Becoming a Surrogate: Requirements, Process & What to Expect
At Over the Rainbow, we believe in the incredible gift you can offer a journey filled with hope, purpose, and connection.
If you’re considering becoming a surrogate, you’re stepping into a remarkable role. In this article, we’ll walk you through the requirements, the process, and what you can expect along the way. Our goal is to provide clear, compassionate guidance so you know what’s ahead and feel confident moving forward.
Why Become a Surrogate?
Becoming a surrogate is a meaningful way to help others grow their family when they’re unable to carry a pregnancy themselves. People may pursue surrogacy for many reasons: medical conditions that make pregnancy risky, same-sex couples wishing to have a biologically related child, single individuals, or anyone for whom carrying a pregnancy isn't possible or safe. A smooth surrogacy journey relies on open communication, professional support, and the right partner agency. Sources like the Yale Fertility Center describe surrogacy as a carefully managed process involving medical, psychological and legal steps. Yale Medicine
At Over the Rainbow, we guide you with warmth, expertise, and full transparency. Whether you’ve just begun thinking about surrogacy or you’re ready to begin the application, we’re here to walk this path with you.
Eligibility & Requirements: Are You a Candidate?
Before diving into the process, you’ll want to make sure you meet common eligibility guidelines for becoming a surrogate. While each clinic or agency may have slight differences, the following represents Over the Rainbow’s requirements.
Medical and health criteria
Between ages 21–40.
At least one prior healthy pregnancy and delivery.
U.S. citizen or permanent resident or green card or Visa holder (that does not expire in the next 2 years.)
Non-smoker, no drug use, stable lifestyle.
Clear medical and psychological history.
Body Mass Index (BMI) within a safe range.
Emotional, psychological & lifestyle criteria
A stable support system at home (partner/family/friends) to help you through the pregnancy and postpartum.
A sincere, thoughtful desire to help others build a family, coupled with realistic expectations.
Residing in a state or region where surrogacy is legal (this can vary by location).
Legal & screening criteria
You’ll undergo thorough medical screening, psychological evaluation, background checks, and you’ll need an independent attorney for the surrogacy agreement. Progyny.
You must be willing to follow the required protocols, including medications, embryo transfers (in gestational surrogacy), prenatal care, and any travel or medical appointments required.
The Surrogacy Process: Step by Step
Here’s a typical sequence of how surrogacy works. Keep in mind: every journey is unique, and Over the Rainbow will help support you and the intended parents every step of the way.
1. Initial Inquiry & Education
You’ll begin by contacting us and getting a clear overview of what surrogacy involves: medical requirements, timing, compensation (if relevant), legal implications, and emotional considerations.
2. Application and Screening
You’ll complete an application and submit health history, pregnancy history, lifestyle details, and consent to begin screening. Screening may include:
Medical evaluations (blood work, ultrasound, physical exam)
Psychological evaluation and counselling
Background check and home environment review
Insurance review (your health insurance may need to be assessed)
3. Matching with Intended Parents
Once approved as a surrogate candidate, you begin the matching process. You’ll be matched with intended parents whose values, communication style, and preferences align with yours. It’s important to establish a relationship you feel comfortable with—they will entrust you with one of life’s greatest gifts.
4. Legal Contract & Medical Preparation
Before any medical procedures begin, a legal agreement (surrogacy contract) must be finalized. This outlines rights, responsibilities, compensation (if applicable), termination conditions, travel, prenatal care, delivery arrangements, and post-birth contact. In some states, a court proceeding may follow the birth to establish parentage.
Medical preparation begins too: Your cycle may be synchronized with the intended mother (or donor) if gestational surrogacy is used. You’ll take medications to prepare your uterus for embryo transfer.
5. Pregnancy & Prenatal Care
Once the embryo transfer is successful, you enter pregnancy. You’ll continue with prenatal care, often in consultation with your fertility clinic and then transitioning to a local obstetrician for the remainder of the pregnancy. You’ll have scheduled check-ups, ultrasounds, and care just as any pregnant person would.
During this time, the relationship between you and the intended parents often deepens. Communication about prenatal milestones, pictures, visits (if agreed upon) often happens.
6. Delivery & Post-Birth
On birth day, you’ll head to the hospital or birthing center arranged in agreement with the intended parents. After delivery, the transfer of parentage occurs according to your contract and applicable state laws. You may remain in contact, or choose limited communication, whatever was agreed upon. It’s an emotional time for everyone involved.
