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Questions Frequently
Asked by Surrogates

Overall

A surrogate is someone who carries a baby for people (“intended parents”) unable to carry the baby on their own. This may because the intended parents do not have the proper biological components, such as with a gay male couple, single man, transwoman, or cisgender woman who does not have a uterus. It may also be because an intended parent has a medical issue that makes carrying a pregnancy to full-term unlikely or extremely high-risk.

No, at least not with Brownstone. We facilitate only gestational surrogacy arrangements not genetic or traditional surrogacy arrangements. In gestational surrogacy, the intended parents create embryos on their own (from their own sperm/egg or those of donors) and the embryo is transferred into the surrogate’s uterus through IVF. The gestational surrogate has no genetic link to the child. A genetic or traditional surrogate is artificially inseminated but uses her own egg, giving the surrogate a genetic link to the child.

Generally surrogates want to give others the happiness of family. They feel called to help and may be inspired by the surrogacy experience or infertility struggle of a friend or family member. Of course, the compensation is also helpful for affording a down payment on a house, financing renovations, saving for college tuition, or enjoying a nice vacation with your family.

It’s quite simple. The intended parents are people who cannot or should not carry a pregnancy. That might mean that be someone without a uterus (gay male couple, single man, transwoman, woman who had a hysterectomy) or someone with a uterus but some indication that carrying the pregnancy would put them and/or the baby at risk. Contrary to popular opinion, it is extremely rare that someone would turn to surrogacy without truly needing a surrogate.

There are many reasons why surrogates are better off working with an (ethical) agency. Independent journeys can work well, but they generally entail more risk for and require more work from surrogates. Agency screening processes can help you avoid a dangerous or fraudulent situation. Agencies are better able to vet third parties involved in your process (medical, legal, psychological, and financial) and simplify your life by handling the legal, medical, and financial details of surrogacy. Finally, and most importantly, the agency provides support to both parents and surrogates and helps navigate conversations that can be difficult to have directly, including about financial and moral issues. You should be able to relax and focus on your relationships and pregnancy!

We have a whole page dedicated to answering that question. But, in a nutshell, because we are personal and professional. We will guide you through the whole process and take our time to create a great fit between you and your intended parents. This work is personal for us and we take our commitments to our surrogates seriously. You can expect smart, ethical, and compassionate support.

We happily work with surrogates from the states where compensated gestational surrogacy may be practiced legally (all but Louisiana). Our parents may reside in any of the 50 states or abroad. If you have a preference for working with parents from a particular area, we can take that into consideration when matching.

It depends. There are a number of significant factors outside of our agency’s control, including any limiting criteria you place on the matching process, whether the medical clearance and legal clearance proceed quickly, and whether the first embryo transfer results in a live birth. However, from the moment you sign up with our agency to when you deliver for your intended parents should average around 14-18 months.

Absolutely! We understand the anxiety this global pandemic can cause. In fact, our founder and his husband contracted coronavirus when their daughter was only one week old! At this point, IVF clinics have adjusted to working during the pandemic, lawyers have a better handle on the challenges of cross-border arrangements, and you can still develop a close relationship with your intended parents from a distance should their ability to travel be affected. Brownstone will be with you every step of the way during these difficult times.

There are two things you should know at the outset: (1) It has become a critical matching point for many parents that their surrogates be fully vaccinated against COVID-19, and (2) the CDC has stated that pregnant individuals are at an increased risk if they contract COVID-19. But while the pandemic has changed the way certain things are done (for example, allowing for more remote mental health assessments), this process takes more than a year from screening to baby and, in our opinion at least, there’s never been a better time to help others build their families.

