u/DanielMalak

I had an interesting conversation today with someone who previously carried as a surrogate and she mentioned that almost all of the materials, expectations, and conversations she encountered assumed a hospital birth from the very beginning.

She said there was very little discussion around:

• home birth
• birthing centers
• midwife-led care
• lower-intervention birth preferences
• or even whether a GC had options outside the traditional hospital model

It made me curious how other people in the surrogacy community think about this.

For GCs:

• Did you feel like hospital birth was just assumed?
• Did you personally WANT a hospital birth, or did you feel pressure toward it?
• Would you ever consider a birthing center or home birth in a surrogacy journey?

For intended parents:

• Would you feel comfortable with a non-hospital birth setting?
• Would that make you anxious? Why or why not? (full transparency: it made me anxious 😬)
• Would you want input into that decision, or do you see it as primarily the GC’s choice?

And for everyone:

• Is there a stigma around home birth in surrogacy specifically?
• Does surrogacy automatically push people toward a more medicalized process?
• Are clinics, agencies, attorneys, or insurers part of the reason?

I’m also genuinely curious what people should know if they’re considering alternatives to hospital birth in a surrogacy journey.

Not looking to start a “hospital vs home birth” debate here. But, I do think this is one of those topics people probably have strong feelings about, but rarely discuss openly in the context of surrogacy.

Would love to hear real experiences from GCs, IPs, doulas, midwives, OBs, attorneys, or anyone who’s actually navigated this.

Genuinely asking, because I've been watching a pattern develop in agency-assisted (and independent) surrogacy, and I want to put it to this community directly.

• Do you require PGT testing before transfer?
• Did your agency or matching service weigh in on it?
• And if you're a surrogate, is this something you discuss with your IPs before you commit to a match?

Why I'm asking these questions:

Some service providers have started listing the absence of PGT testing requirements as a selling point or a feature, right alongside things like no rematching fees and agency owner access. Frankly speaking, I think this is a clinical judgment call being made by people who are not clinicians, on behalf of families who deserve an actual conversation.

To be clear, ASRM does not require PGT-A either. Their 2024 joint opinion with SART walked back universal recommendations. The science is unsettled, and I'm not here to tell you everyone needs to test. That's a conversation for you, your reproductive endocrinologist (RE), and your genetic counselor.

What I am saying is that "no testing required" sounds like it shouldn't be on a features list. What do you think?

IMO, when a business tells you upfront that genetic testing isn't "necessary", ask yourself: necessary according to whom? Your RE didn't say that. A genetic counselor didn't say that. The business that gets paid when your match closes said that. Those are different sources with different incentives. Weigh them accordingly.

If you're a GC, you're the one who goes through the medication protocol, the monitoring, and the transfer. You're the one carrying the physical and emotional weight if a cycle fails. Whether your IPs' embryos have been tested is a completely reasonable thing to raise before you match, and any service that makes you feel like it isn't might not be working in your interest.

DISCLAIMER: This is not medical advice. Talk to your RE about whether PGT testing is appropriate for your situation.

IMO, one thing that doesn’t get talked about enough in independent surrogacy: legal mistakes aren’t usually about bad intentions, they’re about timing.

I’ve been noticing a pattern where people start building a match, having big-picture conversations, and sometimes even moving more toward medical steps before fully bringing in attorneys.

Then contracts get rushed, or important topics come up late, when it’s harder to navigate them cleanly.

So, I’d love to hear from fertility attorneys (and anyone who’s been through this):

>What do you most often see go wrong when legal isn’t brought in early enough?

And just as important:

>When would you ideally want intended parents and gestational carriers to involve attorneys?

Some specific things I’m curious about:

• Is it better to engage legal before matching, or once both sides feel aligned?
• What absolutely needs to be addressed before any medical steps begin?
• What are the issues that seem “simple” early on but actually need careful legal structure?
• What becomes much harder to fix later if it’s not handled upfront?

From what I’ve seen, independent journeys can go really well, but the legal side seems to be one of the biggest make-or-break factors depending on when it’s introduced

Would really value hearing from attorneys, as well as IPs or GCs who learned this firsthand. And especially curious how this varies by state, because I know timing and requirements can look very different depending on where you are.

I’ve been curious to learn more about the “why” behind the choice to become a surrogate.

If you’ve been a gestational carrier (or are seriously considered it), what made you take that step?

Was it something personal, like seeing someone close to you struggle to build a family?
Or was it more about wanting to help in a really tangible way?

I’m especially curious how you thought about the emotional side going in vs. what it actually felt like during and after.

No right or wrong answers here. I’d just really value hearing real experiences from people who’ve lived it.

Disclosure: I am not affiliated with any surrogacy agency. I am currently building a community focused on fertility journeys and I moderate r/IndependentSurrogacy.