Surrogate Pregnancy Process: During Pregnancy Guide

Pregnancy through surrogacy is a unique journey, grounded in teamwork, trust, and medical precision. Once a blood test confirms pregnancy, the journey truly begins, bringing a rhythm of checkups, medications, bonding moments, and shared anticipation. This guide outlines what surrogates and intended parents can expect during each trimester, clearly defining roles and responsibilities.

Learn more about the whole surrogacy process here.

After Pregnancy Confirmation: What’s Next?

Once pregnancy is confirmed via a positive beta hCG blood test, surrogates start a carefully monitored regimen supporting the developing embryo:

• Medications: Hormonal medications (estrogen, progesterone) continue for the first 8–12 weeks to maintain a healthy uterine environment.
• Appointments & Monitoring: Regular bloodwork and ultrasounds are initially coordinated by the IVF clinic, transitioning to the OB-GYN as pregnancy progresses.
• Intended Parent Involvement: Agencies like SurrogateFirst facilitate communication, establishing clear expectations around update frequency.

First Trimester (Weeks 1–12)

• Ultrasounds: 6–7-week ultrasound confirms a heartbeat, with additional scans as needed.
• Medications: Continued hormonal support until placenta fully functions (around week 10–12).
• Check-ins: Open communication about symptoms and milestones builds trust.

Second Trimester (Weeks 13–27)

• OB Appointments: Monthly prenatal care with local OB-GYN.
• Screening Tests: Genetic tests, 20-week anatomy scan, blood pressure checks.
• Parental Involvement: Intended parents often attend anatomy scans virtually or in-person, marking significant bonding moments.

Third Trimester (Weeks 28–40)

• Monitoring: Frequent OB visits (biweekly or weekly), fetal positioning, heartbeat checks.
• Delivery Planning: Birth plan finalized in collaboration with surrogate, intended parents, and care team.
• Parent-Surrogate Coordination: Final logistics include travel plans, hospital preparations, and communication flows.

Surrogacy Responsibilities: Who Does What?

Clear expectations help surrogacy journeys thrive:

Medical Release Forms: Who Signs and When?

Surrogates sign medical release forms after pregnancy confirmation, typically when transitioning from fertility clinic to OB-GYN care. These forms authorize intended parents and the agency to receive health updates.

Keeping Intended Parents in the Loop

Intended parents desire inclusion without overwhelming their surrogate. Communication style and frequency (weekly updates or milestone-focused communications) are agreed upon early in the process.

Medical Appointments: Who Attends?

Surrogates attend all required medical appointments. Intended parents are encouraged (but not obligated) to join:

• First heartbeat ultrasound
• 20-week anatomy scan
• Third-trimester OB visits (optional)
• Delivery

SurrogateFirst helps coordinate these appointments.

The Birth: Intended Parents’ Involvement

Typically, intended parents travel in advance to attend the birth, either in-room or nearby, depending on comfort levels and hospital policies. After delivery, parents typically receive their baby immediately—a profound emotional experience.

What is a Post-Birth Meeting?

A post-birth meeting, scheduled within days or weeks post-delivery, allows surrogate, case manager, and intended parents to reflect, express gratitude, and discuss the experience. Many choose to maintain ongoing relationships beyond this meeting.

Ready to Learn More?

Explore the entire journey in our Surrogacy Process Guide.