Surrogacy Myths & Facts

Truthful, Evidence-Based Answers to 

Common Misconceptions By Olga Pysana

Dear intended parents and surrogate mothers, I know that the world of surrogacy can feel overwhelming, and there is so much misinformation out there that can create unnecessary fear and confusion. I have compiled these answers to the most common myths so that you can move forward on your journey with clarity, confidence, and peace of mind. Every answer here is grounded in truth, empathy, and the latest research available.

About the Surrogate Mother

1. "A surrogate mother is always the biological mother of the child she carries."

This is NOT true.

In the vast majority of modern surrogacy arrangements, the surrogate mother is not the biological mother of the child. The most common form of surrogacy today is gestational surrogacy, where the embryo is created through IVF using the eggs of the intended mother (or an egg donor) and the sperm of the intended father (or a sperm donor). The embryo is then transferred into the surrogate’s uterus. This means the surrogate has no genetic connection whatsoever to the baby she carries.

Traditional surrogacy, where the surrogate’s own egg is used, does still exist but is far less common and is actually prohibited in many countries. So when we talk about surrogacy today, we are almost always talking about a woman who is lovingly carrying a child that is not biologically hers.

2. "Any woman who wants to can become a surrogate mother."

This is NOT true.

Becoming a surrogate is not something that is open to just anyone, and this is for very important, protective reasons. Surrogacy agencies and fertility clinics should follow strict screening guidelines, often based on standards set by the The ESHRE Ethics Committee, Human Fertilisation and Embryology Authority (HFEA), American Society for Reproductive Medicine (ASRM) or the American College of Obstetricians and Gynecologists (ACOG), depending on where the surrogacy is taking place.

A woman must typically be between 21 and 38 years old, must have already given birth to at least one healthy child without serious complications, must be in good physical and mental health, must have a healthy BMI, must be free of drug and tobacco use, and must pass extensive medical, psychological, and background screenings. These requirements exist to protect both the surrogate and the baby, and they reflect just how seriously this process is taken.

3. "All surrogate mothers experience psychological issues after giving birth."

This is NOT true.

This is one of the most persistent and harmful myths. Research consistently shows that the majority of surrogate mothers do not suffer long-term psychological harm. A landmark longitudinal study from the University of Cambridge followed surrogates for over 10 years and found that they scored within the normal range for self-esteem, showed no signs of depression, and none expressed regrets about their involvement in surrogacy.

A further 20-year follow-up found that surrogates experienced average self-esteem and life satisfaction, high levels of psychological flourishing, and more positive than negative emotions. Many continued to reflect positively on their experience.

While some surrogates may find the first few weeks after delivery emotionally adjustive, this is typically short-lived. As with any pregnancy, good support systems matter greatly. The myth that all surrogates are psychologically damaged is simply not supported by the evidence.

4. "Surrogate mothers face a higher risk of miscarriage than women in regular pregnancies."

This is NOT true.

There is no scientific evidence that gestational surrogacy in itself increases the risk of miscarriage. The embryo transfer process used in surrogacy is the same IVF procedure used for millions of women undergoing fertility treatment worldwide. Surrogates are carefully screened for their health and reproductive history specifically to minimize any risks. A systematic review found that medical outcomes for children of gestational carriers were comparable to children conceived through standard IVF procedures.

5. "A surrogate mother must follow all of the intended parents’ instructions, even if she disagrees."

This is NOT true.

Absolutely not. A surrogate mother is not an employee, and she retains full bodily autonomy throughout the pregnancy. While surrogacy agreements do outline expectations regarding prenatal care, lifestyle, and medical decisions, these are created collaboratively. A surrogate always has the right to make decisions about her own health and well-being.

In fact, in well-regulated surrogacy arrangements, the surrogate has her own independent legal counsel who ensures her rights are protected. No ethical surrogacy contract would ever require a woman to do something against her will or that compromises her health. The relationship is one of mutual respect and collaboration, not control.

6. "A surrogate mother must live with the intended parents during the pregnancy."

This is NOT true.

This is completely untrue. Surrogate mothers live in their own homes, with their own families, and continue their normal daily lives throughout the pregnancy. If they are traveling for surrogacy they might live in accommodation provided by the agency, sometimes relocating with their children. They are independent women with their own routines, jobs, children, and support systems. Some surrogates and intended parents become very close and may continue their relationship, but living together is not a requirement in any standard surrogacy arrangement.

7. "Intended parents have full control over every aspect of the surrogate’s pregnancy."

This is NOT true.

