Because she’d experienced pregnancy loss herself, Crystal Henry, a writer who blogged about her surrogacy experience, had no reservations when she decided to carry a child for a friend whose chances of natural conception were slim at best. When her friend decided to try IVF treatments, though, Henry knew she still wanted to be a surrogate.
“I remember thinking I’d love to help another woman become a mother. I loved being pregnant, and after my natural delivery with my second daughter, I knew I wanted to do that again. I also knew our family was complete, so surrogacy was the next natural step to chase that birth high.”
Though Henry knew right away she wanted to be a surrogate, the decision to become a surrogate or gestational carrier is a huge decision.
If you’re considering becoming a surrogate, here’s what you need to know, from fertility doctors, surrogacy lawyers, intended parents, and surrogates who’ve been there.
Surrogate, Gestational Surrogate, Egg Donor: What’s the Difference?
There are a couple of different ways to become a surrogate, and each one has its own pros and cons for all parties involved. Traditional surrogacy is when the surrogate’s own egg is fertilized with either the intended father or a donor’s sperm, meaning that the surrogate is biologically tied to the child. A gestational surrogate, on the other hand, carries a fertilized egg from the intended parents and/or egg and sperm donors, so they have no genetic ties to the child. An egg donor is just that: a woman who only donates her eggs to be fertilized.
Now that we’ve got the basics down, here’s what you need to know if you’re considering becoming a surrogate.
Surrogacy won’t make you rich.
Kim Kardashian West, who famously became a surrogacy advocate when her daughter Chicago was born via surrogate earlier this year, reportedly paid the surrogate around $45,000 (the average cost to hire a surrogate) over a 10-month period. If you’re dreaming of ways to pay down your student debt or make a down payment on your dream home, a $30,000 to $50,000 check can sound ultra-tempting. But when you break down the actual cost-to-work ratio of incubating a little human for almost 10 months, your earnings may surprise you.
“I did get pre-birth child support. If you think about it, there aren’t a lot of babysitters who would do the job 24 hours a day for nine months for free,” says Henry. “It took us two years, months of IVF injections, countless [reproductive endocrinologist] and OB doctor’s visits as well as the risks and pain of labor and childbirth—I delivered without so much as a Tylenol. I think when we totaled it up I got paid just over $1 per hour. So I can assure you that no surrogate does this for the money.”
I just want to help people have kids. How do I become a surrogate?
Becoming a surrogate is a lengthy process. First, you’ll need to meet a few standards that almost all surrogacy agencies require.
“Ideally, surrogates to have a healthy BMI, have delivered at least one healthy baby vaginally, and pass any psychological testing required,” explains Shahin Ghadir, MD, of the Southern California Fertility Center. “In California, a surrogate must also be between the ages of 21 and 39 years old, have had no more than three cesareans, and no more than five vaginal deliveries.”
While the agency won’t require it, Stephanie Caballero, a surrogacy lawyer who practices at the Surrogacy Law Center in California, recommends surrogates also have a stellar support team.
“She’s [a surrogate], been pregnant before, and she gets it,” Caballero says of the ideal surrogate, “but a surrogacy really does take a village and that village includes agency personnel, if any, intended parents, OB-GYN, IVF physician, nurse coordinators, attorney, and a mental health professional.”
After her friend decided to pursue IVF, Henry decided to work with an agency to become a surrogate, but it took a couple of tries to find a good fit.
“During the initial interview process they asked how I felt about termination. …While I’d never begrudge another woman’s decision, I couldn’t be in a position to terminate,” says Henry.
So, she reached out to other agencies until she found a surrogacy agency that did not require termination as part of the surrogate’s contract. If you feel strongly about a particular issue, as Henry did, make sure that you find a reputable surrogacy agency that’s right for you. It may take a little longer to make a match with intended parents, but it’s in everyone’s best interest to be on the same page.
What are a surrogate’s legal rights?
A surrogate will enter into a contract with the intended parents before becoming pregnant. Every single detail will be outlined in that contract, but actual surrogacy law differs from state to state.
“In the United States every state handles surrogacy differently so the potential gestational carrier—the most common form of surrogacy, where the woman carrying the child is not genetically related—needs to check the laws in her state to see if surrogacy is practiced,” says Caballero.
