Surrogate mother service full process and rights protection guide

Surrogate mother’s core responsibilities and service scope

Surrogate mother is an indispensable role in the chain of assisted reproduction, and her core responsibility is to complete pregnancy and delivery for the commissioning family. The scope of services is divided into two categories depending on the technological path:

Traditional surrogacy: using the surrogate mother’s egg to unite with the commissioning party’s sperm, there is a biological link between the surrogate mother and the child.
Gestational surrogacy: the embryo of the commissioning party is transferred to the uterus of the surrogate mother through in vitro fertilization (IVF), and the surrogate mother is not genetically linked to the child.

Core value of the service:

Fertility Replacement: Help women with hysterectomy, severe uterine adhesions, etc. to realize their desire to have children.
Reduce the risk of pregnancy: healthy surrogate mother to replace high-risk pregnant women to complete delivery, such as heart disease, pre-eclampsia patients.

Health Management and Medical Procedures for Surrogate Mothers

Medical screening and pre-initiation preparation

Surrogate mothers are required to pass a rigorous medical examination, including:

Reproductive system assessment: endometrial thickness ≥8mm (normal morphology of third line signs), ovarian reserve function (AMH >1.1 ng/mL).
Infectious disease screening: 8 mandatory tests for HIV, syphilis, hepatitis B, etc. to ensure no risk of vertical transmission from mother to child.
Psychological assessment: SCL-90 scale to screen for postpartum depressive tendencies, with a pass rate of only 65%.
Initiation process:

Pre-embryo transfer: injection of progesterone (60mg per day) to optimize endometrial tolerance and synchronous adjustment of hormone levels.
Embryo transfer operation: ultrasound-guided localization of the upper and middle uterine cavity, painless transfer within 10 minutes, with the rate of twin births controlled at less than 15%.

Pregnancy health monitoring standard

Residence management: stay in a medically supervised apartment, daily record of blood pressure (target <130/85mmHg), fetal heart rate (120-160 beats/min) and weight gain (≤0.4kg per week).
Nutritional program:
High-protein diet: 120g of protein per day (fish and legumes mainly) to reduce the risk of anemia in pregnancy.
Micronutrient supplementation: iron 30mg/day + DHA 200mg/day to prevent fetal neural tube malformation.
Emergency response: When signs of gestational diabetes mellitus or eclampsia are detected, a multidisciplinary consultation mechanism is activated and an intervention plan is formulated within 48 hours.

Legal Risks and Contractual Norms for Surrogate Mothers

Core Terms of Surrogacy Agreements

A legal surrogacy agreement needs to clarify the following

Attribution of parental rights: after embryo transfer, the commissioning party is the legal parent, and the surrogate mother has no right to claim custody.
Payment in stages: 30% for signing, 30% for successful transfer, 40% for final payment after delivery, and 50% deposit for breach of contract.
Division of medical liability: If the surrogate mother smokes or drinks alcohol and causes a miscarriage, she will have to return all the collected money and pay liquidated damages.

Special risks of transnational surrogacy

Conflict of laws: Some countries do not recognize the legality of surrogacy, and transnational birth certificates need to be certified by the Hague (Apostille) before they can be used.
Identity dilemma: Surrogate children may face nationality conflicts, such as the U.S. surrogate baby needs to be 21 years old before applying for a green card for the parents.

Psychological support and social integration of surrogate mothers

Psychological intervention for mother-infant separation

Postpartum evacuation mechanism:
Cognitive Behavioral Therapy (CBT): 2 weekly counseling sessions to alleviate separation anxiety and identity crisis.
Post-traumatic stress screening: assessed using the PCL-5 scale with a 35% positive rate.
Confidentiality agreement enforcement: Surrogate mothers are required to sign a lifelong confidentiality clause, but the agency can provide an “anonymous letter delivery” service that allows handwritten letters to be sent to the commissioning family once a year.

Career Transition Support Program

Skills training: Free training for the qualification of sister-in-law and baby-sitter, with an employment rate of up to 80%.
Economic support: Surrogate compensation (180,000-240,000 RMB) is paid out over 3 years to avoid short-term squandering leading to a return to poverty.

How to choose a compliant surrogacy service agency?

5 qualification standards of the agency

Legal record: need to hold assisted reproduction consulting or cross-border medical license, reject “black intermediary” cooperation.
Medical resources: partner hospitals should have ISO 9001 certified laboratories and clinical pregnancy rate >65%.
Transparent fees: Fees cover ovulation, legal documents and surrogacy compensation, no hidden consumption.

Client testimonials: Third-party platforms (e.g. Trustpilot) need to have a rating of ≥4.5 stars and provide video testimonials of at least 10 successful cases.

Autonomy guarantee for surrogate mothers

Physical autonomy: the surrogate mother has the right to refuse non-essential medical operations (e.g., fetal reduction) during the period of gestation, and the agency is required to provide alternatives.
Contract withdrawal mechanism: unconditional termination of the agreement before the 12th week of pregnancy, only 50% of the money received needs to be refunded.

Conclusion: Reinventing Surrogacy Ethics with Professional Services
Surrogate motherhood services are a combination of medical advances and humane care. Choosing a compliant agency, signing a loophole-free contract, and establishing a systematic physical and mental support system is the only way to achieve a win-win situation for the commissioning party, the surrogate mother and the child. We call on the industry to establish globally uniform ethical standards for surrogacy, strictly prohibit the objectification of women’s bodies, and let every life transmission carry dignity and hope.