Screening

For full details, please visit this page. In short, you need to be in a position in your life that lessens risks—risks to you, to the baby, and to the intended parents. This entails physical criteria (e.g., under 43 years old; under 32 BMI; track record of full-term, uncomplicated pregnancies), legal criteria (e.g., resident of state where surrogacy is legal; no significant criminal history), social criteria (e.g., no drug or alcohol abuse; financially stable; has the support of partner and family), and emotional criteria (e.g., willing to travel; willing to take weeks of injections; not medicated for serious psychological disorder). To find out if you qualify, start our application here. If you have questions, or you are wondering if an exception might be possible on one or more of the criteria, please get in touch!

 

Body Mass Index (BMI) matters because women within a certain BMI range are more likely to respond well to the medications that are a part of the IVF process. While exceptions can be made by certain doctors, Brownstone follows the guidelines set by most fertility clinics. There are also certain pregnancy complications that are correlated with higher BMIs. Ultimately, everyone just wants to create the best conditions for a safe and positive pregnancy.

Your financial stability matters for a few reasons. First, compensation earned by a surrogate can render her ineligible for many forms of government assistance (and could impact children receiving benefits through government assistance as well). Second, it is possible that any evidence of financial coercion could affect the ability of your intended parents to get parental rights. Third, and most broadly, if a surrogate were relying on the surrogacy compensation for basic needs in their family’s life, that financial pressure can have a significant negative impact on the relationship with intended parents.

That’s a complicated question. Pregnancy entails risks and everyone’s goal here is to do what we can to reduce risks to your health and to that of the baby. So for pregnancy conditions that are likely to recur in any future pregnancy, such as gestational diabetes or preeclampsia, that is likely disqualifying. Same goes for many forms of pre-term labor. But if a “complication” was truly a fluke or is clearly attributable to something that would not be an issue in your surrogacy pregnancy, you may still be eligible as a surrogate. In any event, it is the intended parents’ reproductive endocrinologist who makes the ultimate medical determination.

You can! We will discuss with you an appropriate timeline that makes sense for you and your family. We can begin your screening process while you are breastfeeding but cannot match you with intended parents until you have completely weaned.

You should wait until you are done with your own family building to become a surrogate and help others. The reason is simple: Complications can happen in pregnancy, labor, or delivery that render you unable to carry another child in the future. Surrogacy will still be around when you’re truly done!

While it varies by clinic, most fertility clinics want you to recover physically for at least nine to twelve months before undergoing an embryo transfer. That said, you can certainly start the screening and matching process in advance of that milestone.

Absolutely. Just know that you will have to remove your IUD and establish regular periods again before you can be medically cleared, which can delay your matching.

No.

Yes! Having your tubes tied will not affect your ability to be a successful surrogate.

It depends on a number of factors, including when and why you were prescribed antidepressants. We review antidepressant use on a case by case basis.

No. If you have insurance, we’ll have experts review the plan to see if it is likely to cover surrogacy. If the plan does not, or if you do not have insurance, we’ll work with your intended parents to find a plan that will cover you and the surrogate pregnancy and your parents will pay any associated costs. Your base compensation may be affected by your insurance coverage

Yes. Just know that these views are less common among our intended parents, so it may take a long time to match you.

There are lots of requirements to be a surrogate and lots of reasons why wonderful, giving, compassionate potential surrogates are not accepted into our program. You can read more about our screening process here, but at the core, most women do not qualify to be surrogates because something about their medical history or personal situation suggests that matching them would be too risky for them, the baby, or the intended parents.

Thoroughly! We have a section on our screening process here, but it all starts with completing a short intake form. We review it and will contact you within 24 business hours to set up a time to chat about surrogacy and further discuss your personal story and pregnancy history. Assuming you want to move forward and there are no obvious dealbreakers, we then collect your medical records and review them, talk more with you and your spouse/partner/support person about the whole process, conduct a background and credit check, set up your psychological testing and evaluation, review your insurance policy and many more steps. All of our screening processes are aimed at matching you with the perfect intended parents and making sure things go as smoothly as possible medically, legally, emotionally, and financially.

Matching and Intended Parents

That depends on a number of factors, including how quickly you finish the screening process and create your profile, whether you have specific matching criteria that make finding the right fit for you a bit trickier, and whether you choose to move forward with the first potential set of intended parents or not. Typically the matching process takes a few months.

