Surrogate Pregnancy: All You Need to Know

Giselle Robel

Surrogate motherhood is a practice in which a woman (the surrogate mother) carries a child for a married couple who’s unable to produce children in a natural way. Usually, because the wife is infertile or otherwise unable to undergo pregnancy. In so-called traditional surrogacy, the surrogate mother is impregnated through artificial insemination with the sperm of the husband. And in gestational surrogacy, the wife's ova and the husband's sperm. Are undergoing Vitro fertilization, and the resulting embryo is implanted in the surrogate mother. Normally, in either procedure, the surrogate gives up all parental rights, but this has been subject to legal challenge.

What Is a Surrogate Pregnancy?

There are two kinds of surrogacy:

Traditional surrogacy. This is where a woman gets artificially inseminated with the father’s sperm. They then carry the baby and deliver it for you and your partner to raise.

A traditional surrogate is the baby’s biological mother. That’s because it was their egg that was fertilized by the father’s sperm. However, donor sperm can also be used.

Gestational surrogacy. This is where you use a technique called “in vitro fertilization” (IVF) making it possible to gather eggs from the mother (or an egg donor), fertilize them with sperm from the father (or a sperm donor), and place the embryo into the uterus of a gestational surrogate.

The surrogate then carries the baby until birth. They don’t have any genetic linkages to the child because it wasn’t their egg that was used.

A gestational surrogate is called the “birth mother.” The biological mother, though, is still the woman whose egg was fertilized.

In the U.S., gestational surrogacy is less complicated in legal terms. That’s because both intended parents have genetic connections to the baby. As a result, gestational surrogacy has become a more common practice than traditional surrogacy. About 750 babies are born each year using this method.

Who Uses Surrogates?

There are several reasons why a woman considers surrogacy. And some are the following reasons:

• Medical problems with your uterus
• You had a hysterectomy that removed your uterus
• Conditions that make pregnancy impossible or risky for you, such as severe heart disease

You may want to think about surrogacy if you’ve tried getting pregnant, but couldn’t get pregnant even with the help of a variety of assisted reproduction techniques, such as IVF.

This is also one of the best options to have made to experience parenthood for people who might not be able to adopt a child, perhaps because of their age or marital status.

And sometimes gay couples can also have this as an option to have children by using a traditional surrogate, one of them uses their sperm to fertilize the surrogate’s egg through artificial insemination. The surrogate then carries the baby and gives birth.

A gay couple might also choose an egg donor, fertilize that donated egg, and then have the embryo implanted in a gestational surrogate to carry until birth.

Finding a Surrogate

There are several ways you can find a surrogate mother:

Friends or family. Sometimes you can ask a friend or relative to be a surrogate for you. It’s somewhat controversial. But because of the high cost of surrogacy and the complex legal issues, it raises parental rights, a tried- and-tested family relationship can be simpler to manage.

A surrogacy agency. Most people use one to arrange a gestational surrogate. There are about 100 agencies now operating in the U.S. They act as go-betweens.

An agency helps you find a surrogate and make arrangements. It also collects any fees that get passed between you and the surrogate, such as paying for their medical expenses.

How to Choose a Surrogate

Right now there aren’t any rules about who can be a surrogate mother. But experts agree on a few points about how to select a good surrogate mother.

You should choose surrogates who:

• Are at least 21 years old
• Have already given birth to at least one healthy baby so they understand firsthand the medical risks of pregnancy and childbirth and the emotional issues of bonding with a newborn
• Have passed a psychological screening by a mental health professional to uncover any issues with giving up the baby after birth
• Sign a contract about their role and responsibilities in the pregnancy, such as prenatal care and agreeing to give you the baby after birth.

Using a Surrogate

The American Society for Reproductive Medicine says surrogates should get a medical exam to check that they are likely to be physically healthy and can carry a full-term pregnancy. They also suggest that they get tested to check for any infectious diseases such as syphilis, gonorrhea, chlamydia, HIV, cytomegalovirus, and hepatitis B and C.

Surrogates should get tested to make sure they have immunity to measles, rubella (German measles), and chickenpox. Also, you may want to ask that they get a medical procedure to visualize “map” the uterus, which can also help the doctor check their potential to carry a pregnancy. Surrogate mothers should have their own doctor during pregnancy rather than using yours.

The usual cost of surrogacy can range from $80,000 to $120,000. A lot of different things go into the price, such as whether the surrogates have their own medical insurance or whether you need to buy a surrogacy-pregnancy policy for them.

Legal Issues With Surrogates

Parental rights aren’t guaranteed after a surrogate pregnancy. Because the law surrounding this continuously changes as reproductive technology and the very definition of a “parent” changes as well.

There isn’t a federal law on surrogacy and state laws vary. After a surrogate pregnancy, there are some states, that you may still have to pass adoption proceedings to gain legal custody of the child. In other states, a “declaration of parentage” before birth lets you avoid having to “adopt” the baby.

To protect your rights as parents-to-be — and the rights of the child you’re hoping to have — hire an attorney who specializes in reproductive law in your state. They can write a surrogacy contract that clearly spells out what everyone needs to do.

A contract like that may help if legal issues come up after birth. It can also outline agreements about a variety of possible scenarios with the pregnancy, such as what happens if there are twins or triplets.