogate, you maintain full bodily autonomy. In any clinic, doctor’s office, or hospital, you should expect to be treated as the sole decision maker.
However, as a surrogate carrying another family’s child, you must be sensitive to their wishes as well. Before you commit to carrying for someone, make sure you discuss the following medical issues, and of course, be sure this is all outlined in your contract.
Prenatal Care Appointments:
Will the intended parent(s) be allowed to attend these visits in person? If in person is not possible, will you allow video calls to occur during the appointment? Will IPs be allowed to attend ultrasound appointments?
After your prenatal appointments, what information will you be expected to pass along, and when? Becoming clear on all of these questions will help you avoid misaligned expectations and potential hurt feelings.
Invasive Prenatal Testing:
Will you consent to invasive prenatal testing such as amniocentesis or chorionic villus sampling (CVS) if the doctor recommends it? If so, will you receive extra compensation?
Vaccinations:
As a surrogate, you may be asked to receive booster shots or other immunizations before or during pregnancy. Most recently, there has been much debate about requiring COVID-19 immunizations for surrogates.
At the end of the day, no surrogate will be forced to receive any immunizations or medical treatments without her consent. This makes it all the more important to discuss these decisions up front and to make sure you and the IPs are completely aligned.
Method of Birth:
While the surrogate and intended parents can express a preference for the method of birth (home vs. hospital, vaginal vs. Cesarean, medicated vs. non-medicated), ultimately the circumstances are unpredictable.
As an experienced mother, you know that babies often come on their own terms. Complications can arise that require certain medical interventions. When you, as the surrogate, are under the care of medical professionals, the decision on how and what happens to your body during labor and delivery are yours to make — and yours alone.
That being said, we strongly recommend surrogates and IPs work together to discuss an ideal birth plan, while leaving room for flexibility and unforeseen circumstances.
For more about bodily autonomy as a surrogate, check out Episode 43 of the Fertility Cafe podcast.
Postpartum Emotions
While the vast majority of surrogates report feeling as though they are “giving back,” not “giving up” the baby after the child is born, complex postpartum emotions are to be expected. 5 Women Talk About Surrogacy – ‘Why I Decided to Be a Surrogate’ | Marie Claire (US)
Baby blues and postpartum depression are both possible for surrogates. Hormonal changes and a sometimes abrupt change of relationship with the intended parents can cause emotional distress for some surrogates.
It’s important to anticipate fluctuating emotions during the postpartum period. Do not hesitate to reach out to your doctor, a mental health counselor, or an anonymous helpline if you are feeling depressed, anxious, or if you feel you may harm yourself or others.
What Happens When The Child Is Born
While it is of course natural to worry about how you will feel after the child is born, we can report that the vast majority of our surrogates are overjoyed at the gift of life they are able to give their intended parents.
Studies such as this one continually show that surrogacy is a positive experience for most women who choose to carry for someone else. Still, you may experience some doubts or loneliness after the baby goes home with his or her parents.
One way to alleviate these feelings is by discussing your plans for future communication with the intended parents. Include expectations for contact in your surrogacy contract before you even begin the journey.
Will you stay in touch via text, social media, email, or regular in-person visits? The occasional photo update or note can go a long way to staying connected to the happy new family.
It can also be helpful to discuss and execute a meaningful plan for transitioning the baby from the surrogate to the parents at the hospital. The exchange of gifts, a brief faith-based ceremony, or simply additional time together to take photos, talk, and reflect on the shared experience can all go a long way.
How Would You Be Compensated?
Becoming a surrogate is an important and life-changing decision. When you agree to carry a baby for someone else, you are signing up for potential risks, discomfort, and complications.
Your life will be disrupted for over a year as you complete the application and screening process, then the IVF and embryo transfer procedures, and finally the long nine months of pregnancy.
Surrogate compensation is reflective of the enormous sacrifice a woman makes when she agrees to carry someone else’s baby.
Compensation for surrogates greatly varies depending on the circumstances of each arrangement. Altruistic, or compassionate, surrogacy is most common when you agree to carry for someone you know.
In these arrangements, the surrogate’s related expenses will be paid for by the intended parents, along with some incidentals like an allowance for maternity clothes. However, there is no additional base compensation or monthly pay.
In the United States, compensated, or commercial, surrogacy arrangements are more common when you go through an agency or find a surrogate who you did not know previously. In these arrangements, a surrogate will receive base compensation in addition to having all related expenses covered by the intended parents.
Compensated surrogates can expect to earn anywhere from $40,000-$80,000, and more in some instances. At Family Inceptions, our surrogates earn up to $80,000.
Your surrogate compensation package is generally comprised of the following:
- Base Pay (your compensation): Typically paid out in nine monthly installments after a successful pregnancy is confirmed. Experienced surrogates can often receive a lump sum bonus payment as well
- Monthly Allowance: A set amount paid to the surrogate for incidental expenses
- Multiples Fee (for twins, triples, etc.): An extra sum to be paid for the additional risk and difficulty of carrying multiples
- Compensation for Lost Wages (due to bed rest, etc.): If necessary, reimbursement of lost wages for the surrogate and/or her spouse due to pregnancy-related issues
- Health Insurance: A health insurance including maternity coverage will be purchased at the expense of the intended parents
- Costs of Screenings and Exams: All medical, background, and mental health screenings are paid for by the intended parents.
- Legal Fees: Intended parents will pay for a qualified attorney to represent themselves, and a separate attorney to represent the interests of the surrogate. All legal fees related to the drafting and execution of the surrogacy agreement, parentage orders, and other issues as needed, will be paid by IPs.
- Mental Health Support: To include the initial mental health evaluation. Ongoing mental health support may be added during the negotiation phase of the surrogacy contract.
- Cesarean Delivery, if needed: Additional fees will be paid should the surrogate need a C-section.
- Unanticipated Events (miscarriage, fetal reduction, dilation and curettage, etc.): Additional fees should be specified in the surrogacy contract in case of unexpected complications. Examples include miscarriage, fetal reduction, dilation and curettage, cancelled or mock cycle completion, and other complications.
Each aspect of your surrogate compensation must be discussed, mutually agreed upon, and included in your legally binding gestational surrogacy agreement.
Are You Ready To Help Someone Start Their Family?
If the thought of becoming a surrogate has been on your heart, we encourage you to take the first steps. Complete a short initial application to see if you qualify. You are under no obligation to continue the process should you decide it’s not for you. At the very least, you will gain some new clarity about what it takes to become a surrogate.
At best, you could be the literal answer to a hopeful parent’s prayers.
Would you like to find out whether you qualify as a surrogate? Shoot us a message and our specialists will be in touch with you.
