Surrogacy: A Journey to Parenting

Every journey to parenthood is unique, no matter how your baby comes into your life. Surrogacy is a path to parenthood for those who cannot or choose not to carry a pregnancy themselves. During surrogacy, one person – the surrogate – carries a fetus through pregnancy and gives birth to a baby for another person or couple – the intended parent(s). Surrogacy can be a good option for individuals and couples who want involvement with the pregnancy and prenatal care or their child, and to be able to raise their child from day one of life. Intended parents may also choose the genetic makeup of their child by selecting egg and/or sperm donors. In this post, we’ll explore the steps of the surrogacy journey, from choosing a surrogate through the birth your child.

How popular is surrogacy?

Surrogacy has come a long way since the first successful pregnancy via surrogate in 1985. While the data unfortunately has not been tracked as accurately as we’d like, it’s clear that gestational surrogacy is on the rise. Between 1999 and 2013, there were 30,927 surrogate pregnancies in the United States. It’s estimated that more than 1,000 children are born via surrogacy in the US each year.

Steps of the Surrogacy Journey

Like any path to parenthood, surrogacy is rarely linear. Some of the following steps may take little time for some couples, and quite a bit of trial and error for others. Here are the general steps of the surrogacy process:

1. Research the surrogacy process: If you’re reading this, you’re likely in this first step! Thoroughly researching the surrogacy process is an essential part of the decision making process. You’ll want to be sure that surrogacy is the right path to parenthood for you, as opposed to other options such as adoption. You also want to ensure that you’re emotionally and financially ready for parenthood through surrogacy.
2. Application & Consultation: Unless you’re using a personal relative or friend as a surrogate, chances are you’ll have to apply to be an intended parent through a surrogacy agency. This ensures that you, and your partner if applicable, will be a good fit for surrogacy. You’ll then consult with the agency to learn expectations and next steps to the process.
3. Select a surrogate: The next step in surrogacy is for the intended parent(s) to choose a surrogate. This is a very personal process and one that is not meant to be rushed. If using an agency, you’ll be able to browse pre-selected profiles of potential surrogates before interviewing them. The surrogate will also be able to read your profile and decide if your family may be a good fit for her. The decision to work together is a mutual one.
4. Legal representation: The intended parent(s) and surrogate must be represented by separate legal advisors in order to protect everyone’s best interests. They must be licensed in the state and have expertise in surrogacy matters. Attorneys will draft and review legal documents to ensure their clients are protected. During this process it’s also common to set up an escrow account to hold your funds for the surrogacy process.
5. Medical and background screening: Surrogates must be screened to ensure they’re healthy enough to carry a pregnancy. Screening includes blood tests and other lab work, a physical examination, a psychosocial exam, a criminal background check, and a consultation with the health care providers. Intended parents must also typically undergo a criminal background check and psychosocial exam.
6. Purchasing health insurance: At this stage, intended parents must purchase health insurance for their babies or plan to pay the hospital directly for the costs of their care. The surrogate’s health insurance will cover her healthcare only.
7. Surrogacy agreement: Once the surrogate is cleared by the fertility doctor and all screenings have been completed, it’s time to sign the surrogacy agreement. The surrogate and intended parent(s) sign a contract that outlines the terms of the surrogacy arrangement. At this stage, payments to the surrogacy agency and/or surrogate directly may be required.
8. Embryo transfer: Now it’s time to start the IVF process! The intended parent(s) create embryos through in vitro fertilization (IVF) and transfer them to the surrogate’s uterus. The timeline of this process can vary from several weeks to many months.
9. Pregnancy test: About two weeks after the embryo transfer, the surrogate will be tested for pregnancy. If positive, she’ll have follow up blood tests to confirm that hormone levels are rising appropriately.
10. Release to OB/GYN care: Once the pregnancy has been confirmed via blood test and ultrasound, the fertility clinic will release the surrogate to her own OB/GYN or midwife’s care. Per your agreement and location relative to the surrogate, you may be heavily involved in attending prenatal appointments, attend only a select few appointments or none at all.
11. Parental Establishment Judgement: Around the gestational age of viability (~24 weeks), intended parents can legally establish parental judgement so that all decisions about the baby or babies’ care will be theirs.
12. Pregnancy, birth, and immediate postpartum: The surrogate carries the baby to term and gives birth. Intended parents may attend the birth if desired by all parties. The surrogate may express breastmilk for the baby or babies if mutually desired by the intended parents and herself.
13. Signing of the birth certificate: The intended parents will be named as legal parents on the birth certificate(s). If needed, parents can then apply for a passport at this point.
14. Embracing new parenthood: At last, your little one(s) are here! After quite a journey to parenthood, don’t forget to build your support system for after the birth.

Surrogacy is a Journey

Surrogacy can be a great option for individuals and couples who want to have a child but cannot do so through traditional means. No two surrogacy journeys are the same. If surrogacy is the right way to build your family, your journey will be your own. The process involves several steps that can take an unpredictable amount of time. Intended parents should set flexible expectations and ensure they have the support needed to cope with the unpredictable and emotionally demanding nature of the surrogacy process.

We’ve supported many families who’ve gone through the surrogacy process. After a long journey, we can help you settle in with your new baby and embrace the next chapter: parenthood!