If you are wondering how to become a surrogate mother in the United States, the short version is that you must meet strict medical and personal screening standards, pass psychological and legal reviews, get matched with intended parents, and then carry a pregnancy created through IVF. It is a demanding commitment that usually lasts well over a year from application to recovery after birth, but it is also a path that many women describe as deeply meaningful, and it comes with financial compensation. This guide walks through who qualifies, the full step-by-step process, what surrogates are typically paid, how state laws differ, and the risks you should weigh before you apply.
What a Surrogate Mother Actually Does
A surrogate, sometimes called a gestational carrier, carries a baby for intended parents who cannot or choose not to carry a pregnancy themselves. In modern gestational surrogacy, the embryo is created through in vitro fertilization (IVF) using the intended parents’ egg and sperm or those of donors, then transferred into the surrogate’s uterus. This means the surrogate has no genetic link to the baby. Traditional surrogacy, where the surrogate’s own egg is used, is far less common today because it carries more legal and emotional complexity, and most agencies and clinics work only with gestational surrogacy.
Important: A surrogate is not giving up her own child. Intended parents are the legal parents, and the legal steps that confirm this are handled through a contract and, in most states, a parentage order.
Requirements to Become a Surrogate Mother
Requirements are shaped by guidance from the American Society for Reproductive Medicine (ASRM) and by the fertility clinics that perform the embryo transfer, so they are fairly similar across agencies, although the exact limits vary. The table below shows the most common standards.
| Requirement | Typical standard |
|---|---|
| Age | At least 21, with upper limits that commonly fall between about 40 and 44 depending on the agency and clinic |
| Body mass index (BMI) | Usually under about 32 to 33, though some programs use a slightly different cutoff |
| Pregnancy history | At least one prior healthy, full-term pregnancy and delivery, documented by medical records |
| Birth limits | ASRM-based guidance is typically no more than five vaginal births or three C-sections |
| Lifestyle | Nonsmoker, no drug use, and willingness to follow medical and dietary instructions |
| Stability | Stable home life, reliable transportation, a support system, and financial stability |
| Location | Live in the United States, often in a surrogacy-friendly state |
These standards exist for health reasons. Age and BMI are linked to higher risk of complications such as gestational diabetes and high blood pressure disorders, and BMI also affects how your body responds to the IVF medications. Agencies also run background checks and review your medical records, and some will decline applicants with certain histories, such as complications in earlier pregnancies. Being turned down by one agency does not always mean you are ineligible everywhere, since criteria differ, but the medical standards set by clinics are usually firm.
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Tip: Having had healthy pregnancies of your own does not remove the BMI and age rules. Clinics apply them because an IVF pregnancy is managed differently from a natural one.
How to Become a Surrogate Mother: Step by Step
Most journeys follow the same order. From application to the postpartum period, one large agency reports an average of 16 to 18 months, and other sources describe a range of roughly 12 to 24 months depending on matching and medical timing.
| Step | What happens |
|---|---|
| 1. Research and decide | Learn about the commitment, talk with your partner and family, and check your state’s laws |
| 2. Choose an agency or go independent | Agencies handle screening, matching, case management, and legal referrals, while independent surrogacy has more risk if steps are missed |
| 3. Apply | Submit an application with basic health, pregnancy, and lifestyle details |
| 4. Medical and psychological screening | Records review, testing at a fertility clinic, and a mental health evaluation that checks your motivations and understanding of the risks |
| 5. Matching | You review intended parents’ profiles, meet, and both sides agree to move forward |
| 6. Legal contract | You and the intended parents each hire separate attorneys to finalize the agreement |
| 7. Medications and embryo transfer | Hormone medication prepares your uterus, then a frozen embryo is transferred at the clinic |
| 8. Pregnancy, birth, and recovery | Regular monitoring appointments, delivery, and legal finalization of parentage |
The screening stage is thorough because everyone involved needs to be protected. Both the surrogate and the intended parents complete psychological evaluations, and each side is represented by independent legal counsel. The contract commonly covers compensation, medical decisions, expense coverage through an escrow account, communication expectations, and what happens if a transfer fails or the pregnancy ends early. After transfer, a pregnancy test is typically done about two weeks later, and if it is negative, another embryo transfer may be attempted depending on the contract and clinic.
