Considering a Baby by Surrogacy? How to Choose a Surrogate Who’s Right for You

A surrogate is the person that carries and gives birth to your baby. There are many factors to consider when it comes to choosing a surrogate, from health history and age to lifestyle and location. 

Surrogacy can be a long and complicated process. There are many organizations and agencies that can help you through it. You want to be sure that you feel comfortable with the process and that you have the legal protection you need. Read on to learn more what to consider when choosing a surrogate to carry your baby.

What makes a good prospective surrogate?

Choosing the right surrogate can feel like an overwhelming decision. You want your baby to have the best start in life. And even in the easiest of circumstances, becoming a new parent is a big transition. 

Having a baby via surrogate can be a lengthy process. It can also be complicated and emotional. Choosing the right candidate can make the experience as smooth as possible for you, the surrogate, and your baby.

Here are some of the important qualities to look for in a surrogate:

• Physical health: A surrogate should be healthy with no significant medical history or chronic medical conditions. It’s also important to ask about their family history. In particular, conditions that could affect the pregnancy like diabetes.

• Emotional health: Carrying a baby for another person can take a big emotional toll, too. Ask about their mental health and their emotional coping mechanisms. You may also want to ask about a family history of mental health conditions. 

• Healthy lifestyle: A surrogate should enjoy a healthy lifestyle. You may want to ask about exercise habits, diet, and their relationships. You’ll also need to be sure that they’re committed to not drinking alcohol, not smoking, and avoiding other risky behaviors. 

• Experience: It can be a good idea to work with a surrogate who has had a healthy pregnancy in the past — whether their own or a surrogate pregnancy.

• Support system: It’s helpful and reassuring if a surrogate has a good support system. This can help them during the surrogacy process and the pregnancy.

• Communication skills: Good and clear communication are really important with surrogacy. It’s helpful if their communication style matches your own and your expectations. Listen to your instincts and choose someone with whom you feel good working.

• Shared expectations: Surrogacy is often an emotional journey. It’s important to make sure that you and your surrogate are aligned on expectations, as they’re documented in your legal agreement.

What is the best age for a surrogate?

There’s no specific best age for a surrogate. The generally recommended age is between the wide range of 21 and 45 years old. Complications of pregnancy may increase with age. But,  age is only one of many factors when it comes to a healthy pregnancy. 

A surrogate who’s older than 35 years will require additional prenatal testing and screening. It’s best to discuss the right surrogate for you with a surrogacy agency or fertility specialist.

Should you ask about a surrogate's family health history?

Yes, family history is an important part of evaluating a surrogate for your baby. This is because genetic factors can affect a person’s health during pregnancy and have long-term effects on the health of your baby. 

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It’s beneficial, in this context, to know there are two types of surrogacy:

• Gestational surrogacy: A gestational surrogacy is when you supply the egg and the sperm to the surrogate. In this situation, there’s no shared genetics between the surrogate and the baby. This means that the family health history of the surrogate may be less important. But it’s not irrelevant — some health issues can still have an impact on the pregnancy and the baby’s health. These include chronic health conditions like diabetes, mental health conditions, medications, and lifestyle choices.

• Traditional surrogacy: In a traditional surrogacy, the surrogate offers their egg as well as their womb. In this case, there are shared genetics between the surrogate and the baby. It’s important to understand the surrogate’s health history since this will affect the baby’s potential health risks.

Where to look for a pregnancy surrogate

Some people may already have a person who’ll serve as a surrogate — maybe a friend or relative. But if that's not the case for you, you may wonder where to start when finding a surrogate. 

There are several ways to find a surrogate and it will depend on your preference as well as the regulations in your area. Here are some starting points:

• Surrogacy agencies: These agencies specialize in surrogacy and help connect you with a surrogate. They also help with the legal and medical parts of the surrogacy process. And, they can provide counseling and emotional support as you move through this journey.

• Fertility clinics: Fertility clinics may have surrogacy programs and may be able to help connect you with surrogate options.

• Online communities: Online networks can help match intended parents with surrogates.

The legal aspect can be confusing since there are no federal laws regulating surrogacy, but state laws can vary. Make sure you’re aware of local state laws where you live.

How do surrogacy agencies work?

Surrogacy agencies can help you with every step along your surrogacy journey. This will include helping screen potential surrogacy candidates, and matching you with the right surrogate based on your personal preferences and local laws. 

Agencies will also help with the legal process. This can include drawing up surrogacy contracts and making sure you understand your rights and responsibilities. They may also assist you with the medical process, such as connecting you with fertility specialists. Surrogacy agencies can also provide emotional support as well as helping with communication between you and your surrogate.

Surrogacy agencies can differ in their fees and services, so it’s important to do your research to find the right fit for you.

Questions to ask when interviewing a prospective surrogate

Interviewing a potential surrogate is an important part of the process. But it’s not easy — preparing for and doing the interview can bring up many emotions for you. Your surrogate agency or fertility specialist can help provide support, and guide you on what questions to ask a potential surrogate. 

Some of your questions may include:

• Why do you want to be a surrogate?

• Have you been a surrogate before? If yes, can you tell me about that experience?

• Can you tell me about your medical history, including any mental health history?

• Can you tell me about your lifestyle habits, including your diet, exercise, alcohol use, or tobacco use or exposure?

• How would you handle a twin pregnancy?

• How would you like to communicate with us during pregnancy and birth?

• Would you be willing to sign a legal agreement for the surrogacy process?

• What questions or concerns do you have about the process?

It’s important to feel comfortable communicating with and asking questions of your surrogate. It’s also always OK to schedule follow-up meetings to make sure you get your questions answered and you feel good about your plan. 

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Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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