Top 15 Tips For Surrogate Mothers Who Want a Healthy Pregnancy

Surrogacy is a big commitment, and it can feel very personal—even when you’re “just” carrying for someone else. Many surrogates feel proud and excited, then get hit with the less-talked-about parts: hormones, extra appointments, body changes, and days that feel isolating.

That’s why this guide focuses on healthy pregnancy tips for surrogates that actually match real life. We’ll talk about the practical stuff that helps you stay steady: how to prep your body before transfer, how to support your mental health, what to watch for with common pregnancy complications, and how to build support that feels genuine.

If you’re looking for tips for surrogates for a healthy pregnancy, you’re in the right place. These healthy surrogate pregnancy tips are meant to help you feel more confident and cared for—step by step—through prep, pregnancy, delivery, and recovery.

Key Takeaways

• Surrogacy can be emotionally demanding. Hormones, uncertainty, and the long timeline can weigh on you, so mental health support matters from the start.
• Your legal contract protects everyone. A lawyer experienced in surrogacy should outline decisions, expectations, and support, before meds or transfer begin.
• Support should feel real. Lean on people who will show up consistently, not just comment in a group chat.
• Healthy routines work best when they’re realistic. Nutrition, sleep, movement, appointment planning, and postpartum prep all add up across the months.

Your Pre-Pregnancy Preparation

Before the first injection or embryo transfer, the most important work begins. A successful and healthy surrogacy journey is built on a strong foundation of mental, legal, and emotional preparedness.

Taking the time to get these pieces right will protect you and set the stage for a positive experience.

1.  Decide Between Agency vs. Independent Surrogacy

With “so many to choose from and real information past the internet,” selecting the right path can feel overwhelming. Each option has distinct advantages and considerations:

Surrogacy Agency:

• Pros: They handle matching you with Intended Parents (IPs), guide you through the legal and medical process, and often provide a case manager and support groups.
• Cons: Can feel less flexible or offer less freedom in decision-making.

Independent Surrogacy:

• Pros: More direct control and communication with the IPs.
• Cons: You are responsible for finding IPs, navigating legal contracts, and coordinating medical care, which can increase risks.

Also, keep in mind that while agencies provide structure, independent arrangements offer more freedom but with added responsibilities.

2. Secure Your Legal Protection

A comprehensive surrogacy contract is non-negotiable. A well-written contract clarifies that the surrogate has surrendered all parental rights and protects everyone involved.

Key Legal Clauses to Understand:

• Governing Law Provisions: Specifies which state’s laws apply, as surrogacy laws vary significantly across the U.S.
• Parental Rights: Clearly establishes the IPs as the legal parents from birth.
• Compensation & Contingencies: Outlines the “comp plan” and what happens in difficult scenarios like miscarriage or stillbirth.

Pro-tip: Always work with a lawyer who specializes in third-party reproduction, whether provided by your agency or hired independently. This specialized legal expertise is crucial for navigating the complex legal landscape of surrogacy.

3. Understand the Types of Surrogacy

The type of surrogacy you choose determines your genetic relationship to the child:

Gestational Surrogacy:

• You have no genetic connection to the child. The embryo is created using an egg from the intended mother or a donor and sperm from the intended father or a donor.
• This is the most common type of surrogacy today, accounting for approximately 95% of all surrogacy arrangements in the United States.

Traditional Surrogacy:

• You are the biological mother of the child, as your own egg is used.
• This is less common due to the complex legal and emotional implications.

According to a study published in the Journal of Women’s Health, gestational surrogacy has become the standard practice, with traditional surrogacy declining significantly since the early 2000s.

Preparing Your Body: The Medical Journey to Pregnancy

Once your legal and logistical framework is in place, the focus shifts to preparing your body for the incredible task of carrying a child. This medical phase can be demanding, but understanding each step can help demystify the process and reduce anxiety.

4. The Initial Medical Screening

Before embarking on your surrogacy journey, comprehensive medical screenings ensure you’re physically ready for the demands of pregnancy.

Purpose: To confirm you’re in optimal health to carry a pregnancy safely for both yourself and the baby.

What to Expect: The process begins with comprehensive blood draws to check hormone levels and screen for infectious diseases. While there may be minimal discomfort, these tests are essential for establishing your baseline health.

The American Society for Reproductive Medicine (ASRM) recommends that all surrogates undergo thorough screening, including:

• Complete medical history
• Physical examination
• Blood tests for infectious diseases (HIV, hepatitis, etc.)
• Psychological evaluation
• Uterine cavity assessment

5. Learn About Hormone Treatments

Many surrogates consider this the most physically challenging part of the pre-pregnancy process.