Absolutely! Depending on your location and their location, your first contact may be remote (Zoom, email, text, phone, FaceTime, etc.), but eventually you will meet in person. That in-person meeting may be as early as during the matching process or as late as just before delivery (if, for example, the parents are international or there are travel restrictions), but typically you’ll meet first at the IVF clinic for screening or transfer, again during your pregnancy, and at delivery, of course. Your preferences and their preferences for the frequency and mode of your communication and contact during the whole journey is one of the most important things we consider during the matching process so that your expectations are aligned.

100%. Brownstone will send you a profile full of information about intended parents we believe to be a good match, and you get to decide first (before they see your profile) whether you are interested in meeting with them and potentially matching. If it doesn’t feel right–no worries! We’ll go right back to the drawing board and present a new profile to you. Read more about the matching process here.

We do. Intended parents are required to go through background checks, medical screenings and a psychological consultation. We are not judging who should be parents, but we want to make sure you are informed when matching about who you will be helping through this unique and intense journey. We find that the more information we have about everyone’s previous experiences and their feelings and expectations, the better the match we can make.

That’s a fair question. Brownstone works closely with its intended parents to ensure they understand the financial obligations the process entails. But, in any event, the intended parents are required to transfer sufficient funds to the escrow account to cover your fees and pregnancy expenses before you even start any of the medications. In this way, you’ll have peace of mind that you’ll never be left in a lurch.

Yes. If you have strong feelings about the kind of family you’d want to help–married or single, same-sex or opposite-sex, domestic or international, of a certain age, ethnicity, or place, first-time parents or existing parents–please let us know. We’ll consider your preferences when presenting a match.

That really depends on what you and your intended parents want from each other. The relationship between surrogate and parent is really unlike any other relationship. We’ll talk through the type of relationship you believe you’ll want during and after the journey and consider that when matching you. We encourage frequent contact, but the hope is that your relationship will develop organically over time in a way that works for all parties, whether you end up super close or not.

This is another thing we try to discuss upfront and consider when matching. We hope our surrogates and intended parents keep in touch (as our founder and his husband have with their surrogate), but this is ultimately discussed and decided by you and the intended parents. There’s really no way for us to insist on any contact or updates.

Medical Process

Most of the risks of surrogacy are those common to any pregnancy, from mild morning sickness to serious complications or death. There are also some additional risks from going through the IVF process that the fertility doctor will discuss with you. While your history of full-term, uncomplicated pregnancies is the best indication that this pregnancy will be similarly uneventful, that is not always the case. We make sure you are aware of these risks and that you are compensated for complications that may arise, including those that lead to bed rest, invasive procedures, or loss of fertility.

There are also some emotional risks. While most surrogates keep an emotional distance from their surrogate babies, knowing all along that they will be handed back to their parents, you may still experience a real emotional “letdown” that the exciting journey is now over. In rare circumstances, surrogates may also experience postpartum depression from the hormonal changes. We conduct extensive psychological screening at the outset and make sure you have ongoing mental health support through the pregnancy and postpartum if needed.

For more details on the medical process for surrogacy, see our blog post here. In brief, the process starts with a medication protocol set by the fertility doctor, which may include pills, injections, patches, and/or suppositories, that prepare your body for an embryo transfer and pregnancy. The clinic will provide detailed instructions for how and when to take your medications and it’s important to follow them carefully. You will have a few doctors appointments local to you before the embryo transfer to check that you are responding well to the medications and are ready for the transfer.

The embryo transfer is quick and relatively painless. No anesthesia is required and you’ll be able to travel home shortly thereafter. At home, you’ll continue your medications and go to local monitoring appointments to make sure the pregnancy continues to grow. About 8 weeks after the transfer, you will be able to stop medications and start visiting your own OB just like a typical pregnancy.

