How to Become a Surrogate Mother

About Gestational Surrogacy

Imagine changing someone’s life forever.

Think about what that would mean to be able to say you have.  Whether you are interested in being a surrogate mother because you know someone who has fought infertility, or have heard about the comprehensive compensation package and benefits provided to moms who want to help, being a surrogate is profoundly life changing for everyone involved!

In the most simple terms, some surrogates describe themselves as “extreme babysitters.”  They have the physical and mental ability to carry a child for someone who cannot carry a baby themselves.  She isn’t the biological mother, and she understands that at the end of her surrogate pregnancy, she will be giving a baby back to its parents, not giving one up.

What is a Surrogate?

A Surrogate is a woman who successfully carries and delivers a baby for someone who cannot carry themselves. We call those individuals an “Intended Parent.” A surrogacy journey is a process that is complex, both logistically and legally. More than 40 states are considered surrogate friendly, meaning that Intended Parents and Surrogates entering into legal contracts for the purposes of surrogacy are protected.  A Surrogate can also be referred to as a Surrogate Mother or Gestational Carrier.

Types of Surrogacy

Gestational Surrogacy

Gestational surrogacy is now the most common modern surrogacy arrangements in the United States, in which a woman carries a baby created from an egg that is not biologically hers. IVF is required in order to use a gestational carrier because the egg must be fertilized in a lab, grown until it becomes an embryo, and then transferred to the uterus of the Surrogate.

Traditional Surrogacy

Before in-vitro fertilization (IVF) became mainstream, traditional surrogacy was the first and only type of surrogacy. In traditional surrogacy, the Surrogate is carries a baby created using her own egg. This type of surrogacy journey is much less common now due to the legal and psychological components of it, but is still performed under the supervision of a physician using intrauterine insemination (IUI) or in-vitro fertilization (IVF).

How Exactly Does Surrogacy Work?

Most of us have a friend or a family member who has struggled with infertility.  The IVF process that you hear so much about is actually a big part of the entire surrogacy process!

In Vitro Fertilization (IVF) is the process in which an egg is fertilized by sperm in a lab.  Once fertilized, the egg and sperm create what is known as an embryo.  Some people can make lots of embryos, others only have one. The best embryo is placed into the uterus of a patient, and hopefully it implants successfully to become a baby.

In a gestational surrogacy experience, an egg from the Intended Mother or Egg Donor is fertilized to create an embryo.  It is completely biologically unrelated to the surrogate, and is placed into the surrogate’s uterus by a fertility specialist.  Hopefully the embryo implants, pregnancy occurs, and a baby will be born!

If pregnancy is achieved, surrogates are compensated throughout the pregnancy for their responsible care and protection of the baby they are carrying.  We understand that appreciation for helping another family should also be reflected financially, which is why we offer generous compensation and benefits to ensure the journey is a mutually beneficial one.  Once the baby is born, the Intended Parents become the legal parents and their names even go on the birth certificate.  Surrogacy professionals are involved every single step of the way to make your experience a great one.

Who Are The Intended Parents I Will Be Matched With?

Family Makers Surrogacy works with amazing Intended Parents, for one reason or another, medically cannot carry a baby themselves. Whether it is a couple who has struggled with infertility, a same-sex male couple, a single Intended Parent, or someone faced with secondary infertility due to a complicated previous pregnancy, gestational surrogates can help build their families!

Who you match with depends entirely on you! You aren’t assigned a set of parents, you choose them and they choose you. Once approved by our agency, we present profiles of prospective parents who closely meet all of the criteria you are looking for in a match. Profiles will include a lot of information about those specific Intended Parents, including where they are located, their communication style, ethical, medical and social views, infertility history, a personally written letter, and photos. You can then decide if you like their profile enough to meet them over videoconference, guided by our Agency Director to ensure all important topics are covered. If you want to learn more about the matching process and surrogacy timeline, click here!

How Will I Be Supported Through the Process?

