For anyone considering surrogacy, the journey starts with a mix of hope, anticipation, and a fair bit of uncertainty. Knowing what lies ahead can help make the process feel more manageable and give you the confidence to make informed decisions along the way.
As someone who has walked this path myself, I understand just how overwhelming it can feel at first. The medical terms, legal requirements and endless decisions can seem impossible to navigate. But having been there, I can also tell you that with the right guidance, support, and clarity, each step becomes achievable and profoundly rewarding. And while every journey is unique, there are common steps and choices that shape the path from that first dream to finally holding your baby in your arms.
Unfortunately, surrogacy journeys are, in many environments, more complex than a decade ago. Based on what I’ve seen while supporting many intended parents through our Concierge Support program, I wanted to share a guide that can help make each step feel clearer and more manageable.
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Step 1: Facing Uncertainty
The beginning of any surrogacy journey is filled with unknowns. For me, the uncertainty was everywhere: Which country or clinic would be the right fit? How would the legal side work? Could I trust the process and the people guiding me? These questions, and the worry that comes with them, are entirely normal.
Uncertainty isn’t just about logistics; it’s emotional. It’s the fear of the unknown, the what-ifs, and the “will this really work for me?” It can feel isolating, even when you know others have successfully navigated the same path.
The key at this stage is to acknowledge the uncertainty without letting it paralyze you. Start by:
Educating yourself on surrogacy options, processes, and laws.
Seeking out credible guidance from professionals.
Talking openly with your support network about concerns and expectations.
Step 2: Defining Your Path
Once you’ve acknowledged the uncertainty, the next step is to define your path. This is about turning hope and questions into decisions that will shape the rest of your journey.
If you live in a country which allows domestic surrogacy, such as Australia, UK, US, New Zealand, Israel and South Africa, one of the first decisions may be whether to pursue domestic or international surrogacy. Each has its advantages and challenges:
Domestic surrogacy: Logistics are often simpler, travel is minimized and you are expected to build and maintain a close relationship with your surrogate.
International surrogacy: Offers more options in terms of donors and surrogates, can sometimes reduce costs, can add certainty and quicker timeframes to the surrogate matching process, but it will mean extended time away from home, more limited surrogate interactions, complex logistics, and paperwork requirements.
Beyond location, take time to reflect on your motivations and priorities. Are you looking for a faster timeline, more control over the process or cost, or a particular donor ethnicity? Understanding what matters most to you will guide every decision moving forward. Remember also though, for most people, there will be compromises to make.
This stage is also about laying the foundation of your support network. Identify professionals or support organisations you trust and ensure you have personal support to navigate the emotional aspects.
Defining your path transforms uncertainty into direction. It doesn’t remove the challenges, but it gives you a framework to move forward with confidence, knowing each choice aligns with your vision for your family.
Build your support network
Connect with experts and parents who’ve walked the path at our Surrogacy & Donor Conception Conference to get guidance, ask questions and gain confidence for your next steps.
Step 3: Assembling Your Team
The next step is building the team that will support you through every stage of surrogacy. This isn’t just about hiring professionals; it’s about finding people who understand your vision, values and priorities, and who will guide you confidently through the process.
Your core team usually includes:
Fertility Clinics: Your clinic is where the medical journey begins. Look for clinics with experience in surrogacy, strong success rates and clear communication. Don’t hesitate to ask detailed questions about procedures, timelines, embryo selection, and genetic testing.
Surrogacy Agencies: Agencies manage the surrogate relationship and help coordinate the medical, legal, and emotional aspects of the process. Choose an agency that is transparent, supportive, and aligns with your values. Their experience can save you time, reduce stress, and help prevent unexpected issues.
Surrogate: If you’re using an agency, they will handle the matching process. If you’re looking at a domestic, independent surrogate match, the search involves identifying potential surrogates and spending time getting to know each. Huge levels of trust are required on both sides, so this is not an aspect to rush. Consider qualities important to you, such as communication style, medical history and shared values. This is a critical step, as the relationship with your surrogate will shape much of the journey.
Expert Team: Surrogacy involves complex legal considerations, including agreements, contracts, parental rights, and often citizenship and passport applications for a newborn. A skilled team is essential to ensure your rights are protected and that the journey proceeds smoothly.
Support Network: Beyond professionals, having friends, family, or peer groups who understand the surrogacy process can provide emotional support, perspective, and encouragement when the journey feels overwhelming.
When assembling your team, don’t rush. Interview potential providers, ask for references and trust your instincts. Compatibility, communication and transparency are just as important as credentials.
A strong team turns uncertainty into confidence. With the right people guiding you, every decision becomes clearer, more manageable, and ultimately aligned with your goal: bringing your baby home.
Step 4: Navigating Medical Decisions
With your team in place, the next phase is the medical journey. You may have already created embryos. Nonetheless this stage can feel overwhelming.
Some of the key areas to focus on include:
Fertility and Health Assessments: Whether you’re using your own gametes or a donor’s, both intended parents and the surrogate undergo evaluations. For intended parents, this may include hormone testing, ovarian reserve checks, and general reproductive health assessments. For surrogates, medical screenings ensure they are physically and emotionally prepared for pregnancy, including overall health checks, reproductive history review, and any necessary tests to optimize a safe and successful journey.
