How to Become a Surrogate in Tennessee
Surrogacy is practised throughout Tennessee, compensation is legal, and the state’s Supreme Court has confirmed these agreements can be enforced. But Tennessee’s legal machinery is unusually awkward — in most arrangements you’ll be named as the mother on the birth certificate, and you’ll stay there until the intended parents complete an adoption. Here’s what that means, what you’ll be paid, and what to ask before you sign.
Do you qualify to be a surrogate in Tennessee?
Tennessee sets no statutory requirements for surrogates — nothing on age, residency or prior births. Everything below is set by agencies and fertility clinics following ASRM guidance, not by state law.
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 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. You don’t have to live in Tennessee, though it simplifies things.
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.
- Not being employed. Being a stay-at-home mother doesn’t affect eligibility.
- Single, unmarried, or LGBTQ+. Doesn’t affect your eligibility as a carrier — though if you’re married, ask your attorney about how Tennessee’s artificial insemination statute interacts with your husband’s position. 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, and worth particular thought in Tennessee given how the medical exception to the abortion ban is drawn. See below.
- 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 Tennessee 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 |
| Your own attorney | Strongly recommended | Not required by Tennessee law |
| Tennessee residency | Not required | Nobody |
Is surrogacy legal in Tennessee?
Yes — but “legal” here means something narrower than usual, and the details matter more to you than to the intended parents.
Tennessee’s entire surrogacy law consists of a definition sitting in the definitions section of the adoption code, at Tenn. Code Ann. § 36-1-102.
That definition describes “surrogate birth” in two forms: an embryo made from a wife’s egg and a husband’s sperm carried by another woman who relinquishes parental rights under contract, and the insemination of a woman with a man’s sperm where the parties intend that she relinquish the child to the biological father and his wife.
Notice what that definition doesn’t cover. It’s written entirely in terms of a married couple using their own gametes. It doesn’t contemplate donor eggs, single intended parents, unmarried couples or same-sex couples. And it doesn’t say surrogacy is permitted — it simply defines it. Tennessee neither expressly allows nor prohibits surrogacy. Everything that falls outside that narrow definition is handled by workarounds built up in practice.
What the Supreme Court decided
In In re Baby, 447 S.W.3d 807 (Tenn. 2014), the Tennessee Supreme Court considered a traditional surrogacy arrangement. It’s worth knowing what happened, because it’s the only case of its kind across the states we cover where the surrogate came away with a partial win.
Intended parents contracted with a surrogate and her husband for a traditional arrangement — artificial insemination with the intended father’s sperm. Seventeen days before the birth, a juvenile court issued a consent order declaring paternity, granting custody to the intended parents, and terminating the surrogate’s parental rights. She gave birth, breastfed briefly on medical advice, and about a week later asked the court to vacate that order, set aside the contract and give her custody. She was refused at every level.
The Tennessee Supreme Court vacated the part of the order that had terminated her parental rights, while otherwise affirming. It held that public policy does not prohibit enforcing surrogacy contracts, but does impose restrictions — and that a surrogate’s parental rights cannot be terminated before she has given birth. Custody itself is decided on the child’s best interests.
She did not get her child back. But the principle she won protects every Tennessee surrogate since: nobody can sign away your parental rights before your baby exists.
The case also limited how you can be paid. Tennessee’s adoption statutes prohibit payments in exchange for surrendering a child or terminating parental rights. So your compensation must be structured as payment for carrying a pregnancy and for your expenses — not contingent on you handing over a child. That sounds technical. It’s actually in your favour, and it’s why a well-drafted Tennessee contract reads the way it does.
The part that matters most: the birth certificate
This is the single most important thing on this page, and almost no other Tennessee surrogacy page explains it from your side.
In most Tennessee arrangements you will be named as the mother on the birth certificate.
Tennessee case law has established that the gestational carrier goes on the certificate as mother unless the intended parents used both their own egg and their own sperm. Specifically:
- If a donor egg was used — which is common — you remain on the birth certificate until the second intended parent completes an adoption. Only then are you replaced.
- If the intended mother is the genetic mother, she can go straight onto the certificate and this doesn’t arise.
- If the intended father is single, you’re listed as “Mother” on the initial certificate until he obtains a court order disestablishing your parental rights.
