Surrogacy is an extraordinary act of service and strength. If you’re exploring whether to become a surrogate mother, it’s only natural to wonder, is surrogacy considered high risk? Whether you’re hearing stories about surrogacy pregnancies or reading statistics on gestational surrogacy arrangements, understanding the full picture of risk is essential before moving forward.
This guide provides clear, compassionate insight into what medical experts say about evaluated surrogate pregnancy, the potential health risks, and how comprehensive support helps protect the well-being of gestational carriers like you.
What Does “High Risk” Mean in Surrogate Pregnancy?
“High risk” in pregnancy is a medical classification. It means there is an elevated chance of complications during the pregnancy or delivery. These risks can result from age, past medical history, type of conception, or multiple pregnancies.
In the case of gestational surrogacy, the use of artificial reproductive technology like in vitro fertilization means gestational surrogate mothers often undergo more medical interventions than a typical pregnancy. As a result, some surrogate pregnancies are classified as high risk pregnancies, even when the surrogate is otherwise healthy.
Gestational Surrogacy
In gestational surrogacy, the surrogate is not biologically related to the babies born. An embryo created through in vitro fertilization, often using donor eggs and sperm donor contributions, is transferred into the surrogate uterus. Made in the USA Surrogacy only supports gestational surrogacy. This medical distinction reduces certain emotional and genetic risks and aligns with current best practices in fertility medicine.
Medical Risks in Surrogacy Pregnancies
Assisted Reproductive Technology and Its Effects
The journey begins with assisted reproductive technology (ART), including IVF treatment. To prepare for embryo transfer, the surrogate undergoes hormone treatments. While most pregnant women tolerate these medications well, there are potential complications:
- Headaches and fatigue
- Bloating or cramping
- Ovarian hyperstimulation syndrome (rare)
Each evaluated surrogate pregnancy is preceded by a thorough medical evaluation to identify and reduce such risks.
Embryo Transfer and Multiple Pregnancies Risks
Embryo transfer is a key step in gestational surrogacy arrangements. While some programs used to transfer multiple embryos to increase the chance of pregnancy, this practice has shifted. Multiple embryos raise the risk of multiple pregnancies, which increases:
- Preterm delivery
- Cesarean delivery
- Gestational diabetes
- High blood pressure
- Low birth weight neonate complications
Elective single embryo transfer is now commonly encouraged because it reduces these risks and supports lower risk pregnancies.
Pregnancy Complications and Outcomes
Research from recent years shows surrogate women are at higher risk for certain obstetric complications when compared to natural conception families or even other IVF babies pregnancies. A 2024 study found that 7.8% of surrogate pregnancies involved severe maternal health outcomes.
Common complications include:
- Preeclampsia
- Postpartum hemorrhage
- Preterm birth
- Cesarean delivery
- Placenta previa or placental abruption
Women involved in a surrogate pregnancy are monitored closely throughout gestation, often with access to high risk obstetric subspecialists or maternal fetal medicine experts. Monitoring gestational age carefully helps manage risks for both the pregnant woman and children born.
Mental and Emotional Considerations in Surrogate Pregnancy
Emotional Complexity and Psychological Health
Surrogacy involves not only physical changes but also emotional transitions. Surrogate mothers sometimes feel a range of emotions before, during, and after pregnancy. These are normal and valid experiences.
In 2025, a study published in JAMA Network Open revealed that gestational carriers had a 43% increased incidence of mood or anxiety disorders postpartum compared to women who carried their own pregnancies. While these issues are often treatable and temporary, they highlight the importance of:
- Pre-surrogacy psychological screening
- Ongoing emotional support
- Postpartum mental health care
The emotional health of surrogate women is just as vital as physical well-being.
Screening and Support Systems
Surrogacy agencies that follow ethical guidelines include mental health evaluations as part of the approval process. A potential surrogate must be an ideal gestational carrier, which includes having strong emotional resilience and a healthy mental health history.
Support continues after birth, ensuring that every surrogate mother has the resources and care she needs, especially during postpartum recovery.
