How a Surrogacy Contract Is Structured

The gestational carrier agreement is typically a 30 to 60 page legal contract negotiated between two attorneys before any medication arrives at your door. Here's what's inside it, who pays for what, and which sections matter the most.

Published May 29, 2026 · Updated October 7, 2026

A surrogacy contract, or gestational carrier agreement, is typically a 30 to 60 page document drafted by the intended parents' attorney, negotiated by your own attorney (usually paid for by the intended parents), and signed after you match and before any cycle medications begin. It covers medical procedures and conduct, decision-making in difficult medical situations, compensation and payment timing, insurance, parentage, contact, risks, confidentiality and how the agreement ends, and it can never override your right to make the final decisions about your own body.

Surrogacy is one of the few life events where you sign a contract before you do the thing the contract is about. The gestational carrier agreement — the "GCA," or sometimes "GSA" for gestational surrogacy agreement — is signed after match and before cycle medications begin. It governs everything that happens from the first injection through the postpartum window. It's typically 30 to 60 pages, and every clause is there because somebody, somewhere, ran into the situation it covers.

Most surrogates we talk to are nervous about this stage. The fear is that the contract is the moment when the journey becomes adversarial. In practice, it's the opposite — it's the moment when expectations get written down so nothing has to be negotiated in real time when emotions are higher. Below is a walkthrough of how the contract is structured, who's in the room when it gets drafted, and which sections to read most carefully.

Who's drafting and who's reviewing

The intended parents' attorney typically drafts the first version of the contract. That attorney is hired by the IPs and paid by the IPs. Your attorney — the one representing you — is usually also paid by the intended parents, but they work for you, not for them. This separation matters. The two attorneys negotiate the contract, each on behalf of their own clients - you (and your spouse or partner, if you have one) on one side, the intended parents on the other.

You pick your attorney from a list, or you bring your own. We can recommend attorneys who specialize in surrogacy in your state. Your attorney's job is to read every line, flag anything that should change, walk you through it in plain language, and propose edits before you sign. Their fees are normally paid in full by the IPs, regardless of what they negotiate or how long it takes - and you're always free to choose your own attorney.

The major sections

Every contract is different, but the structure is consistent. These are the major sections you'll find in almost every gestational carrier agreement.

1. Recitals and definitions

The first few pages name the parties, define key terms (gestational carrier, intended parents, embryo, child), and lay out the basic facts: that you're carrying a child you have no genetic connection to, that the embryos belong to the IPs, that you intend to relinquish all parental rights at birth. This is foundational and rarely negotiated.

2. Medical procedures and conduct during pregnancy

This is the longest and most carefully drafted section. It covers:

• The number of embryos to be transferred per cycle — almost always one in modern programs. ASRM strongly recommends single embryo transfer in all surrogacy cycles.
• The number of transfer attempts covered by this contract before it expires (usually two to three).
• Diet, activity, and lifestyle commitments — what you'll do and what you won't. Common restrictions: no smoking, no recreational drugs, no alcohol, no hot tubs after a certain point, no air travel after a certain week. These usually mirror what an OB would recommend for any pregnancy.
• Travel restrictions after a defined gestational age — typically no travel outside a specified geographic radius after 32 to 36 weeks.
• Prenatal care expectations — keeping all scheduled appointments, taking prescribed medications, following the doctor's instructions.

This section is where boundaries get set. Your attorney will help you push back on anything overreaching. The contract should respect your bodily autonomy and your medical decision-making, not script your day.

3. Decision-making in difficult medical situations

The most important paragraphs in the whole contract are usually here. These are the sections that cover what happens if the pregnancy carries an unexpected diagnosis, if a doctor recommends selective reduction in a twin pregnancy, or if the surrogate's life is at risk. These decisions are deeply personal, and they have to be talked through and aligned before match, not in the middle of a hospital appointment. The contract records what everyone has agreed to expect, but it can never override your right to make the final decision about your own body and pregnancy.

Your views on termination, selective reduction, and continuation in the face of fetal anomalies need to align with the intended parents' views before you sign anything. Agencies do much of the alignment work during matching - a good agency won't introduce surrogates and IPs whose views on these scenarios are incompatible. The contract is where it gets put in writing.

