Surrogacy in the United States

The U.S. is the international gold standard for surrogacy, and has the most advanced IVF clinics worldwide. The U.S. is expensive, but the higher price tag comes with many conveniences and assurances.

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The SENSIBLE Surrogacy Agency typically recommends surrogacy programs in the United States for couples with the available resources. Success rates among U.S. IVF clinics are the best worldwide. Birth certificates are automatically issued with the name of the intended parents, and children born via surrogacy agreements in the U.S. are entitled to American citizenship.

Local American surrogates are the product of the world’s most advanced medical system. The World Health Organization ranks the U.S. as #143 in its rankings of countries by incidence of Low Birth Weight deliveries and #48 in infant mortality rates. In short, the United States is a great place to be pregnant and deliver a healthy baby.

Pregnancy rates for the specialized “surrogacy clinics” is likewise excellent. About 80% of embryo transfers result in a pregnancy when donor eggs are used. That is significantly higher than in most overseas clinics (which range between 55% and 65%).

Perhaps even more importantly, fertility clinics are required by law to report the results of their IVF and embryo transfer procedures. The U.S. Center for Disease Control reports on which clinics have the best success rates. Intended parents can review the success rates of various clinics to help choose the most reliable program. The most recent clinic rankings can be viewed here.

Typical surrogacy programs in the United States cost more than $160,000 USD. Other programs range from $140,000 to $150,000 USD. While some overseas clinics offer “guarantee” programs with unlimited IVF and embryo transfers, U.S. surrogacy journeys are more likely to be successful with just one or two transfers. General information about the costs of surrogacy are available in the SENSIBLE Surrogacy Guide.
 

Surrogacy-in-the-United-States-lawSurrogacy in the United States remains unregulated at the federal level, with each individual state having its own laws (or court precedent). The individual state laws vary widely even between states that are considered “surrogacy friendly”. For example, some states allow for surrogacy only for heterosexual couples, while others will allow married couples but not singles.

Intended parents should only consider surrogacy programs in “surrogacy friendly” states that have a supportive legal framework. Such states are listed below. A surrogacy friendly legal framework includes these separate court proceedings:

The Surrogacy Agreement.

This is the contract between the intended parents and the surrogate. The Surrogacy Agreement will detail the responsibilities of both the intended parents and the surrogate, as well as all financial arrangements.

The Pre-Birth Order

Sometimes called a Declaration of Parentage, this court order is executed in the 3rd trimester. It dictates that the hospital should inscribe the name of the intended parents on the baby’s birth certificate. States that support pre-birth orders will never put the surrogate’s name on the birth certificate (unless directed to by the intended parents).

The Post-Birth Order

In states that do not support pre-birth orders, the common alternative is a post-birth order. This court order determines the parentage of the baby based on the surrogacy agreement, but the order is only issued after the baby is born. A post-birth order may give the surrogate a brief opportunity to contest the agreement — although a well executed surrogacy contract will make this nearly impossible in most states.

 


Where in the U.S. Can You Pursue Surrogacy?

 

U.S. states that are “Surrogacy Friendly”

California: Very favorable. Multiple court cases have upheld both surrogacy agreements and pre-birth orders.

Connecticut: Connecticut is “friendly” to gestational surrogacy. Pre-birth orders are given to intended parents whether single or coupled, straight or same-sex and even when they have no genetic relation with the child.
For more info, read “Surrogacy in Connecticut” in the Guide.

Delaware: Explicit laws support surrogacy agreements and pre-birth orders.

District of Columbia: As of 2017 commercial surrogacy agreements are upheld by statute. The law also defines parentage according to the terms of various ART procedures.

Maine: As of 2016 pre-birth orders are supported by statute, with some restrictions

New Hampshire: surrogacy agreements are upheld, and pre-birth orders are supported if the intended parents and the surrogate comply with specific guidelines.