No. The intended parents do not “control” the surrogate’s pregnancy. The surrogacy agreement establishes mutual expectations around prenatal care, diet, medical appointments, and lifestyle choices, but the surrogate always retains her bodily autonomy. Key decisions about the pregnancy are made collaboratively, and the surrogate’s well-being is always a priority. Ethical surrogacy is built on trust, communication, and mutual respect, not on one party having power over another.

Surrogate Motivations & Autonomy

1. "Surrogate mothers only agree to carry a baby for financial gain."

This is NOT true.

While compensation is certainly a huge part of many surrogacy arrangements, research repeatedly shows that the primary motivation for some surrogates is altruism, a genuine desire to help others experience the joy of parenthood. Studies have found that surrogates often report wanting to help a family have a child, having enjoyed their own pregnancies, and finding deep meaning in being able to give such a profound gift.

Many surrogates describe their decision as one of the most fulfilling things they have ever done. To reduce their choice to “just money” is dismissive and disrespectful to the incredible generosity and courage these women bring to the surrogacy journey.

2. "Surrogate mothers are pressured into surrogacy and do not choose it freely."

This is NOT true.

In well-regulated surrogacy programs, surrogates are carefully screened, psychologically and emotionally, to ensure that their decision is fully voluntary and informed. Independent legal counsel is provided to the surrogate to make sure she understands her rights and is entering the agreement without any coercion. Psychological evaluations are a mandatory part of the screening process.

Research from the University of Cambridge, following surrogates over two decades, found that surrogates wanted to be understood as “reasonable humans who have made an active choice” These women are making informed, empowered decisions. Suggesting otherwise undermines their agency and intelligence.

3. "All surrogate mothers are taken advantage of and exploited."

This is NOT true.

This is an overgeneralization that does not reflect the reality of surrogacy in well-regulated environments. In countries and states with strong legal frameworks, such as parts of the United States, Canada, and the United Kingdom, surrogates have extensive legal protections, independent legal representation, comprehensive medical coverage, and psychological support throughout the process.

While it is true that exploitation can occur in unregulated environments or with unethical providers, the answer is not to stigmatize surrogacy as a whole. The real solution is to advocate for strong legal frameworks, proper oversight, and clear ethical standards across all jurisdictions.

Surrogate’s Emotional Bond & Relationship with the Baby

1. "A surrogate mother will become too emotionally attached to the baby if she stays in contact with the family after birth."

This is NOT true.

Research actually suggests the opposite. Studies show that ongoing contact between surrogates and the families they helped create tends to be positive for everyone involved. The 10-year longitudinal study from Cambridge found that most surrogates who maintained contact reported positive feelings toward both the child and the intended parents. Many described wanting to maintain a relationship and felt comfortable with their role.

Continued contact does not lead to confusion or unhealthy attachment. Instead, it often brings a sense of closure, joy, and an extended-family-like connection that benefits everyone, including the child.

2. "All surrogate mothers want to maintain a relationship with the child they carried after birth."

This is NOT true.

The truth is that surrogates have a wide range of preferences when it comes to post-birth contact, and all of those preferences are valid. Some surrogates deeply enjoy maintaining a warm relationship with the family and child. Others prefer to step back and have minimal or no contact. We can say that surrogates are happy with whatever level of contact they have, as long as their expectations were discussed and agreed upon beforehand. There is no single “right” way to handle this. What matters is open, honest communication and mutual respect.

3. "A surrogate mother is giving away her own baby."

This is NOT true.

This is perhaps the most emotionally charged myth, and I want to address it with great care. In gestational surrogacy, which represents the vast majority of surrogacy arrangements today, the surrogate has no genetic connection to the baby. The child was created from the intended parents’ (or donors’) genetic material. The surrogate is carrying the intended parents’ child, not giving away her own.

Surrogates understand this distinction deeply. They enter the process knowing whose child they are carrying, and they do so with love and intention. Framing surrogacy as “giving away a baby” misrepresents the nature of the arrangement and can be hurtful to surrogates who take great pride in the gift they are giving.

4. "Surrogate mothers always struggle emotionally when it comes time to handing the baby over."

This is NOT true.

While the moment of birth and transferring the baby to the intended parents can be emotional for everyone involved, research shows that most surrogates do not struggle with relinquishment. Studies in both the UK and the USA have repeatedly shown that the vast majority of surrogates are able to hand over the baby without significant psychological difficulty.

Some surrogates describe the moment as one of the happiest of their lives - seeing the intended parents hold their child for the first time. The psychological screening process helps ensure that surrogates are emotionally prepared for this moment before they ever begin the journey.

5. "Surrogate mothers never have any contact with the child after birth."

This is NOT true.