Embryo Selection: Selecting the best embryo for that first transfer is crucial to a successful journey. Embryologists look at embryo grading, blastocyst development, and genetic testing results. Understanding what these metrics mean helps you build confidence.
Genetic and Carrier Screening: Testing helps identify potential risks and ensures the best possible outcome for your child. Discuss with your team which screenings are recommended and how results may influence embryo selection.
Treatment Planning: Your team will design a treatment plan including hormone preparation for the surrogate, embryo transfer scheduling, and any necessary medications. Clear communication and understanding of each step are essential.
Monitoring and Support: Pregnancy monitoring is ongoing. Stay in close contact with your medical team and surrogate. Ask questions and track progress so you feel informed and involved every step of the way.
Navigating medical decisions is as much about knowledge as it is about trust. By understanding the procedures, asking questions, and leaning on your team’s expertise, you can approach this stage with confidence, knowing each decision is guided by care, precision, and your ultimate goal: bringing your baby home.
Step 5: Understanding Legal Considerations
Surrogacy is as much a legal journey as it is a medical one. Every decision you make has legal implications. Navigating this landscape with the right guidance is essential to protect your rights and ensure a smooth path to parenthood.
Key legal areas to focus on include:
Contracts: A surrogacy agreement outlines the rights and responsibilities of all parties involved. It covers compensation, medical decisions, and expectations throughout the pregnancy. Having a clear, well-drafted contract minimizes misunderstandings and protects everyone.
Related article: Understanding Surrogacy Agreements: What Australians Need to Know
Parental Rights: Laws differ by country and sometimes by state or region. Ensuring your parental rights are recognized, both before and after birth, is critical. Legal experts can guide you through pre-birth orders, adoption processes, or recognition of parentage depending on your location.
Citizenship and Travel Documentation: If you’re pursuing international surrogacy, your baby’s citizenship and passport requirements must be addressed early. Legal guidance ensures there are no delays in bringing your child home.
Dispute Resolution: While uncommon, disagreements can arise. Contracts and legal frameworks provide mechanisms to resolve issues without jeopardizing the pregnancy or parent-child relationship.
With the right legal team, you can approach the surrogacy journey knowing that your family is protected and that each step is aligned with the law. This clarity allows you to focus on what truly matters: the well-being of your child and the joy of parenthood.
Step 6: Managing Emotional Highs and Lows
From the moment you begin your surrogacy journey, you will experience a wide range of feelings: hope, excitement, anxiety, and sometimes fear. Recognizing and managing these emotions is just as important as understanding the practical steps.
Some of the emotional challenges you may encounter include:
Anxiety About Unknowns: Even with careful planning, surrogacy outcomes can feel unpredictable. Pregnancy complications, delays, or unexpected medical results can heighten stress. A strong support network and open communication with your team help manage this.
Attachment and Connection: Building a relationship with your surrogate, understanding the role of donors, and anticipating your child’s arrival can stir complex emotions. Take time to reflect on these feelings and discuss them openly with your partner, counsellor, or support group.
Moments of Joy and Anticipation: Celebrate milestones along the way, like successful transfers, positive test results, and progress in the pregnancy. Acknowledging these highs is crucial to maintaining balance.
Emotional Support: Consider counselling or peer support, either individually or with your partner. Connecting with others who have walked the path provides perspective, reassurance, and practical advice.
Managing your emotions doesn’t remove the challenges, but it helps you navigate them with resilience and clarity. By acknowledging what you feel, seeking support, and celebrating progress, you make space for both mindfulness and joy on the path to parenthood.
Step 7: Preparing for Birth
As the pregnancy progresses, the focus shifts from planning and decision-making to birth preparation. This stage is about ensuring that, when your baby arrives, everything from legal documentation to logistics are ready.
Key areas to focus on include:
Birth Planning: Coordinate with your surrogate and medical team to understand delivery timing, location, and any specific requirements. Discuss your presence at the birth and how updates will be communicated.
Legal and Citizenship Preparations: Make sure parental rights, birth registration, and travel documents are in place, particularly for international surrogacy. Work closely with your legal team to avoid delays in bringing your child home.
Home and Family Preparation: Prepare your home, gather necessary supplies, and consider how to support your family during the first weeks with your newborn. This is also a time to plan for childcare, work leave, and family support.
Emotional Readiness: Even with careful planning, emotions can peak at this stage—anticipation, excitement, and nervousness are natural. Lean on your support network and continue open conversations with your partner, surrogate, and team.
Practical Logistics: If your surrogacy is international, plan travel, accommodations, and any regulatory requirements well in advance. Having a clear plan reduces stress and allows you to focus on welcoming your baby.
Preparing for birth is the final stretch of the surrogacy journey, but it’s also a stage that requires the most attention to detail. If you came to us later in your journey, our Exit Support program can assist with all aspects to ensure a smooth transition from pregnancy to parenthood, ready to finally hold your child in your arms.
The road from uncertainty to family may have challenges, but it is also filled with hope, growth, and the joy of building the family you’ve dreamed of. Each step you take brings you closer to holding your baby, and the journey, complex as it is, can be navigated with the right support.
