Gestational surrogacy used to be something only wealthy Hollywood starlets could undergo to build their families. Today, though, it is slowly becoming an increasingly accessible option, and is particularly appealing for LGBTQIA couples, individuals, and women who are unable to carry their own child. Between 1999 and 2013, there were at least 18,400 infants born via surrogacy in the United States, according to the CDC.
Adoption has also always been a wonderful option for starting a family. There can be potential legal complications and emotional challenges when working with a birth mother or adoption agency, and the adoptive parents do not have a biological connection to the child, which means the process isn’t right for everyone.
If you’re reading this article, then you are likely considering your options for building a family. Understanding the similarities and differences between gestational surrogacy and adoption comes down to a few simple factors.
Both processes have similarities as well as differences that are important to understand. One of the first things to know about both of these options is that they come with their own lingo. Knowing and understanding that lingo from the start can help you understand the process as you learn more.
In adoption, the potential parents are referred to as “adoptive parents.” In surrogacy, potential parents are known as “intended parents.” The end goal is the same — to become parents of a beautiful little baby or, with adoption, it could be an older child. How couples or individuals arrive at parenthood, though, is where these two options vary.
If you opt to pursue surrogacy, the person who will carry your child on your behalf is typically referred to as a “gestational carrier” or “gestational surrogate.” Although you’ll still hear some people refer to her as a “surrogate mother,” this term is somewhat outdated because the “intended parent” or “intended parents” are the true parents, and gender identity runs the full spectrum for parties involved in surrogacy journeys. In many cases, at least one of the intended parents is the biological parent.
Previously, and on occasion today, some surrogates are also the biological “surrogate mother” of the child via what is called “traditional surrogacy” or “genetic surrogacy.” These women would undergo fertility treatments to conceive using their own egg with sperm from the intended father or a sperm donor. Today — as you’ll see later — it is rare for a surrogate to have any biological connection to the child or children that are carried, which is one reason that surrogates are no longer referred to as “surrogate mothers.” Indeed, traditional surrogacy is illegal in many states, because it is considered “baby selling.” In states where it is legal, the parentage process is more akin to adoption than to gestational surrogacy.
Adoption is the legal process that unites a child who has already been conceived — and sometimes already born — with adults who take legal responsibility and assume the role of the “parent.” In adoption, you bring a child into your family who is typically not biologically related to you or your partner.
On average, Americans adopt 135,000 children each year. Many of these adoptions occur through the foster care system or an adoption agency. Some couples or single adoptive parents opt to adopt a child from overseas. In some cases, the decision to adopt is based on religious or spiritual beliefs and a deep desire to give a loving, stable home to a child who doesn’t have one. For others, cost or a difference in the regulations surrounding who can adopt may lead them to look internationally for a child.
In the adoption process, the “birth mother” might bring a unique or challenging family situation to the table. In many cases, birth mothers — and fathers — confidently choose to place their child with a loving family. In other cases, there may be emotional complications that come with the decision to hand their biological child over to another parent. There is a growing trend in the U.S. for adoptions to be “open adoptions,” with contact with the birth parents after the adoption.Overall, the adoption process can be a beautiful journey for all parties involved, and it honors the fact that all families can come in different shapes and sizes.
Surrogacy, on the other hand, occurs when a woman agrees to carry a baby on behalf of a couple or individual who is unable to biologically become pregnant with their own child. In some cases, this is due to infertility or other health issues. In other cases, it allows LBGTQ+ intended parents to build a family. In all cases, the decision to be a gestational surrogate — or to seek one out — happens long before a child is ever conceived via an embryo transfer.
Most of the time, a gestational surrogate is a woman who will be matched to intended parents, conceive via in vitro fertilization, or IVF, and receive compensation for carrying the child. Occasionally, intended parents have a friend or relative who has volunteered to carry their child but, most of the time, the gestational surrogate has not met the intended parents before they were matched. There are also a few states within the United States and many other countries in the world where compensated surrogacy is not allowed.
Once a gestational carrier is matched to intended parents, she will undergo at least one — if not several — rounds of IVF to become pregnant with the intended parents’ child. During the pregnancy, a surrogate typically is excited to share the joys and milestones that happen in any pregnancy with the intended parents. Once the pregnancy is far enough along, intended parents can finally begin the countdown to bringing their baby home.
Whether you choose to pursue adoption or surrogacy, it’s difficult to have a firm timeline as to how long you will need to wait. After all, in the end, babies always come in their own time! But the amount of time it takes to work through adoption vs. surrogacy is important to consider.
The surrogacy timeline begins with an intensive screening process for both the intended parents and the gestational surrogate. This important and thorough screening process has to be completed before a gestational surrogate can even become pregnant. To become a gestational surrogate, certain criteria must be met, depending on the IVF clinic an intended parent has selected.
