How Do I Become a Surrogate Mother?

The surrogacy process in a nutshell

Surrogacy is not as simple as just getting pregnant and then giving birth. Though situations will vary if you already have a person or couple in mind that you’ll carry the child for, here’s what you may confront, in a nutshell:

1. Legality

Before anything else, you must find out if surrogacy is legal in your state. There are no federal laws surrounding this practice, so the rules vary and may change over time. You can find more information about the laws where you live by contacting a local surrogacy agency.

2. Basic requirements

From there, you’ll want to see if you meet certain requirements for becoming a surrogate. These requirements vary by agency and revolve around things like:

• age
• previous pregnancies
• body mass index (BMI)
• health and medication history
• ability to travel
• other lifestyle habits

3. Application

Once you show that you can satisfy the initial requirements, you’ll fill out an application. This may include more details about your health history. You may also need to answer some questions about yourself and your motivation for becoming a surrogate.

4. Exams and screenings

You’ll need a physical exam, a mental health evaluation, and background checks to make the next step of the process. Some agencies may even perform a home study.

5. Choosing an agency and surrogacy plan

Along the way, you’ll need to determine which type of surrogacy interests you. There are two main types — traditional and gestational surrogacy (more on this in a minute).

6. Matching with intended parent(s)

Once you’ve come up with a plan and share your intentions/goals with your agency, you can begin the matching process with intended parent(s). You’ll also share if you’re comfortable being pregnant with multiples and any other considerations you may have.

7. Legal contract

Before you get pregnant, you’ll sign a legal contract with the intended parents that outlines:

• exactly how the process will work
• who will pay for what
• your responsibilities
• how the child will be turned over after delivery
• any other details that apply

8. Getting pregnant

Then there’s the matter of getting pregnant. How this happens has to do with your surrogacy agreement, but it’s usually through either intrauterine insemination (IUI) or in vitro fertilization (IVF).

9. Birth and beyond

When the time comes, you’ll give birth. Your surrogacy agreement will also outline exactly how the baby is transferred to the parents after delivery.

Getting started

Again, there are two types of surrogacy. What you ultimately choose has to do with your personal goals, the laws in your state, and your legal agreement with the intended parent(s).

• Traditional surrogacy involves fertilizing your own egg using IUI. This type is a bit trickier legally because you’re also the baby’s biological mother.
• Gestational surrogacy involves having an embryo placed into your uterus through IVF. The baby doesn’t have any of your genetic information — instead, it contains genetics from the parents or donors.

Whatever type you choose, the requirements for being a surrogate are set by the particular agency you’re working with.

They might include things like:

• being between the ages of 21 and 45
• having a BMI of 30 or lower
• having a history clear of sexually transmitted infections (STIs), drug use, smoking, etc.
• having been off antidepressants/anti-anxiety medications for a year
• having at least one successful pregnancy previously
• having a history of uncomplicated pregnancies/deliveries
• having the ability to travel to appointments
• having a clean criminal record

Agencies also require that you have a physical exam by a doctor (sometimes a fertility specialist) to show that you’re healthy and able to sustain a pregnancy. You may also have lab work as part of the exam to check for hormone levels, STIs, and other infections that might impact fertility.

Beyond your physical fitness, you’ll also have a mental health evaluation. Surrogacy does have the potential to be difficult psychologically, so this can be helpful in introducing you to any potential challenges you might face.

Legal issues

There’s a range of what’s legal and what’s not depending on where you live.

• States like Maine, Washington, New Jersey, and California are considered “green light” areas where all types of surrogacy are legal.
• On the other hand, New York, Michigan, Nebraska, and Louisiana are considered “red light” states because laws prohibit paid surrogacy contracts.
• And some other states — like Alaska, Colorado, and North Carolina — don’t have any specific laws written about surrogacy, but they will allow it.

Laws generally revolve around things like compensation for surrogacy and parental rights (pre- and post-birth orders). Some also dictate what types of couples can attain parental rights. For example, in states like Texas, Utah, and Florida, couples must be married before adding to their families via surrogacy.

For more information on what’s legal where you live, contact your local surrogacy agency. You may also consult the United States Surrogacy Law Map from Creative Family Connections, a surrogacy matching agency.

