KNOW YOUR RIGHTS AS A SURROGATE: CONTRACTS, HEALTHCARE, AND DECISION-MAKING

Becoming a surrogate requires commitment and informed decision-making. You deserve to understand your legal protections, healthcare rights, compensation, and responsibilities before moving forward. At Growing Generations, we help surrogates understand these protections before they sign anything. Surrogacy laws vary by state, so your rights may depend on where you live, receive treatment, and deliver. Your surrogacy agreement should explain these protections clearly, but it does not replace advice from an independent surrogacy attorney.

What Are Surrogate Rights?

Surrogate rights are the legal, medical, financial, and personal protections that support you throughout the process. They may include your right to:

• Independent legal representation

• Make informed healthcare decisions

• Receive agreed-upon compensation and reimbursements

• Understand your insurance coverage

• Protect your privacy

• Access counseling and emotional support

The American Society for Reproductive Medicine states that gestational surrogacy arrangements should include informed consent, independent legal advice, healthcare, and emotional support. Clear protections help you understand what to expect and reduce the risk of disagreements later.

Surrogacy Laws and Regulations

The United States does not have one federal surrogacy law. Each state follows its own statutes,  regulations, and court procedures. Some states provide detailed protections and clear parentage processes. Others offer limited guidance or restrict certain arrangements. Local law may affect whether your agreement is enforceable, how compensation is managed, and which legal protections apply.

For example, California requires separate attorneys for the surrogate and intended parents and requires the parties to sign the agreement before injectable medications or embryo transfer. New York provides a Gestational Surrogates’ Bill of Rights that protects medical decision-making, legal representation, healthcare, insurance, and counseling. Whether you work with an agency or arrange the journey independently, you should have an attorney who represents only your interests.

Understanding Your Rights as a Surrogate

Your surrogacy agreement creates the foundation for your journey. It should explain each party’s rights, responsibilities, and expectations before medical treatment begins. The agreement cannot predict every situation, but it can establish how you will communicate, make decisions, manage expenses, and respond to unexpected circumstances.

Compensation and Payment Terms

Your contract should define your total compensation, payment schedule, reimbursements, and additional benefits. These may include medication and transfer payments, travel, maternity clothing, childcare, lost wages, bed rest support, and payments connected to certain procedures or pregnancy circumstances. It should also explain what happens after an unsuccessful transfer, pregnancy loss, complication, or early delivery. Make sure every payment and reimbursement you expect appears in writing.

Escrow Details

At Growing Generations, compensation and approved reimbursements are managed through an independent third-party escrow company. Before embryo transfer, the account is fully funded to help ensure that your payments and reimbursements remain available throughout the process. The intended parents fund the account, and the escrow provider or surrogacy agency releases compensation and reimbursements according to the contract.

Before signing, confirm who manages the account, when it must be funded, how you submit expenses, how quickly payments are released, and what happens if the balance becomes too low. You should also receive clear payment records.

Medical Decision-Making

As the surrogate, you provide informed consent for your medical care. Your healthcare providers should explain the purpose, benefits, risks, and alternatives for any recommended treatment.

Your agreement may document shared expectations involving prenatal testing, medications, delivery, or termination. Discussing these subjects before matching or embryo transfer can identify important differences early.

A contract does not remove your authority over your body. ASRM states that gestational carriers should retain decision-making authority over their medical care, including prenatal testing, pregnancy termination, and multifetal reduction.

Termination and Selective Reduction

Your agreement should address termination and selective reduction, even though you and the intended parents may never face these decisions. Discussing possible fetal diagnoses, multiple pregnancy, health concerns, and other medical circumstances early can help everyone understand one another’s expectations. Your attorney can explain your decision-making rights, clarify the intended parents’ wishes, and help you understand how state law may apply.

Lifestyle and Conduct Provisions

Your contract may include expectations involving travel, medications, exercise, confidentiality, social media, and medical appointments. Review each requirement carefully. Make sure it is clear, medically reasonable, and compatible with your life. You should also understand whether the intended parents will reimburse other costs created by these requirements.

Contingency Scenarios

Your agreement should explain how the parties will handle unexpected events, such as a failed transfer, pregnancy loss, bed rest, hospitalization, insurance changes, premature delivery, multiple pregnancy, or serious medical complications.

