SURROGATE PRENATAL CARE: WHAT TO EXPECT THROUGHOUT PREGNANCY

In many ways, prenatal care during a surrogacy pregnancy follows the same foundation as prenatal care for any other pregnancy. As a surrogate, you receive regular medical evaluations and support from your healthcare providers. Your process involves added coordination among your fertility clinic, obstetrician, intended parents, and surrogacy support team.

Every pregnancy develops differently. The goal remains consistent throughout your surrogacy journey: to protect your health and support the baby’s development. At Growing Generations, we have provided a dedicated point of contact for every surrogate for 30 years.

Understanding Surrogate Prenatal Care

Prenatal care refers to the medical monitoring and support you receive throughout pregnancy. Your care team uses appointments, testing, and conversations to assess your health, follow the baby’s development, identify potential concerns, and answer your questions. 

Early pregnancy testing may include a complete blood count, blood type and Rh factor testing, urinalysis, and screening for certain infections. Your provider will recommend additional tests based on your health history and the pregnancy.

Prenatal care schedules no longer need to follow one rigid model for every pregnancy. The American College of Obstetricians and Gynecologists encourages providers to tailor the number and format of appointments to each patient’s medical risks, social needs, and preferences.

As a surrogate, you may also communicate appointment updates to the intended parents and your agency team. Your communication plan should support collaboration without making you feel alone in this process. We review this plan with you and the intended parents before these appointments begin, and again once they start, so everyone stays aligned.

First Trimester Support and Early Pregnancy Care

The first trimester involves more medical coordination because your pregnancy began through in vitro fertilization. After the embryo transfer, your fertility clinic will schedule blood tests to confirm pregnancy and early ultrasounds to evaluate its progress.

You may also continue estrogen, progesterone, or other medications during this stage. Follow your clinic’s instructions carefully and speak with your medical team before changing or stopping any medication.

Once the pregnancy is progressing well, the fertility clinic will transition your care to an obstetrician or another prenatal provider. Your care team will discuss first-trimester screenings, including blood tests and ultrasounds, based on medical guidance, your surrogacy agreement, and informed consent.

This stage may require adjustments to your schedule, medication routine, and daily activities.  Ask for clarification when you need it. Your case specialist , medical team, and personal support system can help you manage appointments and early pregnancy changes.

Ongoing Monitoring Throughout Pregnancy

After the first trimester, you will continue seeing your prenatal provider throughout the second and third trimesters. During these appointments, your provider will monitor your blood pressure, weight, uterine growth, and the baby’s heartbeat. Your care team may also recommend ultrasounds, lab work, and other assessments based on the pregnancy. Later testing may include screening for gestational diabetes, which often takes place between 24 and 28 weeks.

Your provider may increase the frequency of appointments as delivery approaches. Keep in mind that appointment frequency and care plans may vary. Contact your healthcare provider promptly when something feels unusual rather than waiting for your next scheduled visit. Your agency or case specialist can provide logistical support, but your medical team directs your clinical care.

Emotional Support and Healthy Boundaries During Pregnancy

Your emotional needs change as the pregnancy progresses. You may feel excited, tired, overwhelmed, or several emotions at the same time. These feelings do not define your ability to serve as a surrogate. They signal that you are moving through a significant physical and emotional experience.

Your support network may include:

• Your case specialist and Education and Experience Specialist

• A counselor or mental health professional

• The intended parents

• Your partner, family members, and friends

• Other surrogates who understand the experience

• Your obstetric and fertility care teams

  
  

Clear communication can help you and the intended parents stay connected throughout the process. Discuss how you will share updates, images, milestones, and appointment participation. Boundaries can change as the pregnancy progresses. You may need more privacy, rest, or practical support at certain points. Speak openly with your case specialist when expectations no longer feel comfortable or manageable.

Emotional care also belongs in your medical care plan. ACOG recommends screening for depression and anxiety during the initial prenatal visit, later in pregnancy, and during postpartum care. Tell your healthcare provider if emotional changes begin affecting your daily life.

Planning for Delivery Before the Final Weeks

Birth planning should begin before the final weeks of pregnancy so you, the intended parents, your agency, and the hospital have time to prepare. These conversations may cover your preferences for labor and pain management, who may be present during delivery, how the intended parents will receive updates, and what hospital visitor policies allow. You may also discuss photography, support for your partner or chosen support person, the intended parents’ time with the baby, your privacy and recovery needs, pumping breast milk when applicable, cord blood banking, and travel or lodging arrangements.

Your case specialist also conducts a hospital interview with the labor and delivery team to confirm protocols, including how many people may be present in the delivery room. These details go into a delivery plan that you, the intended parents, and your case specialist review together, with the understanding that plans can change.

You should feel comfortable asking questions and discussing your needs with your care team. At the same time, birth plans need flexibility because labor and delivery can change quickly. Your healthcare providers may adjust the plan to protect your health and the baby’s health.

Your case specialistcan help everyone understand expectations and prepare for the hospital experience, while the hospital and medical team will guide clinical and operational decisions. Clear planning can reduce confusion and help you focus on delivery and recovery.

What Happens After Delivery: Postpartum Care for Surrogates 

Your care continues after delivery as your body recovers from pregnancy and either vaginal or cesarean birth. Postpartum care may address bleeding, pain, healing, nutrition, lactation, pelvic floor health, and hormonal or emotional changes.

ACOG recommends viewing postpartum care as an ongoing process, with provider contact within the first three weeks and a comprehensive visit within 12 weeks. Your provider may recommend earlier or additional care based on your recovery.

You may feel proud of the connection you built with this family while also processing the end of the journey. Stay connected to your healthcare provider, counselor, agency, and trusted support system, and ask for help with any concerns.

FAQs

How often do surrogates attend prenatal appointments?

Your appointment schedule depends on your health, the pregnancy, and your provider’s recommendations. Many prenatal schedules include visits about once a month during the earlier months, followed by more frequent visits as delivery approaches. However, current guidance supports tailoring prenatal care rather than requiring the same number of visits for every patient. You may also have additional appointments with the fertility clinic during early pregnancy or with a maternal-fetal medicine specialist if the pregnancy requires closer monitoring.

Is prenatal care for surrogates different from traditional pregnancy care?

You receive largely the same core medical care as routine obstetric monitoring and support based on your health and the baby’s development. The main differences often arise during the early IVF stage and in the coordination surrounding the pregnancy. You may take fertility medications, receive early monitoring from an IVF clinic and local monitoring clinic, communicate with intended parents, and work with a case specialist .

Do intended parents attend prenatal appointments?

You and the intended parents can decide together how involved they'll be depending on the agreement and schedule. Some intended parents attend major ultrasounds or a hospital tour in person, while others join through video or receive updates afterward. Discuss appointment participation early so everyone understands your preferences. 

Does prenatal care include emotional support?

Yes. Emotional support is an important part of pregnancy and postpartum care. Counselors, your agency, intended parents, healthcare providers, family, friends, and other surrogates can support you throughout the process. Ask for additional help whenever your emotional needs change.

At Growing Generations, we support you throughout your surrogacy experience, coordinating with the intended parents and your care teams along the way. Every surrogate also has an Education and Experience Specialist for additional support, along with monthly surrogate support calls and a private online community just for Growing Generations surrogates. Learn more about becoming a surrogate and how our team can help you feel informed, supported, and confident at every stage.

SOURCES:

American College of Obstetricians and Gynecologists. “Optimizing Postpartum Care.” ACOG, May 2018. 

American College of Obstetricians and Gynecologists. “Prenatal Care.” ACOG.