How to Become a Surrogate
Most women who look into this want three questions answered: do I qualify, what does it pay, and what am I actually signing up for. Here are honest answers to all three — including the parts agencies tend to leave out, and the one thing that changes everything depending on which state you live in.
Find out if you qualify — 5 minutes, 12 questions
Already carried a healthy pregnancy? You’re most of the way to qualifying.
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The short version
If you’re in a hurry, this is the whole thing in six lines.
- You’ll qualify if you’ve given birth to at least one healthy child, you’re raising that child, you’re between 21 and 45, you don’t use nicotine, and your BMI is roughly 19–35.
- You’ll be paid around $65,000 or more as a first-time surrogate and $75,000 or more if you’ve done it before, with expenses reimbursed on top and nothing payable by you.
- It takes twelve to eighteen months from application to birth.
- You will not be related to the baby. Gestational surrogacy transfers an embryo created from the intended parents’ or donors’ genetic material. It is not your child, genetically or legally.
- The state you live in matters more than anything else on this page. In some states you’re never named on the birth certificate. In one, your contract is void by statute. Jump to the state table.
- The medication is unpleasant, the risks are real, and a significant share of transfers don’t work first time. Anyone who tells you otherwise is selling.
Want the answer for your own situation? Check my eligibility →
Can you be a surrogate?
Almost every program in the country works from the same core criteria, drawn from American Society for Reproductive Medicine guidance. These are clinic and agency standards rather than law — only two states, Illinois and Michigan, write any of them into statute.
The requirements nobody waives:
- You’ve given birth to at least one healthy child, full-term. This is the one absolute. It shows your body can carry a pregnancy and that you understand what you’re agreeing to.
- You’re raising that child. Programs want to know you have parenting experience and a stable home.
- You’re between 21 and 45. Most prefer 21–40; some go to 42 with a strong obstetric history.
- No nicotine. Cigarettes, vapes, patches, pouches. Usually 6–12 months clear, and you will be tested.
- No drug use — yours or anyone’s in your household.
- You’re a U.S. citizen or permanent resident.
- You’ll pass a medical screen, a psychological evaluation and a background check. So will your partner, if you have one.
The ones with more give than you’d think:
- BMI. Most clinics want 19–32, some accept up to 35. A few points over usually means a conversation about reaching the threshold, not a rejection.
- Two or three prior C-sections. Two is comfortably standard. Three is often workable. What matters is how your uterus healed and whether you had complications — not the number.
- Tubal ligation. No barrier at all. The embryo is placed directly into your uterus; your tubes play no part.
- Endometriosis. Usually fine. It affects conceiving rather than carrying, and you’ve already carried.
- HSV-2 (genital herpes). Accepted by most programmes. Managed with antiviral medication from around 36 weeks and a C-section if there are active lesions at delivery.
- Hypothyroidism or Hashimoto’s. Usually fine if well controlled on levothyroxine with TSH in range. Bring recent labs.
- Not being employed. Stay-at-home mothers are among the most common surrogates, and the schedule flexibility genuinely helps.
- Being single, unmarried, or LGBTQ+. Doesn’t affect your eligibility anywhere.
The ones to raise in your first conversation:
- A history of intrahepatic cholestasis of pregnancy (ICP). This recurs in a large share of subsequent pregnancies and carries increased risk to the baby, so most programmes decline or require maternal–fetal medicine clearance. Treat it as a serious hurdle and mention it early rather than after screening.
- Preeclampsia or HELLP previously. Depends heavily on severity and timing. Mild, late-onset preeclampsia in a first pregnancy that didn’t recur is often acceptable. Severe or early-onset usually isn’t.
- Antidepressants or other psychotropic medication. Policies vary widely and are loosening. Some programmes want 6–12 months off medication; others accept stable use with a psychologist’s clearance. Do not stop your medication in order to qualify — talk to your prescriber and to us first.
- Gestational diabetes. Diet-controlled and resolved is usually fine. Insulin-dependent is more difficult.