No two matches are alike.  Intended Parents and Gestational Surrogates have their own expectations and needs from the agency they work with, some feeling more secure with a boutique surrogacy agency approach. Others like more of a hands-off approach big-box agencies are known for.  From screening, matching, embryo transfer and delivery, our Gestational Surrogates are supported by knowledgable, experienced surrogacy professionals who have completed their own journeys and can relate specifically to your needs. We can tailor our support and frequency of communication to fit your needs.

When you first apply to Family Makers, you will meet the surrogacy professionals who will support you step-by-step throughout the surrogate mother process.  You will also have open communication and access to our Agency Owner, who is always available to both Surrogates and their Intended Parents from the time you match through any successful pregnancy.

If you know very little about the surrogacy process and need constant support, or just need some extra handholding to ensure everything is done correctly, we tailor our support to meet your needs.  Our goal is to bring valuable knowledge and unending support during every single phase of your experience with us.  We are there to answer all of your questions and support you, from your first call with us until after your journey ends.

Am I Eligible to Be a Surrogate?

Once approved as a gestational surogate, you become a member of an amazing tribe of women.Meet others, get support and give encouragement to other surrogates in our Family Makers Surrogate Facebook group!

Not everyone can be a gestational surrogate, even though their heart is in the right place.  Not only must applicants pass a rigorous approval process, but must understand all of the risks and responsibilities of helping someone become a parent.

Surrogate Qualifications*

Altrustic and Giving Nature

Uncomplicated, full-term pregnancy history

Ages 21-40

No recent use of nicotine products, marijuana or illegal drugs

No recent use of medications used to treat anxiety or depression

No history of DUI or reckless driving

Financially stable with a strong local support system

Cannot be a recipient of government financial assistance.

No more than 2 cesarean deliveries

Has family and/or partner who is supportive of surrogacy

Flexible morning schedules for appointments

Willing to take daily injections for 10-12 weeks

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*This list is not all-inclusive.

What Does Surrogacy Process Look Like?

A Step by Step Guide – What to Expect

Whether just beginning to research the surrogate process, to being a step away from starting your journey, we are happy to address all of your questions about surrogacy by phone or email before applying!

Whether you found Family Makers Surrogacy Agency through social media, a friend, or found us through a Google search, the first step is to make sure you understand surrogacy.  We understand that there is a lot to consider, which is why we understand that additional information may be needed before committing to the process.  You will never feel pressured to begin until every question has been answered and you are sure you are ready.  Reach out to our Intended Parents and Surrogates on staff through our web form, social media, phone or email and we would be happy to chat!

Applying to Become a Surrogate

Once you are ready to apply to Family Makers, it’s time to sit down and complete an initial application.  It takes about 15-20 minutes to answer a variety of questions pertaining to medical and social history, and provides us with preliminary information needed to determine if you meet our surrogate requirements. The surrogacy professional you will talk to has likely completed their own successful surrogacy journey, and can also answer any lingering questions you may still have about the impact of surrogacy on you and the family you help.

Surrogate Screening

As part of the application process, we will be conducting background checks conducted by a licensed investigator to ensure there is no history of criminal activity or legal concerns we should be aware of that could affect your journey.  This is a question also asked on your initial application. A popular question we get is how far back these checks go. Background checks go back 7-10 years, and are performed on you, anyone you are in a committed relationship with, and anyone over 18 in your household.  A video tour of your home via video chat and/or an in-person home visit from a social worker will also be required.  These checks are also often required by quality fertility clinics we work with.

One of the most important roles an experienced surrogacy agency has is finding an ideal match for Intended Parents and potential Surrogate applicants.  Each agency has it’s own process of doing this, and our approach is based on getting to know you as much as possible. The number one thing that can almost guarantee a pleasant and successful surrogacy journey is the relationship that develops from this match.

