How to Become a Surrogate in Iowa
Iowa’s surrogacy law is stronger than most people realise — the Iowa Supreme Court ruled in 2018 that surrogacy contracts are enforceable here. But the parentage side works differently from neighbouring states, and there’s one thing about that 2018 case every prospective Iowa surrogate should know before signing anything.
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Do you qualify to be a surrogate in Iowa?
One thing to clear up before the list. You’ll see it said that Iowa residency is required to become a surrogate here. It isn’t. Iowa has no surrogacy statute, which means there is no legal requirement about where you live, how old you are, or anything else.
Everything is set by agencies and fertility clinics, following ASRM guidance, not by Iowa law. That distinction is worth holding onto: criteria set by an agency can sometimes be discussed. A statutory requirement can’t.
The non-negotiables:
- You’ve given birth to at least one healthy child, full-term, and you’re raising that child. No programme waives this.
- You’re between 21 and 45, with most Iowa programmes preferring 21–40.
- No nicotine — cigarettes, vapes, pouches, patches. Typically 6–12 months clear, and expect a test.
- No drug use, in your household as well as by you.
- You’ll pass medical screening, a psychological evaluation and a background check — and so will your partner.
- You’re a U.S. citizen or permanent resident.
More flexible than you’d expect:
- BMI. Most clinics want 19–32, some to 35. A few points over usually means “let’s get you there,” not “no.”
- C-sections. Two is standard, three often workable. How you healed matters more than the count.
- Tubal ligation. Irrelevant — embryo transfer bypasses your tubes.
- Endometriosis. Usually fine. It affects conceiving, not carrying.
- HSV-2. Not disqualifying at most programmes.
- Hypothyroidism or Hashimoto’s. Usually fine if well controlled with TSH in range.
- Single, unmarried, or LGBTQ+. Doesn’t affect eligibility — though if you’re married, your husband’s role in Iowa is more significant than in most states. See the legal section.
Raise these early:
- A history of intrahepatic cholestasis of pregnancy (ICP). Recurs often and carries real risk; most programmes decline or require maternal–fetal medicine clearance.
- Preeclampsia or HELLP previously. Depends on severity and timing.
- Antidepressants or other psychotropic medication. Policies vary. Ask before applying; don’t stop medication to qualify.
- Gestational diabetes. Diet-controlled and resolved, usually fine.
- Still breastfeeding. Fully weaned, typically 2–3 months before medication.
| Requirement | Typical Iowa standard | Set by |
|---|---|---|
| Age | 21–45, most prefer 21–40 | Agency / clinic — not law |
| Prior birth | One or more, full-term | Agency / clinic — not law |
| BMI | 19–32, some to 35 | Clinic |
| C-sections | Usually up to 2–3 | Clinic |
| Nicotine | None, 6–12 months | Agency / clinic |
| Psych evaluation | Required | Agency / clinic — not law |
| Iowa residency | Not required | Nobody — this is a myth |
Unsure whether a past complication, your BMI, or a third C-section rules you out? The questionnaire covers all of it.
Check my eligibility →
What surrogates are paid in Iowa
Iowa is a smaller surrogacy market than Illinois or Ohio, but compensation is set by the agency and the intended parents rather than by local demand, so the schedule below applies here as it does anywhere.
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: $15,000–$20,000+ on top
Separate from your fee and not deducted from it: $300 monthly allowance with no receipts; all lost wages, yours and your partner’s; travel and a travel companion; family allowance for overnights away; weekly bed rest allowance; post-birth medical leave, 6–8 weeks; maternity clothing; medical insurance and all medical costs; life insurance; your own attorney’s fees; mental health support.
Your payments are held in third-party escrow. Iowa is one of the better states for this, because your contract is genuinely enforceable here — but escrow means you never have to test that, which is always preferable.
Three things about the money nobody else will tell you
It is very likely taxable. The “non-taxable reimbursement” argument circulating online is unsettled and the IRS has not endorsed it. Most tax professionals treat surrogate compensation as taxable income, and some agencies issue a 1099. Budget as though it’s taxable and speak to a CPA before you sign.
It can affect Iowa benefits. If your household receives the Iowa Health and Wellness Plan, IA Health Link, Hawki, SNAP, the Family Investment Program or child care assistance, surrogate compensation counts as income and could take you over an eligibility threshold. Iowa Medicaid also generally won’t cover a surrogate pregnancy — appropriate coverage is arranged for you. Get advice on timing before you match.
