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Everything You Need to Know About Becoming a Surrogate

1. Getting Started

Learn about surrogacy

When you think about starting a family, surrogacy is not usually the first option that people consider. As a surrogate, you have the chance to help someone on their journey to creating their perfect family. Many times, the couples who come to surrogacy do so after trying other options such in vitro fertilization (IVF). And for women who suffer certain medical issues, such as an impaired uterus or another chronic health problem that makes it impossible or unsafe for her to try to carry a child. There are even recorded cases of mental health issues which prevent otherwise capable women of carrying their own child. Sharing a pregnancy with a carrier (the surrogate) may be the only option for biological parentage for many people. In the case of gay men and couples, a surrogacy arrangement is the only way for them to create biological families.

Most of the couples who build their families via surrogacy choose to go via gestational surrogacy, as opposed to traditional surrogacy. With gestational surrogacy, the embryo is created via IVF using the egg provided by the intended mother or an egg donor and the sperm provided by the intended father or a sperm donor. That embryo is transferred to the gestational carrier otherwise known as the surrogate or GS. In these cases, the GS has no genetic connection to the child. In traditional surrogacy, the embryo is created using the sperm provided by the intended father or a sperm donor and the egg provided by the surrogate herself. In traditional surrogacy, the surrogate mother does share a biological connection to the baby.

Surrogacy is often described in simple terms as a beautiful act in which a woman becomes pregnant and delivers a baby for another person or couple, thereby helping others become parents and creating a new family. However, as you can glean from the short description of surrogacy above, it is a lengthy and often complicated process that involves numerous individuals. It is our aim to help you become fully informed so that you can make sure you’re protected and empowered at all times.

Keep in mind that surrogacy is a long process that can sometimes take a number of years to complete. This guide should help to inform you about everything you need to know to help you decide if this is the right option for you, what the different options are and the possible directions you can take on this journey. We hope this will inform and also inspire you.

General considerations and prerequisites

The American Society for Reproductive Medicine (ASRM) is the leader for information, education, advocacy and standards in the field of reproductive medicine. It is a non-profit organization which publishes evidence-based reports on the topics of fertility and reproduction, covering surrogacy. We consider their recommendations as best practice and would not advise the following if it did not reflect their stance on the topic. The requirements below are the standard that a future surrogate must meet in order to be considered a candidate for surrogacy. These guidelines are also followed by IVF and fertility clinics – but please note that clinics may have other additional requirements not outlined below. Guidelines like these help ensure the safety and security of both the surrogate and the baby.

Consider the following question regarding your personal situation and medical history:

  • Are you are between the ages of 21 and 42 years old?
  • Are you in good physical and emotional health?
  • Are you a non-smoker and non-drug user?
  • Do you have a healthy weight and BMI?
  • Have you previously given birth to at least one living child?
  • Are you a parent to your own children?
  • Have your previous pregnancies been healthy and without complications?
  • Are you financially stable and not on any form of public assistance?

If you can answer all the questions above positively with a YES, then you’re on your way. It’s important to note that a ‘healthy weight’ is rather subjective and most clinics allow some leeway in this regard, do note that the maximum BMI usually allowed is not greater than 32. The list above is the minimum you must comply with according to the ASRM, but the following points are something that agencies usually ask. These are very interesting points to consider before going any further.

Please think about whether you would still like to have your own children or have you already completed your own family? As with any pregnancy complications can and do happen. Think about how you would feel if becoming a surrogate meant you would not be able to carry a pregnancy again.

Ensure that you remove your IUD, if you have one. Also, there are some forms of permanent birth control (like Essure) which would prevent you from becoming a surrogate. Please check with your doctor

You have to be sure you want to do this and that you will follow through with everything you commit to. Including taking any medications exactly as prescribed and following all the terms you agree within your contract.

If you meet the requirements and you had time to think about our other considerations, you can give yourself a pat on the back for making it this far. If you did not meet the standard requirements you may want to find an individual consultation as your personal situation may be different. Maybe it’s not the right time for you to do this. Or perhaps it’s not the right thing for you, which is fine. The guidelines are there to look after surrogates’ emotional and physical safety. And if it’s something you can change then set it as a goal and make it happen.

