An Altruistic Journey or Selling a Baby? The Debate Over What Paid Surrogacy Is Really About

Many surrogacy clients, who are usually called “intended parents” (IPs), are people who are suffering from health or fertility issues that prevent them from conceiving or carrying a pregnancy of their own. Others belong to same-sex couples or are single intended parents, often men without partners.

Most of the women who carry for them are gestational surrogates who conceive via in vitro fertilization (IVF). That means they aren’t genetically related to the children they bear. During the IVF procedure, the intended mother’s (or donor’s) egg is fertilized in a lab. Doctors then transfer the embryo to the surrogate’s uterus.

Surrogacy can be “altruistic,” meaning unpaid except for the reimbursement of necessary expenses. However, in the US, it’s usually paid. Both sides generally sign a contract hammering out all the details:

• How much will the IPs pay?
• When and how will the money be delivered?
• Will this payment be all-inclusive, meaning it will be expected to cover the surrogate’s medical expenses, or will the IPs help cover those separately?
• Will the IPs pay for independent legal representation for the surrogate so her lawyer can confirm the contract is fair?

Unsurprisingly, all of this can get messy, as can connecting IPs and surrogates to begin with. That’s why surrogacy agencies like Eloise Drane’s exist: to facilitate as much of it as possible for both sides.

In addition to running an agency, Eloise Drane has been a surrogate herself three times.

She has described the chain of decisions that led to her interest in surrogacy on her podcast, The Fertility Cafe. It started when she donated a kidney to her cousin, who was on dialysis and badly needed a donor.

“I don’t know if you’ve ever known someone [whose life] literally depended on somebody else, and you know you’re that person,” she said. “It’s truly an awesome feeling. Not awesome like, oh, it’s the greatest, although it was, but … every emotion that you can think of comes flooding in at the same time.”

Tragically, Drane’s cousin did not live long after the transplant; he died for unrelated reasons a few months later. Still, Drane has said, if she could go back, she wouldn’t do anything differently, and the experience sparked a desire to help other people in similar ways.

She couldn’t attempt to save another life by donating her second kidney, but she grew interested in helping people create life instead. This led to her becoming an egg donor, and, eventually, a three-time surrogate, something she persisted with even though each pregnancy took a considerable toll.

Eloise Drane’s surrogacies

The first time Drane was a surrogate, she carried twins.

Twin pregnancies often have intense symptoms, and hers gifted her with “horrible, horrible” morning sickness (nausea). She ultimately gave birth to two healthy babies—one vaginally and the other by C-section—but her recovery was complicated by medical bills that, per her contract, the intended parents were supposed to pay. They didn’t, and Drane said she had to sue them.

Her second time around, she developed Bell’s palsy, a condition that temporarily paralyzes the muscles on one side of the face, and suffered from a year-long string of urinary tract infections (UTIs). On the third, her delivery was followed by chronic bleeding, which persisted for months.

To treat this, her doctors performed a procedure called an endometrial ablation wherein the lining of the uterus is permanently destroyed—in her case, by burning it away. That was in November of 2014, and the bleeding finally stopped in February 2015. Then, in June, it came back “with a vengeance.”

“I was at the office working and I just got in so much pain that it literally knocked me down to my knees,” Drane said. “I couldn’t get up, I couldn’t walk, I damn near couldn’t even breathe.”

Her doctor booked her for an emergency hysterectomy, meaning her uterus was surgically removed. This, in turn, meant she was done with surrogacy. After four children of her own and four more as a surrogate, her body had told her that enough was enough. Even though she’d had no plans to serve as a surrogate again, she was crushed.

“As crazy as this sounds … I actually mourned my uterus,” she said. “I mourned what had been, helping all of these families and being able to bless so many people with it.”

She has said she took this as a sign that, although she would never give birth again, she was meant to channel the passion she had for surrogacy (and egg donation) into running her agency and helping other families through the same process.

