Surrogate Requirements: What Qualification do you need to be a Surrogate Mother

Being a surrogate (or gestational carrier) is a selfless and rewarding process in which you carry a child into the world for a couple struggling to have a child on their own.

Surrogates play a vital role during one of the most meaningful chapters in a family’s life. To ensure the health, safety, and success of each journey, surrogacy agencies have precise requirements for the women who join their programs.

While a small number of surrogacy arrangements are done informally between family members, sometimes referred to as altruistic surrogacy, the vast majority of surrogacies in the U.S. are managed by licensed agencies. These agencies adhere to established guidelines to safeguard the physical, emotional, and legal well-being of all individuals involved.

In this guide, we’ll outline the general surrogate requirements commonly upheld by surrogacy professionals across the U.S., using Surrogate Steps’ specific standards as a detailed example. If you’re thinking about applying, understanding these criteria is the first step.

Gestational Carrier Requirements Overview

Most surrogacy agencies have similar guidelines for gestational carriers. Below are the typical qualifications required by most agencies, each aligned with the specific standards followed at Surrogate Steps:

• Age: Be between 23 and 43

• Proven (and Recent) Birth Record: Have given birth to at least one child without complications within the last 10 years

• Good Health: Be in strong physical and reproductive health

• Healthy BMI: Have a BMI between 18 and 38

• No Drug or Alcohol Abuse

• No Smoking: No Tobacco or Marijuana Use

• Strong Support Network

• Willingness to Travel

• Not Receive Section 8 Housing

• Live in a Surrogate-Friendly State (not NE or LA)

• U.S. Citizen or Permanent Resident

• No Felony Record (including anyone in your household)

This surrogate qualifications checklist serves as a reference for what most agencies require and what Surrogate Steps specifically looks for.

Let’s explore each of these requirements in more detail.

Age 23-43

Most surrogacy professionals require that gestational carriers fall within a healthy reproductive age range.
At Surrogate Steps, surrogate applicants must be between 23 and 43 years old.

This requirement ensures surrogates are physically capable of carrying a pregnancy and emotionally mature enough to navigate the process.

A Proven (and Recent) Birth Record

Agencies typically require surrogates to have at least one full-term, uncomplicated pregnancy and delivery.

At Surrogate Steps, this is a firm requirement. A healthy pregnancy and delivery history offers reassurance that a surrogate is likely to carry safely again.

Additionally, your most recent birth must have occurred within the past 10 years, as more recent pregnancies provide a clearer picture of current reproductive health and make it significantly easier to obtain the necessary medical records for review.

Surrogates who have completed a prior surrogacy journey may also receive an additional $5,000 per successful previous surrogacy.

Reside in a Surrogate-Friendly State

Due to various state laws, the surrogate must reside in a state that is friendly to surrogacy and the intended parents’ ability to secure proper parentage rights.

Most states permit compensated surrogacy in some form, although states differ in the complexity of establishing parentage.

As a surrogate, however, it’s only essential that you do NOT live in Louisiana or Nebraska.

While uncompensated or “altruistic” surrogacy may be possible in these states, compensated surrogacy arrangements/agreements are generally void and unenforceable. Additionally, those entering a paid surrogacy arrangement are subject to criminal penalties.

Good Health

A woman must be in good health to qualify as a gestational surrogate. To qualify, surrogates must:

• Obtain a clearance note from their OBGYN stating they are healthy and fit for pregnancy.
• Pass a medical records inspection from a healthcare specialist.
• Pass a reproductive health exam and testing by a fertility specialist.
• Pass a home study screening and various subjective social and mental health measures.

For example, things like high blood pressure, heart issues, gestational diabetes, cholelithiasis, unfavorable cervix, and more could disqualify you from becoming a surrogate. 

