How Can I Become a Surrogate Mother
Becoming a surrogate mother involves meeting established medical and psychological criteria, applying through a surrogacy agency or pursuing independent surrogacy, completing extensive screening, matching with intended parents, negotiating a legal contract, undergoing IVF embryo transfer, carrying the pregnancy to term, and delivering the baby. The process takes 12-18 months from initial application to delivery.
This article provides a thorough overview of the surrogacy process for women considering gestational surrogacy in the United States. All information reflects current standards and practices as of 2026.
Definition and Overview
Gestational surrogacy is an arrangement in which a woman (the gestational carrier or surrogate mother) carries a pregnancy for intended parents who cannot carry a child themselves. In gestational surrogacy, the surrogate has no genetic relationship to the child — the embryo is created through in vitro fertilization (IVF) using the intended parents’ egg and sperm, or donor gametes.
Gestational surrogacy accounts for over 95% of surrogacy arrangements in the United States. Traditional surrogacy, in which the surrogate provides her own egg, is rarely practiced due to the legal and emotional complexities it introduces.
The gestational surrogate provides the uterine environment for the pregnancy. She does not contribute genetic material and has no legal parental rights to the child born through the arrangement, provided a properly executed surrogacy agreement and parentage order are in place.
Eligibility Requirements
Surrogacy agencies and fertility clinics require candidates to meet the following criteria:
Age: Between 21 and 43 years old. The American Society for Reproductive Medicine (ASRM) recommends an upper age limit of 45, but most agencies and clinics set their own cutoff between 39 and 43.
Prior pregnancy: At least one prior pregnancy carried to term with delivery of a healthy child. This demonstrates that the candidate’s body can sustain a full-term pregnancy.
Body mass index (BMI): Under 32 at most agencies. Some clinics require BMI under 30. Elevated BMI is associated with increased pregnancy risk and reduced IVF transfer success rates.
No smoking or substance use: Candidates must be non-smokers and free of recreational drug use. Most agencies require at least 12 months of tobacco cessation before eligibility.
Mental health: No current untreated mental health conditions. A history of depression or anxiety is not automatically disqualifying if the condition is managed and stable. The psychological screening evaluates current mental health status, not past diagnoses alone.
Stable living situation: Candidates must demonstrate financial stability and a living environment conducive to a healthy pregnancy. This is assessed through financial documentation review and, at some agencies, a home study.
No criminal history: Background checks are standard. Felony convictions are typically disqualifying. Misdemeanor history is evaluated case by case.
Relationship support: While being single is not automatically disqualifying, agencies strongly prefer candidates with a supportive partner, family member, or close friend who understands and supports the surrogacy commitment.
Application and Screening Process
Initial Application
The process begins with a written application to a surrogacy agency. Applications are typically completed online and take 45-90 minutes. The application covers personal demographics, pregnancy and delivery history, current health status and medications, lifestyle information (diet, exercise, occupation), family situation, motivations for becoming a surrogate, and authorization for background check and medical records release.
Medical Screening
If the agency accepts your application, you are scheduled for medical screening at an affiliated fertility clinic. This includes a physical examination (blood pressure, height/weight, BMI measurement, pelvic exam), comprehensive bloodwork (complete blood count, metabolic panel, thyroid function, hemoglobin A1C, hepatitis B/C, HIV, syphilis, gonorrhea, chlamydia, rubella and varicella immunity, blood type and Rh factor), transvaginal ultrasound to assess ovarian and uterine anatomy, and a saline infusion sonogram (SIS) or hysteroscopy to evaluate the uterine cavity for structural abnormalities, fibroids, or polyps.
Psychological Screening
A licensed psychologist conducts a clinical interview lasting 60-90 minutes. The evaluation assesses emotional readiness for surrogacy, understanding of the surrogacy commitment, quality of the candidate’s support system, mental health history and current functioning, ability to establish appropriate boundaries with intended parents, and capacity to relinquish the baby at delivery.
Many psychologists also administer standardized psychological instruments (personality inventories or symptom checklists) as part of the evaluation.
Attrition Rate
Approximately 50% of applicants are screened out during the combined medical and psychological evaluation. Common reasons for disqualification include BMI outside the acceptable range, uterine abnormalities discovered during imaging, unresolved mental health concerns, inadequate pregnancy history, or failure to meet the substance use requirements.
Matching with Intended Parents
After clearing screening, the agency presents your profile to intended parents who align with your stated preferences. Matching considers geographic compatibility, shared values and communication preferences, willingness to carry multiples, preferences regarding selective reduction, desired level of relationship during and after the pregnancy, and the intended parents’ timeline.
Matching typically takes 2-8 weeks, though wait times vary by agency and market conditions. Some surrogates match quickly; others wait several months for a compatible match.
Once a potential match is identified, both parties meet — usually by video call — for a mutual interview. Both the surrogate and the intended parents have the right to decline a match for any reason.
Legal Process
After matching, both parties retain independent surrogacy attorneys. The intended parents typically pay for the surrogate’s legal representation to ensure she has independent counsel.
The surrogacy contract addresses compensation structure and payment schedule, medical decision-making authority, insurance coverage, expectations for prenatal care and lifestyle during pregnancy, handling of complications (multiples, bed rest, medical emergencies), communication expectations, post-delivery contact preferences, and termination clauses.
Contract negotiation typically takes 2-4 weeks. No medical procedures begin until the contract is fully executed by all parties.
Medical Protocol and Pregnancy
Once the legal contract is in place, the fertility clinic places the surrogate on a medication protocol — typically estrogen and progesterone — to prepare the uterine lining for embryo transfer. The medication protocol lasts 3-5 weeks and involves daily self-administered injections.
The embryo transfer is an outpatient procedure lasting approximately 10-15 minutes. A thin catheter is used to place the embryo into the uterine cavity under ultrasound guidance. The procedure is typically painless, though mild cramping may occur.
A blood pregnancy test is performed approximately 10 days after transfer. If positive, monitoring continues with serial blood tests and early ultrasound confirmation at 6-8 weeks.
The pregnancy proceeds with standard prenatal care, supplemented by additional monitoring as determined by the fertility clinic and the surrogate’s obstetrician. The surrogate maintains regular communication with the intended parents throughout the pregnancy per the terms of the contract.
Delivery and Post-Delivery
Delivery follows standard obstetric care. The intended parents are typically present for the delivery. After birth, the baby is released to the intended parents. Legal parentage is established through a pre-birth order (issued before delivery in many states) or a post-birth order (issued after delivery in states that require it).
The surrogate receives post-delivery compensation per the contract terms and undergoes standard postpartum recovery. Many surrogacy arrangements include provisions for post-delivery communication between the surrogate and the intended parents, though the nature and frequency of this contact varies widely.
Frequently Asked Questions
How much do surrogate mothers get paid?
First-time surrogates earn $50,000-$80,000 in total compensation. Experienced surrogates earn $65,000-$120,000+. Compensation varies by geographic region and surrogate experience.
Can I be a surrogate if I am a single mother?
Yes, though agencies prefer candidates with a strong support system. Being single does not disqualify you if you have family or friends who can provide assistance during the pregnancy.
How many times can I be a surrogate?
Most agencies and fertility clinics permit up to 5-6 total deliveries (including your own children). Some surrogates complete 2-3 surrogacy journeys over a period of years.
Is being a surrogate dangerous?
Gestational surrogacy carries the same medical risks as any pregnancy. These include gestational diabetes, preeclampsia, preterm labor, cesarean delivery, and the standard risks of anesthesia and surgery if a C-section is required. Serious complications are uncommon in properly screened surrogates but are not zero-risk.