The best ways to support a friend who's using a surrogate

Jan 29, 2015 at 10:19 a.m. ET

Most women grow up thinking that when they are ready to have a baby, it will be simple.

Yet 6.7 million women in the United States have impaired fertility. While there are many options to improve fertility and get pregnant, these treatments do not work for everyone. There are also gay couples who have limited options on ways to grow their families. One option that these hopeful families have is surrogacy.

What is surrogacy?

Surrogacy is when a woman signs legal documents, undergoes medical and psychiatric evaluations and is paid by a person or a couple to carry and birth their child. There are two types of surrogates:

  • Traditional surrogate. A woman is artificially inseminated with the biological father's sperm. She carries and delivers the baby for a parent or parents to raise. In this case, the surrogate's eggs are used instead of another's, making her the biological mother of the child. Donor sperm can be used or, if there are two fathers trying to have a baby, often both of their sperm is inseminated so they do not know the biological father of the child. Because the surrogate is also the biological mother, the baby technically has to be placed for adoption with the intended parents after the birth. Because of the legal complexity involved with traditional surrogacy, it is rarely used anymore.
  • Gestational surrogate. A gestational surrogate is a woman who has pre-fertilized embryos placed in her uterus to carry and then deliver the child for the parents to raise. This is possible thanks to in-vitro fertilization, or IVF, and is more widely used than traditional surrogacy. Doctors can take the eggs from a donor or the intended mother and fertilize them with the sperm of the intended father or a donor. In this case, the surrogate is called the birth mother since she is not biologically related to the child.

How your friend came to surrogacy

I am sure you know your friend's infertility journey. Many times couples choose surrogacy because all other fertility avenues, such as IVF and operations, have not been successful. Or, if your friend is part of a gay couple, their only options are to use a surrogate to create a child with their DNA or to adopt. Regardless of how they arrived, this decision was undoubtedly a very difficult one for your friend.

There are a lot things your friend has had to deal with emotionally to choose a surrogate. He or she has had to cope with the loss of building a family on their own. If your friend is a woman, it is difficult to deal with the realization that she cannot carry her child. Be there for them while they cope with the emotional fallout of deciding to use a surrogate.

Surrogacy etiquette

After you help your friend through the resolution of using a surrogate, you probably have a lot of questions about the journey. Your friend will have to find a surrogate that they want to carry their baby. This part of the process is a lot like dating. Ideally, your friend will want to find someone they "click" with.

This person will be around a lot for the next nine months and will most likely be part of your friend's life indefinitely. When you meet her, treat the surrogate as a new friend in your life. Be respectful; realize that this woman is giving your friend an amazing gift after all he or she has been through trying to build their family.

From there, the surrogate journey will be a lot like your friend being pregnant. There will still be the same milestones, the same excitement and the same end result. Treat this journey like a traditional pregnancy. Ask how the surrogate is doing with each trimester. Consult with your friend or his or her spouse on what kind of baby shower they want. Offer help decorating, pet sitting, cleaning or cooking as the baby's due date gets closer.

As long as you understand what it means to use surrogacy to grow your family, you will already be able to support your friend fully. Surrogacy is a hard decision to come to, and throughout the journey, there will be emotional moments for your friend. There could be jealousy about the kicks and twitches they don't get to experience, as well as sadness when people close to your friend treat her differently because of her chosen path to parenthood.

Whatever you do, support her emotionally and treat this time the same as you would if your friend was birthing the child herself.

Bio: Nicole Witt is the creator of Beyond Infertility, a community support site and online magazine geared towards families who have gone through infertility. You can visit the website at She is also the owner of The Adoption Consultancy.

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