According to the American Society of Reproductive Medicine , the surrogate should undergo the following testing at the fertility clinic:

• Uterine Cavity Evaluation: HSG, SHG
• Preconception Bloodwork
• Physical examination for Infectious disease:
  
  • Physical evidence for the risk of sexually transmitted disease, such as genital ulcerative lesions, herpes simplex, chancroid, and urethral discharge;
  • Physical evidence of risk for syphilis or evidence of syphilis;
  • Physical evidence of nonmedical percutaneous drug use, such as needle tracks; the examination should include the examination of tattoos,  which might obscure needle tracks;
  • Physical evidence of recent tattooing, ear piercing, or body piercing  (within the past 12 months) where sterile technique was not used.
  • Disseminated lymphadenopathy;
  • Unexplained oral thrush;
  • Blue or purple spots consistent with Kaposi sarcoma;
  • Unexplained jaundice, hepatomegaly, or icterus;
  • Large scab consistent with recent history of smallpox immunization;
  • Eczema vaccinatum, generalized vesicular rash, severely necrotic lesion (consistent with vaccinia necrosum), or corneal scarring (consistent with vaccinial keratitis).
• Lab testing for Infectious disease:
  • HIV-1 antibody;
  • HIV-2 antibody;
  • HIV group O antibody;
  • HTLV-1 and HTLV-2 (male partner of GC only);
  • Hepatitis C antibody;
  • Hepatitis B surface antigen;
  • Hepatitis B core antibody (IgG and IgM);
  • HIV, HBV, and HCV nucleic acid test;
  • Serologic test for syphilis;
  • CMV (IgG and IgM) (Male partner of GC only);
  • N. gonorrhoeae and C. trachomatis testing using the nucleic acid test on urine or a cervical or urethral swab using an FDA-licensed, -approved, or -cleared test labeled for the detection of these organisms in an asymptomatic, low-prevalence population.

Have a Healthy BMI

While BMI is technically part of an overall health assessment, it’s often called out as a separate requirement because it offers a quick and objective measure that helps agencies and clinics make initial screening decisions.

At Surrogate Steps, eligible candidates must have a Body Mass Index (BMI) between 18 and 38. This range is considered healthy for pregnancy and aligns with the guidelines of most fertility clinics.

A BMI outside of this range may increase the risk of complications and typically results in disqualification during the early stages of the screening process.

Calculate your BMI here.

No Drug or Alcohol Abuse

Surrogates must maintain a healthy, stable lifestyle—this is a universal agency standard.

At Surrogate Steps, applicants must have no history of drug or alcohol abuse to ensure a safe and healthy environment for the baby.

No Tobacco and Marijuana Use

While tobacco and marijuana are technically classified as drugs, they are often called out separately because of how frequently they are used, and because some people don’t view them in the same category as other substances.

At Surrogate Steps, you must be completely free from tobacco, marijuana, vaping products, and any form of smoking for at least 6 months before applying. This is essential to protect the health of the baby, support a healthy pregnancy, and meet the requirements of fertility clinics.

Have a strong support network

A strong support system is universally important across all agencies.

Surrogate Steps evaluates whether candidates have consistent emotional and logistical support from family or close friends. If married or partnered, that person must be fully supportive of the journey.

Willingness to Travel

While surrogates are occasionally matched with intended parents who live nearby, more often than not, surrogates must travel out of their local area or state. Unfortunately, kids are usually not allowed to accompany the surrogate on these trips.

Surrogates are usually required to travel to the intended parents’ fertility clinic for a reproductive health evaluation as well as for any embryo transfer.

Having someone you can depend on for childcare during overnight travel is one of the key reasons you need a strong support network to qualify as a surrogate.

Government Assistance

While it may seem counterintuitive, surrogates are not allowed to receive certain types of government assistance—specifically Section 8 housing—to qualify for most surrogacy programs, including Surrogate Steps.

Section 8 and similar housing assistance programs have strict income limits in order to remain eligible. Because surrogate compensation typically ranges between $45,000–$75,000, participation in a surrogacy journey would almost always make a person ineligible for this type of support.

While receiving this level of compensation might sound like a financial step forward, agencies have found that losing long-term housing assistance can create significant hardship, especially if the surrogate’s financial situation changes after the journey ends. Over time, agencies like Surrogate Steps have learned that the short-term gain of compensation often does not outweigh the long-term risks associated with losing housing stability.

