It’s becoming increasingly common for people to want to help their friends have children. With advances in assisted reproductive technology (ART), it’s now possible for one woman to carry a pregnancy for another through surrogacy arrangements. However, there are many legal, ethical, and medical factors to consider before agreeing to be a gestational surrogate for a friend.
What is surrogacy?
Surrogacy is an arrangement where a woman (the surrogate) carries and gives birth to a baby for another person or couple (the intended parents). There are two main types of surrogacy:
- Traditional surrogacy – The surrogate’s own egg is fertilized via artificial insemination using the intended father’s sperm. The surrogate is biologically related to the baby.
- Gestational surrogacy – An embryo created through IVF using the intended parents’ egg and sperm is transferred into the surrogate’s uterus. The surrogate is not biologically related to the baby.
Gestational surrogacy with IVF is more common today because it gives intended parents more confidence that the surrogate will not change her mind about giving up parental rights. It also allows intended mothers who cannot safely carry a pregnancy to still have a biological connection to the child.
Is surrogacy legal where I live?
Surrogacy laws vary greatly from state to state. Some states allow and regulate surrogacy, some prohibit it entirely, and others have no laws at all. It’s important to consult an experienced surrogacy lawyer to understand the legal landscape where you live before moving forward.
Even in states where surrogacy is legal, laws regarding establishing parental rights and citizenship can get complicated for the intended parents. A detailed surrogacy contract is necessary to protect everyone’s rights and interests.
What are the medical risks of being a surrogate?
Any pregnancy comes with health risks, and surrogate pregnancies are no exception. Potential risks include:
- Gestational diabetes
- Preeclampsia (high blood pressure)
- Preterm labor and delivery
- C-section delivery
- Postpartum depression
Multifetal pregnancies (twins, triplets, etc.) carried for surrogacy also have higher risks of complications. It’s critical that surrogates maintain excellent prenatal care throughout pregnancy.
What are the financial considerations?
There are major financial factors to weigh:
- Medical bills related to IVF, pregnancy care, delivery, and postpartum recovery
- Maternity clothes, nutritional supplements
- Lost wages if put on bed rest or unable to work
- Childcare costs if the surrogate has other children
- Insurance coverage – not all policies cover surrogate pregnancies
Some intended parents cover all related expenses for their surrogate. But surrogates should be prepared to pay bills up front and get reimbursed later.
What psychological factors should I consider?
Carrying a baby for 9 months creates a powerful bond, even without biological ties. Many surrogates do not struggle emotionally after giving up the babies as intended. But potential issues include:
- Postpartum depression after delivery
- Grief over giving up the baby
- Fear that intended parents will change their minds
- Stress on surrogate’s family relationships
Counseling and support groups help surrogates process emotions around their journey. This should happen both before getting pregnant and after delivery.
How do I find and screen intended parents?
Vetting intended parents is key to having a healthy surrogacy arrangement. It’s recommended to work with an agency to facilitate matching. Important factors to consider are:
- Personal background, values and intentions for surrogacy
- Physical and mental health history
- Financial stability and ability to pay related expenses
- Views on topics like pregnancy termination and multifetal reduction
- Hopes for relationship with surrogate during and after pregnancy
Background checks, home studies and face-to-face meetings can help surrogates make an informed choice about prospective intended parents.
Should I use an agency or attorney?
Most legal experts strongly recommend having reputable third parties facilitate and supervise the surrogacy process:
- Surrogacy agency – Helps match surrogates and intended parents, provides guidance, coordinates medical care
- Surrogacy lawyer – Draws up contracts protecting all parties’ rights, handles establishment of legal parentage
Even if state law doesn’t require it, these professionals add vital oversight and support through the complex surrogacy journey.
What should a surrogacy contract include?
A comprehensive surrogacy contract should spell out key issues like:
- Payment of medical, legal and other related costs
- Compensation for the surrogate
- Assignment of parental rights to the intended parents
- Duties around medical care and decision-making
- Prenatal testing and termination options
- Confidentiality and non-disclosure rules
- Custody of the baby if either party changes their mind
All parties must agree in writing to the contract terms after consulting independent legal counsel.
How can I prepare emotionally and physically?
To get ready for the rigors of surrogacy, it’s wise to:
- Undergo counseling to confirm psychological readiness
- Get medical clearance from OB/GYN for pregnancy
- Consult with therapist and lawyer about the journey
- Have supportive spouse, family and friends
- Make arrangements for help with your own children
- Get life insurance to cover lost income if unable to work
Being proactive sets up surrogates for the best experience possible.
Becoming a surrogate for a friend is a major commitment emotionally, financially, legally and medically. With adequate preparation, guidance and support, surrogacy can be a profoundly rewarding way for a woman to help another family realize their dream of having children. But jumping in without fully considering all factors and risks could have devastating consequences for all.