Agency or Independent Surrogacy?
An agency is the more common route for first-time surrogates because it provides vetting, matching, legal coordination, and emotional support, and it manages payments through escrow. Independent or self-matched surrogacy can lower costs for intended parents, but it puts more responsibility on you to confirm that medical screening, psychological evaluation, insurance review, and legal work are all done properly. If you go independent, hiring your own surrogacy attorney is essential. Whichever route you choose, ask what the fees include, how matching works, what support you get during pregnancy, and how disputes are handled.
How Much Do Surrogate Mothers Get Paid?
Compensation varies by agency, state, and experience, and figures published by agencies are not guarantees. One large agency reports base pay of roughly $55,000 to $65,000 or more for first-time surrogates and $70,000 to $90,000 or more for experienced surrogates, with total packages often reaching $70,000 to $110,000 or more once bonuses, allowances, and reimbursements are included. Other sources describe lower averages, in the range of $40,000 to $60,000, so always request a written breakdown before you commit.
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Base pay is typically paid in monthly installments after pregnancy is confirmed. For example, a $65,000 base paid over ten months comes to $6,500 a month. On top of base pay, intended parents usually cover medical costs, insurance, legal fees, travel, lost wages, and other allowances. States with higher living costs and strong surrogacy laws, such as California, New York, and Illinois, tend to offer higher compensation. Ask a tax professional how surrogate income will be treated for you.
Surrogacy Laws: Why Your State Matters
No federal law governs surrogacy, so each state decides whether contracts are enforceable and how parentage is established. Most states allow compensated gestational surrogacy, and about 15 offer especially clear legal protections. Michigan changed course recently: the Michigan Family Protection Act, signed in April 2024, repealed the criminal ban on paid surrogacy and took effect on April 1, 2025. Louisiana is generally described as the most restrictive state for compensated surrogacy, while in Nebraska a surrogacy contract is void and unenforceable even though parentage orders may still be issued. Laws change, so confirm current rules with a reproductive attorney in your state before you sign anything.
Important: Never start medications or a transfer before the legal contract is signed and your own attorney has reviewed it.
Risks and Realities to Consider
Surrogacy carries the same medical risks as any pregnancy, including nausea, back pain, high blood pressure, gestational diabetes, preterm labor, and the possibility of a C-section, and recovery takes time. IVF adds hormone injections and frequent clinic visits, and some studies suggest higher rates of certain complications in IVF pregnancies. The time commitment is large: a transfer can mean a trip of several days, and monitoring appointments continue throughout pregnancy. Your partner and children are affected too, so most agencies expect a strong support system. Emotionally, you may feel pride and closeness with the intended parents, and you may also feel a letdown after birth, which is why counseling and a clear postpartum plan matter.
Is Becoming a Surrogate Right for You?
Good candidates tend to be healthy, financially steady, finished with their own family planning, and motivated by more than money. If your reasons are mainly financial, consider whether you are comfortable with the physical demands and the contract limits on your choices. Talk with your doctor, speak with experienced surrogates, and take your time with the psychological evaluation, since it is meant to help you decide as much as to screen you.
Can I be a surrogate if I have never had a baby?
Generally no. Agencies and clinics require at least one prior healthy, full-term pregnancy so they know how your body handles pregnancy.
How long does it take to become a surrogate?
One agency reports an average of 16 to 18 months from application to postpartum, and other sources say 12 to 24 months, depending on matching and medical readiness.
Does it cost me anything to be a surrogate?
In a standard compensated arrangement, intended parents cover medical expenses, insurance, legal fees, and other agreed costs, and you receive compensation. Confirm exactly what is covered in your contract.
Is paid surrogacy legal in every state?
No. Most states allow it, but Louisiana and Nebraska are notable for restrictions or unenforceable contracts, so check your state’s current law with an attorney.
This article is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for advice about your individual health.