Surrogacy friendly states

[Each American state has their own law regarding each aspect of surrogacy. Most surrogacy agencies will only work with surrogates who live in states that are considered ‘surrogacy friendly’. Agencies will consider surrogates from other states on a case by case basis. The information below about state surrogacy laws is not meant as legal advice. Nonetheless, as a general rule, you will be better off seeking the assistance of an experienced Assisted Reproductive Law attorney. Remember that laws can change so ensure that you have the most up to date information!

Importance of having a strong support network

[/fusion_text][fusion_text]A strong support network is really important not just while you are on your surrogacy journey. It means that your partner or significant other in behind you, supporting your decision to become a surrogate. Also that you have your family and friends to turn to in times of need. Your support network can give you a hand in times of crisis and also give you focus and positivity. This support can also come from a surrogacy agency if you choose to work with one.

Support can manifest itself in many forms. For example, emotional support refers to the actions which make us feel cared for or loved. It is essential to our daily life. Practical support refers actions or things, for example, if someone offers to babysit or taking care of the chores. Informational support is what our site is all about – bringing you information in a clear way.

A strong support network will help you reduce the stress which may arise from your surrogacy journey, as well as providing you a sense of security and community. We all need to be able to go to someone we can talk to if we have a problem. The more support you have available to you will increase the way you will feel. People who don’t have a supportive circle of friends and family are more likely to struggle with a surrogacy journey. Surrogacy agencies usually offer different kinds of support. Check with your provider to see what is included.

Online social networks like Facebook groups and forums are also an excellent source of support. When times are tough don’t hide your feelings and if you feel you can’t talk to your partner, then online support groups are one way you can share it with others who maybe experienced a very similar situation. The simple act of able to talk about your problem with others can help you put things in perspective and get a fresh view. It is likely that others in the group will have come across similar struggles. Their thoughts or advice may come in handy.

As we all know, life is full of unplanned events and there is no knowing when you will come head on with sadness or anxiety and there are so many aspects of the surrogacy journey that are outside of your control.

2. Create Your Ideal Journey

Motivation for becoming a surrogate

Motivation to become surrogates comes in many ways. For some, it comes from witnessing someone they know struggle to become pregnant. Others just want to be pregnant again without extending their own family. A surrogacy journey provides a supplement to their families’ income and although it’s important, this is not usually the strongest motivation. You probably have a strong personal reason why you want to do it. The reward for being a surrogate comes from helping to build a family and it is not a decision to be taken lightly. Here we share two different surrogates’ motivations and experiences:

Previous surrogate Marisa shares her motivation:[/fusion_text][fusion_text]

I was introduced to surrogacy by a short magazine a year after I had my last baby. I knew instantly that it was something I could do too. I looked into it straight away and found other stories about couples who couldn’t conceive. I just couldn’t imagine my life if I had not being able to have my kids. So I talked to my now ex-husband about it and he was completely against it. The reasons we split up are unrelated to this, but years later I was talking about it with my new partner. We hadn’t been together for more than a few months at the time but he was so supportive of me. I decided to go ahead with it and I am so happy I did. I loved being able to help this couple have a family. It was the most amazing experience ever.

For me there were a few different reasons why I decided to become a surrogate. First, I was aware of people in my extended circle of friends who were struggling with fertility issues. It made me sad feeling like they would be such great parents if only they could have kids. Secondly, my best friend had been having trouble getting pregnant and that happened at the same time that I became pregnant with my last baby. I felt bad for her when she found out I was pregnant again because I knew how long they had been trying. After that, my husband and I decided our family was complete, but I knew I wanted to be pregnant again. I really liked pregnancy, and as a stay at home mom I felt that I could help our family’s financial goals through surrogacy. And the third reason why I became a surrogate was because I wanted to see my intended parents holding their little baby and becoming a family. I know that I helped build a family and it is a fantastic feeling.

There are two types of surrogacy arrangements as mentioned before. Most surrogacy agencies specialize in only one of these – gestational surrogacy.