New Jersey:New Jersey is considered “Very Friendly” to surrogacy, and intended parents can easily obtain a pre-birth order whether they are using their own genetic material or donor eggs and sperm. For more info, read “Surrogacy in New Jersey” in the Guide.

Nevada: Very favorable. Explicit laws support surrogacy agreements and pre-birth orders.

Washington:Washington is considered “Very Friendly” to gestational surrogacy. The state allows married or unmarried couples, same-sex or heterosexuals, to get a pre-birth order even if neither of the intended parents has a genetic connection with the child.
For more info, read “Surrogacy in Washington” in the Guide.
 

U.S. states that are somewhat surrogacy friendly

Alabama: Supports pre-birth orders only for married couples

Alaska: No laws, but courts have been generally supportive. Does not explicitly support pre-birth orders.

Arkansas: Local law has declared surrogacy agreements valid, and a 2017 court ruling applies the law to both heterosexual and same-sex married couples. Same-sex couples need to be married.

Colorado: No laws, but courts have been generally supportive.

Florida: Gestational surrogacy agreements are permitted only between legally married couples and only after the baby is born.

Georgia: No laws, but courts have been generally supportive.

Hawaii: There are no supportive laws, and pre-birth orders are not issued

Illinois: Illinois is one of the most Surrogacy-Friendly states in the U.S. Specific legislation allows intended parents to obtain pre-birth and post-birth orders as long as one of the parents is genetically related to the baby.
For more info, read “Surrogacy in Illinois” in the Guide.

Kansas: No laws, but courts have been generally supportive. Pre-birth orders may be granted on a case-by-case basis.

Kentucky: No laws, but courts have been generally supportive. Pre-birth orders may be granted to married couples.

Maryland: While it’s possible for intended parents to obtain pre-birth and post-birth orders, there is no statute or case law providing enforcement of surrogacy contracts, which means that the issuance of the parentage orders depends on the court. Nonetheless, in most cases intended parents can obtain a pre-birth order without facing legal hassles.
For more info, read “Surrogacy in Maryland” in the Guide.

Massachusetts: No laws, but courts have been generally supportive.

Minnesota: No laws, but courts have been generally supportive.

Missouri:Despite not giving pre-birth orders, Missouri has an effective system of post-birth orders. The state allows individuals, married or unmarried couples (same-sex or heterosexual) to get a post-birth order even if neither of the intended parents have a genetic connection with the child.
For more info, read “Surrogacy in Missouri” in the Guide.

Mississippi: No laws, but courts have been generally supportive. Per-birth orders may be granted on a case-by-case basis.

North Carolina: North Carolina has no specific laws regarding gestational surrogacy, which means that the procedures and legal results vary greatly by county and judge. Pre-birth orders are given to married intended parents, but unmarried couples may face some legal hassles given the uncertainty of the state’s legal framework.
For more info, read “Surrogacy in North Carolina” in the Guide.

North Dakota: Local laws state that a child born to a surrogate is the child of the intended parents if one of the parents is genetically related to the baby.

New Mexico: No laws, but courts have been generally supportive. Per-birth orders may be granted on a case-by-case basis.

Ohio: intended parents can apply for a pre-birth order in Ohio without going through legal hassles. The state allows individuals, married or unmarried couples (same sex or heterosexual) to get a pre-birth order even if none of the intended parents has a genetic connection with the child.
For more info, read “Surrogacy in Ohio” in the Guide.

Oklahoma:Surrogacy in Oklahoma is rated “Somewhat Friendly”. Whereas legislation allows married intended parents, straight or same-sex, to pursue gestational surrogacy in Oklahoma, unmarried couples are not allowed to obtain a pre-birth order with both of their names on it. Single intended parents can obtain a pre-birth order even if they’re not genetically related to the child.
For more info, read “Surrogacy in Oklahoma” in the Guide.

Oregon: No laws, but courts do permit pre-birth orders if at least one parent is genetically related to the child.

Rhode Island: No laws, but the courts have been generally supportive.