- Pre-birth orders are available only to the biological father, on genetic testing or an agreement to establish parentage filed by both biological parents.
- Where no pre-birth order is obtained, Tennessee generally requires a post-birth adoption rather than a post-birth parentage order.
Compare that with Illinois, where your name never appears at all, or Arkansas, where the original certificate is sealed and substituted within days. In Tennessee you may be the legal mother of record for weeks or months.
Four things to sort out before you sign:
- Which configuration applies? Ask directly whether the intended parents are using the intended mother’s own eggs. If not, expect to be on the certificate.
- What’s the timeline for the adoption or disestablishment order, and who is responsible for filing it promptly?
- What happens in the meantime? While you are the legal mother of record, ask specifically about the baby’s medical costs and insurance, and about anything that touches your own benefits or tax position.
- If you’re married, ask your attorney about Tennessee’s artificial insemination statute, which deems a child born to a married woman by insemination with her husband’s consent to be the child of husband and wife. It’s written for a different situation, but your attorney should tell you how it’s handled here.
None of this makes Tennessee a bad place to be a surrogate. It makes it a place where the paperwork genuinely matters, and where a vague answer from an agency should worry you.
Tennessee has no law at all governing the rights of egg, sperm or embryo donors. That’s a gap your contract has to fill.
Traditional surrogacy — using your own egg — is not prohibited in Tennessee, and In re Baby confirms such contracts can be enforced within limits. It’s also exactly the arrangement that produced that litigation. Agencies don’t do it and you shouldn’t consider it.
What surrogates are paid in Tennessee
Tennessee places no cap on surrogate compensation. There is one structural rule, from In re Baby: your payment cannot be contingent on you surrendering the child or terminating your parental rights. In practice that means your contract pays you for carrying the pregnancy and for your expenses, on a schedule tied to milestones — which is how a well-drafted agreement is built anyway.
First-time surrogates: $65,000+ total. Experienced surrogates: $75,000+ total.
That splits into two parts — your 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.
In Tennessee, add one item to that list when you negotiate: legal costs associated with the post-birth adoption or disestablishment order. Those are the intended parents’ responsibility, but because Tennessee needs that extra step in most cases, make sure the agreement says so explicitly rather than leaving it implied.
Your payments are held in third-party escrow, so the money is set aside independently rather than depending on the intended parents paying on time.
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 Tennessee benefits — and Tennessee has an extra wrinkle. If your household receives TennCare, CoverKids, SNAP or Families First, surrogate compensation counts as income and could take you over an eligibility threshold. TennCare also generally won’t cover a surrogate pregnancy. The Tennessee-specific point: because you may be the legal mother of record for a period after the birth, ask your attorney and a benefits adviser whether that affects anything on your side. Sort this out before you match.
Ask for a schedule, not a range. A quoted range tells you very little. What you want is a list of payments with the milestone attached to each, as above.
The thing about Tennessee nobody else will tell you
Every surrogacy contract contains clauses about termination and selective reduction. In Tennessee, those clauses run into state criminal law.
Tennessee’s Human Life Protection Act has banned abortion since 25 August 2022. Performing one is a Class C felony, carrying three to fifteen years in prison and fines up to $10,000, plus loss of medical licence. Women are protected from prosecution by statute. There are no exceptions for rape or incest, and no standalone exception for fetal anomaly — a bill to create one failed in the legislature.
The law has been amended twice. In 2023 it was changed to allow a physician using reasonable medical judgment to act where necessary to prevent death or “serious risk of substantial and irreversible impairment of a major bodily function,” and molar and ectopic pregnancies were added. In 2025 the listed qualifying conditions were expanded to include inevitable abortion, and fatal fetal diagnoses where they create a serious maternal risk such as severe preeclampsia, infection, uterine rupture or loss of fertility. Mental health diagnoses are explicitly excluded.
Litigation continues. A panel of judges has allowed a challenge to the medical exception to proceed, finding that the plaintiffs had sufficiently alleged its defects put their lives at risk, and concluding that the 2025 amendment did not materially change the case. One plaintiff was denied care at around fifteen weeks after a fatal fetal diagnosis and later delivered a stillborn baby following more than thirty-two hours of labour.