• Purpose of Injections: You’ll take a series of hormone and fertility medications (often injections) over several weeks. These medications help synchronize your cycle with the egg donor’s (or intended mother’s) cycle and prepare your uterine lining to receive the embryo.

Common Medications Include:

• Lupron: Suppresses ovulation
• Estrogen: Builds the uterine lining
• Progesterone: Supports early pregnancy

Research published in Fertility and Sterility indicates that proper hormone preparation significantly increases successful embryo implantation rates, with optimal progesterone levels being particularly crucial.

Coping with Side Effects: Hormone fluctuations can cause mood swings, headaches, bloating, and fatigue. Creating a calendar to track medications and symptoms can help you feel more in control during this phase.

6. The Embryo Transfer and Confirmation

After weeks of preparation, this moment marks the official beginning of your surrogate pregnancy journey.

The Big Day (Implantation): The embryo transfer procedure itself is quick, often taking about 5 minutes. Intended Parents are typically present for this milestone, making it an emotionally significant experience for everyone involved.

What to Expect:

• Light sedation or no sedation at all
• A speculum inserted similar to a pap smear
• A thin catheter used to place the embryo in your uterus
• Brief rest after the procedure

The Wait: After about nine days, you will have blood tests (checking Beta hCG levels) to confirm the pregnancy. This waiting period can be emotionally challenging, as your hopes and those of the IPs rest on the outcome.

Success Rates: According to the CDC’s latest ART Success Rates Report, gestational carrier cycles have success rates of approximately 50-60% per embryo transfer, higher than standard IVF cycles due to the careful screening of surrogates.

Nurturing a Healthy Pregnancy: A Holistic Approach

You’re pregnant! This is a monumental milestone. Now, the focus shifts to nurturing a healthy environment for the baby to grow, which means taking care of yourself—body and mind.

A healthy surrogate pregnancy is about more than just check-ups; it’s a holistic commitment to your well-being.

7. Prioritize Your Nutrition and Hydration

What you eat directly impacts the developing baby and your own health throughout the pregnancy.

• Balanced Diet: Focus on whole foods: lean proteins, fresh fruits, and vegetables. The American College of Obstetricians and Gynecologists (ACOG) recommends an additional 340 calories per day in the second trimester and 450 calories in the third trimester.
• Food Safety: Be diligent about avoiding foods that pose a risk during pregnancy:
  • Unpasteurized dairy products
  • Raw or undercooked meat, eggs, and seafood
  • Fish high in mercury (shark, swordfish, king mackerel)
  • Deli meats and hot dogs unless heated to steaming hot
• Hydration is Key: Dehydration can lead to premature labor. Research published in the Journal of Perinatal Education shows that proper hydration helps prevent preterm contractions. Aim for 8-10 glasses of water daily.
• Prenatal Vitamins: Start taking them before the embryo transfer and continue throughout the pregnancy. Folic acid (400-800 mcg daily) is particularly important for preventing neural tube defects, according to the CDC.

8. Stay Active Safely

Regular, appropriate exercise benefits both you and the baby you’re carrying.

Your Legal Obligation: As a surrogate, maintaining physical health is not just a personal choice but part of your commitment to the health of the baby and your agreement with the IPs.

Recommended Exercises: The American Pregnancy Association suggests low-impact activities for 30 minutes a day:

• Walking
• Swimming
• Stretching & Prenatal Yoga
• Stationary cycling

Benefits: Regular exercise can:

• Reduce back pain
• Decrease the risk of gestational diabetes
• Boost your mood and energy levels
• Improve sleep quality
• Help prepare your body for labor

Exercise Precautions: Avoid activities with a high risk of falling or abdominal trauma. Always consult with your healthcare provider before starting or continuing any exercise regimen during your surrogate pregnancy.

9. Get Enough Rest

Quality sleep is critical during pregnancy but can become increasingly challenging as the pregnancy progresses.

Sleep is Essential: Aim for at least eight hours of sleep per night. A National Sleep Foundation study found that poor sleep during pregnancy is associated with longer labors and increased rates of C-section deliveries.

Practical Tips:

• After the first trimester, switch to side sleeping (preferably left side). This improves blood flow to the baby and can be more comfortable.
• Use pregnancy pillows for support
• Establish a consistent bedtime routine
• Limit fluid intake before bed to reduce nighttime bathroom trips

10. Build Your Authentic Emotional Support System

Many surrogates report feeling isolated or finding “other surrogates I’ve met through my agency support groups to be super fake.” This highlights the crucial need for genuine emotional connections.