“For instance, surrogacy is very limited in the state of New York where only compassionate surrogacy is allowed. No fees are involved, so typically surrogacy is between family or friends,” Caballero explains. “Contrast that with the state of California, where my firm is located. California has very solid case law and a surrogacy statute that defines the roles of both the gestational carrier and the intended parents and protects them.”
Surrogacy contracts are very detailed. A surrogacy contract will cover everything from the rights and responsibilities of both the parents-to-be and the gestational carrier, medical and life insurance, parental rights, intent of the parties, escrow and trust holder information and details, medical procedures, delivery and birth, and conduct of the surrogate, as well as payment to the surrogate, if that’s applicable.
While extreme surrogacy cases (like a surrogate keeping a child) make for great Lifetime movies, they hardly ever happen in real life, says Caballero.
“These situations are extremely rare and usually happen when corners have been cut and the surrogate has not received psychological screening and testing and she did not have an attorney represent her,” Caballero explains.
Who uses surrogates—and is it weird for a surrogate to be friends with the intended parents?
The demographics of intended parents vary: Of course there are heterosexual couples who cannot or choose not to conceive and opt to use a surrogate, as in Henry’s experience, which involved an intended mother and an intended father. That said, gay couples are increasingly using surrogacy to build their families, too.
The Chicago Tribune reports that at Fertility Centers of Illinois, gay men rarely pursued surrogacy just five years ago. Since then, the number has been increasing. A 2018 report showed that overall, gay male couples are content with the level of contact they have with their surrogate; the only men in the study who were discontent wanted more contact with their surrogate, not less. Also heartening if you’re considering becoming a surrogate: The findings of a 2016 report showed that children conceived by surrogacy and raised by gay men tend to have positive relationships with their surrogates.
But before anyone can build a positive relationship with their surrogate, they have to find one! So how do couples feel about finding (and nurturing a relationship with) the right surrogate?
“It takes a long time to meet the right surrogate, but when you do, you just know,” Dustin Lance Black, an Academy Award-winning screenwriter, tells HealthyWay. He and his husband, Olympic diver Tom Daley, are expecting their first child via surrogate later this year. “I knew the first time we met our surrogate that we’d made a match. It was partly how she was with her own kids and husband, loving and hilarious, and how she was with Tom and I. …She reminded me so much of our own families that I hoped and prayed she’d say yes to carrying our firstborn. Because at the end of the day, she’s going to be in our family’s heart and lives for a good long time, and we adore her and her family.”
The relationship between a surrogate and the intended parents is very intimate for obvious reasons, but it will mostly be defined by the contract both parties agreed upon. For example, the intended parents will probably want to attend the surrogate’s OB appointments and be present for the birth of the child. Still, each surrogacy relationship is totally unique.
“An open line of communication is key in these relationships,” says Ghadir. “It is very important that both parties—potential surrogates and intended parent(s)—feel a good connection.”
When Henry was matched with her first intended parents, she felt an immediate connection.
“They asked questions like Would I feel comfortable with them being in the room during delivery?” Henry remembers. “I joked that not only would they be in the room, but [the intended father] would deliver the baby. They laughed, but two years later he sat at the edge of my hospital bed and caught his daughter as she came into the world. Baby mama was laying next to me in the bed ready to be the first one to hold her daughter skin-to-skin. It was absolutely the most incredible thing I’ve ever done.”
Surrogacy is a challenging (and totally rewarding) experience.
Being a surrogate is a life-changing experience for the surrogate, intended parents, and most importantly, the child who’s being born.
Most of the people I spoke to about surrogacy said they’d do it again without hesitation. For Henry, helping a family have a child fulfilled her own desire to make a difference in the world.
“If this little surro baby grows up to be president, I get to say I played a role in her existence,” explains Henry. “People always say I’m some kind of angel or some selfless person, and they couldn’t be more wrong. I was just trying to fulfill my own dream, and it happened to fulfill the dreams of another couple. The family who allowed me to carry their only hope of a child were the brave and inspiring ones. They were the ones that had to wait for two years, and to trust someone they hardly knew to care for their child.”
For Black and Daley, surrogacy has been a lesson in gratitude.
“I lost my mother many years ago now. Tom lost his father as well. When Tom and I first met, we shared our dream of having children of our own one day, to pass on our parents’ love and lessons to our own. Surrogacy has given us this chance. There’s nothing I’ve ever been more grateful for.”