In gestational surrogacy arrangements, the surrogate is not related to the baby she is carrying genetically. The genetic material (egg and sperm) comes from the Intended Parents (the IPs) and/or a donor. There are multiple configurations possible and it all depends on the IPs situation.

In traditional surrogacy arrangements, the surrogate mother is also the egg donor. In such cases, the baby is genetically related to the surrogate. The legal framework for surrogacy is currently aimed at gestational surrogacy which is why most agencies deal in gestational arrangements predominantly.

Thinking about your ideal situation

Set yourself the ideal outcome of your surrogacy story, having a clear picture in your mind will make matching much easier later on. Thinking about the following questions will get you started.

  • What kind of people are these intended parents (IPs) that you are going to help?
  • What background are they from?Are you looking to help a single IP or a couple?
  • Can they be same-sex couples?
  • Is it important for you that your IPs are local people?
  • How far would you consider reasonable?
  • Would you prefer if it was someone from overseas?
  • In your ideal surrogacy journey, would you carry a single baby or multiples?
  • How many embryos are you happy to transfer at a time?
  • Are you aware of the risks to you and the unborn babies when carrying multiples?
  • How do you feel about terminations?
  • In which cases would you approve?
  • What if the embryo splits, would you want to have a selective reduction?
  • What are your thoughts about genetic testing of embryos?

A big commitment

As mentioned already, surrogacy is a lengthy process. For some surrogates completing a journey can take years. To give you an idea, a very brief overview of a typical journey means you need to pass medical and psychological evaluations, match with your ideal intended parents, complete legal contracts, prepare your body with medications and injections, become pregnant and finally deliver the baby. Sometimes the first attempt at pregnancy is unsuccessful and you will have to repeat the medication and embryo transfers. You can see why it can be such a long process.

With so many people involved it just means everything takes longer. First and foremost you have to be prepared for the unexpected. Set out everything that you want in your journey, and specify anything that you are not comfortable with. This will help you avoid some common misunderstandings that could occur further down the process.

Agency or independent surrogacy

[Everyone is different and there is no right or wrong way to go about your journey. There isn’t one solution that suits everyone and there are pros and cons to each method.

Becoming a surrogate with an agency will give you support and assistance to guide things along. Many times the agencies are staffed by former surrogates who know what the experience is like and are on hand to help you navigate the journey. The agency will be doing all of the planning, preparing, and laying out the journey for you. They will be in touch with the doctor and the IPs and help you book your appointments.

If you choose to go independent it means that you will be in charge of communicating with your IPs directly. You will need to make all your appointments and keep yourself organized. If you are comfortable setting your own fees and able to act as your own advocate if something doesn’t seem right to you, then maybe an independent journey could be right for you.

Become a surrogate via an agency

There are so many surrogacy agencies out there for you to choose from. Each one will be able to offer you different levels of support. The most important thing for you should be whether you feel comfortable working with them. You can browse through our directory of agencies and get in touch with the ones that interest you, ask them some questions and see if you would be a good fit for you.

Don’t worry about their location too much. Agencies are used to working with IPs and surrogates all over the country. Make sure that they are well respected and ethical. You can look at their reviews online to check that previous surrogates recommend them. You have every right to ask them for references of previous surrogates and IPs. Personal reviews are subjective, so look for hard facts too. You gotta be sure that you do your research on the agency you choose.

The most important part that the agency will play is to match you to the IPs. They will suggest matches for you but you have every right to refuse. Never feel obliged to accept a match that you are not comfortable with. Most agencies have an online application and they will generally get in touch with you in a few days. If you do not hear from them then you should get in touch to find out what the status of your application is. If they are interested in your application, they will request further information from you. This will include information about your general health (and your partner too), your previous pregnancies and they may also request your medical history from your doctor.

Some agencies out there will accept surrogates before doing medical and psychological screenings. They will only action their screening once they get you a match. Others pre-screen, so please check that with the agencies you are researching. The agency will do a background check on you and your partner. They will arrange for you to attend a psychological screenings with a licensed therapist. You will be asked to attend a medical screening at a fertility clinic where the doctor will evaluate your medical history and look for any possible issues that could disqualify you from becoming a surrogate. Everything is done to protect your safety and to ensure that you can carry another successful pregnancy.

