Surrogacy has become an increasingly common way for individuals and couples to build their families. But while the process is often discussed in medical and legal terms, it is also a deeply emotional journey for everyone involved. Intended parents, gestational surrogates, and even egg donors face unique psychological challenges that can impact their experience.
Despite these emotional complexities, mental health support in surrogacy remains inconsistent. Some agencies and professionals prioritize comprehensive mental health care, while others offer little to no support. Establishing clear industry-wide standards for mental health is essential to ensuring that surrogacy remains ethical, supportive, and beneficial for all parties involved.
Why Mental Health Support is Essential in Surrogacy
Surrogacy is about more than medical procedures and legal contracts—it is an emotional journey that can be both rewarding and challenging. Intended parents often bring a history of infertility, past losses, or anxiety about the process. They may feel excitement, hope, and nervousness all at once. Many worry about the unknowns of working with a gestational surrogate or fear that something could go wrong.
Gestational surrogates also experience complex emotions. They are carrying a child for someone else, balancing their personal life with the demands of pregnancy, and sometimes facing societal judgment. The transition after birth—while expected—can still bring a range of emotions. Without the right support, unresolved feelings can lead to distress, misunderstandings, and in some cases, even conflicts that impact the entire surrogacy journey.
When mental health is prioritized, all parties have the resources they need to navigate the surrogacy experience with clarity, confidence, and emotional well-being.
Current Gaps in Surrogacy Mental Health Practices
Right now, mental health support in surrogacy varies widely, creating an inconsistent experience for intended parents and gestational surrogates alike. While some agencies prioritize psychological well-being by offering thorough screenings and ongoing counseling, others provide little to no structured mental health support. This gap in care can leave individuals unprepared for the emotional complexities of the journey, increasing the risk of stress, misunderstandings, and unmet expectations. Without clear, enforceable mental health guidelines, surrogacy remains an uneven landscape where the quality of support depends largely on the agency or clinic involved. Standardizing mental health care across the surrogacy industry is essential to ensuring a safe, ethical, and emotionally healthy experience for everyone. Some inconsistencies include:
- Lack of Uniform Guidelines: There are no universally accepted standards for mental health care in surrogacy. Some agencies and clinics require thorough psychological screenings and ongoing counseling, while others provide minimal or no support.
- Inconsistent Screening Processes: While many agencies screen gestational surrogates for mental health concerns, intended parents often do not receive the same level of assessment. This imbalance can create emotional challenges later in the process.
- Limited Emotional Support: Some surrogates and intended parents have access to counseling throughout the journey, while others are left to navigate the emotional complexities on their own.
This lack of standardization can leave intended parents and surrogates vulnerable, making the surrogacy process more stressful than it needs to be.
What Should Mental Health Standards in Surrogacy Include?
To create a more ethical and supportive surrogacy industry, mental health care must be treated as a fundamental part of the process rather than an optional add-on. Ensuring the emotional well-being of both intended parents and gestational surrogates requires a proactive, structured approach that addresses mental health from the initial stages of surrogacy through postpartum care. When agencies, clinics, and legal professionals work together to implement consistent psychological support, they not only reduce emotional stress but also foster stronger, more positive relationships between all parties involved. A well-defined mental health framework helps mitigate potential conflicts, supports informed decision-making, and promotes a smoother, healthier surrogacy journey. Without these standards, individuals may struggle with unexpected emotional challenges, leading to unnecessary distress that could have been prevented with the right guidance and resources.
A structured approach to mental health in surrogacy should include the following key elements:
Comprehensive Psychological Screening
Mental health evaluations should be mandatory for both gestational surrogates and intended parents. These screenings assess emotional readiness, relationship dynamics, past trauma, and expectations for the surrogacy journey. Identifying potential concerns early can prevent complications later on.
Pre-Surrogacy Counseling and Education
All parties should have access to counseling before the process begins. These sessions can cover:
- Emotional preparedness for surrogacy
- Communication strategies between intended parents and surrogates
- Setting boundaries and expectations
- Post-birth emotions and how to navigate them
By discussing these topics early, surrogacy teams can build a strong foundation of trust and understanding.
Ongoing Mental Health Support During the Surrogacy Process
Emotional support should not stop once contracts are signed. Throughout the pregnancy, agencies should:
- Offer regular check-ins for both surrogates and intended parents
- Provide access to counseling for unexpected stressors, such as medical complications or delays
- Create opportunities for support groups or peer mentorship
Pregnancy is a time of emotional and physical change, and professional support can make the experience more positive for everyone involved.
Post-Surrogacy Mental Health Care
Once the baby is born, surrogacy agencies should continue to provide mental health resources. Gestational surrogates need support to process the transition after delivery. Intended parents may also need help adjusting to their new roles, especially if they have experienced infertility or previous losses. Encouraging access to therapy or check-ins with a mental health professional can help everyone navigate this life-changing event.
Why Ethical Standards Matter in Surrogacy
Mental health guidelines should be a core part of ethical surrogacy practices. Agencies, medical professionals, and legal experts all play a role in ensuring that intended parents and surrogates receive the support they need.
When mental health is not addressed properly, challenges can arise that impact the success of the journey. Case studies have shown that when surrogates and intended parents do not receive emotional support, misunderstandings, unmet expectations, and emotional distress can result. A structured mental health framework helps prevent these issues before they start.
How the Surrogacy Industry Can Implement Mental Health Standards
The surrogacy industry must take a proactive approach to integrating mental health care into standard practice. Some steps that can be taken include:
- Establishing clear guidelines through organizations such as the American Society for Reproductive Medicine (ASRM) and the Mental Health Professionals Group (MHPG).
- Encouraging agencies to work with licensed mental health professionals to provide screenings and ongoing support.
- Promoting research on the mental health needs of intended parents, surrogates, and egg donors to refine best practices.
- Implementing policies that require agencies to offer psychological support at all stages of the surrogacy process.
By making mental health a priority, surrogacy professionals can create a more ethical, supportive, and effective process for all involved.
Moving Toward a More Supportive Surrogacy Industry
Mental health is not an optional part of surrogacy—it is essential. Ensuring that intended parents and gestational surrogates receive the emotional support they need leads to better outcomes, stronger relationships, and a healthier overall experience.
The surrogacy industry must take responsibility for implementing ethical mental health practices that protect everyone involved. By setting enforceable standards, surrogacy agencies and medical professionals can help create a more supportive and responsible industry.
If you are an intended parent, gestational surrogate, or surrogacy professional looking for guidance on mental health best practices, PECNA encourages you to seek agencies that prioritize emotional well-being. Standardized mental health support ensures a more positive and ethical surrogacy journey for all.