In addition to several interviews and calls with you, we give you the opportunity to be involved with creating a beautiful profile that allow Intended Parents to get to know important information about you. That info will include your health history, results from your background screening, a letter stating why you want to be a Gestational Carrier, and photos.  ​Once we have everything we need, we provide you with a final draft for approval before it is shared with any possible matches.

The second part of your profile is an outline of your compensation structure.  This will allow your prospective match to know what to expect in terms of overall costs.  Every possible scenario and topic will be covered, including lost wages and childcare for routine appointments, and even health insurance.  Each Gestational Carrier has a different situation, and your financial needs should reflect that.  Listing the surrogacy attorney you wish to represent you for the legal contract will be noted, as well as the health care professional that will oversee the entire pregnancy.  Any situations that may require additional compensation, like an unplanned c-section is also provided in this list so that there are no surprises on agreed-upon terms when it’s time for the legal contract.

Unlike some agencies, we do not match you with Intended Parents based on who has been waiting the longest.  Instead, much consideration goes into presenting a profile based on what you’ve told us you would like in a match.  In fact, more than 95% of Intended Parents and Surrogates who work with Family Makers agree to the first match they are presented with.  We do everything possible to get it right the first time.

Unlike other national surrogacy agencies, 100% of our Intended Parents are based in the United States.  We do everything we can to ensure that travel and accessibility of your perfect match is as easy as possible.  Due to the current pandemic, international surrogacy arrangements are both logistically difficult and uncertain for International Parents trying to visit.  If a specific state or location is important to you, we also do everything we can to accommodate that request.  When you are provided a profile, it should reflect what you have told the entire match management team that you want in a potential match.  If you have specified a preference for helping a single Intended Mother, a couple struggling with clinical infertility who has never had a child, or even a set of Intended Fathers, we take all of it into account when presenting your perfect match.

Meeting Your Perfect Match

Many Surrogates have described meeting their a prospective Intended Parents to be very much like a first date.  You have seen one another’s profile and like what you see.  Still, it can be a little nerve wracking when meeting someone for the first time and trying to create a conversation out of thin air.  The great news is, we will prepare you so that you know exactly what to discuss, and a member of our staff will help guide the conversation to ensure that all major topics are covered.  If you forget to ask a question, or you think of one after your call, no worries!  We can clarify anything you need to know before making the decision to match.

Once matched, believe that communication is the foundation for a healthy journey, and so we encourage you to begin building your relationship with your Intended Parents immediately.  Once a match is official, we will provide email and phone contact information so that you can begin getting to know one another!

As part of your initial application to Family Makers, one of the first things we do is a thorough medical record review for every gestational carrier. This ensures that we are doing everything possible to increase chances that you have a healthy baby and can carry another pregnancy safely. Records pertaining to previous obstetric and gynecological history, pregnancy and delivery of previous babies are reviewed for any issues that could cause possible issues for future pregnancies.  If you are an experienced carrier, we also review records from previous monitoring appointments and embryo transfers.  Once you have passed Family Makers’ approval process, they are then sent to a fertility specialist for final review and approval.

Surrogacy Mental Health Screening

Once the fertility specialist has confirmed that your medical records are acceptable, a physical examination and psychological screening are performed.  This lengthy interview is an opportunity for the physician and mental health professional to go over the medical requirements, risks and responsibilities of this life-changing decision. Reviewing social history for the you and your significant other will be discussed, as well as if a donor egg or donor sperm will be used in the process.  This evaluation also typically includes a group consultation with the Intended Parents review and clarify key decisions and important topics known to come up in surrogacy arrangements as a group.  Topics will include Lastly, you be required to complete a standardized personality assessment called a MMPI-2 or PAI, an additional tool used to assist the mental health professional in the overall evaluation.

In-Person Or Remote Surrogacy Screening

In addition to a mental health evaluation, you will be required to travel to your Intended Parents’ fertility clinic for a day of testing and appointments.  There will be extensive blood tests taken from you and your partner to look for infectious diseases, common health problems, and drug use.  An ultrasound will be performed to evaluate your uterus for any scar tissue, fibroids, polyps or anatomical malformations that could interfere with becoming a Surrogate.