As a result, you cannot receive Section 8 housing to qualify as a surrogate with Surrogate Steps.

That said, not all forms of government assistance disqualify you. Programs like SNAP (Food Stamps) or Medicaid may still be acceptable, depending on your situation. If you’re unsure, we’re happy to talk through your eligibility.

Surrogate-Friendly State

To become a gestational carrier with any reputable surrogacy agency, you must live in a state where compensated surrogacy is legally permitted and enforceable.

At Surrogate Steps, we cannot accept applicants who reside in Nebraska or Louisiana. That’s because both states have laws that either prohibit compensated surrogacy altogether or refuse to legally recognize surrogacy contracts, making it virtually impossible to protect the rights of all parties involved.

If you currently live in either of these states, you would need to relocate to a surrogacy-friendly state before applying.

Surrogacy laws vary by state, so we always verify legal eligibility during the application process to ensure that intended parents can obtain legal parentage smoothly and ethically.

U.S. Citizen or Permanent Resident

To become a surrogate with Surrogate Steps, or nearly any U.S. based surrogacy agency, you must be a U.S. citizen or a lawful permanent resident. This requirement exists for several important reasons related to legal, medical, and logistical stability throughout the journey.

First, numerous legal steps are involved in a surrogacy arrangement, including contracts, court orders, and establishing legal parentage for the intended parents. These processes vary by state but often involve the courts and require participants to have legal status in the U.S. to ensure the agreements are valid and enforceable.

Second, surrogates must undergo medical treatment at licensed U.S. fertility clinics, sometimes across state lines. Citizenship or permanent residency ensures there are no barriers to traveling for appointments, accessing medical care, or participating in legal proceedings.

Lastly, being a U.S. citizen or permanent resident provides a baseline level of stability and security throughout the journey for the surrogate, the intended parents, and the future child.

Applicants must also possess a valid government-issued ID or driver’s license, which is used for identity verification, background checks, and medical and legal documentation.

No Felony Records

Surrogacy is a deeply personal and legally complex process that involves a high level of trust and accountability. For this reason, surrogacy agencies— including Surrogate Steps—require that all applicants have no felony convictions, and that no one residing in the same household has a felony record either.

This policy is in place to ensure the safety, stability, and reliability of the surrogate’s home environment throughout the pregnancy. Intended parents, legal professionals, and fertility clinics all rely on the integrity and background of the surrogate and those around her.

Felony convictions, particularly those related to violence, fraud, drugs, or child welfare, may raise concerns about judgment, decision-making, or safety. Even if an applicant has maintained a clean record personally, having someone with a felony conviction in the household could affect the perception of risk and may create challenges during the screening, legal, and home study processes.

For this reason, both the surrogate applicant and all adult household members must undergo and pass criminal background checks as part of the qualification process.

This requirement helps protect everyone involved—including the surrogate, the intended parents, and the baby—by establishing a clear foundation of trust and legal security.

Recap of Gestational Carrier Requirements

Becoming a surrogate is a generous and life-changing commitment and one that comes with specific gestational carrier requirements designed to protect the health, safety, and legal interests of everyone involved.

While surrogate requirements are fairly consistent across agencies, this guide has used Surrogate Steps’ standards to provide real-world clarity on what’s expected.

To qualify, you must meet key criteria related to age, health, lifestyle, and legal status, including:

• Being between the ages of 23 and 43

• Having had at least one uncomplicated full-term pregnancy within the past 10 years

• Maintaining a healthy BMI between 18 and 38

• Passing medical and psychological screenings

• Being tobacco, marijuana, and drug-free

• Having a strong support system and a willingness to travel

• Not receiving Section 8 housing assistance

• Live in a surrogacy-friendly U.S. state (not Nebraska or Louisiana)

• Holding U.S. citizenship or permanent residency

• Having no felony record (and living with no one who does)

Meeting these requirements ensures that you and the family you’re helping are set up for a safe, stable, and successful journey.

If this sounds like you, and you’re ready to help build a family while being generously compensated for your time, dedication, and sacrifice, we’d love to hear from you.

Apply today to become a surrogate with Surrogate Steps.