Become a surrogate independently

Independent surrogacy is often referred to as ‘going indy’. It’s when the surrogate is doing the matching and working directly with the IPs without an agency. You have to think about all the same issues if you are going indy just like if you were with an agency. You have to be very detail focused and able to plan ahead.

As an indy surrogate, you have to make your own decision about the fees you expect. You can look at what the agencies are doing and go from there. You will be able to get a schedule of fees from any agency. Asking an experienced surrogate is also a good idea.

As mentioned above, the agency will match you with the IPs, but there are many ways that surrogates can match with IPs on their own. For example, many surrogates choose to post a classified ad on surrogacy websites or in social media groups, like Facebook. You will want to give as much information about what your ideal IPs are like and what (if any) non-negotiables you want to stick to. Once you begin talking to possible IPs, you should discuss everything openly from the beginning to make sure you all are on the same page.

IPs who come through an agency have had a background check done by the agency (you can check that with individual agencies), so you should feel comfortable to ask them for references. You can do your own background check or you can get one done online. You can also expect them to feel the same way and want to do a background check on you.

It is very important to find the IPs who are on the same wavelength as you. You gotta have a good impression and a positive feeling in your gut. You will need to be in agreement over what to do in regards to carrying a single baby or multiples, termination, reduction, etc. Never just agree to something that you aren’t comfortable with.

3. Getting Matched

Find the right match

Whether you choose to go via an agency or go independent, you need to be prepared to say no if you are not comfortable with anything you find. Thinking back to your ideal situation and your motivation for becoming a surrogate will help you loads.

You should meet the IPs in person at some point, although many meetings happen over video calls, there is nothing like a face to face to help you get a feeling for a person. You have to be honest with yourself about whether it’s the right match for you or not. Never feel bad about turning down a potential match for whatever reason. Having the support of an agency as a middleman can facilitate the relationship.

If you can find a IPs that you feel you can trust and you can nurture a good relationship into a friendship even, you can often become like extended families to each other, keeping in touch via calls text video calls and plenty of visits. The other alternative is that you build a colder and more distant business like relationship. In such a case, you may find it easier to talk about your requirements. You will keep in touch during the pregnancy as much as is necessary but in a matter of fact way. Your ideal relationship may be somewhere in between one of these

The 3 surrogacy must-have’s

Whether you choose to go with an agency or decide to go independent, most of the steps and procedures will be the same. The following three elements are part of every surrogacy journey, and you will require the green light or ‘clearance’ from your legal rep as well as the medical expert before you can proceed. An essential part of every journey is that you are represented by a qualified attorney. Your IPs will also have their own attorney and both parties will be in touch to negotiate the details of your arrangement. The ‘contract’ between you and the IPs should cover every eventuality, so that in the unforeseen circumstances of things not going according to plan, you have already set out what needs to be done.

An escrow is like a bank account where your IPs should deposit all the funds for their journey. This will guarantee that the IPs have the resources required to complete a journey. The management company will keep track of all the invoices and payments and ensure that you are paid as per the contract.[/fusion_content_box][fusion_content_box title=

The doctor who will perform your medical screening and the procedure known as embryo transfer. They will be looking after you all the while until a pregnancy is achieved. After that you will see your own doctor for the remainder of the pregnancy. Your IPs will most likely have a doctor they’re already set up with.

Legal contracts

Both you and your IPs will each have different lawyers who specialize in assisted reproduction law and surrogacy law. You will have to choose one or your agency will recommend one, so choose someone you feel comfortable with. They can go through the contract with you to explain anything you are unsure about. Your lawyer’s fees will be paid for by your IPs which means that there will be a clause in the contract about ‘conflict of interests’. Don’t stress, it is common in these arrangements. The contract will lay out every eventuality and possible combination of events to give you peace of mind during the journey. The contract helps to establish parentage and covers compensation rates too.

