Surrogacy is a life-changing journey built on trust, dedication, and careful planning. Miscarriages are more common than we might think, and they remain a possibility in any pregnancy, including surrogate pregnancies. Ethical surrogacy contracts protect all parties, especially surrogates. Intended parents should be fairly compensated* for their significant time, effort, and physical health risks throughout a journey. These legal protections reflect a surrogate’s commitment and the importance of their role in helping intended parents build their families.
Surrogacy agreements, structured to comply with state surrogacy laws, protect both surrogates and intended parents by clearly outlining the rights and obligations of all parties, including financial rights and obligations. Surrogates, often referred to as gestational carriers, are compensated based on milestones throughout the journey, starting with medical screening and continuing through embryo transfer, pregnancy confirmation, delivery, and postpartum recovery. These milestones reflect not only the time and labor involved throughout the process, but also the emotional commitment required to support a healthy pregnancy and relationship with the intended parents. From attending appointments to carefully managing their health, surrogates dedicate themselves fully to helping intended parents build their family. At CFC, surrogates receive disbursements even before the first embryo transfer, after screenings and contracts are completed.
While some first embryo transfers result in a positive pregnancy test, many cases require multiple embryo transfers before achieving a surrogate pregnancy. In each case, surrogates receive compensation and reimbursements during the cycle preceding an embryo transfer, as well as during the embryo transfer itself. Reimbursements intend to cover any medications, travel expenses, lost wages, and time and energy involved in an embryo transfer cycle. Surrogates are entitled to these reimbursements regardless of whether the transfer is successful or results in a negative pregnancy test, a chemical pregnancy, or biochemical pregnancy, or early miscarriage. A chemical or biochemical pregnancy happens after an embryo transfer where the hCG beta levels/pregnancy tests are initially positive, but ultimately decline due to the embryo not continuing to develop. A chemical pregnancy is considered a very early miscarriage.1
Once surrogates are confirmed pregnant, they receive disbursements aimed to reimburse them for their pregnancy-related expenses, as well as the time and energy they dedicate toward nurturing the pregnancy. If the pregnancy ends in a miscarriage, surrogates are entitled to pro rata reimbursements for the time and dedication involved while they were pregnant. This includes the base compensation, coverage of medical expenses like fertility medications and co-pays at OBGYN visits, and reimbursement or stipends for practical needs such as lost wages, childcare, travel expenses, and maternity clothing. Health insurance premiums are sometimes coordinated through the surrogacy agency, ensuring no lapses of coverage for surrogates. Working with an experienced agency helps ensure these coverages are administered smoothly, providing peace of mind for all parties involved—even during the unexpected.2
The physical and emotional investment in surrogacy begins long before an ultrasound confirms pregnancy. Surrogates commit to a rigorous process that includes comprehensive medical screenings, fertility medications, lifestyle modifications, and careful adherence to medical protocols. Each stage requires significant time, energy, and dedication—from attending multiple medical appointments to following precise IVF medication schedules for embryo transfer preparation. This investment significantly impacts both work and family life, and demonstrates the profound commitment that exists independent of the pregnancy outcome. Surrogacy agreements acknowledge this reality by ensuring reimbursement is administered fairly even if a pregnancy ends unexpectedly. Ethical surrogacy contracts also outline reimbursements in the event of selective reduction (multifetal pregnancy reduction3) or termination.
Surrogacy agencies understand that supporting surrogates through challenging times extends to both emotional care and practical considerations. When a miscarriage happens, surrogates may have urgent needs, like time away from work for mental health appointments and recovery, payment for unexpected healthcare expenses, or help with childcare and household responsibilities. Comprehensive surrogacy agreements address these needs through reimbursement for incurred expenses and making surrogates “whole” for their time, energy, and discomfort during a pregnancy or following a pregnancy’s termination. This approach reflects the understanding that a surrogate’s contribution to the family-building journey holds immense value regardless of the outcome, and their wellbeing remains a top priority throughout the process. By maintaining financial and emotional support during difficult times, agencies honor the dedication and sacrifice that surrogates demonstrate from the very beginning of their journey.
Surrogacy agencies understand that a miscarriage can be emotionally devastating for surrogates and intended parents. Providing careful and holistic support during this time is essential to championing a surrogate’s wellbeing. Agencies often assist with coordinating medical care, including follow-up appointments and necessary treatments to support recovery. Surrogates may also receive support with practical needs, such as time off work or additional house and childcare, allowing them the space and resources to focus on their health.
Emotional care after a miscarriage is just as important as physical and financial care. Surrogates navigating the aftermath of a miscarriage can experience a range of feelings, from sadness to a deep sense of loss. To address these emotions, surrogacy agencies should provide access to counseling services, mental health providers, support groups, or connections with experienced surrogates who can offer understanding and guidance. These resources ensure that surrogates feel supported not just physically, but also emotionally, as they process this difficult part of the surrogacy journey.
While miscarriage is a possibility in any pregnancy, family building professionals require intended parents and surrogates to take critical steps throughout the surrogacy process to minimize risks and ensure the best chance for a healthy pregnancy outcome. The process begins with thorough medical screenings to confirm that potential surrogates are physically and emotionally prepared for the journey ahead. These screenings evaluate overall health, uterine condition, and medical history to reduce the likelihood of complications.
During the preparation phase, fertility clinics play a critical role in supporting the surrogate’s body for pregnancy. Through in vitro fertilization (IVF), clinics carefully monitor embryos created using the intended parents’ or donors’ genetic material or quality before transferring them to a surrogate’s uterus. Specifically, IVF clinics grade each embryo and provide intended parents the option to biopsy the embryos for pre-implantation genetic testing (PGT). PGT helps detect any chromosomal abnormalities, arming intended parents with the information to transfer high quality embryos. While PGT is not 100% accurate, it strongly reduces the risk of miscarriage. Fertility specialists also oversee the use of medications to regulate hormone levels and create an optimal environment for embryo transfer and implantation. Advances in reproductive technology and strict medical protocols have contributed to improved success rates in gestational surrogacy, helping to reduce risks while supporting a surrogate’s health.
Once an ultrasound confirms pregnancy, consistent care becomes a priority. Surrogates attend regular check-ups with healthcare providers to monitor their well-being and the pregnancy’s development. Genetic testing can help detect potential abnormalities or differences early, providing information for both surrogates and intended parents. Agencies also offer ongoing support for practical needs like insurance coverage and travel arrangements. Whether a first-time surrogate or an experienced surrogate, prioritizing the surrogate’s health and comfort at every milestone is essential to ensuring a positive surrogacy experience.4
Surrogacy is a partnership built on trust, care, and mutual respect. Whether you are looking to grow your family or considering becoming a surrogate, partnering with an experienced surrogacy agency helps ensure both parties are protected and supported throughout the process. Creative Family Connections is here to help you navigate every aspect of your surrogacy journey with compassion and expertise, including understanding compensation and legal protections. Reach out today to learn more about how we can support you on your path to building families through surrogacy.
*Compensation must comply with individual state laws.