19 Factors that Can Disqualify Surrogate Mother Applicants
Your Guide to Understanding the 19 Surrogate Disqualifications in 2024
Stepping into the role of a surrogate is an extraordinary gesture of kindness and dedication, one that requires careful consideration and commitment. Not everyone is ready to beginning the surrogacy journey as a gestational carrier, but if you feel that it is your way, or if you just considering becoming a surrogate, you may wonder about existing disqualifications of surrogacy, health requirements, what if you have a previous C-section in your medical history, and many more things associated this this process.
As you contemplate this unique journey, it’s essential to be aware that it involves navigating a complex array of criteria set forth by surrogacy agencies, adhering to meticulous medical protocols, and aligning with the legalities specific to your location. The criteria outlined below represent 19 key factors that could determine your suitability for surrogacy in 2024. This is a moment for introspection — to ensure that you are not only physically primed but also emotionally prepared for the rewarding yet demanding experience of carrying a child for another family. As you read on, consider each point as a stepping stone toward realizing the incredible gift you are considering to offer.
1. No Reproductive Background — No Own Children
First–time mothers, unfortunately, find themselves ineligible for surrogacy under these conditions. The absence of a prior pregnancy and childbirth experience leaves agencies without a basis to determine whether a potential surrogate can successfully carry a pregnancy to term. This criterion is not just a matter of reproductive health; it also touches upon the psychological preparedness of the applicant to become pregnant. Thus, to become a surrogate if you’ve never been pregnant is not possible. Any surrogate candidate is disqualified during initial interview after saying that she does not have at least one child.
2. Being Under 21 or Over 42 Years Old
Age is a key factor in surrogacy requirements, with most clinics and agencies recommending a range between 21 and 42 years old for the prospective surrogates to be considered eligible. Studies show that pregnancy complications are more likely outside this range. However, other factors like overall health, medical history, and previous successful pregnancies also play important roles in the selection process.
Pregnancy before the age of 21 or beyond the peak reproductive years, typically considered around 40, is associated with an increased risk of various complications. Younger expectant mothers, especially those under 18, face a higher risk of issues like anemia, high blood pressure, and preeclampsia, which could lead to further complications. Additionally, they are at a higher risk of premature birth, delivering low birth weight babies, and experiencing a higher rate of infant mortality.
On the other end of the spectrum, women over the age of 44 are more susceptible to complications like gestational diabetes, preeclampsia, miscarriage, and the need for cesarean sections. Babies born to mothers in this age group are also at a greater risk of being underweight, experiencing stillbirth, or encountering complications that can lead to pregnancy loss and postpartum hemorrhage.
It is noteworthy that women who have gone through menopause are generally considered unsuitable candidates for surrogacy. Fertility clinics tend to reject applications from postmenopausal women due to the multitude of pregnancy complications associated with this stage of life, as the body naturally works to prevent future pregnancies.
3. Not Being a U.S. Citizen or Legal Resident
Ensuring a seamless and secure surrogacy process is essential, particularly when engaging with U.S.–based surrogacy agencies and IVF clinics. For this reason, these agencies typically prefer to work exclusively with surrogates who hold U.S. citizenship or legal resident status. This approach guarantees that all parties involved experience a journey that is both safer and more convenient.
Surrogacy agencies commit to thorough pre–screening processes, aiming to verify that each candidate is exceptionally suited for the surrogacy role — socially, medically, and psychologically. Prospective surrogates should anticipate comprehensive state and federal background checks, alongside meticulous financial screenings. Given the immense responsibility placed upon surrogates, such extensive vetting is crucial to ensure safety and provide peace of mind to all parties involved.
4. Residing in a Non–Surrogacy–Friendly State or a State with Complex Surrogacy Laws
The legal framework surrounding surrogacy varies significantly across the United States, with states adopting diverse stances on the matter. While a substantial number of states have wholeheartedly embraced and legalized surrogacy, others impose stringent conditions, restrictions, or outright prohibitions.
As of now, surrogacy is categorically outlawed in three states: Nebraska, Louisiana, and Michigan. On the other hand, states such as Arizona, Idaho, Indiana, New York, Tennessee, Virginia, and Wyoming permit surrogacy, albeit with a note of caution due to potential intricacies and ambiguities in their respective legal provisions. The remaining states generally allow surrogacy arrangements.
Given the dynamic nature of legal regulations, it is crucial for surrogate applicants and intended parents to seek current and comprehensive legal counsel to navigate the complexities of surrogacy laws in their specific state.
5. Residing in an Unsafe Environment
Agencies diligently assess the living conditions of surrogates, ensuring they are committed to maintaining a healthy lifestyle throughout the pregnancy. This evaluation includes thorough background checks to identify any criminal history or financial instability, as these factors could contribute to an unsafe living environment. Women who are undergoing financial hardships, reliant on state assistance such as food stamps, or have significant concerns highlighted in their background checks are generally deemed ineligible to become surrogates.