You will discuss the contract with your lawyer, making amends as you see fit. Both attorneys will be in touch with one another, so you don’t have to try negotiating details with your IPs directly. The contracts will also detail the amount of compensation you will receive and what additional costs will need to be covered by your IPs. This is where you can state exactly how much you expect to be reimbursed for say, travel, inconvenience and other expenses that you may incur during the pregnancy.

If you decide to go indy, ensure you look at an agency’s compensation and expenses table. The surrogate compensation rates vary at $20,000 – $35,000 depending on the state you live in and other factors. In some cases, it can be much higher. Also, if you were to include carrying multiples or needing to deliver via c-section, then your compensation will be higher. Once your contracts are signed your lawyer will issue ‘legal clearance’ to your doctor or agency and you will be ready for the next step.

Contents of a typical contract

  • Outline of parentage – the embryo is not biologically related to the surrogate
  • Statement that the IPs accept full responsibility for the child born via the surrogate
  • Statement that the surrogate does not intend to be parent of the unborn child
  • Number of embryos that will be transferred
  • How many times will you agree to have an embryo transfer
  • Conditions regarding your lifestyle like prohibited activities or foods
  • What constitutes a ‘Breach of Contract’
  • Outline of eventualities such as, what it one or both of the IPs die while you pregnant
  • Agreement on termination and selective reduction
  • Compensation amount and expenses cover

Taxes on your compensation

Another consideration around your compensation is about paying taxes. Make sure you speak to your agency or lawyer about it, your contract should state that you’re being compensated for your ‘pain and suffering’ of carrying a surrogate pregnancy. Make sure you speak to your tax professional and even the IRS. If you end up paying taxes on your compensation, you should then appeal the decision and request a refund. The situation around surrogacy is not clearly defined, so while some surrogates end up paying tax, those who apply for a refund usually receive it.

Reproductive endocrinologist (RE)

The fertility clinic that your IPs are working with will be the one to conduct your medical screening and assign you with your Reproductive Endocrinologist or IVF doctor. The RE will review your past pregnancy history and general health to assess if you are a good candidate to be a surrogate. You will need to travel to the clinic which may not be near to you at all. Your agency or IPs will normally cover these expenses and any additional things like finding childcare too. The usual blood tests (often referred to as FDAs) will be done for all relevant parties, which may or may not include your partner. It is not necessary for your partner to attend the clinic since their blood tests can be done at a local lab, your RE or agency can recommend one. Everything going well, your RE will issue ‘medical clearance’ and you will be ready for the next step.

Another consideration around your compensation is about paying taxes. Make sure you speak to your agency or lawyer about it, your contract should state that you’re being compensated for your ‘pain and suffering’ of carrying a surrogate pregnancy. Make sure you speak to your tax professional and even the IRS. If you end up paying taxes on your compensation, you should then appeal the decision and request a refund. The situation around surrogacy is not clearly defined, so while some surrogates end up paying tax, those who apply for a refund usually receive it.

Psychological screenings

If you go via an agency they will assign a licensed family therapist to conduct a psychological screening that will include an online test and a short telephone evaluation. If you decide to go indy, your IPs may arrange such an evaluation through their lawyer or the clinic. Not everyone can become a surrogate and the screenings are designed as a precautionary measure to ensure the safety of all parties involved in a surrogacy agreement. The psychological screening is not something you should stress out about, just be open and honest. The therapist may find grounds for denying a candidate based on different factors they find during the screening, and if that is your case do not get disheartened and see if you can remedy the situation. It may take time and you should try if you can to improve your situation. Once you have clearance from the family therapist, you will be ready for the next step in your journey.

Another consideration around your compensation is about paying taxes. Make sure you speak to your agency or lawyer about it, your contract should state that you’re being compensated for your ‘pain and suffering’ of carrying a surrogate pregnancy. Make sure you speak to your tax professional and even the IRS. If you end up paying taxes on your compensation, you should then appeal the decision and request a refund. The situation around surrogacy is not clearly defined, so while some surrogates end up paying tax, those who apply for a refund usually receive it.