It might be and it might not. If you have not gone through in vitro fertilization (IVF) before, that part will certainly be different. But once you are pregnant, your surrogate pregnancy might be the same (or even easier) than your previous pregnancies, or it might be harder because you are slightly older now and are taking new medications. For medical questions, you can speak to your OB/GYN or the IVF doctor for more information.

They might. The medications likely include hormones, which can cause mood swings just like you might experience during your monthly cycle.

No—not if you don’t want to. For most surrogacy journeys, one embryo is transferred at a time. And as an agency, we have a policy of single embryo transfer only.  Fortunately, more often than not, that first transfer will result in pregnancy. This is not like the earlier days of IVF when doctors would transfer three or more embryos to achieve pregnancy. Of course, embryos can split, but we will discuss with you at the beginning how many babies you are willing to carry and under what circumstances.

Each fertility clinic sets its own policies, but typically surrogates are asked to abstain for a few weeks leading up to and just after an embryo transfer.

Absolutely. In fact, we usually recommend that you use the same hospital and OB/GYN that you used with your own pregnancies. Where necessary, we can work with you to locate a new local OB for your surrogacy pregnancy.

The short answer is yes. The longer answer is that many intended parents are uncomfortable with the idea of a surrogate delivering at home or in a birthing center, and so you should know that your match may take longer. We’ll talk through your preferences for setting (hospital, water birth, birthing center, home) and assistance (doula, midwife, OB).

Most surrogates give birth at a local hospital, often the hospital where they have delivered previously. In cases where you have moved or prefer an alternative birthing option, we can discuss the options available to you and match you with parents who support your preference. All else being equal, we recommend a hospital with a level III NICU or above.

Most hospitals are great with surrogacy births these days and, if they have room, will give the intended parents a separate room near you in the hospital. We will work together on a birth plan early on so that everyone knows who will be in the room, where they will be standing, who is cutting a cord or performing skin-to-skin, etc. We also encourage everyone to attend a hospital tour, which we can help arrange. Of course, all of these plans can and do change in the moment, but we want to make sure everyone is on the same page at the outset.

Financial and Legal

Most of our surrogates end up earning around $60,000, but the number can be higher or lower based on a number of factors. Ultimately, the amount you agree to is your decision, but for more information on our program’s standard compensation, please click here.

Your intended parents. Surrogacy should never cost you anything. The parents are responsible for your medical expenses, attorney fees, travel expenses, additional insurance costs like copays and deductibles, and more. Plus, your contract with the parents will account for all kinds of contingencies so that you are taken care of financially if you have to go on bed rest or anything else arises that temporarily affects your ability to work or take care of your children.

We do not send surrogates a 1099 form. We are not tax experts and advise you to speak with a tax professional or CPA. If your intended parents want to send you a 1099, that will be part of the negotiation upfront as it would affect your take-home compensation.

You do. Brownstone will ensure that you have the information for several highly qualified lawyers in your state. Some agencies will just assign you an attorney, and that attorney may owe their loyalties to the agency as much as to you, their client. We believe in truly free choice, so long as your lawyer has expertise in this area of the law.

New York’s surrogacy law has a conflict-of-interest provision that states that any person involved in matching parents with surrogates cannot represent either side as an attorney. We think it’s a great law that protects parents and surrogates alike. Based on Jarret’s legal background and membership in the ART law community, Brownstone stands ready to make excellent referrals to top surrogacy lawyers.

Absolutely not. Your intended parents will take the necessary legal steps, guided by Brownstone, to acquire a court order so that they are legally responsible from birth.

The law varies from state to state, so it will depend on where you live and where your intended parents are from. In most states, the intended parents’ names are on the first birth certificate issued based on a pre-birth court order. In any event, you will not have any parental rights or obligations to their child.

Spouse/Partner/Family

You can certainly apply, but we will not be able to move forward until your spouse or partner is fully supportive. Surrogacy can be physically and emotionally challenging and it impacts your whole family. As a result, it’s a decision you need to make together. We’re happy to talk through your partner’s concerns if we can be helpful at all.

