Every year, approximately 130 million babies are born. When thinking about that, one picture's women lying on their backs in a hospital bed pushing their babies out. But that’s not always how it happens. Lots of mommas are choosing to push on their hands and knees. Some don’t push at all and wait for the fetal ejection reflex to kick in. Others are in surgery, and some — some aren’t pregnant at all.

Yes, we’re talking about surrogates. If there is one area of birth and parenthood that the medical industry hasn’t failed us in, it’s this. Modern technology has become so advanced that we can allow other women to carry our babies for us if we can’t.

There are gestational surrogates and there are traditional surrogates. The latter would involve a woman that carries the baby of another couple, but the egg used to make that baby would come from the surrogate. Conception is achieved by intrauterine insemination using either the biological father’s sperm or donor sperm. Gestational surrogates use invitro fertilization to conceive an embryo with the biological parents’ egg and sperm — or a cocktail of donor’s — and then implant them into the surrogate’s womb.

It’s absolutely an amazing and selfless process, but surrogacy isn’t something to be approached without caution. A lot of women adore being pregnant and would love to give this gift to a couple who is struggling with infertility. Couples in search of a surrogate need to make sure they aren’t overlooking anything when it comes to the future relationship with this woman and their child. This will get them started.

15 Motivation For Doing This?

This is pretty darn important. We’ve all heard those horror stories about women who have gotten pregnant with another couple’s baby and then tried to go on the run with the baby in their belly. Is it kidnapping? Are there laws on this? What would the couple do?

Okay, it might be more common on Lifetime than in real life, but we swear, it happens. There’s a reason an attorney is involved in this process, and there’s a reason most people are encouraged to use a reputable agency when going the way of surrogacy. Not everyone has good intentions.

Some women want to be a surrogate for completely selfless reasons; they want to give back. Some really enjoy being pregnant. Others went through the process for someone they know and decided it was something they really enjoy doing. But some ladies might just be in it for the money or other not so savory reasons. Be up front. Ask.

14 Is This The First Time?

If you’re dealing with an agency, it’s important that you thoroughly investigate them. Look for reviews. Don’t just stick to online ones, either. Ask for references from prior clients of theirs. Then actually call those people and inquire about their experience with the agency and any hiccups they had during the process, as well as how they were dealt with.

If you’re ready to sit down and interview a potential surrogate, you need to use the same diligence with them. Have they been a surrogate before? How many times? You should ask questions about each experience.

How was her relationship with the parents? Does she remain in contact with them now? Have there been disagreements? How were they handled? Moving forward, if you choose her as your surrogate, would she expect you to fall in line with how her previous experiences went? Or is she open to tweaking a few things?

13 What About Your Past?

Any reputable surrogacy agency should be performing in depth background checks on all surrogacy candidates. Just because someone is approved as a surrogate does not mean that they have a neat and tidy past. There are certain things that are acceptable and certain things that aren’t.

Some parents will balk at so much as a handful of speeding or parking tickets that went unpaid. This speaks to a certain level of irresponsibility to some hopeful parents. Others are just worried about serious crimes and inappropriate or unhealthy behavior.

You need to verify all of this with your potential surrogate. If there are remarks about their past, don’t shy away from asking them what happened and how they would handle the same situation if it occurred today. We all make mistakes. Keep that in mind.

12 Do You Have Children?

The majority of surrogates do already have children. It just makes practical sense that women who have already sustained pregnancies and given birth know that they could do so again for someone else. This kind of reassurance doesn’t exist for first-time mothers.

When it comes to the potential candidate’s own children, inquire about ages. Check how far apart they have become pregnant each time. Question whether any of their children have special needs. Even when using your own egg and sperm, a surrogate could make certain lifestyle choices that may contribute to a variety of disorders and developmental issues. This doesn’t mean you should never choose someone who has a special needs child; you should just go into the situation fully informed.

Last but not least, it is imperative that surrogates retain custody of their own kids to most wannabe parents. If a surrogate doesn’t have custody of one or more of her own children, be sure to ask why. It is perfectly acceptable to request court documents that verify their story, too.