4. During the Pregnancy

Surrogacy medications

Once you have your legal and medical clearance, you have the foundation to proceed with your surrogacy journey. You will undergo standard IVF procedures which require you to take medications and injections. Your RE will recommend a course of meds that is suitable for you, it usually means taking these medications for up to 4 months. Before the embryo transfer, your body will need meds to prepare for a future pregnancy. Then after the transfer, your body will still need medications up until the first trimester. These medications are the best way to ensure a safe and uncomplicated pregnancy.  Your contract binds you to follow your doctor’s instructions, so make sure you understand exactly what is expected of you. The following are some of the most commonly used medications.

Birth control pills are prescribed to change your cycle if it is necessary to get it to sync with the egg donor. It is also used to ensure you do not become pregnant before the surrogate journey is meant to begin.[

  • Leuprolide Acetate is an injection that is commonly called Lupron. It’s prescribed to stop the surrogate from ovulating during the cycle.
  • Another commonly used drug is called Progesterone. It’s used to help thicken the lining of the uterus which prepares your body to keep the embryo. Progesterone can be found as an injection, a gel or a tablet.
  • Delestrogen is another injection that is often prescribed. It is a form of the hormone estrogen.

Whichever medications you are prescribed, make sure you understand exactly how to take them and why you need them. Your doctor will be there to explain and help with any questions you have. If you have any negative reactions to the meds, speak to your doctor immediately.

The embryo transfer

There are certain medications that you will be taking before the pregnancy, especially before the embryo transfer. These meds will trick your body into believing it’s already pregnant. This will help your uterus accept the embryo and have a pregnancy.

During the embryo transfer, your IPs may be present. It depends on your arrangement, while it is an amazing experience for the IPs it may be impossible due to location or schedules. The transfer is a painless process performed by your RE. They will give you instructions on what you need to do to prepare for the transfer. You may be given medication prior to the procedure to ensure that you are fully relaxed. Using an ultrasound to ensure they have a good picture, the doctor will insert a catheter into your uterus to place the embryo. It is a process that requires lots of care and precision. You will need to remain in position and rest for a few minutes before you can leave, this is to give the embryo and the uterus enough time to hold. You may be asked to rest and take it extra easy for a day or two.

About two weeks later you will have to undergo a small blood test to check for hCG (human chorionic gonadotropin), this is known as the beta test. It checks for the levels of hormones in your system and can help to establish if the embryo transfer was a success or not. This can be a very stressful time as you await the results, just remember to keep your positivity push ahead. You will be required to repeat the beta tests a few times so the doctor can determine if you need the medications to be increased or decreased. If the transfer was not a success you will be feeling disappointed and that is normal. It usually takes more than one try to get a pregnancy with IVF. You can only do your best! Your doctor may recommend that you try again usually after you’ve had a month or so to rest.

If the tests show that you are indeed pregnant, then you will continue going to monitoring appointments to keep a close check on your pregnancy. The first three months are crucial and require lots of attention. Once you reach the second trimester, you will probably be off all medications  and/or wean off meds.

Once you reach the start of your 2nd trimester you will probably come off any medications and just need to take your pregnancy vitamins. At that point, your IVF doctor will stop being involved and your own doctor, your OB/GYN will continue to look after your pregnancy. You will need to attend your normal appointments and ultrasounds. Your IPs will be very curious about your status since they probably want to be a part of your pregnancy, so test results and scans will all be interesting for them. If your IPs are not local, they will look at other ways to be included, like being present at your appointments via video calls.

Delivering the baby

The surrogate delivery is very different from having a pregnancy for your own family. You should discuss and plan what is going to happen at the time of delivery with your IPs in advance. Clearly, you have to follow the hospital’s guidelines but there are a lot of things you can have a say on. In fact, you will have more of a say in what happens in the delivery room. You can find out from your doctor or local hospital if your IPs will be able to be present in the delivery room or not. Together with your IPs, you should prepare an ideal birth plan as well as a contingency plan. Finally, you should make sure that your hospital and nurses know exactly how you want the delivery to play out.