Try to figure out what those concerns are specifically. If they have concerns related to your children, you might tell them that there are age-appropriate ways to explain surrogacy to children and that children are usually a lot more open-minded and supportive than adults. If they have concerns about your own emotional wellbeing, you might reiterate that you will not be genetically related to the child and so can go into the process with a level of separation because you know you are taking care of someone else’s baby for nine months and then giving them back. If the concerns are about the judgments and comments of friends, family, and strangers, we can rehearse common answers to common questions or comments. Once you figure out what those concerns are specifically, we are here to help you talk through them. But you really do need any spouse or partner in your life to be fully supportive.

 

This is understandably one of the biggest concerns for many surrogates and, honestly, ends up being one of the easiest parts of the process for most. When explained in an age-appropriate way, children understand that their parent is simply helping grow a baby for another set of parents (who they have often met in person or over video). There are great books we can recommend to facilitate those conversations.

Social and Emotional

That depends on where your intended parents’ fertility clinic is located. If it’s local to you, then you won’t have to do any long distance travel. But if the clinic is not located near your home, you will have to travel to the clinic at least once and most likely twice. Travel for an initial screening is usually a one or two-day trip and travel for an embryo transfer is usually a three to four-day trip. The intended parents will cover the cost of your travel and that of any needed companions (like a spouse), and you’ll be reimbursed for lost wages, childcare, pet care, and other related expenses. We take care of all your travel arrangements.

Probably some. Many appointments during the IVF process are time-sensitive and may require you to miss work or schedule appointments before or after work. You may also miss work for travel or for physician-ordered bed rest if there are pregnancy complications.

That is up to you, but we find that it is important to discuss it with those you hope to have as your support system during the whole surrogacy journey.

While there is some natural attachment to a baby you have carried for nine months and planned to carry for even longer, most surrogates maintain some detachment because they know that this is not their child and will go home with its parents. You may experience some sadness post-birth but it would likely be about this intense experience coming to an end (and, maybe, hormonal shifts), not sadness about delivering the baby to its parents.

“What If” Questions

While many surrogates become pregnant during the first IVF cycle, sometimes it takes a few attempts. Usually there is no cause for concern and everyone gears up to do another transfer as soon as it is medically advisable. Brownstone is here to offer you any support you need as you process this setback.

Unfortunately, miscarriages happen. First thing would be to make sure that you and your parents have the mental health support you need. Miscarriage can be traumatic even if you are carrying for someone else. Then we would assess the specific situation and make a plan. Most of the time miscarriages are not attributable to the surrogate herself and are more a function of egg/embryo quality or genetic abnormalities. Depending on the doctor’s opinion and your personal situation, we generally just gear up for another embryo transfer.

This question is difficult to answer in the abstract. Your first step should be to discuss any issues with us. While most surrogates have a wonderful relationship with their intended parents, issues can certainly arise. In our experience, tensions are often attributable to miscommunications or to a misalignment in expectations. Many times simply talking it through can help clear the air and put everyone back on the same page. Brownstone can help advise you on how to repair the relationship and can help mediate any conflicts, as necessary.

The parents really want to be there for the birth of their baby and we work with them to make arrangements to arrive in advance (if they are international) or to be ready to get on a plane or in the car at a moment’s notice. But in the case where they are not local to you, we make sure in advance that there is someone who has been given the power to make medical decisions about the baby in the time before the parents arrive.

We cannot say this never happened ever, but it basically never happens. Your intended parents have spent a lot of time, emotional energy, and money to bring their child into the world. Rest assured, they want this baby!

In the unlikely scenario of a divorce before you give birth, custody of the children would be resolved between the intended parents through court proceedings. The child would not be your responsibility.

We require our parents to execute a will that designates a guardian for all children born through the surrogacy arrangement and that ensures that their executor will perform any obligations the parents have under your contract.