Understanding gestational surrogacy in the United States: a primer for obstetricians and gynecologists

Kate Swanson*, Nina K. Ayala, Randall B. Barnes, Nidhi Desai, Marcy Miller, Lynn M. Yee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


As gestational surrogacy (a process by which intended parents contract with a woman to carry a fetus that the intended parents will raise) increases across the United States, it is imperative that obstetrician/gynecologists understand the unique nuances of caring for patients who are gestational surrogates. Gestational surrogacy offers a route to parenthood for individuals and families who may otherwise have limited options. Understanding surrogacy requires multiple ethical considerations about the potential medical and psychosocial effects on gestational surrogates as well as the families built through surrogacy. There is a dearth of research on the subject, particularly in the United States and other countries that practice compensated surrogacy. Here we seek to review the process of gestational surrogacy in the United States, including the legal landscape, current trends in gestational surrogacy use, and what is known about the medical and social effects of this process on all participants. We also aim to highlight the limitations of available data and to identify topics for future research to provide optimal evidence-based and just care for these patients.

Original languageEnglish (US)
Pages (from-to)330-337
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Issue number4
StatePublished - Apr 2020


  • assisted reproductive technology
  • gestational carrier pregnancies
  • gestational surrogacy
  • health policy
  • medical ethics

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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