- Still breastfeeding. You’ll need to be fully weaned, typically 2–3 months before medication starts.
| Requirement | Typical standard | What actually matters |
|---|---|---|
| Prior birth | At least one, full-term, uncomplicated | Your delivery records |
| Raising a child | Yes | Stability at home |
| Age | 21–45, most prefer 21–40 | Obstetric history over the number |
| BMI | 19–32, some to 35 | Trend and overall health |
| C-sections | Usually up to 2–3 | Healing and complications |
| Nicotine | None, 6–12 months | Includes vaping; expect a test |
| Mental health | Stable, no active crisis | Current medication; support at home |
Not sure whether your BMI, a third C-section or a past complication rules you out? The questionnaire asks about all of it and tells you where you stand.
Check my eligibility →
What surrogates are paid
Surrogate compensation isn’t set by the state you live in. It’s set by the agency programme and the agreement you sign, which means the schedule below applies wherever you are.
First-time surrogates: $65,000+ total. Experienced surrogates: $75,000+ total.
That splits into two parts — your surrogate compensation, and your expenses.
Your compensation: a sample of $50,500
Applying to become a surrogate through SurroAdvisor lets you choose your fee structure rather than getting handed a fixed number, so this is a representative schedule rather than a quote. What’s unusual — and worth paying attention to — is that we publish when each payment lands, which almost no nobody else does.
| When you’re paid | Amount |
|---|---|
| At match | $1,250 |
| At medical clearance | $500 |
| At legal clearance | $1,000 |
| When you start medication | $500 |
| At embryo transfer | $1,000 |
| At hCG pregnancy confirmation | $1,000 |
| At heartbeat confirmation | $3,500 |
| Monthly during pregnancy (8 payments of $5,000) | $40,000 |
| Wellness package | $1,750 |
| Sample base total | $50,500 |
Experienced surrogates add $10,000, taking a comparable schedule to roughly $60,500.
Your expenses, reimbursed on top
Separate from your fee and never deducted from it: $300 monthly allowance with no receipts; all lost wages, yours and your partner’s; travel, plus a travel companion; a family allowance for every overnight you’re away; a weekly bed rest allowance if it comes to that; post-birth medical leave of 6–8 weeks; maternity clothing; medical insurance and all medical expenses; life insurance; your own attorney’s fees; and mental health support.
The bed rest allowance, your partner’s lost wages and the overnight family allowance are the three women most often forget to ask about — and the three that matter most if a pregnancy gets complicated.
Your payments are held in third-party escrow. This is the single most important protection you have. It means the full amount is set aside by an independent company before you begin, rather than depending on the intended parents paying on time. In a handful of states it is the only thing standing behind your compensation, because the contract itself isn’t reliably enforceable. Ask for written confirmation that escrow is fully funded before you start medication, and treat reluctance to provide it as a reason to walk away.
Three things about the money nobody else will tell you
It is very likely taxable. You’ll find claims online that surrogate base pay is a non-taxable “reimbursement for pain and suffering.” That argument exists, but the IRS has not endorsed it, most tax professionals treat surrogate compensation as taxable income, and how your contract is drafted matters a great deal. Some agencies issue a 1099. Budget as though it’s taxable and speak to a CPA before you sign anything. Getting this wrong can cost you thousands.
It can affect income-based benefits. If your household receives Medicaid, SNAP, housing assistance, childcare assistance or a state cash-assistance programme, surrogate compensation counts as income and may take you over an eligibility threshold. Separately, Medicaid generally won’t cover a surrogate pregnancy — appropriate coverage is arranged for you as part of the journey. This is the mistake we see most often, and it’s entirely avoidable if you get advice before you match.
Be sceptical of both ends of the range. You’ll see pages advertising totals “up to $150,000” and others quoting base pay of $30,000. Neither describes what a first-time surrogate at a mainstream programme is actually offered. Ask for a written payment schedule with a milestone against each line, like the one above, rather than a range.