4. Compensation and payment schedule

The full compensation breakdown lives in this section. It lists base pay, allowances, per-procedure fees, lost wages reimbursement, and the timing of every payment. The exact schedule depends on your contract, but it often runs something like this:

• Mock cycle fee paid upon completion
• Monthly base payments often begin with cycle medications or at confirmed pregnancy, depending on your contract
• Embryo transfer fee paid after each transfer
• Heartbeat confirmation often triggers a defined milestone payment
• Monthly base continues through pregnancy
• Delivery fee paid postpartum
• Final payment after postpartum follow-up appointment

Your compensation is for your time, inconvenience and risk. Under ASRM’s ethics guidance it should not be contingent on the birth of a healthy baby. Your contract should also spell out what you’re paid if a pregnancy ends early.

The contract spells out the payment vehicle (typically an escrow account funded by the IPs and managed by a neutral third-party administrator), so payments don't depend on the IPs writing personal checks each month.

5. Insurance and medical expenses

This section confirms that the intended parents will pay all medical costs connected to the pregnancy and that they'll either use your existing insurance (if it doesn't exclude surrogacy) or purchase a separate policy. It identifies the policy, the beneficiary structure, and what happens if the policy changes during the pregnancy.

6. Parentage and birth certificate

The contract describes the legal process for establishing the intended parents as the legal parents at birth. In surrogacy-friendly states, this typically involves a pre-birth order — a court order, obtained during pregnancy, that directs the hospital to put the IPs on the birth certificate from day one. In some states, this happens post-birth. Either way, you are explicitly not the legal parent of the child you're carrying, and the contract documents your intention to relinquish any presumptive parental rights.

7. Relationship and contact post-delivery

The contract typically describes the relationship expectations during pregnancy (frequency of updates, attendance at appointments, presence at delivery) and after delivery (photos, occasional updates, holiday cards). These vary widely by match. Some surrogate-IP relationships stay close for years; others stay warm but distant. The contract sets the baseline, not the ceiling.

8. Risk acknowledgment and emergency provisions

This section asks you to acknowledge the known risks of pregnancy and surrogacy. It also covers what happens in worst-case scenarios — a medical emergency, a loss of the pregnancy, loss of reproductive organs requiring a hysterectomy. The compensation for those rare outcomes is defined here, usually in clear dollar amounts.

9. Confidentiality and conduct

The contract addresses what the IPs can and can't share about you (typically nothing identifiable without your consent), what you can and can't share about them (the same rule applies in reverse), and how social media is handled. Most contracts allow you to share that you're a surrogate without identifying the IPs or sharing photos of the baby.

10. Termination of the agreement

Finally, the contract describes how it ends — typically once the postpartum window closes and final payments have been made — and what happens if either party needs to terminate early (before cycle medications begin, this is usually straightforward; after, it gets more complex).

How long the contract phase takes

From the IP attorney's first draft to mutual signatures, the contract phase typically runs three to six weeks. The first draft often lands a week or two after match. Your attorney typically reads it and prepares a redline within another week. The two attorneys go back and forth — usually two or three rounds of edits — over the next two to three weeks. You and your attorney have a final review call, and you sign.

Once everyone signs - you, your spouse or partner if you have one, and the intended parents - and your attorney confirms legal clearance to the clinic, the contract is in effect, and the clinic typically schedules the start of cycle medications for the following month.

What your attorney actually does for you

People sometimes assume the attorney is a formality — that the contract is mostly standard and your attorney just rubber-stamps it. The good ones don't. Your attorney will:

• Read every line and explain anything that doesn't make sense.
• Flag clauses that are unusual, overbroad, or unfair, and propose alternative language.
• Check that the comp and payment schedule match what you were told during matching.
• Confirm the contract is enforceable under your state's laws — this is one reason we only place surrogates in states with clear surrogacy frameworks.
• Be available after signing for any questions that come up during the pregnancy.

If your attorney is hard to reach, doesn't return calls within a few business days, or never proposes any edits, that's worth raising with your match coordinator. You're entitled to representation that takes your interests seriously.