A surrogate candidate must complete a detailed medical history screening, as well as undergo an extensive medical evaluation. Surrogate candidates also complete a psychological evaluation to ensure she is mentally prepared and suitable for the various aspects of a surrogacy journey, including the fact that she will be carrying another family’s child. During this time, the intended parents may also be undergoing procedures to retrieve eggs or sperm to be used to fertilize the embryos that will be placed inside the gestational carrier via an “embryo transfer.”
Because a gestational surrogate has to go through fertility treatments and IVF to conceive, there is no way to pinpoint an exact timeline for how long surrogacy will take. Some gestational surrogates become pregnant after the first embryo transfer, while others may require a couple of rounds of IVF to become pregnant. In general, however, the process for screening gestational surrogate candidates and matching them with intended parents through a first introductory meeting can take an average of six to nine months, if your agency’s vetting process is strict. At Creative Family Connections, 98% of candidates do not make it all the way through the pre-screening process.
There is no timeline for how long it may take to be selected as adoptive parents. When intended parents opt to pursue adoption, they typically undergo a rigorous screening process to ensure they can provide a safe and loving home to a child. Then, they wait to be selected by a woman who is carrying a child or to be accepted into an adoption waitlist through an agency. The adoption timeline for abroad adoptions via adoption agencies and orphanages varies greatly as well.
The good news is that once intended parents are selected a birth mother may already be pregnant, or a baby may have been recently born, which means they generally won’t have to wait nine months for the baby to be born. But, in adoption, the birth mother typically has the right to change her mind up to a certain point after the baby is born, which means the adoptive parents won’t know for sure the baby is theirs until after the birth. It is best to try to be as prepared as possible, accept the unexpected, and remain patient and positive.
One of the other potential hold-ups with the adoption process is that babies are in high demand for loving households. If adoptive parents have their heart set on adopting an infant, they may be on a waitlist for several months or possibly years before they are selected. Parents willing to adopt older children may not have to wait as long. On occasion, intended parents will remain on an adoption waitlist while they pursue surrogacy as well. So long as all parties are on the same page, this dual method of family building can be an option for those hoping to have two or more children as soon as possible.
One common question that comes up as couples debate whether to pursue adoption or surrogacy is which costs less, surrogacy or adoption. While no one wants money to be the way they make such an important decision, it is a major factor in considering your options. Both are expensive undertakings, but what you pay and what those costs include varies depending on a number of factors.
Many potential adoptive parents choose to work with an agency to find a child. An adoption agency provides all the guidance and legal assistance needed to find a child and bring them home. Adoption costs typically include legal fees, the cost of a home study if required, medical expenses for the birth mother — if she isn’t covering her own — and travel if the child is out of state or in another country. Other than some assistance with medical expenses (in states where it is allowed), the birth mother receives no compensation for carrying and giving birth to the child.
Similarly, many potential parents building their family via surrogacy also choose to work with an agency. A surrogacy agency helps to find a gestational surrogate and guides the intended parent or parents through the entire process. Surrogacy costs can vary, depending on the agency you work with and what services they offer. If a gestational surrogate requires multiple rounds of IVF to conceive or if an intended parent needs to use a sperm and/or egg donor, the price can be greater. In general, the costs of surrogacy will include all agency fees, medical fees, and compensation for the gestational surrogate. Intended parents typically also pay for any lost wages or childcare expenses a gestational surrogate incurs during the process. Curious about additional stipends a gestational surrogate may receive? See our surrogate financial page here.
In some cases, prospective parents may choose to pursue private adoption, which means they don’t use an agency to pursue adoption. Instead, they connect with a woman who wants to give her baby up for adoption, and, using an experienced attorney, they work out a legal agreement regarding the child. Private adoptions vary widely in their costs, with legal fees being the biggest contributing factor to the cost. In an adoption, the biological mother does not receive money for giving up her child for adoption.
Whether pursuing adoption privately or through an agency, many potential adoptive parents can apply for grants that help cover their costs. Some also raise money via community fundraisers to offset costs. And, in some cases, some employers offer financial assistance to employees who are adopting. Adoptive parents are also eligible for a federal tax credit in the year they adopt, and any employer adoption assistance they receive cannot be taxed.
Surrogacy is also something that some intended parents decide to do independently — i.e., without the assistance of an agency. In some cases, a woman may agree to carry a child for a relative or close friend as a surrogate. In these cases, the intended parent or parents might decide to forego the help of a surrogacy agency, and complete an independent, or “indie” surrogacy journey. However, even when a surrogacy journey is orchestrated privately or independently of an agency, there are still a lot of medical and legal expenses that are necessary. Although there are no tax credits or employer assistance (for most companies) available for surrogacy, many intended parents take advantage of surrogacy financing opportunities to help spread out the cost of surrogacy and make it more manageable over time. Employers are slowly starting to increase infertility and surrogacy benefits, and we hope to see more employers offer this kind of assistance in the near future!