Once the medical approval process is complete, you will return home.  You should receive final confirmation of approval in 1-2 weeks once blood tests and the psychological evaluation have been reported.  After this is complete, you may be asked to start birth control pills so that you will be ready to begin the embryo transfer process the moment legal contracts are completed.

 

Choosing Your Surrogacy Attorney

All that’s left before you can begin your journey is the surrogacy contract!

As part of your application process, Family Makers Surrogacy confirmed that you live in a state with favorable surrogacy laws.  One of the most important steps you can do to protect yourself and your Intended Parents is to select a qualified attorney experienced in surrogacy.  Family Makers is privileged to partner with legal experts throughout the United States and abroad who will prepare and negotiate your surrogacy agreement.  First time surrogates will be provided with a list of recommended attorneys to review the surrogate process with you from a legal standpoint.  In most cases, you will use this same legal expert once you becomes pregnant to ensure your Intended Parents’ are acknowledged as the baby’s legal parents by obtaining a Pre-Birth Order.  Experienced surrogates may have an attorney they have worked with before that they like, and they can choose to use them as well for the gestational surrogacy arrangement.

Legal Contracts for Surrogacy

The average Surrogate can find contracts to be a bit stressful, even for matches who believe they are on the same page about everything.  As part of preparing for this stage of the process, Family Makers supplies a detailed list of match terms to the prospective Surrogate outlining all of the things you and your Intended Parents have already agreed on, including compensation and delivery location.  Surrogacy contracts, some as lengthy as forty pages, cover anything and everything that could arise during your journey and can provide you with peace of mind that both parties are as protected as possible throughout the pregnancy and post – delivery. Even previous surrogate mothers can have tons of questions, so now is your chance to ask about anything you are unclear about. Laws around surrogacy vary state to state, and so any legal requirements for the parents to obtain rights to their baby will be outlined. Once the contract has been approved by you and by your Intended Parents, you will visit a notary to sign.  It’s now official and now the next exciting step begins!

 

Once your attorney has provided a legal clearance letter to the fertility clinic stating that contracts have been finalized and executed, a number of things start happening! In addition to the administrative side of things that we will be handling for you, such as setting up your escrow account and activating any required health insurance policies, you will finally begin preparing your body for embryo transfer.  You will be prescribed surrogate medications, and provided a calendar listing appointments you will need to attend leading up to the big day.  Your journey support team will review your shipment of medications and instructions just to confirm that there are no outstanding questions or concerns you should address with the clinic before beginning.  The infertility field is unique, and so the medications you take may be completely different than other Surrogates you meet.

Many Surrogates do not live physically close to their Intended Parents’ fertility clinic, which means that a clinic located near your home is utilized for your personalized care.  This is what we call a “monitoring clinic,” and is the place you will be receiving 2-3 ultrasounds and blood work in preparation for transfer.

For traditional surrogates, on the other hand, they prepare instead for Intrauterine Insemination.  This form of surrogacy allows for less medications but more appointments in order to capture the ovulation window when using their own egg.

Transfer Day

This is a big day, and one you’ve been waiting for!  Some Intended Parents and their Surrogates come dressed in matching pineapple socks, transfer shirts, lucky green polish, or other ways symbolizing the day.  Just as common are those that are more reserved and do not do anything.  Whatever your preference, many Intended Parents are present for embryo transfer and are allowed in the procedure room to witness the big moment.  Most procedures occur mid-day, so you will usually be asked to arrive the day before or the morning of the transfer.  The procedure itself lasts a few moments, and then the 10-day countdown begins to find out if it was a successful carrier cycle!

Positive Pregnancy Test!

Ten days after transfer, a blood test is performed to determine if there is a specific hormone present to indicate pregnancy.  This is commonly called “beta,” and should increase steadily over time.  The fertility specialist will order a second, and sometimes third, blood text to ensure that these levels are rising appropriately…indicating a viable pregnancy.

