Dear Mindful Surrogate: How to Avoid Issues in Surrogacy

Dear Mindful Surrogate,

I have been wanting to be a surrogate for so long. I have done lot’s of research. I know there are many steps in a surrogacy clearance process.  At which points can I be denied or when might issues arise? Anxious about all the pieces fitting together in this crazy puzzle.

Dear Anxious About the Puzzle,

You are right in that this process can be complex with many pieces, we like to call it a “hurry up and wait” process, because usually a few things come together quickly then we wait for the next step, then hurry up to get the next one done. Here are the main places that as a GC you can be denied, and honestly know that most of these things are out of your control ;-). (These steps and the order may vary depending on the agency you are working with; these are based on Pacific Northwest Surrogacy process.) Pacific Northwest Surrogacy clears GCs before matching; below are some of the pieces in that process.

Piece 1: There are some basic qualifications to be a Gestational Carrier, if you fit this description you may want to apply by filling out our Intake Form by clicking here.

·     Have your own children – good pregnancies and deliveries with no complications

·     Under the age of 40 and over the age of 21

·     Not on anti-depressants

·     Financially Stable

·     Not on Medicaid

·     Under 5 births

·     Under 3 C-sections

·     No tobacco or cannabis for the last 12 months

*** There are many disqualifiers, usually based on individual situations, and far too many to list ***

Piece 2: Application – this is more in-depth information to get to know you

Piece 3: Retrieving and Reviewing all medical records – We need all OB and Delivery records from all pregnancies.  Not only do we review these in house but we also have a Reproductive Endocrinologist review them before clearance in granted. THIS is the toughest part, and the hardest to pass.  As a Gestational Carrier, Intended Parents and fertility clinics, want the “best” candidate in order to have the best possible outcome in a usually already difficult story. “Best” means no disqualifiers, with the least amount of complications, and overall good medical, psychological and physical health.

Piece 4: Background Check – this is done for you and any adult living in the household

Piece 5: Psychological evaluation – This is an interview with a psychologist for you (and your partner). You will take the MMPI or PAI.

Piece 6: Personal Interview with a member of Pacific Northwest Surrogacy’s staff - We just want to get to know you and your family more before moving forward in the process. We will also be asking some of the tough questions like your views on termination.

There are a lot of pieces, which is why working with an agency is a huge help. We are here for you and will help you through the process of putting the pieces together. Yes, there is a chance you may be disqualified, but you taking the time to consider this and start the process is self-less and thoughtful! Please contact us if you have any other questions about the process at

Dear Mindful Surrogate,

What are some of the common issues you see in surrogacy?  Wanting to make sure I am aware with hopes of avoiding these? I know there are a lot of variables and it depends on many different things, including IPs and their clinic. Want to be as prepared as possible

Dear Aware,

Common issues are tough, as each situation is so different, and honestly the issues that could occur hopefully are not all that common ;-).  Here are a few issues I have seen:

Cycle Dates -There a lot of parts that need to be in place or done precisely for the transfer to happen. 

The first of which, the legal contract, also known as the Gestational Carrier Agreement, must be in place before injectable medications begin. There are a lot of parts to the legal process and it is possible to miss the deadline date and have to postpone the transfer date. This is the reason some clinics will not even set a transfer calendar until legal is complete.

Medications need to be started and taken following the clinics calendar precisely, or this could postpone transfer. Sometimes the medications don’t work like the clinic wants them to, therefore medications are adjusted and it may end up adjusting the transfer schedule.

Transfer dates do move more often than you might expect, they are not set in stone!

Breach of Contract

There is always a possibility that one of the parties does not abide by the Gestational Carrier Agreement, which can be a huge issue, resulting in moving cycle dates, break of the match or worse.  From my experience people that make it this far and have signed a legal contract want the best and don’t usually intentionally breech the contract.

PBO or Parentage Status

Knowing if the state the baby will be born in will allow for the IP(s) to be named as parents of the child(ren) on the birth certificate and at birth is super important! If this is not done properly it could cause a lot more time, money and heartache even after the child(ren) are born.  Once you know that a state allows parentage status to be given to the IP(s), doing the correct paperwork on time is also equally as important, such as a Pre-Birth Order (PBO) or Post-Birth Parentage Order (PBPO). 

The fact that you are aware and asking these questions is a great way to avoid issues. As an agency we welcome questions, concerns and feedback to also avoid these issues and help you have the smoothest, amongst the inevitable bumps, process as possible. 

Please email us at, fill out our intake form to become a gestational carrier or request a free consultation for intended parents.