A surrogacy journey may begin with intended parents and a gestational carrier, but many experienced professionals work alongside them from matching through delivery and postpartum recovery.
Each person on the surrogacy team has a different role:
- Mental health professionals provide screening and support.
- Fertility specialists manage the medical process surrounding embryo transfer.
- Attorneys protect the legal rights of everyone involved.
- Escrow and insurance professionals help manage financial and coverage needs.
- A surrogacy agency helps bring these pieces together and keeps the journey moving forward.
Understanding who is involved, and when you will work with them, can make the surrogacy process feel much more manageable.
The Intended Parents and Gestational Carrier
At the center of every gestational surrogacy journey are the intended parents and gestational carrier.
Intended parents are building their family through surrogacy and work closely with the agency, clinic, attorneys, and gestational carrier throughout the process. They are responsible for making important decisions about their fertility treatment, participate in the matching process, complete legal agreements, fund the necessary expenses, and prepare for their baby’s arrival.
The gestational carrier is the woman who carries the pregnancy. In gestational surrogacy, she does not have a genetic relationship to the baby. The embryo is created through IVF using eggs and sperm from the intended parents, donors, or a combination of both.
Before moving forward, a gestational carrier completes an in-depth screening process and must be medically cleared to carry a pregnancy. She also receives independent legal counsel and participates in the embryo transfer process, prenatal care, delivery, and postpartum recovery.
Matching should be a mutual decision. Intended parents want to feel comfortable with the woman carrying their baby, and the gestational carrier should also feel confident about the intended parents she chooses to work with.
The Surrogacy Agency
A surrogacy agency serves as one of the main points of coordination throughout the journey.
Before matching, the agency screens gestational carrier applicants and helps intended parents understand the process and prepare for matching. Once a potential match is identified, the agency helps both sides get to know one another and determine whether they are comfortable moving forward together.
After matching, the agency helps coordinate the many professionals involved. This may include communicating with fertility clinics, connecting clients with experienced reproductive attorneys, coordinating escrow setup and insurance reviews, arranging travel, and helping everyone prepare for important milestones.
The agency also provides ongoing support throughout pregnancy, delivery, and postpartum recovery.
An agency does not replace the fertility clinic, attorney, escrow provider, insurance professional, or mental health professional. Instead, its role is to coordinate the many moving pieces, keep everyone connected, and make sure important steps do not get missed along the way.
The Mental Health Professional
Surrogacy involves much more than medical appointments and legal paperwork. Emotional preparation is also an important part of the process.
Mental health professionals with experience in third-party reproduction may evaluate and counsel gestational carriers and intended parents before a journey begins.
These conversations can address expectations about communication, boundaries, pregnancy, delivery, relationships, and life after the journey. Mental health professionals can also provide support if emotional or relationship challenges arise along the way.
The Fertility Clinic
The fertility clinic manages the medical portion of the journey surrounding embryo transfer and early pregnancy.
Once a gestational carrier is matched, the intended parents’ fertility clinic reviews her medical and pregnancy history. The clinic then completes its own medical evaluation before providing final clearance for the IVF process and embryo transfer.
The fertility team also creates the medication protocol used to prepare the gestational carrier’s uterus for transfer, monitors her response to medication, and performs the embryo transfer. If she doesn’t live within traveling distance of the intended parents’ fertility clinic, some monitoring appointments, such as bloodwork and ultrasounds, may be completed at a local monitoring clinic closer to her home. Results are then sent to the intended parents’ fertility clinic, which continues directing her treatment and medication plan.
If pregnancy occurs, the clinic typically performs blood work and early ultrasounds before eventually releasing the gestational carrier to her regular prenatal provider. The exact timing varies by clinic and pregnancy.
The Surrogacy Attorneys
Both intended parents and gestational carriers should have their own attorneys who are experienced in assisted reproductive law.
The intended parents’ attorney typically prepares or reviews the gestational surrogacy agreement. The contract addresses important parts of the journey, including responsibilities, compensation and expenses, medical decisions, insurance, communication, and other agreed-upon terms.
The attorney also helps intended parents complete the appropriate legal parentage process. Depending on the state and circumstances, this may involve a pre-birth order, post-birth process, or other legal steps.
The gestational carrier’s attorney represents her independently. The attorney reviews the proposed agreement with her, explains her rights and responsibilities, answers questions, and negotiates changes when necessary.
A strong surrogacy contract is essential to a successful journey. Because surrogacy laws vary by state, working with attorneys who have experience in assisted reproductive technology and the applicable state laws is especially important.
The Escrow and Insurance Professionals
Surrogacy also involves financial and insurance considerations that require specialized expertise.
An independent escrow provider holds funds for expenses outlined in the surrogacy agreement. Throughout the journey, the escrow company may distribute gestational carrier compensation, reimburse approved expenses, maintain financial records, and provide account information to the parties.
Using an experienced independent escrow provider creates separation between the people involved in the relationship and the person or company managing the money. The Society for Ethics in Egg Donation and Surrogacy, or SEEDS, has established ethical standards for member escrow providers designed around security, transparency, accountability, and client protection.
A surrogacy insurance professional reviews the gestational carrier’s health insurance to determine how it may apply to a surrogate pregnancy and whether exclusions or coverage concerns exist.
Depending on the journey, an insurance professional may also help identify appropriate pregnancy coverage and review other insurance needs, such as life or short-term disability coverage.
The Pregnancy and Delivery Care Team
After the fertility clinic releases the pregnancy, the gestational carrier transitions to the healthcare professionals who will manage her prenatal care.
Her team may include an OB/GYN or certified nurse-midwife, nurses, ultrasound technicians, and other healthcare professionals. If additional monitoring is needed, a maternal-fetal medicine specialist may also become involved.
As delivery approaches, the gestational carrier, intended parents, agency, and hospital team may also work together on a surrogacy birth plan. This can help clarify preferences and expectations for labor, delivery, hospital access, communication, newborn care, and time together after birth. A birth plan cannot predict every medical situation, but it can help everyone feel more prepared before delivery.
At delivery, labor and delivery nurses, physicians, pediatric providers, hospital social workers, and other hospital staff may become part of the team.
One important distinction is that the gestational carrier remains the patient throughout pregnancy, labor, delivery, and postpartum care. She makes decisions about her own medical care in consultation with her healthcare providers, while the intended parents are responsible for decisions about the baby’s medical care.
Why the Right Surrogacy Support Team Matters
There are many moving pieces in a surrogacy journey but having experienced professionals in place helps protect everyone involved, creates clearer expectations, and makes it easier to understand what happens next.
At Shining Light Baby, we help coordinate each stage of the journey while supporting both intended parents and gestational carriers. From matching and medical clearance through legal coordination, pregnancy, delivery, and postpartum support, our team helps connect the right people at the right time.
If you are considering surrogacy, contact Shining Light Baby to learn more about the process and the support available throughout your journey.