11 Ethical And Religious Beliefs?

Yes, their religious belief matter more than you might think. No, they won’t be raising your child. No, they may not ever even meet that child or have any contact with them. But they are the determining factor about how they get to be your child.

In not so many words, sometimes conditions arise during pregnancy that may threaten the life or the surrogate, the baby, or both. It is critical that the surrogate and parents agree ahead of time what should be done in these circumstances. If possible, even lay out ahead of time which circumstances qualify as life-threatening and which don’t.

It is a terribly sticky mess when a condition might occur in a child that would render them disabled for example, and the hopeful parents want to abort, but the surrogate’s religious or moral beliefs interfere with this. It has happened many times, and the outfall of it is not pretty.

10 Current Living Situation?

That surrogate you’re interviewing is going home when you’re done talking. Where is she going? Where does she live? Is it a reasonably safe area? Are there any manufacturing plants, fracking locations, or other plants nearby to her home that may potentially contaminate the water supply or air more so than other regions? Yes, some parents are this tedious about their surrogate, and that is their right.

How are things at home? Any history of abuse of any kind? Is the surrogate married or living with a partner? Will she engage in sex during pregnancy? This bothers some parents. Decide whether or not it bothers you.

How stable is the relationship she’s in, if there is one? Any risk of divorce or other undue stress she sees coming her way in the next year or so? What would she do if her relationship did fall apart while she was pregnant with your baby? Who is financially supporting the family? Would she have the means to continue supporting the pregnancy to the same standard?

9 Any Favorite Pass Times?

It might start to feel like you’re inquiring about a personal ad at some point during this interview. Remember, you are trying to learn as much as you can about this individual to make a choice for the future of your family. They could make or break that situation for you. So, you need to feel like you can trust them.

Yes, anyone could lie about what they do in their free time. Ask them up front. Later on, ask for pictures of their family. If they’re an avid CrossFit enthusiast, you may want to discuss the level of activity during pregnancy.

It could be a red flag if they don’t really have any hobbies to report outside of caring for their own family or working. The well-rounded life usually produces the happiest people, and you want a content and happy surrogate. There are always exceptions, but pay attention if someone can’t explain themselves to you and what they’re about.

8 Who Else Knows?

This may be one of the most important steps to verify with a surrogate. Believe it or not, some surrogates go through the medical and mental evaluations with an agency before they ever mention anything to their partners. They don’t tell their parents or their kids. They just segue through the process without entertaining the idea of what others might think and feel about it.

Of course, they will have feelings about it. It’s only natural that a child would have questions and concerns about their mother being pregnant with a baby that belongs to two strangers. It’s normal that a husband might be put off by this and wonder how it would affect his marriage.

It’s best for surrogates to discuss all of this with their friends and family beforehand. If they haven’t, consider it a red flag. You could select them and then they might back out when their husband objects to it or their mother-in-law shames them into thinking it’s too weird. It’s not for everyone, and everyone needs to be on board.

7 Career Prospects?

Keep in mind that your surrogate is not just a place for your baby to grow and develop. They have a life of their own. They may have families, hobbies, and interests that you don’t. You might be an attorney and the surrogate may be a factory worker. Her environment during the day will be different than your environment would if you were pregnant.

Make sure to ask questions about their job. Do they get paid fairly? Is there any concern of job instability? Are their hours consistent if they are paid on an hourly basis? Will the pregnancy interfere with their job or advancement at it?

If their job is labor-intensive, will there be accommodations made to ensure that they are safe and protected from harm during those nine months? Will their boss allow the time off for doctor appointments? This is especially important if they will need to travel to appointments to meet you there. Thus, they’ll need more time off.

6 Emphasis On Education?

This doesn’t matter to everyone, but most potential parents do desire that their surrogate has at least graduated from high school. Generally, a GED completion is frowned upon, but in some cases, women have completed their GED early so they can start attending college sooner. This isn’t common, but it happens.

A college education ranks pretty high among parents. They would like to see that the surrogate they are choosing has a real career, and a stable background that proves they had the fortitude to stick with the four-plus-year commitment such an education requires.

Ask them what led them into the career field of their choosing. Where did they go to school? How were their grades? Don’t be afraid to ask for transcripts to back up their testimony. They expect these kinds of questions. If they received poor grades, pay attention to whether they’re honest with you about it or not. That says a lot about a person’s character.