Pennsylvania:Although there is no explicit case law or legislation, the Pennsylvania Superior Court has struck down lower-court decisions that deny surrogacy contracts and intended parents’ rights. But in absence of legislation, the availability of parental orders still varies throughout the state.
For more info, read “Surrogacy in Pennsylvania” in the Guide.

South Carolina: No laws, but courts have been generally supportive.

South Dakota: No laws, but courts have been generally supportive.

Texas: Gestational surrogacy agreements are supported, but only between legally married, heterosexual couples.

Utah: Gestational surrogacy agreements are permitted only between legally married, heterosexual couples,, and only if a court review validates the Agreement after the birth.

Wisconsin: Courts may support pre-birth orders, but post-birth orders are always required following the birth to establish legal parentage.

West Virginia: Pre-birth orders are supported, but only between legally married, heterosexual couples.
 

U.S. states that are friendly under some conditions

Iowa: No laws, but the local statute does acknowledge that a “surrogate arrangement” does not constitute the sale of human beings.

Idaho: There are no supportive laws, but pre-birth orders can only be issued if the couple use their own egg/sperm in the IVF cycle.

Montana: No laws, and very few legal precedents.

Nebraska: Commercial surrogacy agreements are prohibited by law. There is no explicit law supporting altruistic surrogacy agreements.

New York: Surrogacy agreements are legal and pre-birth orders can be issued as of 2021 if the intended parents are resident of the state. Either the surrogate or at least one parent must be a resident for 6 months to qualify for a pre-birth order.

Tennessee: Local law defines surrogacy agreements, and supportive when both intended parents are genetically related to the baby. If an egg donor is used then the surrogate must waive her parental rights.

Vermont: There is no law governing surrogacy. Courts do not support pre-birth orders, but post-birth orders may be issued.

Virginia: Gestational surrogacy agreements are permitted subject to a wide array of complicated restrictions. Post-birth orders are generally issued instead.
 

U.S. states that are NOT surrogacy friendly

Arizona: Local law forbids surrogacy agreements, and the surrogate is the legal mother by statute.

Indiana:Surrogacy in Indiana is against local public policy, and surrogacy contracts are prohibited. This makes Indiana one of the few “unfriendly” U.S. states for surrogacy. That said, some courts will still grant parental orders even if the surrogacy contract is invalid. For more info, read “Surrogacy in Indiana” in the Guide.
 

Louisiana: Surrogacy is legally restricted to only married heterosexual couples using their own egg/sperm.

Michigan: Commercial surrogacy agreements are prohibited. Individuals who pursue commercial arrangements may face stiff criminal penalties.

 

U.S. states that have no surrogacy legislation

Wyoming: No laws, and very few legal precedents.
 


Frequent Questions for Surrogacy in the USA

How much does surrogacy in the USA cost?

Surrogacy costs range from $140,000 to $180,000 for an agency program in the United States. 'Independent Surrogacy' can cost as little as $80,000, but can be difficult to manage.

What are the lower-cost options?

Low-cost surrogacy options can reduce fees from $10,000 to $30,000 with an 'Independent Journey'. Indy surrogacy works without a typical agency, requiring the intended parents to work directly with the surrogate.

How much does a surrogate earn?

Your surrogate's total expenses will take about one-half of your surrogacy budget. In the U.S., that’s from $60,000 to $80,000 USD for a typical journey. Overseas, surrogates earn similar compensation but adjusted for the cost of living. That’s about $15,000 to $20,000 USD.

How can Sensible help manage costs?

Sensible offers complete surrogacy services to manage your entire surrogacy journey! We have US surrogates ready to match immediately, as well as international programs.

 

About the authors

  • Bill-Houghton
  • Author: William Houghton

    Bill Houghton is the founder of Sensible Surrogacy, author of the Sensible Surrogacy Guide, 2x surrogacy dad, and a dedicated advocate for secure, legal and ethical Gestational Surrogacy. Read Bill's Biography

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