7. Closure & Aftercare
Some agencies offer post-surrogacy support, debriefing, and emotional counselling for you. You’ll have the satisfaction of knowing you’ve given a precious gift. Over the Rainbow supports our surrogates with resources and community during and after the journey.
What to Expect: Emotions, Health & Practicalities
Emotional considerations
Surrogacy may bring a profound sense of meaning and connection. Knowing you are helping someone experience parenthood is powerful.
At the same time, it’s normal to experience a mix of emotions—joy, pride, anxiety, and even some grief when you hand the baby to the intended parents. Talking openly with your support system and counselors helps.
Communication with the intended parents about expectations during pregnancy and post-birth is crucial for emotional clarity.
Health considerations
Pregnancy via surrogacy is very similar to any pregnancy medically, with the addition of extra coordination and monitoring.
You’ll need to follow medical instructions carefully: medications, lifestyle restrictions (e.g., avoiding smoking, alcohol), attending appointments. Many clinics exclude surrogates with risky health conditions, uncontrolled chronic disease, or a high BMI because these increase risks.
Because you are providing a vital service, agencies often provide extra support: case managers, 24/7 contact, and psychological counseling.
Time and commitment
The full process, from application through to delivery, typically spans 12 to 18 months. Every phase (screening, matching, cycle start, pregnancy) takes time.
You may need to travel for certain medical steps or for the delivery, depending on location and match circumstances.
You’ll need to maintain open communication, medical appointment attendance, and follow agreed behaviours throughout.
Practical matters
Compensation: Many agencies provide a compensation package for surrogates, especially when the arrangement is compensated. Even if altruistic, most surrogates receive expense reimbursement (medical, travel, maternity clothing) and additional benefits. Surrogacy compensation typically ranges between $40,000-$100,00.
Insurance: You’ll need to understand how your health insurance treats surrogacy pregnancies (some policies exclude maternity for gestational carriers). Agencies often review this carefully.
Legal contracts: Every surrogacy arrangement should have clean, clear contracts reviewed by independent attorneys for both you and the intended parents. Laws vary by state so it’s important your agency ensures legal compliance.
Aftercare: Some agencies include postpartum support, counselling and community for surrogates, because it’s a major life event for you too.
Working with Over the Rainbow
At Over the Rainbow, our mission is to ensure that every surrogate feels supported, respected, and fully informed from start to finish. Here’s how we stand out:
A warm, experienced team dedicated to your journey—not just clinically, but emotionally
Thorough screening and matching processes to find the right fit for you and the intended parents
Clear contract guidance, legal connectivity, and advocacy so you know your rights and responsibilities
Ongoing support during the pregnancy, delivery, and post-birth phase
Transparent communication about time commitments, health logistics, compensation (if applicable), and next steps
If you’re ready to explore becoming a surrogate or simply want to ask questions and learn more please reach out to us at Over the Rainbow. Schedule a no-obligation consultation and we’ll walk with you step-by-step.
FAQs: Frequently Asked Questions
Q: What is the difference between gestational surrogacy and traditional surrogacy?
A: In gestational surrogacy, the surrogate carries an embryo created via IVF from the intended parents’ egg/sperm (or donors). She is not genetically related to the baby. In traditional surrogacy, the surrogate uses her own egg and is genetically linked to the child. Most programs use gestational surrogacy because of reduced legal/ethical complexity.
Q: How soon can I become a surrogate after my own delivery?
A: It depends on your prior delivery method and your health status. Many agencies recommend waiting at least 6 months after a vaginal delivery or 12 months after a C-section, but you may already begin initial screening before that time.
Q: Do I need to live in a certain state to become a surrogate?
A: Yes—legal regulations vary significantly from state to state. Some states have very favorable laws, others more restrictive. Your agency will guide you through your state’s surrogacy-friendly laws and ensure compliance.
Q: What happens if the embryo transfer is unsuccessful or there’s a miscarriage?
A: Outcomes vary. Your contract should clearly outline how such situations are handled—including whether the intended parents and you might attempt another transfer and how compensation or reimbursement is handled. It’s important to discuss this in advance.
Q: Will I stay in contact with the intended parents after birth?
A: That depends on your mutual agreement. Some surrogates and intended parents maintain contact via updates and cards; others prefer minimal communication. This should be discussed and clearly covered in the contract ahead of time.
Ready to Start Your Journey?
Becoming a surrogate is one of the most generous, life-changing decisions you can make. It takes heart, preparation, and commitment—but the gift you provide is immeasurable. At Over the Rainbow, we deeply value every surrogate and are devoted to providing resources, guidance, and support every step of the way.