Being a Surrogate for a Friend

Being a surrogate for a friend or family member is a special act of generosity, but that gift comes with a price tag. There are costs of being pregnant and of being a surrogate specifically — and these you may often pay from your own pocket. Be certain to address all these costs and ask the parents to reimburse you for all of these expenses.

The total cost of being a surrogate depends on your personal situation. Here’s a summary:

The Hidden Costs

Does your current medical insurance cover a surrogate pregnancy?

Not all insurance policies cover maternity care. Those that do often exclude surrogacy pregnancies. If your insurance will cover a surrogate pregnancy, then that’s a good start. But it’s more complicated.

The typical insurance will cover all of the prenatal care, including office visits, ultrasound exams, and (eventually) the delivery. Complications and non-standard treatments may be extra, usually with a hefty deductible or co-payment.

Most insurance policies will include some co-payment or deductible. The amount you (or your friend) will have to pay depends on the policy. Some policies ask you to pay a co-payment of $25 to $50 for each prenatal visit to your obstetrician. Others have a deductible and won’t pay anything until you have paid at least $5000 out of your own pocket. To understand the total costs, you should talk with the insurance provider.

Obviously the Intended Parents should pay any deductible or co-payment. In the commercial surrogacy world, it’s common for the Intended Parents to pay for the surrogate’s health insurance premiums while she is pregnant (since they are the ones taking advantage of that service). The Intended Parents should offer to pay the full insurance premiums, but if your insurance also covers your entire family (and a lot of non-pregnancy treatments) then you may agree to pay a portion of the costs. Even if you would pay for the insurance premium anyway, the parents should still chip in given the effort your are making for them — perhaps to pay just half the insurance premiums.

You also need to find an obstetrician to care you during the pregnancy. Maybe your current OBGYN can manage this, or she may refer you to a good obstetrician if she can’t. The chosen obstetrician should have treatment privileges at a local hospital –and that is probably where you will deliver the baby. Check with both the doctor and the hospital if they will accept the health insurance. If not, you may need to find another doctor or hospital. There’s a full discussion about the surrogate’s compensation and benefits in the Surrogacy Guide.

What other surrogacy costs will you encounter?

Other than the prenatal care and delivery, there are some additional expenses you should be aware of. Most official surrogacy contracts will include these fees as “out of pocket” expenses. They include:

• Maternity clothes. Yep, none of your clothes are going to fit after the first trimester of pregnancy. Plan on a whole new wardrobe of comfortable and practical clothes. This is usually about $500 in a typical contract.
• Medications. This can be $2,000 to $4,000 in injections to prepare your uterus for the embryo transfer. After the transfer, there are vitamins and hormone supplements, which can cost $500 or more.
• If you get sick during the pregnancy, the doctor may recommend bed rest. That means you may be out several days of salary from your job — which can be a big blow to the family budget. That’s why most surrogacy contracts include payments for Loss of Work. This benefit can cost thousands of dollars depending on your current wages and how long you are under bed rest.
• If you are married and your husband needs to stay home and look after you, then his lost wages are an additional expense as well. Most surrogacy contracts limit Loss of Wages to just a few weeks of lost work, or alternatively a simple maximum amount to be paid (about $5,000 is a typical number).
• Alternatively, if the doctor recommends bed rest, the Intended Parents can chip in for a weekly housekeeper to do the household chores you now can’t. Consider a few hundred dollars for that. (And be sure to add daycare or babysitting charges as well).
• Bed rest can also be prescribed after the delivery as well (especially if the baby arrives via a C-section). You may be unable to work for 2 to 3 weeks if the pregnancy is difficult.
• Depending on where the obstetrician is, you may have significant travel expenses. (The Intended Parents should reimburse for travel expenses for gas and mileage.)

Negotiated fees in the surrogacy agreement

If you’re lucky enough to be friends with the Intended Parents, you can discuss these possible costs in a friendly conversation. But the final recommendation is the most important… It’s critical that all these agreements are written down so that there is no confusion or misunderstanding during the pregnancy.

Regardless of the personal relationship between the Surrogate and the Intended Parents, every journey should start with a legal, signed Surrogacy Agreement.

The Surrogacy Agreement should make clear what will be your future relationship to the child. You won’t be the legal mother, but will the baby know the role you played in its birth? Will you be the “Cool Aunt” or just a friend of the family? Will you get to visit the child regularly? What are the limits? What if the family moves away, can you still come visit?

The Surrogacy Agreement will also manage expectations about the pregnancy itself. Will the Intended Parents insist that you changes your diet (no more tuna sandwiches or packaged lunch meats!)? Will they object if you travel on an airplane during the final trimester? What if you want to vacation in Mexico or the Florida Keys where Zika mosquitoes still persist? Will you be comfortable with both parents in the delivery room… with a camera? Will your friends want you to breastfeed (which can be very problematic, by the way).

A Surrogacy Agreement is a bit like a prenuptial agreement — nobody thinks it will be necessary, and in most cases it may not be. But if it becomes necessary, it is REALLY necessary! The Agreement forces everyone to put all of their expectations out on the table. It protects against misunderstandings that can devastate a friendship. There are many examples of entire families torn apart over the very emotional topic of a baby. It would be a shame to see such an act of love and generosity have such a painful final result.

It’s always better to be safe than sorry