The Emotional Journey of Surrogacy: Why Mental Health Support Matters
Surrogacy is a meaningful and complex experience, and the emotional side of the journey is often overlooked. As a therapist specializing in surrogacy evaluations and ongoing support for gestational carriers, I see how much emotional bandwidth these journeys require. This post outlines the feelings many carriers encounter and why structured support creates steadier, healthier outcomes for everyone involved.
Surrogacy can be a beautiful thing. An experience you’ll always feel proud of. But even joyful journeys carry emotional complexity. Behind every smooth process, there are often feelings that get brushed aside. This post walks through what many surrogates experience and why consistent, thoughtful support makes a difference.
It starts with curiosity. You learn about surrogacy, start researching, and before you know it, you’re completely sold. It’s not just something you could do, it feels like something you have to do. It becomes your mission. You’re excited. Nervous too, but mostly excited. You fill out the application, go through lengthy conversations with your family or partner, convincing them this is a good idea, meet with the agency, and imagine the moment that baby is handed to someone who’s been waiting years. It feels big because it is big. But early on, it’s mostly paperwork and optimism.
And then… things begin to veer off course.
Sometimes you don’t match right away. Or you do, but it falls through. Or the clinic calls and says you need to remove a polyp, redo bloodwork, or lose five pounds. The excitement is still there, but now it’s mixed with doubt, anxiety, frustration, maybe even guilt. You wonder if the intended parents will be disappointed. You wonder if this is a sign that it’s not meant to happen. But you’re resolved to keep going.
The Emotional Cost of Delays and Disappointment
When things don’t move as quickly or smoothly as you expected, you try to be rational. You tell yourself it’s not personal. People remind you “this is part of the process.” And yes, you know that. But it doesn’t stop the quiet fear that maybe you’re letting someone down or that this journey might stall out before it even really begins.
The waiting can feel relentless. Waiting to match, waiting for medical records, psych clearance, legal, medical screening, escrow funding. You think you’ve cleared one hurdle, and then another pops up. Sometimes it’s not even about you; maybe the IPs weren’t able to create embryos or need time to fund escrow. Still, you carry on.
Then finally, the transfer. More waiting. Ten days that feel like two years. And if it doesn’t work? Even though everyone says “it’s not your fault,” your body still feels like the one that failed. You know that’s not true. But it still lands like that.
Navigating Relationships and Boundaries
Matching can feel like dating. And when it clicks, you feel it…you just know. But then the relationship starts, and you’re trying to navigate this space between connection and boundaries. You may have pictured one thing and then gotten something completely different.
Maybe you expected a close friendship, but it starts to feel transactional. Maybe you were hoping for a more “hands-off” dynamic, just checking in around appointments, but now you’re getting daily texts and constant questions. You wonder what’s reasonable. You wonder if you’re allowed to ask for space.
There’s also this confusing thing that happens with sharing. In the beginning, everyone’s excited and open. You might overshare because it feels good to be connected. But then things shift, and reality sets in. You’re carrying someone else’s child and what you previously shared starts to become a concern. Now you don’t know what’s too much or too little. Cultural differences, emotional styles, and coping mechanisms that seemed aligned on paper may suddenly feel mismatched.
The Physical Toll and the Weight No One Sees
You might assume it’ll be just like your own pregnancies. Maybe even easier. But then the meds start, and the bruises pile up, and suddenly you’re crying because your behind is sore and your kid wants to play, but you have no energy left. You’re up early for appointments, coordinating school drop-offs around ultrasound times, waiting on hold with the clinic, injecting hormones into your body while still running your household.
And the truth is: not all clinics are kind. Not all providers treat surrogates like people. Some are warm. Some make you feel like a vessel.
Meanwhile, you’re still showing up for your life. You’re carrying the pregnancy, but also the mental load of someone else’s dreams, fears, and hopes. You feel pressure to protect the IPs from disappointment, to sound upbeat, to keep things moving forward. And it’s not that you regret it. But it can be a lot. Sometimes more than you imagined.
The Emotional Cost of Loss
Then there’s the stuff you hope won’t happen, but sometimes it does. A failed transfer. A chemical pregnancy. A miscarriage. A termination. And suddenly, what felt like a hopeful journey becomes something else entirely. You’re grieving a pregnancy that wasn’t even yours. And people try to show up for you, but the comments sting.
“You did your job.”
“It wasn’t your baby.”
“I can’t imagine how hard this must be for the intended parents.”
You hear those things and think, I guess I’m not supposed to feel this sad. Maybe something’s wrong with me.
But you’re not just grieving the loss. You’re grieving the way it reshapes the whole journey. The joy gets dulled. You no longer look at the next transfer or pregnancy with the same lightness. You’re aware, maybe too aware, of what can go wrong. You also feel the weight of the IPs’ disappointment. It was their embryo, their financial hit, their almost-baby. You’re carrying their sadness, too. And the world around you doesn’t slow down, because, well, it wasn’t your baby.
Sometimes there are flashbacks. You regret what you said, or how quickly you told people. You question your body. You replay the loss. It all just loops in your head, and you’re stuck trying to manage it silently, because it feels like no one gets it. And if your relationship with the intended parents wasn’t solid before, this can shake it even more. You might start to wonder if they’re blaming you. You worry they’ll pull back, or worse, disappear. Or maybe they start micromanaging, reaching out constantly, questioning every update, every delay, every symptom.
After Delivery: Healing in the Quiet
If you make it through pregnancy and delivery with a healthy baby and grateful intended parents, you’re pumped. It feels like an accomplishment. You did it. You feel proud, maybe even on top of the world. And then, suddenly, you don’t.
You go from being checked on constantly to no one asking how you are. From daily texts to silence. From feeling important to feeling invisible. And even though your body is still very much postpartum, there’s no baby in your arms, so that grace period people usually offer? It’s not the same.
If you’re pumping, your days are still organized around someone else’s baby. And if you’re not, you’re dealing with leaking, engorgement, hormone drops, and sleep disruption with no baby to justify it. Either way, your body is healing, and you just quietly recover while the world around you moves on.
Some surrogates feel peaceful. Some feel lost. A lot feel both. You’re mostly okay, but you wish there were space to talk about it. You’re not even sure what you need, but you know you need something. And even though your case manager was lovely, you know she’s already helping someone else now. The journey’s over…
What Makes This Easier to Carry
Here’s what people get wrong: they think emotional support is only needed when something goes wrong. But the truth is, it’s needed all the way through.
Support looks like:
Having a third-party support person who not only understands third-party, but understands emotions, knows how to help you process and cope and has the space for you to do so
Being able to say “I feel hurt” when your IPs start responding with emojis or when there is silence after the pregnancy ends
Having someone remind you it’s okay to grieve, or be angry, or feel nothing for a while
Getting check-ins not just before matching and during pregnancy, but after delivery, when things go quiet and the world expects you to bounce back.
If You’re in It or About to Be
If you’re a gestational carrier or thinking about becoming one and your agency offers someone to track the emotional side of the journey, you’ll have something a lot of carriers don’t: space.
Not space to spill your guts every week or rehash your childhood angst. A place to check in with someone who’s not your partner, not the IPs, not the agency. Someone who’s just there for you.
For some, the journey is smooth and special. Emotional support lets you actually take that in, to reflect on what you did and how it changed you. And if it’s harder than you expected? That same support becomes the thing that helps you keep going.
Agencies that offer consistent, high-quality emotional support create healthier, more resilient journeys for everyone involved.
