What conditions are required to become a surrogate mother in the United States?
Ⅰ.Legal and Residential Requirements
1. Compliance with state laws
List of Legal States: There are 41 states in the United States and Washington D.C. that allow surrogacy, including California, New York (effective February 15, 2025), Massachusetts, and others. Among them, California's laws are the most comprehensive, allowing commercial surrogacy and clarifying the ownership of guardianship.
Prohibited states: Louisiana and three other states explicitly prohibit commercial surrogacy, and it is necessary to avoid choosing such states.
• Classification of legal types:
Complete surrogacy (using reproductive cells from the principal or donor): legal in most states.
Partial surrogacy (using surrogate eggs): Some states restrict or prohibit it.
2. Residence and Citizenship
Nationality requirements: Typically, surrogate mothers are required to be US citizens or legal residents, with some states allowing foreign nationals but subject to specific conditions (such as visa type).
Residential stability: Proof of fixed residence is required, and some institutions require a certain period of residence (such as 6 months) in the surrogacy state.
3. Age restrictions
Legal age range: Most states require surrogate mothers to be between 21 and 40 years old to ensure that their physical condition is suitable for pregnancy.
Exception: Some states allow women over 40 years old but in good health to apply, subject to additional medical assessment.
Ⅱ.Body and Health Standards
1. Birth history
• Required conditions: Must have given birth to at least one child and are currently being raised to demonstrate fertility and sense of responsibility.
• Pregnancy history: No adverse pregnancy history such as recurrent miscarriage or premature birth, and no more than two cesarean sections.
2. Physical health
• Infectious disease screening: HIV, hepatitis B, hepatitis C, syphilis and other tests must be negative.
• Chronic diseases: no serious chronic diseases such as diabetes, hypertension, heart disease, etc., and BMI should be between 18.5-24.9.
•Reproductive system health: The uterus has a normal shape and there are no diseases that may affect pregnancy, such as uterine fibroids or adenomyosis.
3. Mental health
Psychological assessment: It is necessary to have a professional psychologist evaluate and confirm the absence of serious psychological disorders such as depression and anxiety.
• Stress coping ability: It is necessary to demonstrate the ability to rationally handle emotional fluctuations and changes in family relationships during the surrogacy process.
Ⅲ.Economic and Life Stability
1. Economic independence
Proof of income: Tax receipts or bank statements are required to prove that surrogacy fees are not the primary source of income.
Financial difficulties: No bankruptcy record, some institutions require credit scores above 650 points.
2. Living environment
Stable residence: A lease agreement or property certificate is required to ensure a safe and comfortable living environment during pregnancy.
• Family support:
Married individuals: require the spouse to sign a consent form and provide proof of stable family relationship.
Single individuals: A written commitment from a reliable support system (such as relatives or friends) is required.
Ⅳ.Legal agreements and procedures
1. Contract signing
Agreement content: Clarify the type of surrogacy (complete/partial), payment method, medical decision-making power, guardianship ownership, etc.
Legal Review: The agreement must be reviewed by both parties' lawyers to ensure compliance with state laws and the American Society for Reproductive Medicine (ASRM) guidelines.
2. Embryo type restrictions
• Prohibition of traditional surrogacy: Most states only allow gestational surrogacy (using reproductive cells from the principal or donor) and prohibit surrogates from providing eggs.
• Embryo quantity: Usually 1-2 embryos are implanted, and multiple pregnancies require medical evaluation and additional informed consent.
3. Judicial procedures
• Pre birth instructions: In areas such as New York State, entrusted parents must apply for a court order to confirm custody before the child is born.
• Identity documents: Surrogacy mothers need to cooperate in obtaining legal documents such as birth certificates and paternity testing.
Ⅴ.Other requirements
1. No criminal record
Background check: Some states or institutions require a certificate of non criminal record, especially when it comes to foreign surrogate mothers.
2. Insurance coverage
Medical insurance: It is necessary to have insurance that covers pregnancy, childbirth, and complications. California's SB 729 proposal mandates that medical insurance cover surrogacy fees for LGBTQ+and single individuals.
3. Ethical compliance
Prohibition of Advertising: US law prohibits commercial surrogacy advertising, but allows institutions to match surrogate mothers with surrogate parents through legal channels.
Reasonable compensation: The surrogacy fee is usually between 30000 to 50000 US dollars (paid in stages), covering medical, living expenses, and risk compensation.
Ⅵ. Summary
To become a surrogate mother in the United States, multiple criteria must be met, including:
1. Legal compliance: Choose a legal state for surrogacy and comply with local laws.
2. Physical health: Through strict medical screening, it is proven that there is fertility and no major illness.
3. Psychological stability: possessing the psychological resilience to cope with the pressure of surrogacy.
4. Economic and livelihood security: Prove economic independence and stable living environment.
5. Legal agreement: Sign detailed contracts and complete judicial procedures.