Payment and how it works

There are various costs that the intended parent(s) pay when it comes to surrogacy. These include things like agency fees, fertility clinic fees, and legal fees. Intended parent(s) also pay compensation and expenses to the surrogate, along with any medical costs associated with the pregnancy and delivery.

The cost to intended parent(s) may generally be between $50,000 to $100,000 with some areas ranging as high as $90,000 to $130,000, according to individual agencies. You, as the surrogate, don’t pay any of the legal or medical fees. Instead, you’re compensated for your service.

The payment you receive and how it’s disbursed will be outlined in the legal agreement you draft with the intended parent(s). The contract should also outline what happens in the event of pregnancy loss or unforeseen complications. Basically, you’ll want to have all the bases covered.

Intended parent(s) pay for the following:

• base pay (your compensation)
• monthly allowance
• multiples fee (for twins, triples, etc.)
• compensation for lost wages (due to bed rest, etc.)
• health insurance
• costs of screenings and exams
• legal fees
• mental health support
• cesarean delivery, if needed
• unanticipated events (miscarriage, fetal reduction, dilation and curettage, etc.)

Of course, you can get a much better idea of the exact things that are covered from your agency.

How much is compensation?

If you’re looking to be compensated for surrogacy, you can expect to make up to $50,000 for a single baby.

This number may be higher or lower depending on where you live and how much experience you have. And if you have multiples, the number may also be $5,000 to $10,000 higher, since you’re having more than one baby, says West Coast Surrogacy in Southern California.

Related: Infertility after donating eggs

Finding parents in need of a surrogate

Unless you have a specific person or couple in mind, you’ll likely find matches with intended parent(s) through your agency.

After you fill out your application and have your screenings, you’ll be entered into a database. Families are also in the database.

Your agency should work with you and the intended parent(s) to find a match based on things like your expectations during pregnancy and birth, your desired relationship with the child after birth, and any other unique circumstances you may have.

Various agencies, such as Surrogate Solutions, will tell you that communication is key at this point in the process. You’ll have the opportunity to meet with intended parent(s) before signing contracts to make sure you’re on the same page.

Sometimes you may just get a feeling that a particular family is the right fit. Other times, it may be less clear. Take your time with this part, as you’ll be in close contact with the intended parent(s) for the better part of a year (or more).

Becoming a surrogate for a friend or relative

Have a friend or family member you’d like to work with? The matching process is pretty straightforward.

If you choose to become a surrogate for someone you know, it’s important that you’re transparent from the very beginning about your desires and expectations once the baby is born. This means that even if you know someone well, you may still want to have the help of a surrogacy agency.

All the same screenings and requirements and state laws still apply here. It’s a good idea to treat the arrangement formally, as you never know exactly what complications or liabilities may crop up throughout your pregnancy and beyond.

An agency can help guide you and the intended parent(s) through the process and provide resources as necessary so it runs smoothly for all parties involved.

Related: I didn’t think surrogacy was for me. And then life happened

Getting legal representation

Since the laws vary by where you live, you and the intended parent(s) should each arrange for separate legal representation with experienced lawyers. This applies even if you’re going to be a surrogate for a family member or friend.

Your agency can point you in the right direction when it comes to representation. Otherwise, you need to look for a surrogacy attorney who’s familiar with the laws in the state in which you reside and intend to have the baby.

Contracts — surrogacy agreements — you draft surround things like:

• how many embryos can be transferred
• different testing options during pregnancy
• what to do if tests come back abnormal

The agreements should cover anything and everything you can think of that may be involved before you get pregnant, during your 9-month journey, and even after delivery.

Beyond the surrogacy contract, the intended parent(s) will need to be listed on the baby’s birth certificate. This involves something called a Declaration of Parentage. Again, experienced lawyers can guide you all through this process and how it works in your state(s).

Process of getting pregnant

No matter what type of surrogacy you choose, you’ll become pregnant through artificial reproductive technologies (ART). This just means that you’ll use either IUI or IVF to get pregnant in a medical setting.

