What to Look for in a Surrogate: Beyond the Medical Checklist

Most intended parents know the basics: a surrogate should be healthy, between 21 and 41, have had at least one uncomplicated pregnancy, be a non-smoker, not use recreational drugs, have stable finances, and pass medical and psychological screening. Those are the floor, not the ceiling. The surrogates who make for the most successful, rewarding journeys are distinguished by factors that don't appear on a medical clearance form.

Clarity About Why She's Doing This

The most important non-medical factor is motivation. A surrogate who has a clear, articulate sense of why she wants to do this — who connects it to something genuine in her own experience, values, or sense of purpose — is going to navigate the inevitable hard moments very differently than someone who hasn't thought through her motivation deeply. This isn't about disqualifying anyone; it's about understanding who you're partnering with to carry your child and beyond.

Alignment on the Issues That Actually Matter

There are several topics where misalignment creates serious problems later: views on selective reduction (reducing a multiple pregnancy to a singleton or twins at intended parents' request), termination in the case of a serious fetal anomaly, how much contact the surrogate wants during the pregnancy, whether she wants an ongoing relationship after birth, and her expectations around decision-making. These conversations need to happen before the match is finalized — and they should be honest, not polished.

Her Support System

A surrogate's partner, family, and close friends matter enormously to how the journey goes. A supportive partner who understands and endorses the decision, children who have been age-appropriately prepared, and a broader support network that isn't going to create stress and drama are all genuine assets. Part of our screening process looks specifically at the surrogate's home environment. If you are working with an agency, the agency can also be a significant resource for surrogate support — and that counts. Ask your agency to talk through some examples of situations where a surrogate had an issue that the agency was able to work through.

Communication Style

You will be in regular contact with your surrogate for over a year. Think about whether your natural communication styles are compatible. Does she prefer text updates or video calls? Is she emotionally expressive or more private? Are you the kind of intended parent who wants to be involved in every appointment, or would you prefer periodic updates? Neither style is wrong, but mismatches create friction.

Experience vs. First-Time Surrogates

Experienced surrogates often command higher compensation but bring something genuinely valuable: they know what the process feels like from the inside, they've navigated the emotional aspects of delivery and handing over the baby, and they're less likely to be surprised by the experience. First-time surrogates bring enormous enthusiasm and motivation. Both can be excellent — the question is which is the right fit for your specific journey.

How the Matching Process Actually Works at Advocates for Surrogacy

Understanding what to look for is one thing — having the right structure to explore it is another. Our matching process is designed specifically to give intended parents and surrogates the time and space for real conversation. Once the fertility clinic has approved a surrogate candidate based on a review of her medical records, we share profiles with everyone and step back. If there's mutual interest, the first meeting includes Candace O'Brien directly — not a case manager, not a coordinator, but the founder of the agency who knows everyone involved and can facilitate an honest conversation. If that meeting goes well, we provide direct contact information and give intended parents and surrogates the opportunity to continue getting to know each other without the agency in the room. This matters because the conversations that determine whether a match is truly right — about fears, expectations, personal values, how someone handles hard news — are rarely the ones that happen in a first meeting. We've found that the most important discussions often happen in the third or fourth conversation, once people feel comfortable enough to be candid. That takes time, and we build that time into the process intentionally.

To learn more about how we approach matching, read through our FAQs for the Surrogacy Process. You may also want to review our guide on 10 Questions to Ask a Surrogacy Agency and The Matching Process Explained.