The questionnaire tells you which fee structure you’d qualify for — first-time or experienced — and what your schedule would look like.
See what I’d be paid →
Where you live affects the law — a lot
This is the section most guides skip, and it matters more than anything else here.
There is no federal surrogacy law in the United States. Every state decides for itself, and the differences are not small. In Illinois your name never appears on the birth certificate and no judge is ever involved. In Indiana, the legislature has declared surrogacy agreements void, so you would have no legal route to enforce your own compensation. Those are neighbouring states.
What actually varies:
- Whether your contract is enforceable — and therefore whether your compensation terms mean anything in court
- Whether your name goes on the birth certificate, and for how long
- Whether your husband is presumed the legal father, and what has to be done about it
- Whether you’re guaranteed your own lawyer, paid for by the intended parents
- Whether your medical decision-making is protected by statute or only by contract
- What happens if a serious problem is found during the pregnancy — some states’ criminal law limits your options regardless of what your contract says
Two things to take from this. First, if you live somewhere with weaker protections, that doesn’t mean you can’t be a surrogate — it means escrow, your own attorney and a careful contract matter more. Second, be wary of any page that calls your state “surrogacy-friendly” without saying what it actually means. That phrase usually describes how convenient the process is for intended parents, not how protected you are.
What the process actually looks like
Twelve to eighteen months, application to birth.
Month 1 — Application and matching. You apply, your history is reviewed, and you talk to the agency. If your medical records raise questions, this is when they surface. Matching with intended parents usually takes one to three months, and you have a say — you are not assigned to anyone and you can decline a match after a first conversation.
Months 2–3 — Screening. Bloodwork, an infectious disease panel, a saline sonogram or hysteroscopy to check your uterus, and a psychological evaluation with someone experienced in third-party reproduction. Your partner is screened too. This takes place at a fertility clinic, which may involve travel — reimbursed, along with your time.
Month 4 — Contracts. Your attorney and theirs negotiate the agreement, and the intended parents pay for yours. Do not rush this stage. It is the stage that protects you. Read every clause on termination, selective reduction, bed rest, travel restrictions and delivery method, and negotiate anything you’re uneasy about before you sign.
Months 5–6 — Medication and transfer. Estrogen and progesterone to prepare your uterine lining, monitored by ultrasound and bloodwork. The transfer itself takes minutes and needs no anaesthetic. A pregnancy test about ten days later. Not every transfer works first time — this is normal, and your contract covers repeat attempts.
Months 6–15 — Pregnancy. Care with your own OB or a practice the clinic refers you to. How much contact you have with the intended parents is agreed in advance and can be anything from monthly texts to their presence at every scan.
Birth and after. You deliver at a hospital you choose. What happens with parentage depends entirely on your state — see the table above. You recover for six to eight weeks with support, and with counselling available if you want it.
The first step is twelve questions about your pregnancy history. If you’re not a fit, we’ll tell you straight away rather than putting you through screening.
Start the questionnaire →
What are the downsides of surrogacy?
Every agency page lists the rewards. This is the other half, and you’re entitled to it before you apply rather than after.
You take on every risk of pregnancy again. Gestational diabetes, preeclampsia, hyperemesis, preterm labour, haemorrhage, and the real possibility of a C-section you didn’t plan. IVF pregnancies carry a modestly elevated rate of some complications. If a previous pregnancy was difficult, it can be difficult again. Maternal mortality in the United States is low but not zero, and you deserve to have that said plainly rather than skipped.
The medication is genuinely unpleasant. Weeks of injections, with bruising, mood swings, headaches and bloating. Most surrogates describe it as irritating rather than awful. Some find it considerably harder than that.
Transfers fail. A significant proportion don’t result in pregnancy first time, and you may go through the medication protocol more than once. It is deflating in a way people don’t anticipate.
Miscarriage happens, at roughly the rate it happens in any pregnancy. It is a strange and heavy thing to carry when it wasn’t your pregnancy to lose, and it is the least-discussed part of surrogacy.
