The decision to work with a gestational surrogate – a woman who carries your child, but is not biologically related to your child – to have a baby is not an easy one to make.  Whether the reason is medical or biological, the process poses unique challenges and hurdles.  The gestational surrogacy journey is complex, and can be emotionally taxing and financially overwhelming.  You are also developing an intimate relationship with someone whom you have possibly met once or twice; trusting them to take care of themselves and your child, can be disquieting.  However, this is a life-changing event for all involved and should be a journey filled with great reward and joy.

Here are five ways to reduce anxiety and ensure a healthy relationship with your surrogate.


How to Find a Gestational Surrogate

After making the decision to use a gestational surrogate, the next question most people have to answer is ‘where do I find this person’?  Most intended parents work with agencies who help them identify a suitable surrogate based on her location, traits, and personality type.  Some people decide to use a family member or friend, but this is less common.  There are plenty of reputable agencies out there–make sure you take the time to fully vet anyone you decide to work with.  You can ask for references from former clients and do your own research online to make sure that they are a legitimate agency.   Some agencies are large, with many employees and extensive websites and some are smaller.  Make sure you feel comfortable with whoever you work with, but most importantly, make sure that they have a good reputation.  You can also check in with your fertility center to see who they typically work with, or depending which family-building benefit management company your employer or insurance company uses, you may have access to surrogacy navigation. Certain benefit management companies offer surrogacy programs to help you navigate this complicated process and connect you with a vetted and recommended surrogacy agency that fits your needs, and gives you access to qualified surrogates.


Have the hard conversations before you start treatment.

Most intended parents want to make a good first impression with their gestational surrogate.  It’s kind of like dating—you want your surrogate to like you!  However, those initial conversations are crucial in developing an open, honest relationship.  You want to be certain that you and your surrogate are on the same page regarding a whole host of issues, such as communication style, expectations of surrogate and intended parent throughout pregnancy, intended parent’s ability to meet the emotional and physical needs of the gestational surrogate and her family, and social media use while the surrogate is pregnant. 

The gestational surrogate is the sole source of consent for their medical care, thus topics must be shared openly.  For example, there could be circumstaces where the intended parents would want the surrogate to terminate the pregnancy.  Understand if your feelings on this are aligned. Similarly, the intended parents should make their desires clear if the surrogate became pregnant with twins or even triplets.  Some intended parents would like their gestational surrogates to have extensive, and sometimes invasive, prenatal testing, such as an amniocentesis or CVS testing.  Early conversations will determine her comfort level with these tests, and under what circumstances they may be okay.  Transparency before you engage is a win-win for all involved to ensure that no one feels misled or surprised during the pregnancy.


Make sure you have an attorney with experience in reproductive medicine who can help guide you through this complicated process.

Having a trusted lawyer to help guide you through the legal process of having a gestational surrogate is crucial.  Every state has its own laws governing the legality of gestational surrogacy and the circumstances surrounding the surrogacy arrangements.  Depending on your specific situation, you may need a pre-birth order, a post-birth order, or an adoption.  It is also important that both the intended parents and gestational surrogate have separate legal representation. If there is an urgent or serious medical issue that you have attempted to resolve, but are unable to do so, you can consult your lawyer to get advice on the best way to handle it.


There will be times of conflict or miscommunication that need to be addressed, a mental health specialist can guide you through this process.

As in any intimate relationship, there is bound to be the occasional miscommunication or disagreement.  This is very normal—try not to let a small issue escalate.  Try and have an open relationship with your surrogate, one in which you both can voice your concerns and opinions and feel as though the other person is listening and empathizing.  Keep in mind that your goal is to have a healthy baby and a good relationship with your surrogate—so try to address issues as gently and sensitively as possible.  If you’re looking for guidance on the best way to handle an issue, you can consult a mental health professional or behavioral health specialist, which are sometimes offered free of charge through your insurance provider. In fact, depending on what your insurance company offers, some fertility benefit management companies have behavioral health programs that counsel parents to be throughout the entire process, helping them understand what the gestational surrogate is going through, how to enhance the relationship and how to work through the range of emotions and challenges you may face.


Gather information and educate yourself.

In addition to asking your employer or insurance company about the resources that are available to you, there are several great blogs that you can follow to gather information including; Stories from the Stork, WINFertility and Circle Surrogacy. Finally, offers resources on the legal aspects of domestic gestational surrogates.  Consulting professionals who have expertise in the field of reproductive medicine and surrogacy will undoubtedly be your greatest resource, as they will be able to connect you with families who have gone through the process.  

For some people, the relationship they have with their gestational surrogate will be one of the most meaningful and long-lasting they have.  For others, it may be more cordial or business-like.  Whichever kind of relationship you’d prefer to have, make sure you and your surrogate have the same expectations.  Discuss your intentions in regards to your relationship before she starts treatment, so you feel confident that you’re both headed in the same direction.  Unexpected things may come up, but if you have open communication you should be able to navigate most of what comes your way!