Women become surrogates for a mix of deeply personal and practical reasons, but the driving force is overwhelmingly altruistic. Research analyzing surrogates’ own accounts consistently finds that empathy and a desire to help someone else build a family are the primary motivations. The financial compensation, which ranges from $50,000 to $90,000 or more, is meaningful but rarely the sole reason women sign up for what is a physically and emotionally demanding commitment.
The Desire to Help Someone Else
A large-scale analysis of surrogate profiles in the United States, published in the journal Reproductive BioMedicine Online, found that women’s primary motivation for becoming a surrogate is prosocial. Altruism and empathy ranked above all other factors, including financial ones. Many surrogates describe knowing someone who struggled with infertility, or simply feeling that their ability to carry a healthy pregnancy is something they can offer to people who can’t do it themselves.
The intended parents who turn to surrogacy come from a wide range of circumstances. Some have a history of miscarriage or repeated failed embryo transfers. Others have undergone a hysterectomy or gender-affirming surgery. Same-sex male couples and single men rely on surrogates paired with egg donors. Lesbian couples sometimes use reciprocal IVF, where one partner provides the egg and the surrogate (or the other partner) carries the pregnancy. Knowing that you’re the reason a family exists is, for many surrogates, the single most powerful part of the experience.
Financial Compensation
Surrogacy pays well, and there’s no reason to downplay that as a motivation. In 2025, first-time surrogates in the U.S. typically earn between $50,000 and $70,000 in base compensation. Experienced surrogates who have completed at least one successful journey can earn $75,000 to $90,000 or more, depending on location and circumstances.
Beyond the base pay, surrogates receive additional support throughout the process. A typical arrangement includes a monthly allowance of around $250 from the time you sign the contract until eight weeks after delivery, covering everyday pregnancy costs like copays, vitamins, childcare during appointments, and parking. You’ll also receive a maternity clothing allowance, usually $750 for a single pregnancy or $1,000 for multiples. If you need to miss work for medical screenings, the embryo transfer trip, appointments, or post-delivery recovery, lost wages are reimbursed. If bedrest is required at any point, that lost income is covered as well.
All medical expenses related to the surrogacy pregnancy are paid by the intended parents, not by you.
Who Qualifies
Not everyone who wants to become a surrogate will meet the requirements. The American Society for Reproductive Medicine recommends that gestational carriers be of legal age, preferably between 21 and 45. You should have had at least one uncomplicated, full-term pregnancy before applying. There are also upper limits: ideally no more than five total previous deliveries, and no more than three cesarean sections.
Most surrogacy agencies add their own screening criteria on top of these guidelines, including psychological evaluations, background checks, and a stable living situation. The goal is to ensure you’re physically and emotionally prepared for the journey ahead.
What the Medical Process Looks Like
Gestational surrogacy uses IVF, meaning the embryo is created from the intended parents’ (or donors’) egg and sperm and then transferred to you. You are not genetically related to the baby.
The medication phase begins about one to two months before the embryo transfer. During this time, you’ll take hormones to prepare your uterine lining. Estrogen builds the lining, and progesterone mimics early pregnancy conditions so the embryo can implant. Progesterone is often given as injections, vaginal suppositories, or patches, and most surrogates stay on it for many weeks. You may also take a short course of steroids before the transfer to reduce immune activity and encourage implantation, along with a daily baby aspirin as a precaution against blood clots from the elevated hormone levels. Prenatal vitamins, folate, and DHA supplements are standard throughout.
Once pregnancy is confirmed, you’ll continue the hormone medications until about 10 to 12 weeks, when the placenta takes over hormone production. Coming off the medications is a gradual weaning process over several days, not a sudden stop. After that point, the pregnancy proceeds like any other, with regular OB appointments and standard prenatal care.
Legal Protections for Surrogates
Before any medical procedures begin, you and the intended parents will sign a detailed legal agreement. One of the most important protections built into these contracts is your right to make all health and welfare decisions about yourself and your pregnancy. The 2017 Uniform Parentage Act, which many states have adopted, explicitly requires that surrogacy agreements preserve this autonomy. Courts have recognized that a pregnant woman has an absolute constitutional right to make decisions about her pregnancy regardless of genetic parentage, and any contractual promise to the contrary is unenforceable.
The contract also spells out financial terms, health insurance coverage, and liability. If your own health insurance is used for pregnancy-related care, the agreement must disclose any possible liability to you, third-party liens, notice requirements, and anything else that could affect your coverage. The financial reimbursements in the contract are carefully structured as expense coverage, not as payment for relinquishing parental rights, which is an important legal distinction in most states.
You’ll have your own independent attorney, separate from the intended parents’ lawyer, to review the agreement and negotiate on your behalf. This is standard practice, and the intended parents cover the cost of your legal representation.
Emotional Experience and Long-Term Outcomes
One of the biggest concerns women have before becoming a surrogate is whether they’ll struggle emotionally after handing the baby to the intended parents. A review published in the American Journal of Obstetrics and Gynecology found no evidence of substantial adverse psychological outcomes among women who served as gestational carriers. The same review also found no concerning outcomes for the children born through surrogacy.
This doesn’t mean the process is emotionally simple. Pregnancy hormones, the physical demands of carrying a child, and the unique social dynamics of surrogacy all require real emotional resilience. Most agencies provide counseling before, during, and after the journey, and many surrogates describe the post-delivery period as bittersweet but ultimately fulfilling. The relationship you build with the intended parents varies widely. Some surrogates stay in close contact with the family for years. Others have a warm but more limited connection. Both are normal.
Women who pursue surrogacy more than once often cite the emotional reward as the reason they come back. Watching someone become a parent, knowing you made that possible, is a feeling that surrogates consistently describe as unlike anything else in their lives.