Ignore historic figures. Iowa’s leading surrogacy case involved a contract worth up to $13,000, signed around a decade ago. Rates have moved a very long way since. If anyone quotes you a five-figure number starting with a one, they are working from something old.
The questionnaire tells you which fee structure you’d qualify for and what your schedule would look like.
See what I’d be paid →
Is surrogacy legal in Iowa?
Yes, and Iowa’s position is stronger than its lack of a surrogacy statute suggests. Three things establish it.
1. The criminal code specifically exempts surrogacy. Iowa Code § 710.11 makes it a felony to buy or sell a human being — and expressly excludes “a surrogate mother arrangement” from that prohibition. The timing matters: Iowa passed this in 1989, in the legislative session immediately following the Baby M case in New Jersey, which had invalidated a surrogacy contract as baby-selling. The Iowa Supreme Court later read that timing as a deliberate choice to permit surrogacy rather than prohibit it.
2. State regulations assume it happens. Iowa Administrative Code r. 641-99.15 sets out exactly how Vital Records handles birth certificates for children born to gestational carriers. Regulators don’t write procedures for things that aren’t allowed.
3. The Iowa Supreme Court has ruled on it. In P.M. & C.M. v. T.B. & D.B. (16 February 2018), the court held that gestational surrogacy contracts are enforceable and violate neither public policy nor the constitutional rights of the carrier or the child. It described such agreements as enabling infertile couples to raise their own children.
That’s a stronger foundation than Minnesota, where the appellate court declined to decide, and vastly stronger than Indiana, where the legislature has declared surrogacy agreements void.
The part of that case you should know about
Here’s what most Iowa surrogacy pages leave out, and you should hear it from us.
P.M. v. T.B. wasn’t a case about intended parents behaving badly. It was a case about a surrogate trying to get out of her agreement, and losing comprehensively.
The facts: a married couple contracted with a surrogate and her husband for payments of up to $13,000 plus medical expenses. The embryos were made with the intended father’s sperm and donor eggs. The surrogate became pregnant with twins, then asked for more money and refused to hand over the babies. The children were born prematurely and one of them died. The intended parents sued.
The district court enforced the contract, terminated the surrogate’s and her husband’s presumptive parental rights, and gave custody to the biological father. The Iowa Supreme Court affirmed.
Why this matters to you, in two directions. Enforceability protects your compensation — if intended parents stopped paying, you’d have a real remedy, which you would not have in Indiana. But it protects them symmetrically. In Iowa the contract you sign is the contract you’re held to, and the leading authority in the state is a decision enforcing one against a surrogate.
None of that is an argument against being a surrogate in Iowa. Disputes like that are genuinely rare. It’s an argument for treating the contract stage as the most important part of the process rather than paperwork to get through — read every clause on termination, selective reduction, bed rest, travel and delivery, and negotiate anything you’re uneasy about before you sign.
Iowa’s quirk: you will be presumed the mother at birth
Iowa is strong on contracts and awkward on parentage — roughly the reverse of Missouri.
Under Iowa law the woman who gives birth is presumed to be the legal mother. In practice that means:
- A pre-birth order is generally available only to the biological father. If the intended father’s sperm was used, he can usually be established before delivery.
- The non-biological intended parent normally has to complete an adoption to be added to the birth certificate — Iowa’s own regulations point to the adoption chapter of the Iowa Code for exactly this. So an intended mother using donor eggs typically finishes the process after the birth, not before.
- If you’re married, your husband is presumptively the father. In P.M. v. T.B. the court had to terminate his presumptive rights along with hers. That’s why your spouse will be a party to the agreement and will sign documents. It’s procedure rather than a problem, but don’t be surprised by it.
What to ask. Who will be on the initial birth certificate? What’s the timeline for the intended mother’s adoption or parentage step? What does the hospital need in advance? And who covers the baby’s medical costs in the interval? Any competent Iowa agency will have answers ready.
Traditional surrogacy — using your own egg — is decriminalised in Iowa and the 2018 decision hints the courts might enforce such contracts too, but it requires termination of parental rights and often adoption, and it’s substantially riskier. Agencies don’t do it.
What the process looks like in Iowa
Twelve to eighteen months from application to birth.
