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Surrogacy is an arrangement between a woman and a couple or individual to carry and deliver a baby. It is a controversial process that is not legal in all states. The surrogate mother is also known as a gestational carrier. In many cases, the process is an expensive, time consuming, and emotional one. Women or couples who choose surrogacy often do so because they are unable to conceive due to a missing or abnormal uterus, have experienced multiple pregnancy losses, or have had multiple in vitro fertilization attempts that have failed. The advantage of gestational surrogacy to the parents is that the embryo is created from the woman’s egg and the man’s sperm, so it is biologically theirs.

The surrogacy arrangement is sometimes made through an agency and other times contracted privately. When searching for a surrogate mother, a couple might use the Internet, contact an agency, or network through friends and family. Surrogacy arrangements are sometimes made between strangers who never meet, or between persons who meet only occasionally through the process. A surrogacy arrangement might also involve persons whose lives become intertwined during the process, and even those who are family members or friends before entering a surrogacy arrangement.

In gestational surrogacy, the embryo is implanted in the surrogate through in vitro fertilization. The surrogate carries the baby to term, then gives up the child and signs over parental rights at birth. Usually, the couple pays legal fees, agency fees if applicable, and a fee to the carrier. If the carrier does not have health insurance that covers prenatal care and delivery, the couple would most likely pay those costs also.

Disadvantages of surrogacy include the possibility that the surrogate will change her mind about giving up the rights after birth. Some couples also worry about legal issues. There might also be differences between the couple and the carrier regarding medical, nutritional, or testing issues.

The success rate of surrogacy cannot be determined because it is dependent on many factors. The first successful gestational surrogacy took place in 1985. Other forms of surrogacy have existed since Biblical times.

The surrogacy issue was highly publicized when the “Baby M” court case was presented in New Jersey in the mid 1980s. In this custody case, the surrogate mother declared she was unable to fulfill her contract and turn over the child she carried to the intended parents. Initially, the court ruled for the intended parents and gave them custody. Later, the surrogate mother regained some parental rights and was granted parental visitation.