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The surrogate pregnancy process, explained

April 6, 2021

Through modern-day gestational surrogacy, women all over the world are helping others bring a child into their homes. What begins with screenings, interviews and medical appointments has now come to the moment you've all been waiting for: the pregnancy (and birth!).

Of course, a congratulations are in order! After your blood test confirms pregnancy, here’s what to expect during each trimester of your gestational surrogacy to make your pregnancy as smooth as possible. 

What to expect during your pregnancy as a surrogate

Your first trimester

Your pregnancy will be monitored through ultrasounds and blood tests by the IVF doctor either at your recipient parents’ office, or through a monitoring clinic closer to your home until about 10 weeks of pregnancy. Here’s what you can expect during your first trimester of the pregnancy: 

  • At four to six weeks of pregnancy, you’ll have an ultrasound to check for a gestational sac in the uterus. 
  • At six to eight weeks, you’ll have an ultrasound to check for fetal heartbeat. 
  • At 10 weeks of pregnancy, you’ll have one to two more visits before graduating from IVF care to OB care. 
  • At around 10 weeks of pregnancy, they’ll provide instructions for gradually tapering off the IVF medications. The clinical coordinator responsible for your care at the IVF clinic will inform you how your doctor is adjusting your medications after each appointment. 

Your second and third trimester

Once your pregnancy has been confirmed by fetal heartbeat ultrasound, your surrogate coordinator will help you transition to OB care. We’ll check what OB/hospital options are in-network with the surrogacy insurance plan, and you and your intended parent(s) will decide on the best option for this as  a team. 

Your IVF doctor will inform you of the time frame for setting up your first OB appointment. Before your first OB appointment, your Surrogate Match Coordinator will make sure your OB has all of the relevant information from your IVF cycle and pregnancy thus far, a copy of your insurance card, and a copy of the medical records from the IVF clinic.

Screening tests during your second trimester

Most intended parents wish to do the non-invasive pregnancy screening tests, such as the Nuchal Translucency ultrasound, at around 12 weeks, state first and second trimester blood tests, and/or the NIPT blood test. You can coordinate this through your OB, or we can provide a referral within L.A. if you’re able to travel for these tests. 

Some intended parents opt to do invasive testing, such as an amniocentesis or Chorionic Villus Sampling (CVS), if there are concerns resulting from the non-invasive testing. If your intended parents choose to pursue this, you’ll be compensated for the inconvenience associated with these tests. 

Legal processes

At around 16 weeks of pregnancy, the legal parentage process will be initiated with the same attorneys who assisted with the initial contract. Depending on the state laws where you reside, both you and your spouse (if applicable) will sign documents to confirm that the intended parents are the legal parents of their baby in advance of the birth. 

In some states, there are steps to complete post-birth. Because of this, it’s possible that you’ll attend a court date to solidify legal parentage. 

Ultrasounds and monitoring before birth

Around 20 weeks of pregnancy, you’ll have a 20-week fetal anatomy ultrasound and possibly a fetal echocardiogram, which is the ultrasound of the baby’s heart. In many cases, the intended parents like to come out for this appointment. At this appointment, you can also tour the delivery hospital together. We can assist with finding a point of contact at your delivery hospital to coordinate this. 

Most intended parents will plan to be in town two weeks before the due date (barring any indicators of an earlier birth) so that they don’t miss this special experience. It’s typical for the intended parents to be present for the birth, as long as the surrogate is comfortable with this.  

If you have a scheduled C-section or induction, please make sure to let both your intended parents and us know in advance. When labor begins, please let your OB, your intended parents, and us know right away. Even if your water breaks in the middle of the night, please let us know by calling us and the intended parents. You’re never bothering anyone, and we’re all here to support you!

After giving birth, please stay in touch with us and your intended parents in case of any postpartum medical appointments. We’d all love to know how you’re recovering from birth and provide support (and gratitude) whenever we can.

Experience the rewarding journey of surrogacy

At Hatch, we're proud to be one of the most established surrogacy agencies in the world, with the top 5% of candidates and top compensation. We greatly appreciate and cherish your contribution as a surrogate, and we'll do everything in our power to make sure that this is the life-affirming journey it's meant to be. 

If you have any questions or concerns, contact us and we'll get back to you as soon as possible. Make sure to learn about Surrogacy Success Rates, Surrogate Compensation, and the Surrogate Matching Process. 

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