Your medical autonomy has limits you may not expect. Your contract will address termination and selective reduction. In several states, criminal law now constrains what is actually possible regardless of what your contract says — and if a serious fetal anomaly were found, that constraint would apply to your body. Check your state’s page.
It affects your family, not just you. Your partner signs paperwork and, in some states, is legally implicated. Your children will have questions, and you’ll be the one answering them. Families who talk it through properly beforehand do markedly better than families who don’t.
The relationship may not be what you hoped. Some surrogates stay close to the families they carried for. Some drift. Some find the intended parents distant, or the match awkward, or the contact less than they wanted. This is normal, and knowing it in advance stops it feeling like failure.
It’s eighteen months of your life. Appointments, travel, medication schedules, and a recovery managed alongside your own children.
And the emotional part is not what people assume. Most gestational surrogates do not experience the grief outsiders expect, largely because the child isn’t genetically theirs and the framing is clear throughout. But postpartum depression is as possible for you as for any birth, and many describe a distinct flatness when the intensity ends and everyone goes home. Use the counselling. It’s included for a reason.
None of this is an argument against becoming a surrogate. It’s an argument for going in with your eyes open, which is the only way this works well.
How we make money
SurroAdvisor is free for you and always will be. When we match you with an agency and you’re accepted into their programme, they pay us a fee. You are never charged, and your compensation is not reduced because you came through us.
We think you should know that, and we think it should change how you read this page. It’s also why we only work with just one, trusted, Midwest-based agency partner, who work with surrogates nationwide. Rather than listing everyone who’ll pay us: we’d rather send you somewhere we’d send a friend, in fact we worked with them ourselves for our own surrogacy journeys.
What we do that contacting an agency directly doesn’t:
- We tell you whether you qualify before you spend six weeks on an application
- We know which programmes will look at a third C-section, a BMI of 34, HSV-2 or a history of preeclampsia — the questions where a blanket “no” online isn’t the real answer
- We’ll tell you what your own state’s law actually means for you, including when the answer isn’t in our commercial interest
Two surrogates, in their own words
Meet Kelsey, a first-time surrogate from Indiana
Kelsey is an Indiana mother of four who carried for the first time this year. Her story is worth reading not because it went perfectly, but because it didn’t quite, and she’s clear-eyed about that.
How she got here. Friends of hers were struggling to conceive, and she found herself thinking that if it came to it, she would offer to carry for them. They went on to have their daughter without needing a surrogate — but the thought didn’t leave her. It sat there for a few years before she acted on it.
The two things that went wrong. At around six weeks she had a subchorionic haemorrhage — bleeding between the uterine wall and the membrane. An ultrasound and bloodwork confirmed the pregnancy was progressing normally, but she describes the couple of days before those results as genuinely frightening. Separately, she turned out to be allergic to the carrier oil in her progesterone injections, which made an already unpleasant part of the process considerably worse until the medication was switched. Both are common enough, both were manageable, and neither is the kind of thing you’ll find in most agency testimonials.
The reaction from people around her. Not everyone was immediately supportive. She’s frank that surrogacy still strikes some people as strange or alarming, and that she had to sit with that. Her husband backed her from the outset, and the family members who had reservations came round as they watched how settled she was in the decision.
What made the match work. She met her intended parents over Zoom and knew quickly. What stuck with her was that they thanked her before there was any commitment — simply for being willing to consider them.
Kelsey advice, in her own words:
“No one knows what is right for you except for you.”
Meet Nicole, a first-time surrogate from Ohio
Nicole is an Ohio mother of three and a registered nurse. That second fact is the one worth pausing on: she reads consent forms for a living, she understands what a medicated cycle involves and what can go wrong in a pregnancy, and she decided to do this anyway.
She knows the other side of it. Nicole and her husband Tim struggled to conceive their first son, because of poor egg quality. She’s described the stretch of not knowing whether they would ever become parents, and it’s the reason she went looking into surrogacy years later — she’d already lived the uncertainty that her intended parents were living.