Approximately 3 weeks after your last blood test, you will be scheduled for your first ultrasound to look for baby’s heartbeat!  This appointment usually takes place at your monitoring clinic or OB’s office.

 First Trimester of Pregnancy

And there it is – the baby’s heartbeat!  Because this is a surrogacy pregnancy created through IVF, medical treatment for a gestational carrier is a bit different than traditional pregnancy.  Instead of prenatal care early on, you will continue being monitored by your fertility specialist for another 4-6 weeksafter heartbeat is confirmed to ensure there are no complications or concerns prior to being released to a general obstetrician or midwife.  You will also stay on hormonal medications to support the pregnancy for several more weeks.​

Once released out of the care of the fertility specialist between 9-12 weeks, you will begin attending regular prenatal appointments at your own provider’s office that will be managing the remainder of the pregnancy.  You can even invite your Intended Parents to come along via in person, over phone, or video call and “meet” your doctor and ask any questions they may have about their precious baby.

One of the first tests many Parents learn about during pregnancy is prenatal testing (also called NIPT), a simple blood test that can identify possible genetic abnormalities.  An ultrasound-guided test called a nuchal translucency test can also be performed to check for early signs of physical birth defects as well.  We encourage Surrogates and their Intended Parents to discuss these optional tests with the provider during their first visit since it can only be done before 14 weeks gestation.  Billing, insurance, and HIPAA releases can also be addressed during one of these first trimester visits.

Establishing Parental Rights

Once you have reached the second trimester, we will initiate a vital part of the legal process in order to establish who the baby’s Parents are between 14-24 weeks of pregnancy.  A Pre-Birth Order (commonly referred to as the PBO) is used in all but a handful of states to assign parentage prior to the baby’s birth. Once the baby is born, the document goes into effect and protects the Intended Parents’ rights, while also stating that you have no financial or legal responsibility for the baby.  These rights allow Intended Parents to make medical decisions regarding care of their baby after delivery, ensures that their name goes on the baby’s birth certificate, can assist in resolving insurance claim issues, and allows the baby to be discharged home in its parents’ care.

Second Trimester of Pregnancy

We hope that the second trimester of pregnancy is a relatively quiet and enjoyable time for both you and your Intended Parents.  At the 18-20 week mark, an anatomy scan will be performed to evaluate growth and to ensure everything is as it should be.  Many Intended Parents attend this milestone appointment for a chance to see their baby and visit with their Surrogate. If they have not already discovered their baby’s gender and want to, they can find out now.  Some Parents want to be the first to know and keep the secret to themselves, others like to plan a party and make an announcement.  It is important to discuss how and when they want to know so that you are all on the same page.

Preparing the Hospital for a Surrogacy Delivery

During the third trimester, we recommend touring the delivery hospital with your Intended Parents if you haven’t already during a previous visit.  From assisting with travel for your Intended Parents who aren’t local to their Surrogate, to ensuring the hospital is provided with all the insurance and legal paperwork needed, Family Makers does everything needed for a positive experience during this exciting time.

Many Surrogates have questions about how exactly the delivery will go.  Will the Intended Parents be in the delivery room?  Will they get their own room after the baby is born?  What if they miss the birth due to travel delays?  What happens in case of a c-section or complications?  Can you provide breastmilk? What should you pack and bring with you to the hospital?

All of these questions, we can help answer to ensure you feel as prepared as possible when the big day arrives!

Delivery Day!

Whether delivery is planned, or you go into labor spontaneously, delivery day can be extremely stressful and exciting all at the same time.  Many of the women who have completed journeys with us say one of the most special moments of their entire experience is witnessing their Intended Parents meeting their baby for the first time.  In most cases, Parents are allowed to attend delivery, or shortly after if a cesarean is performed.  Once the baby has arrived, we will request that your Intended Parents are provided with their own private area or room in the hospital to bond and enjoy one-on-one time with their baby, while you can have some much deserved rest.