This varies widely and depends entirely on what is agreed upon between the surrogate and the intended parents. Many surrogacy arrangements include ongoing contact, whether that’s regular updates, photos, occasional visits, or even close family-like relationships. Many surrogates choose to stay in contact with the families for years, and the majority of these relationships are positive. Some arrangements are more private, with little or no contact, and that is okay too. Every surrogacy relationship is unique, and what matters most is that all parties feel comfortable and respected.

Legal & Contractual Misconceptions

1. "A surrogate mother can easily change her mind and legally keep the baby."

This is NOT true.

In jurisdictions with established surrogacy laws, the legal framework is designed to protect the parentage rights of the intended parents. In Mexico for example, pre-birth orders legally establish the intended parents as the legal parents before the baby is even born. This means the surrogate has no legal claim to the child. In gestational surrogacy, where the surrogate has no genetic link to the baby, this is particularly clear-cut. While legal specifics vary by jurisdiction, in well-regulated arrangements, the legal protections are strong and reliable.

2. "Intended parents can easily change their minds and legally abandon the baby."

This is NOT true.

Surrogacy agreements are legally binding contracts that establish the intended parents’ responsibilities, including their legal parentage of the child. These contracts are carefully drafted to protect all parties, including the baby and the surrogate. Once parentage is legally established, the intended parents have the same legal obligations as any parent. They cannot simply walk away. The legal framework ensures accountability and protects the welfare of the child above all.

3. "A surrogate mother can choose to terminate the pregnancy at any point if she changes her mind."

This is NOT true.

Surrogacy contracts typically address the topic of pregnancy termination, and these decisions are discussed and agreed upon before the journey begins. While a surrogate retains bodily autonomy as a matter of constitutional and human rights, the contract outlines the circumstances under which termination might be considered (such as severe medical complications or fetal abnormalities), and these are agreed upon by all parties with legal and medical guidance. Termination “on a whim” is not part of any ethical surrogacy arrangement. These are deeply considered and collaboratively agreed-upon frameworks.

4. "Surrogacy is the same as buying a baby."

This is NOT true.

This is a deeply hurtful and inaccurate characterization. Surrogacy compensation covers the surrogate’s time, effort, physical demands, medical risks, and the significant lifestyle adjustments she makes during pregnancy. It is comparable to compensating someone for their labor and sacrifice, not purchasing a human being. The intended parents are the child’s parents, and the surrogacy process facilitates the creation and delivery of their child. There is no sale, no ownership transfer. In altruistic surrogacy arrangements, there may be no compensation beyond medical and pregnancy-related expenses. The characterization of surrogacy as “buying a baby” ignores the humanity and selflessness at the heart of this process.

5. "Compensating a surrogate mother financially is always illegal."

This is NOT true.

This is not true. Compensated (commercial) surrogacy is fully legal in many countries. Some jurisdictions only allow altruistic surrogacy (where the surrogate receives no compensation beyond expenses), and some countries prohibit all forms of surrogacy entirely. The legality of compensation depends entirely on the jurisdiction, and calling it “always illegal” is simply incorrect.

6. "Surrogacy is illegal in most countries, with the USA being one of the only exceptions."

This is NOT true.

Surrogacy is permitted in various forms in many countries around the world. Beyond the United States, surrogacy is legal (in various forms) in countries including Ukraine, Georgia, Armenia, Ghana, Greece, Kazakhstan, Mexico and others. The legal landscape varies widely - from fully regulated commercial surrogacy to altruistic-only arrangements, but the USA is far from being the only option. That said, laws change frequently, so it is always essential to consult with an experienced surrogacy attorney or surrogacy consultant before starting the process in any country.

7. "Surrogacy lawyers only represent and protect the interests of the intended parents."

This is NOT true.

In ethical and well-regulated surrogacy arrangements, the surrogate always has her own independent legal counsel - a lawyer whose sole job is to represent and protect her interests. This is separate from the lawyer representing the intended parents. This dual representation is a fundamental safeguard in the surrogacy process and ensures that the surrogate fully understands her rights, the terms of the contract, and that her interests are protected throughout the journey.

8. "Surrogacy agencies only represent and protect the interests of the intended parents."

This is NOT true.

Reputable surrogacy agencies serve both the intended parents and the surrogates. Their role is to facilitate a positive experience for everyone involved. This includes providing surrogates with support, guidance, counseling, and connecting them with independent legal representation. A good agency advocates for the well-being, safety, and fair treatment of the surrogate just as much as it supports the intended parents. If an agency only focuses on the intended parents, that is a red flag, and a sign to seek a different, more ethical agency.

About the Intended Parents

1. "It is difficult for a mother to bond with her baby if she did not carry the pregnancy herself."