If you’re wondering whether a history of difficulty conceiving rules you out, it generally doesn’t. What matters is whether you carried a pregnancy safely to term, not how long it took to get pregnant.
She likes being pregnant, and says so plainly.
“I absolutely love being pregnant!”
That sounds like a small thing. It isn’t. The women who find surrogacy manageable are usually the ones who had straightforward pregnancies and didn’t mind them. If you dreaded every week of yours, that’s worth being honest with yourself about before you apply.
On choosing the intended parents. She felt it reading their profile and it held up on the match call. What she credits it to isn’t chemistry so much as both sides being candid early — about what they each wanted, and about what worried them. That’s a useful benchmark for your own match call: if nobody raises a concern, not enough is being said.
Her family were behind her, including Tim, whom she has been with since high school. She’s clear that mattered.
Nicole’s and Kelsey’s journeys were with SurroAvisor’s partner agency we match surrogates with. They came to them directly.
Common questions
What will disqualify you from being a surrogate?
The two near-universal bars are never having given birth and not currently raising a child. After that: current nicotine use including vaping, drug use in your household, a BMI well outside roughly 19–35, more than two or three prior C-sections, a serious complication in a previous pregnancy such as severe preeclampsia, HELLP or cholestasis, an unstable or untreated mental health condition, certain medications, and a criminal record depending on the offence. Plenty of things people assume are disqualifying aren’t — tubal ligation, endometriosis, HSV-2, well-controlled thyroid disease, being unemployed, being single, being LGBTQ+, or having had a difficult time conceiving your own children.
Is it hard to qualify to be a surrogate?
The requirements are specific but not exotic. If you’ve carried at least one healthy full-term pregnancy without major complications, you’re raising that child, you’re between about 21 and 45, and you don’t use nicotine, you’re likely to qualify. The most common things that stop an application are BMI, nicotine, C-section count and a serious prior complication. The fastest way to find out is to answer twelve questions rather than guess.
How much do surrogates get paid?
Total packages start around $65,000 for a first-time surrogate and $75,000 for an experienced one, made up of base compensation plus expenses reimbursed separately. The largest component arrives as monthly instalments during the pregnancy, with the rest paid at milestones. See the schedule above for exactly when each payment lands.
Do surrogates get paid monthly?
Partly. The biggest single component of your compensation is paid as monthly instalments once pregnancy is confirmed. The rest arrives at defined points: match, medical clearance, legal clearance, medication start, embryo transfer, pregnancy confirmation and heartbeat confirmation. There’s also a separate monthly allowance for incidentals that requires no receipts.
Will the baby be related to me?
No. In gestational surrogacy — which is what essentially all agency programmes do — the embryo is created from the intended parents’ genetic material, or a donor’s, and transferred to your uterus. You have no genetic relationship to the child. Traditional surrogacy, where the surrogate’s own egg is used, is a completely different legal proposition and agencies don’t do it.
Do I need my own lawyer?
Yes, always, and the intended parents pay for it. Only two states — Illinois and Michigan — make this a legal requirement, so in most of the country the protection exists only if you insist on it. Never sign a surrogacy agreement reviewed only by the intended parents’ attorney.
Does being a surrogate affect my own fertility?
There’s no evidence that carrying a gestational surrogacy pregnancy reduces future fertility, and many surrogates go on to have more children of their own. The risks are the risks of any pregnancy: a C-section adds scar tissue, and a serious complication such as a haemorrhage could have lasting consequences.
Can I choose the intended parents?
Yes. Matching runs both ways and you can decline a match, including after a first conversation. Think in advance about how much contact you want during the pregnancy, whether you want an ongoing relationship afterwards, and how you’d each want to handle a difficult prenatal diagnosis. Mismatches on that last question cause more trouble than anything else in surrogacy.
Can I be a surrogate if I’m on antidepressants?
It depends on the programme, and it’s worth asking before you apply. Some require six to twelve months off psychotropic medication; others accept stable long-term SSRI use with clearance from the evaluating psychologist. Do not stop your medication in order to qualify — speak to your prescriber and to us first.