Planning ahead establishes expectations and reduces uncertainty. It clarifies expenses, how compensation will continue, and what medical, legal, and emotional support you will receive.

Post-Delivery Terms

Your responsibilities and protections continue after birth. Your agreement may address postpartum care, recovery expenses, counseling, pumping arrangements, communication, insurance coverage, and final escrow payments.

Ask how long each protection remains available, who pays for postpartum complications, and when your contractual obligations formally end.

Understanding Surrogacy Compensation Rights 

Compensation is a structured part of your legal agreement. It should recognize your time and commitment while protecting you from carrying the financial costs of the journey.

Your contract should separate base compensation from reimbursements and explain payment timing, allowances, lost wages, childcare, travel, insurance responsibilities, and payments related to complications or pregnancy loss.

The total compensation amount does not provide the full picture. Strong financial protections should also address insurance exclusions, missed work, medical expenses, and unexpected costs. Review the complete package with your attorney before signing. Learn more about how surrogate compensation works.

Understanding Parental Rights and Custody Considerations 

Your agreement should state that the intended parents plan to become the child’s legal parents and accept responsibility after birth. In gestational surrogacy, you carry an embryo created with eggs and sperm from the intended parents or donors, so you do not provide the egg. In traditional surrogacy, the surrogate provides the egg, which creates different legal considerations.

Parentage procedures vary by state. Some states allow intended parents to secure a court order before birth, while others require additional steps after delivery. Your attorney should explain which state’s law applies, when the parentage process will occur, whether your spouse or partner must participate, how the hospital will receive the documents, and how the birth certificate process will work. These procedures should support a clear transition at birth while protecting your rights as the patient during pregnancy and delivery.

Questions Surrogates Should Ask Before Signing a Contract

You should never feel pressured to sign a surrogacy agreement before you understand it. Take time to review the contract with your own attorney and ask for revisions when a provision feels vague, incomplete, or inconsistent with your understanding of the match. Consider asking the following questions:

• What is my total compensation, and how will I receive it?

• What financial protections do I have if a transfer fails or a pregnancy ends unexpectedly?

• Which pregnancy-related expenses and reimbursements are included in my agreement?

• Who has decision-making authority if medical complications occur during pregnancy?

• What lifestyle guidelines or restrictions am I agreeing to follow?

• Will my compensation be protected through an escrow account before the process begins?

• What options and protections do I have if I decide to step away from the journey?

• How does the agreement address selective reduction or pregnancy termination decisions?

• What kind of support continues after delivery, and for how long?

• Are there any contract terms I should review more carefully or negotiate?

Independent legal representation gives you a private place to raise these questions. Your attorney should explain the agreement in language you understand and advocate for terms that protect your interests.

FAQs

Can a surrogate make medical decisions during pregnancy?

Yes. As the pregnant patient, you provide informed consent for your medical care. Your contract may document shared expectations and communication responsibilities, but decisions involving your body require your participation and consent.

Can a surrogate change her mind during the process?

Your options depend on the stage of the journey, your contract, and state law. You may be able to leave the process before pregnancy under the agreement or applicable law. Once pregnancy begins, you retain authority over your medical care, but ending other contractual responsibilities may create legal issues. Contact your independent attorney immediately if concerns arise.

Are surrogate rights different in every state?

Yes. Each state follows different surrogacy laws, contract requirements, and parentage procedures. Work with an attorney who understands the laws where you live, receive care, and plan to deliver.

Understanding your rights as a surrogate can help you move forward with clear, realistic expectations. At Growing Generations, we help coordinate the legal, medical, financial, and emotional support professionals who guide you through the surrogacy process, and 26% of our own staff have been surrogates themselves. Learn what the surrogate process looks like at Growing Generations. 

Sources

American Society for Reproductive Medicine. “Consideration of the Gestational Carrier: An Ethics Committee Opinion.”ASRM, 2023. 

American Society for Reproductive Medicine. “Gestational Carrier Policy in the United States.” ASRM. 

American Society for Reproductive Medicine. “Recommendations for Practices Using Gestational Carriers: A Committee Opinion.” ASRM, 2022. 

California Legislative Information. “Family Code Sections 7960–7962.” State of California. 

New York State Department of Health. “Gestational Surrogates’ Bill of Rights.” New York State Department of Health.