• Seek Genuine Connections:
  • Look for private, vetted online communities or forums where honest conversations are encouraged
  • Find platforms that offer moderated spaces for authentic discussion
  • Consider one-on-one connections with experienced surrogates rather than only relying on group settings
• Professional Support: Your agency-provided case manager or a professional social worker can be an invaluable, unbiased resource. Research published in Fertility and Sterility found that surrogates who received specialized counseling reported better emotional outcomes throughout their journey.
• Manage Stress: Use techniques like journaling, meditation, or deep breathing. The American Psychological Association notes that chronic stress during pregnancy can impact both maternal and fetal health.
• Lean on Your Core Circle: It’s okay to lean on your partner, friends, and family for support with pregnancy symptoms, rather than the IPs. Having clear boundaries can help maintain healthy relationships with all parties involved.

Navigating Milestones and Unexpected Challenges

A surrogate pregnancy is a journey of milestones, from the first heartbeat to the final weeks.

But sometimes, the path includes unexpected turns. Knowing what to expect during key appointments and how to prepare for potential complications can empower you to handle whatever comes your way.

11. Embrace the Check-ups and Ultrasounds

Surrogate pregnancies typically involve more medical monitoring than traditional pregnancies.

Increased Prenatal Care: Expect more frequent appointments than in a typical pregnancy, especially in the first trimester when monitoring is crucial for confirming a healthy start.

Involving the IPs: Invite the Intended Parents to regular check-ups and especially to ultrasound appointments. This helps them bond with the baby and is a critical part of their journey.

Key Ultrasounds:

• First Ultrasound: Between 4-6 weeks post-transfer to confirm the heartbeat. This is often an emotional milestone for the IPs.
• Anatomy Scan: Around 20 weeks, this detailed ultrasound checks the baby’s development and can often determine gender if the IPs wish to know.

Sharing Results: Discuss with your IPs beforehand how they prefer to receive updates and test results. Some want to be present for everything, while others might prefer a phone call or text immediately after appointments.

12. When Complications Arise: A Word on GD and SCH

Even with perfect preparation, complications can occur. As one surrogate shared, “At 28 weeks I was diagnosed with gestational diabetes and it came as a huge shock.” Unexpected diagnoses can be terrifying and isolating.

Gestational Diabetes (GD):

• Affects 2-10% of pregnancies annually in the U.S., according to the CDC
• Can occur even without risk factors or family history
• Managed through diet, exercise, and sometimes insulin
• Close monitoring helps prevent complications like delivering a larger baby

Subchorionic Hematoma (SCH):

• Appears as bleeding between the uterine wall and the placenta
• Can cause “huge hemorrhages and non-stop bleeding” as experienced by some surrogates
• A study in the Journal of Ultrasound in Medicine found that while SCH can be frightening, most pregnancies with this condition result in healthy births when properly monitored

What to Do:

• Trust Your Medical Team: Your doctors have protocols to manage these conditions and ensure the best possible outcome.
• Control What You Can: If diagnosed with GD, focus on the dietary and exercise plan your doctor provides. A study in Diabetes Care found that strict adherence to medical guidelines significantly reduces risks for both surrogate and baby.
• Find Specific Support: Seek out support groups for pregnant women dealing with these specific conditions. Hearing from others who truly understand can make all the difference.

13. Creating a Collaborative Birth Plan

Many surrogates express confusion about “how to feel about my birth plan or what things are appropriate.” This uncertainty is completely normal.

A Team Effort: The birth plan is a collaborative document between you, the IPs, and your medical team, facilitated by your agency.

Key Discussion Points:

• Who will be in the delivery room?
• What are your preferences for pain management?
• Plans for skin-to-skin contact (usually with the IPs immediately after birth)
• Post-delivery contact and communication preferences

Communication is Key: The American College of Obstetricians and Gynecologists recommends discussing all aspects of your birth plan with your healthcare provider by the beginning of your third trimester.

Be Flexible: Remember that birth plans may need to change based on medical necessities. Having contingency discussions in advance can help everyone feel prepared for various scenarios.

The Fourth Trimester: Postpartum Care for You

The delivery is not the end of your journey. The postpartum period, often called the “fourth trimester,” is a critical time of physical recovery and profound emotional transition. Prioritizing your own care during this phase is not selfish; it’s essential.

14. Understand and Prepare for Postpartum Depression (PPD)

The emotional complexity of recovering from birth while also experiencing the transfer of the baby to the IPs creates unique challenges for surrogates.

Know the Statistics: It’s not just you. 10-20% of all women experience postpartum depression, and surrogates are not immune. It is primarily caused by massive hormonal shifts after delivery. According to research published in Fertility and Sterility, surrogates may face distinctive emotional responses following birth.