Can I be a surrogate if I’ve had a C-section?
Yes. Two prior C-sections is standard at most programmes and three is often workable. What the clinic assesses is how your uterus healed, whether there were complications such as heavy bleeding or a placental abnormality, and what imaging shows. Start requesting your operative reports now — hospital records take longer to arrive than people expect.
Can I be a surrogate if I had cholestasis of pregnancy?
Usually not, and it’s better to know now. Intrahepatic cholestasis recurs in a large proportion of subsequent pregnancies and is associated with increased risk to the baby, so most programmes either decline or require sign-off from a maternal–fetal medicine specialist. Raise it in your first conversation.
Can you be a surrogate with endometriosis?
Usually yes, which surprises people. Endometriosis mainly affects conceiving rather than carrying, and you’ve already demonstrated you can carry to term. Your uterine cavity is checked as part of standard screening.
Can you be a surrogate with HSV-2?
Generally yes. Genital herpes is common and manageable in pregnancy: suppressive antiviral medication from around 36 weeks, and a C-section if there are active lesions at delivery. Most programmes accept HSV-2 positive surrogates. Disclose it at application — it’s a planning conversation, not a disqualification.
Can you be a surrogate with Hashimoto’s or hypothyroidism?
Very often yes, if it’s well controlled on levothyroxine with your TSH in the target range. Thyroid function is monitored closely in any IVF pregnancy. Bring recent labs.
Can a stay-at-home mom be a surrogate?
Yes, and stay-at-home mothers are among the most common surrogates. Not being employed doesn’t affect eligibility, and the flexibility helps with the number of monitoring appointments. Lost-wage reimbursement won’t apply if you have no wages, but base compensation and every other benefit are unaffected, and childcare for appointments is reimbursable — make sure that’s written in rather than assumed.
Do I have to pay tax on it?
Assume yes and plan accordingly. The “non-taxable reimbursement” argument is unsettled and unendorsed by the IRS; most tax professionals treat this as taxable income and some agencies issue a 1099. Set money aside and speak to a CPA before your first payment, not after.
How long does it take?
Twelve to eighteen months from application to birth, of which roughly six to eight months precede pregnancy: one to three months to match, six to eight weeks of screening, four to six weeks for contracts, then a medicated cycle. Some journeys move faster and some need a second or third transfer.
Can I be a surrogate for a friend or family member?
You can, and people do — but do it through a proper process rather than an informal agreement. The leading surrogacy cases in several states arose from exactly this situation: two friends, good intentions, no agency, and a relationship that broke down. At minimum, get separate independent legal advice for everyone and put the expectations about contact and decision-making in writing.
What if I change my mind?
Before the embryo transfer you can withdraw, and your agreement will set out how. Once you’re pregnant, you cannot be compelled to undergo any medical procedure. Beyond that you would be in breach of contract, with the financial consequences your agreement specifies — and in a handful of states the position is genuinely untested for everyone involved. This is precisely why the contract stage matters and shouldn’t be rushed.
Ready to find out where you stand?
If you’ve carried a healthy pregnancy, you’re between 21 and 45, you don’t use nicotine and you’re raising your own child, you’re likely eligible — and the questionnaire will tell you in about five minutes.
If there’s something in your history you’re unsure about, that’s exactly what the questions are for. We’d rather tell you no early than waste six weeks of your time.
Check your eligibility
12 questions · about 5 minutes · free · no obligation
Your answers go to our team and the agency you’re matched with, and nowhere else.
More on surrogacy:
What is a surrogate mother? · Gestational vs traditional surrogacy · Surrogate health insurance · Surrogacy statistics · Glossary
This page is general information, not medical, legal, or tax advice. Eligibility is determined by the fertility clinic and physician overseeing your care, and surrogacy law differs substantially by state. Speak to a reproductive attorney in your own state before signing any agreement, and to a CPA before receiving compensation.