Becoming a surrogate is a legal, medical, and emotional process that typically takes 12 to 18 months from application to birth. You receive compensation that is often paid in monthly installments, with the total amount varying by state and agency. The journey involves a strict screening process, a legal contract, embryo transfer, and a full pregnancy, with clear steps and a defined payment schedule from start to finish.
What Are the Basic Requirements to Become a Surrogate?
Surrogacy agencies and fertility clinics follow guidelines set by the American Society for Reproductive Medicine (ASRM). These are medical standards, not just agency preferences. Most programs require you to meet all of the following criteria.
You must be between 21 and 40 years old. Some agencies accept up to age 42, but the medical evidence for safety is strongest under 40. You must have already given birth to at least one child of your own. You must be raising that child in your home. This proves your body can carry a pregnancy to term.
Your Body Mass Index (BMI) must typically be under 32. This is a strict cutoff because higher BMIs increase the risk of pregnancy complications. You must be a non-smoker, live in a smoke-free home, and be free of illegal drug use. Many agencies require you to stop using cannabis and nicotine products for at least six months before applying.
You cannot be receiving government financial assistance like Medicaid or food stamps. This rule exists because surrogacy compensation may affect your benefits. You must also have a stable home life and a strong support system, as the process is emotionally demanding.
What Are the Steps in the Surrogacy Process?
The process is structured but long. It is divided into clear phases. Understanding each phase helps you know what to expect and how long it takes.
Step 1: Application and Initial Screening (1-2 months)
You submit an application to an agency. They review your medical history, pregnancy history, and lifestyle. You provide medical records from your previous deliveries. If you pass, you move to a phone interview and then a video interview.
Step 2: Medical and Psychological Evaluation (1-2 months)
You complete a full medical screening at a fertility clinic. This includes blood work, a uterine exam, and a full physical. You also meet with a psychologist who specializes in third-party reproduction. They assess your mental readiness and ensure you are not being coerced.
Step 3: Matching with Intended Parents (1-3 months)
The agency presents your profile to waiting intended parents. You review their profiles too. Some matches happen in weeks. Others take months. You meet via video call and decide together if you are a good fit. You are never obligated to accept a match.
Step 4: Legal Contracts (1-2 months)
You and the intended parents hire separate lawyers. Your lawyer is paid for by the intended parents. The contract outlines your compensation, payment schedule, medical procedures, and expectations. It also covers difficult scenarios like multiples or pregnancy complications. You must never sign a contract without your own attorney reviewing it.
Step 5: Medical Preparation and Embryo Transfer (1-3 months)
You begin taking medications to prepare your uterus. These include estrogen and progesterone. You take them as pills, patches, or injections. The embryo transfer is a quick outpatient procedure. It involves placing the embryo into your uterus through a thin catheter. You are awake for it and can go home the same day.
Step 6: Pregnancy and Prenatal Care (9 months)
About 10 to 12 days after transfer, you take a pregnancy test. If positive, you continue prenatal care with your own OB-GYN. The fertility clinic monitors you for the first 8 to 10 weeks. After that, your regular doctor takes over. You attend all standard prenatal appointments.
Step 7: Birth and Post-Delivery (1-2 months)
You deliver the baby at a hospital. The intended parents are usually present. You sign legal documents after birth to establish their parentage. You receive your final compensation payment after delivery. You also have postpartum checkups to ensure your recovery is on track.
How Much Do Surrogates Get Paid?
Compensation varies significantly by state and agency. Base pay typically ranges from $45,000 to $65,000 for first-time surrogates. Experienced surrogates who have already completed a journey can earn more. Some agencies offer higher base pay in states with high demand or high cost of living.
This base amount is not your total compensation. You also receive additional payments for specific circumstances. Carrying twins earns an extra $5,000 to $10,000. A cesarean section adds $3,000 to $5,000. Invasive procedures like amniocentesis add a few thousand dollars.
You receive a monthly allowance for expenses. This covers things like maternity clothing, travel to appointments, and childcare for your own children during medical visits. This allowance is paid on top of your base compensation and is not deducted from it.
All medical expenses are covered by the intended parents. This includes your fertility medications, prenatal care, delivery, and any pregnancy-related complications. You should never pay out of pocket for medical costs related to the surrogacy.