This is NOT true.

Research powerfully refutes this myth. A major longitudinal study by Professor Susan Golombok at the University of Cambridge followed surrogacy families from infancy through adolescence and found that intended mothers showed high levels of warmth, joy, and positive parenting, in many cases even higher than in natural conception families. 

By age 14, surrogacy families continued to show strong, positive mother-child relationships, with mothers through surrogacy showing less negative parenting and greater acceptance of their adolescent children compared to other family types. Bonding is about love, presence, care, and connection, not about who carried the pregnancy.

2. "Women only choose surrogacy to avoid the physical effects of pregnancy or to preserve their appearance."

This is NOT true.

This is a deeply unfair and inaccurate stereotype. The vast majority of people who turn to surrogacy do so because of serious medical reasons: uterine abnormalities, previous hysterectomy, medical conditions that make pregnancy dangerous or impossible, repeated IVF failures, recurrent pregnancy loss, or age-related fertility challenges. Surrogacy is also a path to parenthood for same-sex male couples and single men.

Surrogacy is an emotionally, financially, and logistically demanding process. Nobody enters it lightly or “for convenience.” For most intended parents, surrogacy comes after a long, often heartbreaking journey through infertility, and it represents hope after many disappointments.

3. "Surrogacy is a simple and straightforward solution to infertility."

This is NOT true.

I wish I could tell you it were that simple, but the truth is that surrogacy is a complex, multi-step process that requires significant emotional, legal, medical, and financial investment. It involves medical screenings, psychological evaluations, legal contracts, IVF procedures, embryo transfers, an entire pregnancy, and navigating legal parentage. The process can take one to two years or more from start to finish. It requires patience, resilience, trust, and a strong support system. It is a beautiful path to parenthood, but it is far from “simple.”

4. "Only married heterosexual couples are allowed to use surrogacy."

This is NOT true.

This is outdated and incorrect for many countries. In numerous countries, surrogacy is available to heterosexual couples, same-sex couples, and single individuals regardless of marital status or sexual orientation. While it is true that some countries restrict surrogacy to married heterosexual couples, the global landscape is diverse, and there are many options available for all types of families.

5. "Anyone who wants to become a parent can use surrogacy."

This is NOT true.

While surrogacy is a wonderful path to parenthood, it is not accessible to everyone. There are significant financial barriers. First of all, surrogacy can cost anywhere from tens of thousands to over $250,000 depending on the country and complexity of the surrogacy process. There are also legal restrictions depending on where you live and where the surrogacy takes place. Additionally, in many jurisdictions intended parents must go through their own screening process, including medical evaluations, psychological assessments, and legal reviews. Surrogacy requires a deep commitment of time, resources, and emotional energy.

6. "Single individuals cannot have a child through surrogacy."

This is NOT true.

This is not true. Many surrogacy-friendly countries, including Armenia, Canada, Colombia, Mexico, etc., fully support surrogacy for single individuals, sometimes for all, sometimes only for single women or single men. In cases like these, single parents usually use a combination of their own gametes and donor eggs or sperm, along with a gestational surrogate, to build their family. While some countries may restrict surrogacy to single parents by choice, there are plenty of well-regulated options available for single intended parents.

About the Children Born Through Surrogacy

1. "Children who are born through surrogacy are more likely to experience psychological difficulties."

This is NOT true.

This is one of the most studied aspects of surrogacy, and the evidence is reassuring. The most comprehensive longitudinal research, led by Professor Susan Golombok at the University of Cambridge, has followed surrogacy-born children from infancy through adolescence. At ages 1, 2, and 3, no differences were found in cognitive development or psychological adjustment between surrogacy children and naturally conceived children. At age 7, while a small increase in adjustment difficulties was noted, scores remained well below clinical thresholds and returned to normal by age 10.

By age 14, the surrogacy families showed some of the most positive mother-child relationships of any family type studied. A systematic review confirmed that children born through surrogacy show no major psychological differences compared to children born through other methods of conception or natural conception.

What matters most for a child’s well-being is not how they were conceived, but the quality of love, warmth, and stability in the family they grow up in. And surrogacy families, as the research shows, provide exactly that.

As Professor Golombok’s decades of research concludes: the most important factors for children’s well-being are parental sensitivity, warmth, and reflective functioning, not biological relatedness or the method of conception.

A Final Word

Whether you are a surrogate mother or an intended parent reading this, I want you to know that your journey is valid, your feelings are valid, and the path you are on, however complex, is one built on love and hope. 

Surrogacy, when done ethically and with proper support, is a beautiful way to bring families together. 

Do not let myths and misconceptions steal the joy from your experience.