Month 1 — Application and matching. You apply, we review your history, and you speak to the agency. Matching typically takes one to three months and you have a say — you’re not assigned to anyone. Iowa is a smaller market, so matching can take a little longer than in Illinois.
Months 2–3 — Screening. Bloodwork, an infectious disease panel, a saline sonogram or hysteroscopy, and a psychological evaluation with someone experienced in third-party reproduction. Your partner is screened too. Iowa has established programmes including surrogacy services at the University of Iowa Hospitals & Clinics in Iowa City. [VERIFY which Iowa clinics your partner agency actually works with before publishing.] If you’re in Sioux City, Council Bluffs or Dubuque, expect to travel to Iowa City or Des Moines for monitoring, reimbursed.
Month 4 — Contracts. Your attorney and theirs negotiate the agreement, paid for by the intended parents. Take this seriously in Iowa — it’s the stage the 2018 Supreme Court decision makes most consequential. Your husband will sign too, if you have one.
Months 5–6 — Medication and transfer. Estrogen and progesterone to prepare your lining, monitored by ultrasound and bloodwork. The transfer takes minutes and needs no anaesthetic. A pregnancy test around ten days later. Not every transfer works first time; that’s normal and covered.
Months 6–15 — Pregnancy. Care with your own OB or a practice the clinic refers you to. Well before your due date, confirm the hospital knows the plan and the parentage paperwork is in motion.
Birth and after. You deliver at an Iowa hospital you choose. The biological father is usually established by pre-birth order; the other intended parent’s step follows afterwards. You recover for six to eight weeks with support.
The first step is 12 questions about your pregnancy history. If you’re not a fit, we’ll say so straight away.
Start the questionnaire →
The risks, honestly
Any page listing only the rewards is selling you something.
Physical. Every risk of pregnancy again: gestational diabetes, preeclampsia, hyperemesis, preterm labour, haemorrhage, an unplanned C-section. IVF pregnancies carry a modestly elevated rate of some complications. If a previous pregnancy was difficult, it can be again. Maternal mortality in the US is low but not zero, and that deserves saying plainly.
The medication is not nothing. Weeks of injections, with bruising, mood swings, headaches and bloating.
Legal, and specific to Iowa: the contract binds you. The state’s leading surrogacy decision enforced an agreement against a surrogate and terminated her parental rights. That’s the correct outcome for the system to produce, and it’s also a reason to read what you sign.
Emotional. Most gestational surrogates don’t experience the grief people expect. But postpartum depression is as possible for you as for any birth, and there’s a flatness some women describe when the intensity ends. Use the counselling.
Relational. Your husband is legally involved here, not just emotionally. Your children will have questions.
Failed transfers and loss. Not every transfer takes, and miscarriage happens at roughly the general rate. It’s hard to carry when it wasn’t your pregnancy to lose. Worth noting that in the 2018 Iowa case one of the twins died — surrogacy pregnancies carry the same real risks as any other, and multiples carry more.
The relationship may not be what you hoped. Some surrogates stay close to the families they carried for; some drift.
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 isn’t 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, agency partner — based right here in the Midwest — 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 if you don’t 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
- In Iowa specifically, we’ll make sure you understand what you’re signing — because here, more than in most states, you’ll be held to it
Common questions from Iowa surrogates
Is surrogacy legal in Iowa?
Yes. Iowa has no surrogacy statute, but three things establish it clearly: the criminal code expressly exempts surrogacy arrangements from the ban on buying or selling a person, state regulations set out how birth certificates are issued for children born to gestational carriers, and in 2018 the Iowa Supreme Court held that gestational surrogacy contracts are enforceable and don’t violate public policy. That’s a firmer footing than most states without a statute.
Do I have to live in Iowa to be a surrogate here?
No. You’ll see this stated as a requirement and it isn’t one — there’s no Iowa law imposing residency. Living in Iowa makes clinic monitoring, your delivery hospital and the court paperwork much simpler, but it isn’t a legal condition.
What disqualifies you from becoming a surrogate?
Never having given birth, and not currently raising a child, are the near-universal bars. After that: current nicotine use, drug use in the household, a BMI well outside roughly 19–35, more than two or three prior C-sections, serious complications in a previous pregnancy such as severe preeclampsia or cholestasis, an unstable mental health condition, and certain medications. Plenty of things people assume are disqualifying aren’t — tubal ligation, endometriosis, HSV-2, well-controlled thyroid disease, being single or LGBTQ+.
