If you are looking into the possibility of having another person carry your baby, it’s important to know what these types of surrogacy arrangements mean. Learn more about the difference between a gestational carrier and a surrogate.

What Is a Surrogate?

Surrogate is a frequently misused and misunderstood term. When people refer to a “surrogate,” they usually intend to refer to a person who carries a pregnancy for another person. However, the proper term (in the vast majority of cases) is a gestational carrier. Gestational carriers are also called gestational surrogates. Technically, calling someone a surrogate is only correct if the pregnancy uses the gestational carrier’s own eggs as opposed to the eggs of another, such as an egg donor’s or the intended mother’s. This type of gestational carrier is called a traditional surrogate.

What is a Traditional Surrogate?

A traditional surrogate is someone who is genetically related to the child they are carrying. In other words, the surrogate’s eggs will help conceive the child. A traditional surrogate may also be called a partial surrogate, natural surrogate, or just surrogate. This arrangement is also sometimes known as straight surrogacy. Sometimes, people refer to traditional surrogates as the “surrogate mother.” However, this term is typically avoided as it can cause confusion about who the parent (or parents) of the baby is. The parent (or parents) of the baby is the person or couple that arranged for the surrogacy. This person (or people) is called the baby’s intended mother, father, or parent. In traditional surrogacy, the surrogate’s eggs are fertilized via an insemination procedure, so IVF is not required. The insemination may be via intrauterine insemination (IUI), where specially washed sperm cells are transferred directly to the uterus via a catheter, or another form of artificial insemination may be used. Alternative options to IUI are intracervical insemination and intravaginal insemination.  Often, the male intended parent provides the sperm. However, in other cases, a sperm donor is used. If a sperm donor is used in traditional surrogacy, there is an increased risk of legal complications. This is because the child is not genetically related to the intended father or mother. In this case, an adoption procedure may be required to establish parenthood for the intended parents.

Complications With Surrogates

A traditional surrogacy arrangement is rarely recommended because it is riskier from a legal standpoint than a gestational carrier. Since the baby is genetically related to a surrogate and they are giving birth to the baby, surrogacy contracts may be questioned if the surrogate changes their mind about giving the baby to the intended parents. This may occur regardless of what papers are signed beforehand.

What Is a Gestational Carrier?

A gestational carrier, or gestational surrogate, is a person who is not genetically related to the child they are carrying for an intended parent or parents. The arrangement is also called IVF surrogacy, host surrogacy, or full surrogacy. In gestational surrogacy, the egg and sperm are usually taken from the intended parents, as in an IVF procedure, and any resulting embryo is transferred to the gestational carrier. But this is not always the case. Other possibilities include the intended mother’s egg along with a sperm donor, the use of an egg donor with an intended male parent’s sperm, an egg donor with a sperm donor, and an embryo donation.

Compensated vs. Compassionate Surrogacy

The term “compensated surrogacy” refers to an arrangement where the gestational carrier receives financial compensation above and beyond any expenses related to the pregnancy. This is a legal arrangement in some states and countries. Another term for compensated surrogacy is “commercial surrogacy,” though this term is considered to be outdated.  In some places, compensated surrogacy is illegal. In that case, the intended parents may pay for medical costs, legal costs, lost work, or other “reasonable expenses,” but they cannot pay the gestational carrier purely for their role as a gestational carrier. Surrogacy arrangements where there is no additional financial compensation beyond “reasonable expenses” are called “compassionate surrogacies.” An outdated term for compassionate surrogacy is “altruistic surrogacy.”

There are also places where any form of gestational carrier or surrogacy is illegal. In those locations, contracts declaring the intended parents as the true parents are not recognized, valid, or enforceable. Surrogacy contracts may also not be enforceable even in states or countries where surrogacy is technically legal, while other states and countries do enforce surrogacy contracts. Due to the complexity of surrogacy arrangements, getting legal advice and consulting with an experienced psychologist about surrogacy is very important. Also, doing as much up-front research on surrogacy and other family-building options is essential to avoid potential problems.  Unfortunately, there are scammers who try to steal money from people looking for a gestational carrier. If an arrangement sounds too good to be true, it probably is.

Who May Need a Gestational Carrier?

There are a variety of reasons why an intended parent (or parents) may need or want a gestational carrier to carry a baby for them. These include:

Medical conditions that may endanger the parent or baby’s life if they were pregnant Previous pregnancy or birth complications, such as severe preeclampsia, that may endanger the parent or child Repeated pregnancy loss not resolved with other treatments Repeated unexplained IVF implantation failure The person or couple wanting a child does not have a uterus (from birth or after removal for medical reasons) Uterine malformations

Who Can Be a Gestational Carrier?

Sometimes, a gestational carrier is known to the intended parent or parents before the pregnancy arrangement. In this situation, a family member or friend agrees to carry the baby. In other cases, the gestational carrier starts out as a stranger. Carrying a pregnancy for someone else is a beautiful gift a person can give to someone they know or a stranger who wants to have a child. However, it is also a very involved process, medically and physically invasive, and emotionally trying. It’s not uncommon for people to back out at the last minute, causing tremendous financial loss to the intended parents and great emotional pain. A gestational carrier must be in good overall health, have had at least one healthy pregnancy and birth in the past, have had fewer than five previous pregnancies, and be older than 21 but ideally younger than 35 (sometimes known gestational carriers may be older). Gestational carriers also need to live in a surrogacy-friendly state or country, be available and willing to attend prenatal appointments, and agree to have pregnancy-related procedures and tests done. They also need to be willing to attend counseling, psychological and legal, before and possibly during the surrogacy arrangement.

A Word From Verywell

In most cases, if you want to pursue having another person carry your baby, a gestational carrier rather than a traditional surrogate is recommended. With a gestational carrier, the person carrying the baby is not genetically related to the child. However you choose to add to your family, consult both a doctor and lawyer to make sure you are considering all the complex legal, medical, and emotional issues at play.