Gestational surrogacy, where a woman carries a pregnancy for intended parents (IPs) using an embryo created from the IPs’ or donors’ gametes, is a complex journey. Although the process is medically managed, not all pregnancies continue to term. A miscarriage, the spontaneous loss of a pregnancy before 20 weeks, requires a clear, pre-defined framework to manage, affecting the surrogate, the intended parents, and the surrogacy arrangement.
Immediate Medical and Procedural Response
The first priority following any indication of a potential loss is the surrogate’s physical well-being. Once symptoms occur or a loss is detected, the medical team acts quickly to confirm the miscarriage. Treatment options include expectant management, allowing the tissue to pass naturally, or medical management using prescribed medication to expedite the process.
A minor surgical procedure called dilation and curettage (D&C) is also an option. This procedure allows for quick tissue removal and offers the possibility of testing the tissue for chromosomal abnormalities, a common cause of early loss. The medical team establishes follow-up care, including bloodwork to monitor hormone levels and ensure physical recovery.
Communication protocols are immediately activated, with the medical team informing the surrogate and the surrogacy specialist. The specialist then facilitates sharing the news with the intended parents. The surrogate’s medical care is fully covered by the intended parents, as outlined in the contract, ensuring she receives necessary physical and emotional attention. The surrogate must be medically cleared before any further steps in the surrogacy journey are considered.
Reviewing the Surrogacy Agreement
The surrogacy agreement acts as the governing document for all potential outcomes, including a miscarriage. This contract, executed before the embryo transfer, contains specific clauses that dictate the procedural and legal steps following a pregnancy loss. These clauses clarify the termination of the pregnancy and the subsequent continuation or cessation of the contract.
The contract details the number of embryo transfer attempts the parties agreed to pursue. This pre-agreed number determines whether to proceed with another transfer or conclude the arrangement. The agreement also specifies the requirement for legal consultation post-loss. This ensures both the intended parents and the surrogate have independent legal counsel to review the situation and any proposed amendments.
The enforceability of these contractual terms is often determined by state-specific surrogacy laws. The initial legal planning safeguards the rights and responsibilities of all parties during such an unforeseen event.
Financial Management and Cost Allocation
A core function of the surrogacy contract is defining the financial consequences of a miscarriage, particularly the allocation of escrow funds. Intended parents deposit money into a third-party escrow account before the process begins, covering base compensation, medical expenses, and allowances. Upon a miscarriage, the surrogate is compensated for services rendered up until that point, including monthly allowances and any milestone payments tied to the pregnancy duration.
The contract outlines that the surrogate’s base compensation is often paid out pro-rata, calculated based on the duration the pregnancy was carried. Funds not yet earned, such as remaining base compensation or future allowances, are not disbursed to the surrogate and are managed according to the escrow agreement. The intended parents remain responsible for all medical costs associated with the miscarriage, including hospital fees, follow-up appointments, and post-loss care for the surrogate.
Fees already paid to third parties, such as agencies and attorneys, are generally not reimbursed, as those fees cover services already provided. Any remaining funds in the escrow account, after all final medical and compensation payments are made, are returned to the intended parents.
Psychological Support and Emotional Recovery
The experience of a miscarriage carries a significant emotional toll on both the surrogate and the intended parents, necessitating immediate and ongoing psychological support. Many surrogacy arrangements mandate counseling for all parties, often with professionals specializing in reproductive trauma and loss. This support helps the surrogate process feelings of grief or disappointment, reminding her that the loss is a biological event and not her fault.
Intended parents experience a profound sense of loss for the child they had hoped for, compounded by the financial investment and emotional weight of their journey. Their grief, often called secondary grief, includes the loss of progress, time, and the future they had envisioned. Counseling provides a safe space to navigate these complex emotions, as the surrogate experiences the physical loss while the IPs experience the genetic and anticipatory loss.
Open and empathetic communication between the IPs and the surrogate is encouraged during the recovery phase, often facilitated by a specialist or mental health professional. This supportive dialogue is paramount for maintaining a healthy relationship moving forward. Psychological recovery is a necessary precursor to any discussion about re-attempting a pregnancy.
Determining the Path Forward
Once the surrogate has been medically cleared and both parties have had time for emotional recovery, the focus shifts to the next steps, guided by the original contract. If the intended parents have remaining embryos and all parties are ready, a second embryo transfer with the same surrogate is often considered. This decision involves renewed medical and psychological consultations to ensure the continued well-being and commitment of everyone involved.
If the parties decide to proceed, the contract may be amended or renewed to outline the terms of the subsequent attempt. Alternatively, if no embryos remain or if either party chooses not to continue the relationship, the match concludes. The intended parents may then opt to pursue a new surrogate match or end their pursuit of parenthood through surrogacy entirely.