Moreover, the surrogate’s mental and emotional stability is equally essential. She should ideally be surrounded by a stable family environment and have a solid network of emotional support. This is essential for helping her manage the added stress and emotional complexities that can arise during pregnancy. To wrap things up, a safe environment for a surrogate mother is one that promotes her physical, mental, and emotional well–being, ensuring a healthy and stable journey throughout the pregnancy.
6. Having a History of Drug or Alcohol Abuse
Although smoking and consuming alcohol are not illegal, they are the top disqualifications for surrogacy. Therefore, prospective surrogates with any history of drug or alcohol abuse get eliminated from the vetting process. Surrogates must abstain from tobacco, vape, cannabis, and alcohol products pre–conception and throughout the surrogacy.
7. Having Above–or Under–Normal BMI
While being slightly overweight doesn’t automatically disqualify applicants, individuals with a BMI over 32, categorized as morbidly obese, must reduce their weight to qualify as a surrogate due to increased health risks. Many surrogacy agencies typically set the lower BMI limit at 19 to mitigate risks like disrupted menstrual cycles and premature births, while specifically capping the upper limit at 32 to minimize pregnancy complications.
8. Having Past Fallopian Tube Issues or other Medical Conditions
Past inflammation or scarring of the fallopian tubes doesn’t automatically disqualify you, and you still can become a gestational surrogate. For traditional surrogacy, the fallopian tubes are essential, as the surrogate acts as an egg donor, and those with tubal issues can’t become a surrogate. On the contrary, gestational surrogate with tubal conditions may still become a good candidate if screening showed that her uterus is healthy because the embryo is transferred directly there.
9. Being Diagnosed with a Polycystic Ovary Syndrome (PCOS)
Individuals with a history of Polycystic Ovary Syndrome (PCOS) may find their eligibility for surrogacy impacted, as PCOS is associated with increased risks during pregnancy. Women with PCOS have higher rates of complications such as pregnancy loss before 20 weeks, gestational diabetes, preeclampsia, and the necessity for cesarean sections. Additionally, PCOS can contribute to elevated blood pressure and potential heart issues. Given the surrogate mother’s crucial role in carrying and nurturing the baby, agencies and medical professionals take these risks seriously. As a result, having PCOS in your medical history could lead to disqualification from the surrogate application process to ensure the safety of both the surrogate and the baby.
10. Being Diagnosed with Diabetes
For applicants wishing to become surrogates, a diagnosis of diabetes requires careful consideration due to the potential complications and necessary management of the condition. Maintaining stable blood sugar levels prior to conception and throughout the pregnancy is crucial, as elevated levels in the early stages of pregnancy can lead to birth defects. Even if diabetes is typically well-managed, pregnancy can cause changes in metabolism, necessitating additional care or treatment to ensure a healthy delivery. Infants born to mothers with diabetes are often larger and may experience low blood sugar levels shortly after birth. Due to these complexities and potential risks, candidates diagnosed with diabetes are most likely deemed ineligible for surrogacy.
11. Being Diagnosed with Gestational Diabetes during Previous Pregnancy
Gestational diabetes is a form of diabetes that can develop during pregnancy in women without prior diagnosis, poses potential health risks to both the surrogate and the baby. This condition, occurring exclusively during pregnancy, increases the risk of complications for both parties, including heightened chances of heart disease in the newborn and a predisposition to type 2 diabetes. While gestational diabetes is not an autoimmune condition like type 1, its classification as a metabolic disorder requires careful management.
Sometimes, an applicant may become a surrogate and subsequently be diagnosed with gestational diabetes. If this is your situation and you are aware of what to expect, you can still have a healthy pregnancy with proper management. In some cases, you may need to take medication for your gestational diabetes to protect the health of the baby and decrease risk of complications during pregnancy.
While a history of gestational diabetes doesn’t necessarily disqualify an applicant, those who required insulin or similar medications for management are typically not accepted due to increased risks. However, if the condition was managed with diet alone and the surrogate has demonstrated normal A1C test results and fasting glucose levels subsequently, she may still be considered a good candidate.
12. Being Diagnosed with Preeclampsia during Previous Pregnancy
For those applying to become surrogates, a previous history of preeclampsia warrants thorough evaluation due to its impact on maternal and fetal health. Characterized by high blood pressure and proteinuria after the 20th week of pregnancy, along with symptoms like swelling, headaches and blurry vision, preeclampsia can lead to critical complications, including risk of miscarriage. It poses risks such as preterm labor, which may require early delivery, challenging both surrogates and intended parents within the surrogacy journey.
