Surrogacy can be a last resort for creating a family.  The need for surrogacy may stem from an underlying health issue that would make pregnancy dangerous, while recovering from cancer when raising hormone levels risk a cancer recurrence, when congenital malformations of a uterus make carrying to term impossible, or when a patient has tried everything else to use her own body to conceive.  Sometimes using a surrogate is the best solution to a difficult medical problem.

For gay couples, it’s a straightforward choice.

Intended parents may find it takes emotional processing and reflection before deciding to use a surrogate. For women who have tried everything, using a surrogate can be a relief.

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Where do surrogates come from?

A surrogate can be found in a patient’s family, circle of friends, online, or through an agency.  Family members and friends may volunteer to carry a baby for someone close to them.  Using is family member as a surrogate requires taking a family’s emotional dynamics into account; it’s not a good choice for every woman.

Who would want to become a paid surrogate and then give up a newborn baby?  In general women who decide to carry a baby for someone else like being pregnant.  Often, they have children of their own and their family is complete.  They know they are successful at delivering a healthy baby.   They want other families to have to joy of a child.  And sure, they like to get paid for a job well done.  A paid surrogate is screened medically, psychologically, tested for drug use, and often has a home study done.

What are the drawbacks to using a surrogate?

Some women need to mourn the loss of experiencing pregnancy before delegating the intimate job to a surrogate. For the intended parent, it means being willing to interact with the surrogate and have a supportive relationship with her during pregnancy.  Their baby is a cooperative effort.  Lack of day to day control by the intended parents can lead to worrying about how the baby is being taken care of. Is the surrogate eating well? Is she staying safe?

Finally, for many patients, the biggest obstacle is cost.  Paid surrogates earn in the range from $30,000 to $90,000 per pregnancy.  In addition, there are legal fees, agency fees, medical and life insurance costs, possible travel expenses, and maternity expenses.

Kris Bevilacqua  is a clinical psychologist who offers counseling and support while patients are navigating their fertility journey.