Are surrogacy contracts enforceable in Iowa?
Yes, and this is unusually well settled for a state with no surrogacy statute. The Iowa Supreme Court confirmed it in P.M. v. T.B. in 2018. Worth knowing that the case reached that conclusion by enforcing a contract against a surrogate who had changed her mind — so enforceability protects your compensation, and it also holds you to what you signed. Read the contract properly.
Will my name be on the birth certificate?
Initially, possibly yes — Iowa presumes the woman who gives birth is the legal mother. A pre-birth order is generally available to the biological father, while the other intended parent usually completes an adoption step afterwards to be added. It’s a two-stage process rather than the single administrative step you’d get in Illinois. Ask your attorney what the timeline looks like and what the hospital will be told.
Does my husband have to be involved?
Yes, more than in most states. Iowa presumes the husband of the woman who gives birth is the child’s father — in the 2018 case, his presumptive rights had to be terminated alongside hers. He’ll be a party to the agreement and will sign documents. Have the conversation early.
Can you be a surrogate if you have 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, so clinics are comfortable managing it. Bring recent labs. Newly diagnosed or poorly controlled thyroid disease needs stabilising first.
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 during standard screening.
Can you be a surrogate with HSV-2?
Generally yes. It’s managed with 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 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 decline or require maternal–fetal medicine sign-off. Raise it in your first conversation.
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. The clinic assesses how your uterus healed, whether you had complications, 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’m on antidepressants?
It depends on the programme. Some require six to twelve months off psychotropic medication; others accept stable long-term SSRI use with clearance from the evaluating psychologist. Don’t stop your medication to qualify — speak to your prescriber and to us first.
I’ve had my tubes tied. Does that disqualify me?
No. Gestational surrogacy places an embryo directly into your uterus, so your fallopian tubes aren’t involved. An IUD needs removing and Depo-Provera needs a wash-out period, but neither is a barrier.
What if my BMI is over the limit?
Most clinics want under 32, with flexibility to around 35. At 34 or 36 the usual outcome is a conversation about reaching the threshold before transfer, not rejection.
How much do surrogates get paid in Iowa?
Total packages start around $65,000 for first-time surrogates and $75,000 for experienced ones, made up of base compensation plus expenses. See the schedule above for exactly when each payment lands. Be sceptical of much lower figures — Iowa’s 2018 court case involved a contract worth up to $13,000, and rates have moved a very long way since then.
Will surrogate pay affect Iowa Medicaid or SNAP?
It can, and it’s the question we most wish women asked earlier. Surrogate compensation is income and may take your household over an eligibility threshold for the Iowa Health and Wellness Plan, SNAP, the Family Investment Program or child care assistance. Iowa Medicaid also generally won’t cover a surrogate pregnancy. Get advice on the timing before you match.
Do I have to pay tax on it?
Assume yes. The “non-taxable reimbursement” theory is unsettled and unendorsed by the IRS. Set money aside and talk to a CPA before your first payment.
Can I choose the intended parents?
Yes. Matching runs both ways and you can decline a match. Think in advance about contact during pregnancy, any relationship afterwards, and how you’d each handle a difficult prenatal diagnosis.
What if I change my mind?
Before transfer you can withdraw, and your agreement sets out how. Once pregnant, you cannot be compelled to undergo a medical procedure. But Iowa is the state where a surrogate tried to keep the babies and the courts enforced the contract against her, terminating her parental rights. Take that as a reason to be certain before you sign, not as a reason to be frightened — but do be certain.
Does being a surrogate affect my own fertility?
There’s no evidence that carrying a gestational surrogacy pregnancy reduces future fertility. The risks are those of any pregnancy: a C-section adds scar tissue, and a serious complication could have lasting effects.
Ready to find out where you stand?
If you’ve carried a healthy pregnancy, you’re 21 to 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.
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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 · Surrogacy requirements
Nearby states: Minnesota · Wisconsin · Missouri · Illinois
This page is general information, not medical, legal, or tax advice. Eligibility is determined by the fertility clinic and physician overseeing your care. Speak to an Iowa reproductive attorney before signing any agreement, and to a CPA before receiving compensation.