It’s important to carefully weigh the costs and benefits of surrogacy before you proceed. One of the biggest reasons intended parents choose surrogacy is because they want to have a biological connection to their child. In many cases, at least one of the intended parents has contributed their genetic material to create the embryo that is implanted in the surrogate.
In the United States, there is no national law governing surrogacy. This means that each state has its own statutes or case laws (and sometimes no published law at all) regarding surrogacy and how it can be pursued in that state. This is why many people pursuing surrogacy to add to their family work with agencies and surrogacy attorneys to safely navigate the legal landscape. International surrogacy laws vary widely as well, with many international countries prohibiting surrogacy in their country. In many cases, international intended parents will seek surrogacy services abroad to complete a surrogacy journey so long as they go to a place where it is legal. The surrogacy agency you work with does not need to be based in your state of residence, in the same way that international intended parents often will seek the help of a reputable agency in the United States.
In surrogacy, the legal analysis begins during the matching process. It is very important to ensure that the match between the intended parent and surrogate is legally sound before proceeding with a surrogacy journey. An intended parent’s relationship status, the surrogate’s relationship status, the intended parents’ state or country of residence, and the kind of genetic material used for the embryo transfer are all factors that need to be carefully considered to ensure a match is legally sound for all parties involved. For international clients, this includes the ability to obtain citizenship rights for the child once they return home. International and intended parents who reside in the United States cannot safely be matched to a gestational surrogate in every state in the United States, therefore, it is important to seek experienced surrogacy attorneys to guide you in this critical legal process.
Once a match is confirmed by an agency and/or surrogacy attorneys, both parties can then enter into a legal agreement for the carrier to conceive and carry a child on behalf of the parent or parents. The legal agreement needs to be comprehensive, specifying the legal intentions and the obligations of all parties and the schedule of all fees and compensation. Before the baby is born, the legal process continues, with a court order obtained naming the intended parent(s) as the sole legal parent(s) of the child and specifying that the gestational surrogate and her spouse, if applicable, have no legal rights or obligations for the child. The gestational surrogate will be part of this legal court proceeding, as she does not want any of the legal obligations for the child. A surrogate is usually overjoyed and grateful to have been a part of an intended parent’s journey to parenthood, and she is equally overjoyed not to have the diapers phase of caring for a newborn!
Like surrogacy, the adoption process has benefits and costs that need to be weighed carefully when deciding how to proceed. Many potential parents choose to pursue adoption because they want to build their family with children who need a home. Because birth mothers aren’t matched with adoptive parents until the baby has already been conceived, adoptive parents feel that they can give a good home to a child who might not otherwise have one.
Another reason some couples choose to pursue adoption is because, in some cases, it costs less than surrogacy. However, this isn’t always the case, so cost should only be one of many factors you weigh when considering adoption versus surrogacy.
One of the “cons” of adoption is the legal process. In adoption situations, the legal process of surrendering a baby to the adoptive parents is completed after the baby is born. Most US states even allow the birth mother a window of time after birth to change her mind before the adoption is finalized. This creates a certain amount of uncertainty within the adoptive process because it is possible for a birth mother to change her mind. Birth mothers sometimes change their minds and withdraw their child or children from the adoption process after birth, creating a heartbreaking situation for the adoptive parents.
In both surrogacy and adoption situations, everyone involved has to decide what — if any — contact will be allowed between the woman who carried the child and the family raising the child. In the case of surrogacy, intentions about communications and a future relationship are part of the matching process between the intended parents and gestational surrogate. Some gestational surrogates and intended parents want to stay in touch, exchanging photos and emails as the child grows. Other families choose not to maintain a relationship with their gestational surrogate after birth.
In adoption, the birth mother and the adoptive parents must decide whether they want an “open” or “closed” adoption. In a closed adoption, both parties agree that they will not have any contact with each other once the baby goes home with the adoptive parents. Some adoptive parents may even choose not to share information with their child about their biological parents or adoption history at all; however, this is considered to be an unethical practice. In an open adoption, the child not only knows about the adoption, but the adoptive family may have regular visits from the birth mother. Of course, the frequency of these visits can vary.
There is a lot to consider when choosing whether to pursue surrogacy or adoption as a means to start your family. Is surrogacy better than adoption? It’s difficult to say because each family — and each situation — is different. In all situations, adoption pros and cons should be carefully weighed next to surrogacy pros and cons.
At Creative Family Connections, our team of experienced professionals has assisted hundreds of intended parents as they pursued the dream of completing a family via a gestational surrogate. No matter how many times we watch this process unfold, we are continually amazed at the unique and powerful stories from our intended parents — and their surrogates — as they journey through the process of conception, surrogate pregnancy, and birth.
If you are interested in learning more about surrogacy or ready to take the first step toward extending your family, we are here to help! Contact us today to learn more or begin your surrogacy journey.