What this means for you specifically
A fatal fetal anomaly, by itself, is not an exception. Tennessee’s 2025 amendment goes further than some states by listing fatal diagnoses that cause maternal risk — preeclampsia, infection, uterine rupture, threatened fertility. But if a twenty-week scan finds a condition incompatible with life and you are otherwise well, termination is not lawfully available in Tennessee.
Selective reduction of a multiple pregnancy is not available in-state.
The exception is drawn around your physical health, and it excludes mental health. Doctors facing three to fifteen years may act more cautiously than a contract assumes.
Travel is more feasible here than in some states. Most of Tennessee’s neighbours also restrict abortion, but Virginia and North Carolina are accessible. That’s a real difference from Arkansas, where all six border states have bans — though it still means distance, cost and delay.
What to actually do about it
We’re not telling you not to be a surrogate in Tennessee. The overwhelming majority of surrogacy pregnancies are uncomplicated and none of this arises. We’re telling you to have four conversations before you sign:
- With your attorney: what do the termination and reduction clauses mean in Tennessee, and what happens if one becomes impossible to perform?
- With the intended parents: what would each of you want if a serious anomaly were diagnosed, and are you actually aligned?
- With the agency: if out-of-state care were needed, who arranges it, who pays, including travel and accommodation, and how quickly?
- With yourself, if you’ve had preeclampsia, HELLP or another serious complication. Tennessee’s exception is drawn around exactly those conditions, which cuts both ways — it may apply to you, and you may need it to.
If any of those parties won’t have the conversation, that tells you something.
What the process looks like in Tennessee
Twelve to eighteen months from application to birth, plus the extra legal step afterwards.
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. Ask early whether the intended parents are using the intended mother’s own eggs — it determines the birth certificate position.
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. If you’re in a rural county, expect real travel for monitoring, reimbursed.
Month 4 — Contracts. Your attorney and theirs negotiate the agreement, paid for by the intended parents. In Tennessee, get written answers on the birth certificate sequence, the adoption timeline, who covers the baby’s medical costs in the interim, and the termination clauses. This is the stage that determines how straightforward the next eighteen months are.
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. Where a pre-birth order is available to the biological father, your attorney obtains it during this period.
Birth. You deliver at a Tennessee hospital you choose. Depending on the configuration, your name goes on the initial birth certificate as mother.
After the birth — the extra step. The intended parents complete the adoption or disestablishment order that replaces your name. Ask for the expected timeline in writing, and ask to be told when it’s done. You recover for six to eight weeks with support.
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 Tennessee’s maternal health outcomes are poorer than the national average — that deserves saying plainly.
Legal, and Tennessee has more of this than most. Your name on the birth certificate, a required adoption step, a statute that doesn’t contemplate most modern family configurations, and no law on donor rights. None of it is dangerous. All of it means the contract and the attorney matter, and a loose process will cause you administrative grief months after you’ve gone home.
Medical autonomy. State criminal law sets an outer limit that no contract can move. See the section above.
The medication is not nothing. Weeks of injections, with bruising, mood swings, headaches and bloating.
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. Being on the birth certificate for a period is something a few Tennessee surrogates find unexpectedly unsettling — worth knowing in advance.
Relational. Your partner will be part of the process. 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.
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 that it should shape how you read this page — including the two sections we’d have a commercial incentive to leave out and haven’t.
It’s also why we only work with just one, trusted, agency partner. 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 Tennessee specifically, we’ll make sure you know before you match whether you’ll be on the birth certificate, and for how long — the question that most affects a Tennessee surrogate and the one least likely to be volunteered
Common questions from Tennessee surrogates
Is Tennessee a surrogacy-friendly state?
Moderately. Surrogacy is practised throughout Tennessee, compensation is lawful, and the Tennessee Supreme Court confirmed in 2014 that these contracts can be enforced. But Tennessee has no proper surrogacy statute — only a definition tucked into the adoption code, written in terms of a married couple using their own eggs and sperm. Everything outside that needs workarounds, and in most arrangements the carrier is named on the birth certificate until an adoption completes. It’s workable with good lawyers. It’s noticeably more cumbersome than Illinois or Michigan.
Will my name be on the birth certificate?