How Risk Is Managed in a Surrogacy Pregnancy
Medical Screening and Lower Risk Pregnancies
Surrogacy agencies partner with medical professionals to thoroughly screen every applicant. This includes:
- Reviewing past pregnancies for complications
- Evaluating physical health and fitness for pregnancy
- Psychological assessment
- OB clearance from a qualified physician
These steps ensure that each surrogate begins her journey from the healthiest foundation possible.
Reducing Risk with Elective Single Embryo Transfer
To prevent complications linked to multiple pregnancies, many clinics now use elective single embryo transfer. This helps reduce the risk of premature birth, low birth weight, and gestational diabetes.
When only one embryo is transferred, it often results in an uncomplicated surrogate pregnancy with fewer interventions.
Ongoing Monitoring with Maternal Fetal Medicine
Once pregnant, a surrogate is typically monitored by both a fertility specialist and an OB/GYN. If needed, maternal fetal medicine specialists step in for high risk pregnancies or complex cases. Regular ultrasounds and prenatal visits allow for early detection and treatment of any fetal anomalies, birth defects, gestational diabetes, or preeclampsia.
Legal and Ethical Safeguards in Surrogacy
Understanding the Surrogacy Contract
A surrogacy pregnancy also includes a legally binding surrogacy contract. This document outlines the responsibilities and protections for the surrogate mother, including:
- Medical expenses
- Insurance coverage
- Mental health support
- Pregnancy-related decision-making
This legal process ensures your rights and safety are upheld throughout the surrogacy arrangement.
Ethical Medical Practices
At Made in the USA Surrogacy, only U.S.-based surrogacy arrangements are supported. We do not facilitate international or unregulated programs. Every surrogate works with licensed professionals in reproductive medicine and receives evidence-based care at every stage.
We uphold only commercial surrogacy practices that are legal, transparent, and structured to support the well-being of the surrogate woman.
Long-Term Outlook After Surrogacy
Most surrogate women go on to have healthy, full-term pregnancies for themselves in the future. Complications like postpartum hemorrhage or cesarean delivery can affect fertility, but such risks are rare when medical care is properly managed.
In fact, many surrogates report positive outcomes after completing their surrogacy pregnancies, including improved self-esteem, a deep sense of purpose, and ongoing relationships with the professionals who supported them.
Who Makes an Ideal Gestational Carrier?
If you are considering whether to pursue surrogacy, the following qualities are typically required:
- Age between 21–38
- At least one prior full-term, healthy delivery
- No major pregnancy complications in the past
- Physically and mentally healthy
- Supportive home environment
You will also undergo a thorough medical evaluation and receive clear information about any potential complications before officially beginning the process.
Frequently Asked Surrogate Pregnancy Risks Questions
Is surrogacy considered high risk for the surrogate mother?
Yes, gestational surrogacy involves some higher risk factors due to in vitro fertilization and hormone treatments. However, with close monitoring and support, many surrogates complete healthy, uncomplicated pregnancies.
Can surrogacy lead to long-term health issues?
In rare cases, complications such as cesarean delivery or severe hemorrhage could impact future fertility. Most surrogate women recover well and resume their normal health after birth.
Are emotional challenges common after surrogacy?
Some women experience postpartum mood changes or sadness after delivery. Mental health support is available and effective in helping you feel stable and supported.
How are surrogate pregnancies monitored for complications?
Through regular OB/GYN visits, blood pressure checks, gestational diabetes screenings, and access to high risk obstetric subspecialists, surrogate pregnancies are closely managed from start to finish.
What legal protections are in place for surrogates?
A legally binding surrogacy agreement ensures your rights are protected. It covers everything from medical care to mental health resources to legal fees and responsibilities.
Final Thoughts: Surrogacy Risks Are Real, But So Are the Protections
So, is surrogacy considered high risk? In medical terms, yes, some risk factors are elevated compared to natural pregnancies. But with the right team, evidence-based care, and ethical support, surrogate pregnancy is not only safe, it’s incredibly rewarding.
Every surrogate deserves to be fully informed, fully supported, and fully empowered. If you are exploring this journey, know that your health, your experience, and your voice matter.
Made in the USA Surrogacy is here to guide you through each stage, making sure that any potential complications are met with clarity, compassion, and expert care.