Furthermore, preeclampsia shares risk factors with gestational hypertension and may include others, such as a pre–pregnancy history of hypertension or thrombophilia and conceiving via in vitro fertilization. Given these concerns, surrogacy professionals rigorously assess applicants with a preeclampsia history to ensure the healthiest possible pregnancy for the surrogate and the baby.
13. Being Diagnosed with Gestational Hypertension
A previous diagnosis of gestational hypertension, characterized by high blood pressure after 20 weeks of pregnancy without protein in urine, can significantly impact surrogacy eligibility. During review, agencies consider if it was isolated or part of a broader pattern, presence of related complications like preeclampsia in past pregnancies, and any pre–existing conditions like diabetes or autoimmune diseases. While individual assessments are possible, prioritizing the safety of both the surrogate and the child often leads to disqualification from becoming a surrogate mother in such cases.
14. Being Diagnosed with Endometriosis
Endometriosis can be a disqualifying condition for surrogate candidates due to its potential impact on physical health. This disorder, where tissue similar to the lining inside the uterus grows outside it, often leads to complications such as pelvic pain and may impair reproductive organs. Surrogacy requires a candidate’s reproductive system to be uncompromised to maximize the chances of a successful pregnancy. Consequently, agencies and medical professionals typically exclude applicants with a history of endometriosis, especially when it has significantly affected their fertility or poses risks to a healthy pregnancy.
15. Developing Placenta Previa in Previous Pregnancy Can Be a No for Gestational Surrogacy
Placenta previa, a condition where the placenta covers the cervix, can significantly raise the risk of complications in pregnancy and is one of the major disqualifying factors. If a prospective surrogate has a history of placenta previa, especially if it led to adverse outcomes such as preterm delivery or hemorrhage, it may disqualify her from surrogacy programs. Given that placenta previa can recur in subsequent pregnancies and may necessitate early delivery or result in placenta accreta, where the placenta becomes inseparably attached to the uterine wall, surrogacy agencies are cautious. The priority is to ensure the safety and health of both the surrogate and the intended baby, and a history of placenta previa can pose too great a risk to be considered suitable for a surrogacy arrangement.
16. Having More Than 5 Previous Deliveries or Multiple C-Sections May Disqualify You
For women considering surrogacy, it’s important to note that a reproductive history profile of more than five pregnancies and deliveries can impact your eligibility. Typically, agencies look for candidates with at least one previous uncomplicated pregnancy, but with no more than five deliveries or three cesarean sections.
17. Becoming a Surrogate While Breastfeeding, After a Recent Delivery in Less Than 6 Months Ago
Surrogacy agencies and fertility clinics typically require a waiting period of at least 6 months after childbirth for potential surrogates. This crucial period allows a woman’s body to recover physically, hormonally, and emotionally, ensuring her well–being and the success of a future pregnancy. Any application from a woman who has delivered a child in the last 6 months will likely be deferred until she meets this critical recovery and waiting period criterion.
18. Taking/Having Taken Anti–Anxiety Medications or Antidepressants Can Disqualify You from Becoming a Potential Surrogate
Studies have shown that fetuses of women experiencing high anxiety levels at 36 weeks of gestation exhibit increased physical activity. Moreover, elevated hormone levels associated with stress and depression can lead to severe complications, including spontaneous abortion, structural malformations, and preeclampsia.
The risks are especially high during the first trimester, a critical period for fetal development. Depression or anxiety during this time, coupled with elevated levels of placental CRH (corticotrophin–releasing hormone), can result in a smaller head circumference, potentially affecting brain growth. Therefore, agencies and medical professionals thoroughly assess the use of such medications in surrogate candidates and any history of these medications within the past 12 months to ensure a safe pregnancy.
19. Having a History of Stress or Anxiety in Previous Pregnancies May Lead to Disqualification from a Surrogacy Journey
Stress experienced during pregnancy has been linked to a variety of adverse outcomes, making it a crucial factor to consider when assessing applicants. The body’s response to stress, characterized by the production of adrenaline, results in symptoms such as tachycardia (rapid heartbeat) and accelerated breathing. These physical responses can further exacerbate the effects of stress on both the surrogate mother and the developing fetus. Maternal stress in the third trimester can lead to preterm uterine activity and subsequent preterm delivery. In contrast, stress during the first trimester has been associated with low birth weight.
If you have a history of significant stress or anxiety during previous pregnancies, and it was challenging to manage without medication, surrogacy agencies are likely to consider these factors critically, potentially affecting your eligibility as a surrogate mother candidate.
A Final Note to Surrogate Candidate
The eligibility of surrogate applicants is governed by a range of factors designed to ensure the safety and health of both the surrogate and the child. While the criteria may seem daunting, they are essential in maintaining the integrity and success of the surrogacy process. As such, those considering surrogacy must approach it with informed commitment and the understanding that these regulations are in place to safeguard the miraculous journey of bringing new life into the world.