5 History Of Smoking Or Drinking?

These are automatic strikes against surrogates for many parents. Others don’t care as much. In some cases, even the couple who have smoked in the past or currently do want to opt for a surrogate that has never smoked. It may seem hypocritical, but it’s not uncommon that they use the opportunity to their advantage to pick a surrogate with optimal medical health.

That being said, some parents are just fine with a mother that used to smoke but hasn’t in several years. Alcohol consumption should be limited in nature or non-existent for most wannabe surrogates. It should definitely be off limits during the period of time when conception is being attempted.

Any history of addiction needs to be put on the table, too. Substance abuse is usually picked up by agencies during background checks, but may not be obvious if not working with an agency. Sometimes, women who dabbled in marijuana or alcohol abuse during their college years turn out to make fine candidates later on, but this is still information the hopeful parents are entitled to know.

4 History Of STD’s?

Sexually transmitted diseases are not nearly as uncommon as most people think. It is estimated that some 110 million people are affected by them. So, what’s the big deal? They aren’t as traumatizing as most people think. However, they can come with some health risks.

For instance, the prevalence of the Human Papilloma Virus is increasing, and it does carry a small risk of boosting the chance of cervical and prostate cancer. When a mother has HPV, it may lie dormant in her body and resurface during pregnancy. The strain of HPV that presents with genital warts may flare up because of the hormones involved during that time. This infection can then be passed onto a baby if they are birthed vaginally.

The same is true of herpes. If a woman is infected, parents typically want the surrogate to agree to a Cesarean if she is having an outbreak at the time of delivery. Others have interest in avoiding C-sections altogether, because they carry so many risks. So, they may not want a surrogate with herpes. It’s not personal, and hopefully surrogates know that.

3 History Of Mental Illness Or Autoimmune Illness?

Mental illness is a big concern among many potential parents who are in search of a surrogate. Sure, if you’re using a gestational surrogate and her egg, it’s an even bigger concern. Still, even traditional surrogates need to be screened for mental illness. It’s not just about her either, but her family history. If her mom was diagnosed with schizophrenia, it’s a big deal, even if she is in the clear herself.

Autoimmune disorders are also concerning during pregnancy, because they can often flare up. Certain disorders, like lupus, are known for intensifying during pregnancy due to the hormones being produced. This can lead to a lot of distress and discomfort for the surrogate. It may complicate the pregnancy physically, and she may need more time off from work or even mandatory bed rest.

The concern with both mental illness and autoimmune disorders is that they may lead to side effects or the need for medications during pregnancy that you — the parents — are not comfortable with. For this reason, you may choose not to go with a surrogate with any history of these issues.

2 Fertility History?

Obviously, when two people are relying on a complete stranger to become pregnant with their child and carry it to term, they will want to be sure to pick a surrogate that has established fertility. In other words, it’s understandable that you wouldn’t be inclined to pick a surrogate who hasn’t had any children of her own.

Furthermore, you have every right to ask about previous fertility history, such as miscarriages, abortions and stillbirths. Hopeful surrogates expect these tough questions to come up. So, don’t be worried about catching them off guard. If they have had an abortion, take into account whether that bothers you deeply enough on a moral level or not to affect the outcome of your decision. Remember, it’s important that you feel comfortable with the surrogate. Even if the reasons you aren’t comfortable aren’t exactly PC, they’re valid.

1 Thoughts On Compensation?

Last but not least, it’s vital that wannabe parents and surrogates stay on the same page regarding compensation. Ask the surrogate you’re interviewing what they expect in terms of compensation. Make sure you lay out the details for everyone to go over together and in their own time. Have it documented and readily available for the surrogate to take home with them.

Go over the little things, like who would pay for the ambulance should an emergency arise. What about co-pays for doctor visits? Would the surrogate be covered on your insurance or not? What about the cost of birth?

Will you pitch in if the surrogate wants her placenta encapsulated to help ward off postpartum disorders? What about the cost of a doula? In addition, verify when they expect payment for their service to you and how much. This can be a deal breaker. Get it out of the way early.

Sources: UNICEF, CBS News