Symptoms to Watch For:

• Persistent sadness or emptiness
• Loss of interest in activities you usually enjoy
• Extreme fatigue or energy loss
• Feeling worthless or excessively guilty
• Thoughts of harm to yourself

Emotional Complexity: The Journal of Women’s Health notes that surrogates face the unique situation of physical postpartum recovery without the presence of a baby, which can create complex emotional responses.

15. Actionable Steps for a Healthy Postpartum Recovery

• Set Realistic Expectations: The American College of Obstetricians and Gynecologists recommends giving your body at least six weeks to heal from childbirth. For emotional recovery, be patient with yourself and recognize that processing your surrogacy experience may take longer.
• Do Not Isolate Yourself: Surround yourself with your primary support system—family and friends. Research in the Journal of Affective Disorders found that social support is one of the strongest protective factors against postpartum depression.
• Talk to Other Surrogates: Connect with experienced surrogates who can share their honest postpartum stories. They are the ones who will truly understand the unique emotional landscape you’re navigating.
• Seek Professional Help: If you are struggling, reach out to your agency counselor or a therapist who specializes in postpartum and/or third-party reproduction. Early intervention for postpartum depression leads to faster recovery, according to the National Institute of Mental Health.

Your Incredible Gift

Surrogacy is a unique path, filled with immense joy and real challenges. By preparing legally, physically, and emotionally—and by building an authentic support system—you can navigate this journey with strength and health.

Remember the incredible gift you are giving. Your health and well-being are paramount to this process. Cherish the experience, be kind to yourself, and never hesitate to ask for the support you deserve.

Frequently Asked Questions

What is the hardest part of being a surrogate?

The hardest part of being a surrogate often involves the emotional journey and the physical demands of the medical treatments before pregnancy. Many surrogates find the series of hormone injections required to prepare the body for embryo transfer to be physically and emotionally taxing due to side effects like mood swings and fatigue. Additionally, navigating the emotional complexities, such as managing relationships with the intended parents and finding authentic support, can be challenging. Postpartum recovery also presents a unique emotional landscape as you heal from childbirth without a baby to care for.

How much control does a surrogate have during the pregnancy?

A surrogate has significant control over her own body and daily life, but key pregnancy decisions are made collaboratively with the intended parents as outlined in the legal contract. Your surrogacy agreement will detail decision-making processes for medical care, diet, and travel. While you make day-to-day choices about your health and well-being, major decisions are shared. The birth plan is a prime example of collaboration, where your preferences for labor and delivery are discussed and agreed upon with the intended parents and medical team.

What happens if a surrogate gets attached to the baby?

It is natural for a surrogate to form a bond with the baby she carries; however, the legal and psychological frameworks in place are designed to manage these emotions and ensure a clear understanding of parental rights from the start. The comprehensive legal contract you sign before the journey begins clearly establishes that the intended parents are the legal parents. Furthermore, psychological screening and ongoing counseling are crucial parts of the process that help you process the unique emotions of carrying a child for someone else, focusing on the joy of giving a gift rather than a sense of loss.

Why are there so many medical appointments and injections for a surrogate?

The extensive medical treatments and appointments are necessary to carefully synchronize your body with the embryo’s needs and maximize the chances of a successful, healthy pregnancy. Unlike a spontaneous pregnancy, a surrogate pregnancy is medically orchestrated. Hormone injections prepare your uterine lining to accept the embryo, and frequent appointments in the first trimester are crucial for monitoring hormone levels, confirming the pregnancy is viable, and ensuring the health of both you and the baby.

What are the main legal protections for a surrogate mother?

The primary legal protection for a surrogate is a comprehensive, well-drafted surrogacy contract reviewed by your own independent legal counsel. This legally binding agreement protects you by clearly defining all aspects of the journey. It outlines your compensation, covers contingencies like miscarriage, clarifies parental rights to ensure the intended parents are the legal parents from birth, and specifies which state’s laws govern the agreement. This ensures all parties understand their rights and responsibilities before the pregnancy begins.

How can I find authentic support from other surrogates?

Finding authentic support involves looking beyond agency-provided groups and seeking out private, vetted online communities or one-on-one connections with experienced surrogates. Many surrogates report that larger, agency-run groups can sometimes feel superficial. To find genuine connections, consider moderated forums where honest and open conversations are the norm. Connecting with a surrogate who has completed a journey can provide invaluable, real-world insight and empathy that is hard to find elsewhere.

Surrogacy is a profound journey, and you don’t have to navigate it alone. If you’re seeking guidance or have questions, Physician’s Surrogacy is here to listen and provide support. Talk to us for a confidential conversation about your path forward!

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