Traditional surrogacy (IUI)

With IUI, you use your own egg. The sperm is supplied by either the intended father or a donor. The procedure itself can be performed in a doctor’s office after some initial monitoring of your cycle and possible use of fertility drugs.

You lie on an exam table with your legs in stirrups, much like you do for a pelvic exam. A speculum is inserted into your vagina. Then the vial of sperm is attached to a catheter that is inserted into the vaginal canal, through the cervix, and into the uterus. The sperm is deposited into the uterus for hopeful fertilization and implantation.

Gestational surrogacy (IVF)

With IVF, the egg and sperm either belong to the intended parents or to donors. You may take medication to synchronize your cycle with that of the intended mother or donor if you are doing a fresh transfer. (This isn’t necessary if the embryo you are using is frozen.)

The egg is then fertilized in a lab, creating an embryo. You’ll take fertility medications to prime your body for the transfer of the embryo. After the embryo is transferred, it will hopefully implant and result in a successful pregnancy.

Related: Self-care for IVF: 5 women share their experiences

What happens at birth

As far as when the baby is given to the intended parent(s), that’s something you’ll outline in your surrogacy agreement. The same goes with what, if any, communication you’ll have with the child after they’re born.

In cases where you’re a surrogate for a friend or family member, you may have some contact with the baby. In other contracts, no contact with the child is granted after delivery. It’s a case-by-case situation.

Giving birth itself can be both physically and emotionally challenging. While you may not be bringing the baby home with you, you’ll still deal with the physical after-effects of delivering a baby.

For example, your body will need to heal whether you deliver vaginally or have a cesarean section. Your breasts will likely produce milk, making you engorged for some time. And you may be carrying some extra pregnancy weight.

You may even deal with baby blues or postpartum depression. Knowing what’s ahead, preparing yourself, and having a good support network can help you cope with issues as they arise.

Related: Everything you need to know about postpartum depression

Things to consider

Some pros of surrogacy include things like being able to help a person or couple add to their family when they otherwise couldn’t. This can be very gratifying.

Of course, there’s also the financial benefit that could help you and your family do things like go to college or afford a new home.

And if you and the intended parent(s) decide to stay in contact, you may also find that you’re able to create a new connection/friendship.

On the flip side, there are some potential cons:

• You’ll need to dedicate a chunk of your life to getting pregnant, carrying a baby, and then recovering from birth. In a way, your body isn’t entirely your own during this time. You’ll likely need to take fertility medications, eat well and exercise to stay healthy, and attend appointments. This can take a lot of time and energy away from your schedule or even your own family.
• You may or may not enjoy pregnancy. And even if you have had easy pregnancies in the past, there’s no guarantee that your pregnancy will be smooth sailing. In fact, you may find it more challenging to carry someone else’s baby, especially if you have to deal with complications or bed rest.
• You may also not fully understand the emotional impact of surrogacy until you go through it. It’s extremely important that you prepare yourself for what’s to come — especially after the baby is born. Pregnancy is a wild ride and your hormones may heighten your emotions further.

Be sure to talk over this big decision with your partner or a surrogacy specialist. Take your time to think about all the benefits and disadvantages of how surrogacy may or may not fit into your life plan.

Related: Why your mental health before and after baby is so important

For more information

Want more information about surrogacy? You can start by browsing forums or groups to find out more from real surrogates about how the process works and what it’s like. Try visiting the All About Surrogacy Forum and Surrogate Mothers Online to read over different experiences and birth stories.

For help with matching, consider these Facebook groups:

• Surrogate/IP Meeting Place
• Surrogate & IPs Match/Chat
• All Things Surrogacy
• Surrogates and Intended Parents

There’s also the Find a Surrogate Mother website that matches potential surrogates and parents.

And if you’re seeking legal representation, try looking over the Academy of Adoption & Assisted Reproduction Attorneys Database and finding out more about the laws in your state on the United States Surrogacy Law Map.

The takeaway

If becoming a surrogate mother is something that interests you, don’t hesitate to find out more about how the process works.

Contacting an agency can be helpful in giving you more specific details about the requirements and legal situations you’ll encounter.

Aside from that, making the decision is deeply personal. So, take your time, think about all the pros and cons, and follow your heart.