What Is the Payment Timeline?
You do not receive your entire compensation at birth. Payments are spread across the journey. This protects both you and the intended parents. The schedule is written into your legal contract.
A typical payment schedule looks like this. You receive a portion at the start of medications. This is often around $500 to $1,000. You receive monthly payments during the pregnancy. These usually range from $1,000 to $2,000 per month. You receive a larger payment at the confirmation of a heartbeat, often around $1,500.
Your final payment comes after the birth and the signing of legal documents. This is usually the largest single payment, often $10,000 to $15,000. Some contracts structure it differently, but the total is the same. Your lawyer reviews the schedule before you sign.
If the pregnancy ends in a miscarriage, you keep the payments you have already received. The contract also outlines what happens if the pregnancy ends before viability. You are never required to return compensation for completed work.
What Are the Medical Risks of Being a Surrogate?
Surrogacy carries the same risks as any pregnancy. These risks are real and should not be minimized. You are not immune because the baby is not genetically yours.
Common pregnancy complications include gestational diabetes, preeclampsia, and placenta previa. These occur at the same rates as in non-surrogacy pregnancies. The American College of Obstetricians and Gynecologists notes that carrying multiples significantly increases these risks. That is why many clinics transfer only one embryo.
You also face the physical demands of delivery. This includes the risk of cesarean section, postpartum hemorrhage, and infection. Your recovery time is the same as any postpartum recovery. You need weeks to heal and should not rush back to normal activity.
The medications used to prepare your uterus also carry risks. Estrogen and progesterone can cause mood changes, headaches, and injection site reactions. Ovarian hyperstimulation syndrome is rare in surrogacy because the eggs are not yours. Still, the hormonal medications are powerful and require monitoring.
What Are the Legal Rights of a Surrogate?
Your legal rights depend on the state where you live. Surrogacy laws are not federal. They vary widely. Some states like California and Illinois are very surrogacy-friendly. Others have restrictions or outright bans.
In most surrogacy-friendly states, you have the right to make all medical decisions about your body during the pregnancy. You can refuse any procedure you are uncomfortable with. The contract cannot override your medical autonomy. You also have the right to choose your own healthcare providers when possible.
You cannot be forced to terminate a pregnancy, even if the fetus has a serious abnormality. Some contracts address this scenario, but your medical decisions remain yours. You also cannot be forced to undergo selective reduction if you are carrying multiples. These decisions are made jointly but ultimately rest with you.
Your privacy is protected. Your medical records are shared only with your care team and the intended parents with your consent. The agency cannot share your identifying information without your permission. You also have the right to withdraw from the process before the embryo transfer without penalty.
How Do You Choose a Surrogacy Agency?
Choosing an agency is one of the most important decisions you will make. A reputable agency is transparent about its screening process and compensation structure. They provide you with a detailed breakdown of fees and payments before you sign anything.
Ask about their matching process. How many intended parents are waiting? How do they screen intended parents? Do they require the intended parents to have a medical need for surrogacy, or do they accept anyone? A good agency verifies that intended parents are medically and financially prepared.
Check the agency’s track record. Ask how many surrogates they have worked with and how many successful births they have facilitated. Ask to speak with former surrogates. A legitimate agency will connect you with experienced surrogates who can share their honest experiences.
Be wary of agencies that pressure you to sign quickly or promise unusually high compensation. The average range is well established. Offers far above that range should raise questions. Also verify that the agency is accredited by an organization like the Society for Ethics in Egg Donation and Surrogacy.
Frequently Asked Questions
How long does the surrogacy process take from start to finish?
The full process takes 12 to 18 months from initial application to birth. This includes screening, matching, legal contracts, and the pregnancy itself.
Can I be a surrogate if I have never been pregnant before?
No, you must have given birth to at least one child of your own. This requirement is a medical standard that proves your body can carry a pregnancy safely.
Do I receive my full surrogacy pay all at once?
No, compensation is paid in installments throughout the journey. You receive monthly payments during pregnancy and a final lump sum after the birth.
Can I change my mind after signing a surrogacy contract?
You can withdraw before the embryo transfer without penalty in most states. After the transfer, your legal obligations are governed by your contract and state law.