5. After the Birth

Possible complications

Any pregnancy and birth can have complications and surrogacy pregnancies are no different. As a surrogate you are effectively carrying someone else’s baby, you are taking the risk for someone else. Medical screenings aim to prevent these and everyone hopes for a smooth pregnancy. As a surrogate, you must be aware that you may be putting yourself at risk. This is another reason why it is important to have a good relationship with your doctor, ask as many questions as you need to and have all the information before making any important decisions that may impact your health later on in life.

Bleeding is a common complication during pregnancy you can develop a pocket of blood inside the uterus which causes bleeding. It affects about a quarter of women in who become pregnant via IVF. Your doctor will perform an ultrasound to check on the baby/babies and the size of the pocket of blood (hematoma). They will decide on your resulting diagnosis. If you experience bleeding during your surrogate pregnancy, you must get checked out by a doctor immediately. You should also inform your IPs or agency.

It is always possible that you will develop an allergic reaction to the medications prescribed to help your body prepare for pregnancy. These allergic reactions can be common things like rashes, hives, redness, swollen and itchy patches, breathing troubles, and more. If at any time you experience a reaction to any medication you should notify your doctor immediately.

Every embryo has the possibility of splitting to produce identical twins, and with IVF treatment, many IPs choose to transfer more than 1 embryo in the hope of having twins. Such practice may lead to situations selective reductions or termination are called for. Selective reduction and termination can be done for medical and non-medical reasons, so ensure you are prepared for that conversation. It should always be something you think about beforehand, and should be included in your contract.

There are multiple situations where your doctor may order you to rest either at home or in the hospital, you may be placed on bed rest for days. You have to make sure you have a plan in place in case this could happen to you. Consider child care, not being able to work and lost wages, housekeeping, and cooking… Ensure that it is included in your contract because you will benefit from having planned ahead and saved yourself the stress.


Discuss with your IPs what the plan is for the delivery. Most surrogacy births happen in hospitals, but it is important to discuss this with your IPs how you all want it to go. Who will be present and how will the delivery look. Plan it together! At hospitals in surrogacy friendly states there are usually no issues, just make sure the hospital is aware of the situation. The baby will probably be handed directly to the new parents for bonding and skin to skin and the IPs will be the ones given the ID bands for the baby.

Breastfeeding and breast milk

An important point to discuss at the contract stage is about breastfeeding and pumping breast milk. Although not everyone will be interested in this, there is a strong case in favor for the sake of the newborn. Every pregnant woman will make milk after delivery and for some time after the birth. The first milk, called colostrum and even referred to as ‘liquid gold’ for its yellowish hue, is very concentrated and it’s health benefits for the newborn are well established. Sucking is also good for the newborn as it eases the tension from the stress of labor and birth. Amazingly, the baby sucking is also good for mothers immediately after birth. The stimulation to the nipples triggers the release of hormones that cause the uterus to contract in turn helping to control bleeding.

After delivery, the baby will probably leave with its parents but there are ways you can still provide your breastmilk. Pumping breastmilk will allow you to store and send it to the baby. All the supplies and shipping costs should be reimbursed by the parents.

If your IPs don’t want you to breastfeed or to pump breastmilk, you can still donate your breastmilk to a bank. When donating, all costs like the bottles and the shipment, are covered by the breastmilk bank. Some hospitals have milk donation programs – otherwise, you can speak to your doctor who may be able to refer you. You may also be interested in becoming a wet-nurse for another baby.

The Bond of the Surrogate and Keeping in Touch

Depending on how close you are with you IPs, you will have been on an emotional journey together. Some surrogates develop a fabulous bond with their IPs, creating a kind of extended family in the process. The kind of relationship that comes out from a surrogacy journey very much depends on you. At the beginning of this guide, you had to think about the ideal journey for you and who the ideal IPs would be. Now that you successfully completed your surrogacy journey, where this relationship goes depends on all of you. For many, long distances mean that visits are rare. Christmas cards, birthday cards, and facetime calls are the types of interactions that are more likely. For those who develop closer ties, it means sharing holidays and babysitting for each other. You may also choose not to hear from them again, and that is okay too. You helped to create a family and you should be immensely pleased about that.