Probably, yes — and this is the most important question a Tennessee surrogate can ask. Unless the intended parents use both their own egg and their own sperm, Tennessee case law puts the gestational carrier on the certificate as mother. Where a donor egg is used, you stay there until the second intended parent completes an adoption. Where the intended father is single, you’re listed until he obtains an order disestablishing your parental rights. Ask which configuration applies before you match, and get the expected timeline for the follow-up step in writing.
How long will I be the legal mother of record?
It depends on how quickly the adoption or disestablishment order is filed and processed, which is why you should ask for a timeline rather than an assurance. It’s typically weeks to a few months. In Illinois your name never appears; in Arkansas the original certificate is sealed within days. Tennessee is slower than both, and it’s reasonable to ask the intended parents’ attorney to commit to a date.
Are surrogacy contracts enforceable in Tennessee?
Yes, within limits. In In re Baby (2014) the Tennessee Supreme Court held that public policy doesn’t prohibit enforcing surrogacy contracts but does impose restrictions. Two matter to you: your parental rights cannot be terminated before you give birth, and your compensation cannot be contingent on you surrendering the child or terminating your rights. Both of those are protections rather than limitations.
How much does a surrogate cost in Tennessee?
That’s the question intended parents ask; here’s the answer from your side. Total packages start around $65,000 for first-time surrogates and $75,000 for experienced ones, made up of base compensation plus expenses that are reimbursed separately and not deducted from your fee. The schedule above shows exactly when each payment lands, including eight monthly instalments during the pregnancy. Ask any agency for a payment schedule with milestones attached rather than a headline range.
Do surrogates get paid monthly?
Partly. The largest single component is paid as monthly instalments once pregnancy is confirmed — eight of them in the schedule above. The rest arrives at milestones: match, medical clearance, legal clearance, medication start, transfer, pregnancy confirmation and heartbeat confirmation. There’s also a separate monthly allowance for incidentals with no receipts required.
Do I need my own lawyer?
Tennessee doesn’t require it, which is exactly why you should insist — and it matters more here than in most states, because Tennessee’s process has extra moving parts. Illinois and Michigan make independent counsel a statutory condition; Tennessee leaves it to best practice. The intended parents should pay for yours. Never sign an agreement reviewed only by their attorney.
How does Tennessee’s abortion law affect me as a surrogate?
Tennessee has banned abortion since August 2022, with narrow medical exceptions that were expanded in 2023 and 2025. There is no exception for rape, incest, or for a fatal fetal anomaly on its own — though the 2025 amendment does cover fatal diagnoses that create a serious maternal risk such as severe preeclampsia, infection or uterine rupture. Mental health is explicitly excluded. Practically, the termination and selective reduction clauses in your contract may not be performable here. Talk it through with your attorney, the intended parents and the agency before you sign, including who would arrange and pay for care in another state.
Do I have to live in Tennessee?
No. Tennessee imposes no residency requirement on surrogates. Living here simplifies clinic access, your delivery hospital and the court handling parentage, but it isn’t a legal condition.
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 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 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 Hashimoto’s or hypothyroidism?
Very often yes, if it’s well controlled on levothyroxine with your TSH in the target range. Bring recent labs.
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.
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.
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.
Can a stay-at-home mom be a surrogate?
Yes, and it’s common. Not being employed doesn’t affect eligibility, and the flexibility helps with 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 — get it written in.
Will surrogate pay affect TennCare or SNAP?
It can. Surrogate compensation is income and may take your household over an eligibility threshold, and TennCare generally won’t cover a surrogate pregnancy. Tennessee has an extra wrinkle worth raising with an adviser: because you may be the legal mother of record for a period after the birth, check whether that touches anything on your side. Get advice 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. In Tennessee, use one of those conversations to ask whether they’re using the intended mother’s eggs, and how they’d want to handle a difficult prenatal diagnosis. Both questions have more consequence here than in most states.
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, and under In re Baby your parental rights cannot be terminated before the birth. Beyond that you’d be in breach of contract with the consequences your agreement specifies. This is why the contract stage matters.
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.
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
Nearby states: Arkansas · Missouri
This page is general information, not medical, legal, or tax advice. Tennessee has no comprehensive surrogacy statute and its abortion law is under active challenge; both positions should be checked against current law. Speak to a Tennessee reproductive attorney before signing any agreement, and to a CPA before receiving compensation.