Not all surrogacies end as dramatically as Drane’s, although some research has found that they have higher complication rates than “ordinary” pregnancies. A 2024 study of more than 860,000 births in Ontario, Canada (where surrogacy is unpaid) found that 7.8% of gestational carriers experienced serious complications, compared with 4.3% of women who conceived their own children through IVF and 2.3% who conceived without assistance.1 2

Regardless, even when everything goes well, pregnancy is rarely easy. Being a surrogate means accepting a certain amount of stress, discomfort, and risk. In extreme cases, surrogates can even die, although this appears to be very rare. (No official data on the frequency exists. The most widely reported recent death was that of Michelle Reaves, who died in 2020.)3

Despite—or perhaps partly because of—the discomforts and risks, many surrogates are very passionate about what they do. It isn’t uncommon to read about women who, like Drane, return for multiple “journeys,” the insider term for a surrogate pregnancy.

But given the physical, financial, and emotional stress they undergo, many people, at least in the US, believe that surrogates deserve to be paid. Side Hustles contacted several advocates of the compensated model, and all made similar points.

“A surrogate is giving a great deal of her time and taking on real physical and emotional demands,” said Parham Zar of the Egg Donor & Surrogacy Institute, an agency like Drane’s. “Compensation is part of recognizing that.”

Janene Oleaga, a New York– and Maine–licensed attorney who specializes in fertility and surrogacy, went a step further, telling me that “society just needs to accept that women should be paid for things that have been classified as ‘women’s work’ without being made to feel like they are selfish for doing so.”

Surrogacy as an offshoot of women’s rights

Many paid surrogacy advocates use rhetoric like this to frame surrogacy as a feminist issue. Drane equated it to the fight over abortion, and more than a little heat crept into her voice when she spoke about it.

“Who are you to tell me what I can and can’t do with my body?” she said. “I’m just like—you want to rip women of all their rights, or pull options for abortion, because we’re not smart enough to make those kinds of decisions?”

Critics of paid surrogacy reject the comparison.

In the US, arguably the most visible anti-surrogacy organization is the Center for Bioethics and Culture (CBC) Network. Kallie Fell, its executive director, told me that “bodily autonomy is important” and that the CBC recognizes that “a woman should have authority over her own body and medical care.” However, she said, “There is a difference between having the freedom to make decisions about one’s body and concluding that every arrangement involving one’s body is therefore ethically justified.”

Abortion, she said, only involves decisions about a woman’s own pregnancy, whereas surrogacy involves other parties and contractual expectations. This makes the ethical considerations different.

Organizations like the CBC criticize paid surrogacy on many grounds. Fell told me that one of their central critiques is that the practice “commodifies women’s reproductive capacity” in a way that violates human dignity. (The CBC also opposes unpaid surrogacy, IVF, and embryonic stem cell research, holding that they are similarly unethical.)

The “commodification” critique resonates with many people, including some who don’t necessarily oppose commercial surrogacy but who do find the idea of being paid to do something as intimate as carry a baby … odd. Off-putting.

For their part, paid surrogacy advocates see this as misguided. That’s because to them, surrogacy isn’t actually about the money. Yes, it changes hands, but that’s not the point; the primary motivation is altruistic, born of a real desire to help people.

This claim is often repeated by the owners of surrogacy agencies. Jeff Hu, the founder and CEO of SurrogateFirst, told me that according to an online survey his company conducted in 2023, the “number one reason” women pursue surrogacy is to “assist a family in need.” He said that compensation ranked last.

His survey can’t be treated as the first and last word on this; his report was vague about the survey’s methodology, and his company has a financial incentive to paint a positive portrait of the industry. The same holds for Drane and many of the other figures I contacted—that doesn’t discredit them, but it is important context.

But regardless of the strength of the data backing up the idea that it isn’t about the money, that’s a very common claim. This can be something of a sore spot within surrogacy communities.

Community norms, or the “ethos of surrogacy”

In 2016, Zsuzsa Berend, a sociologist at the University of California, Los Angeles (UCLA), published “The Online World of Surrogacy,” an ethnography describing SurroMomsOnline.com (SMO). Although that site is now defunct, in the 2000s–2010s, it was one of the Internet’s most active surrogacy-related message boards, and many of the norms that still define surrogacy subculture took shape on it.

In her 270-page work, Berend described a community that broadly agreed that the money they earned was “well deserved,” but also that surrogacy was a calling, not a side hustle. “Nothing I could ever do could give me the feeling of joy like hearing my IM’s [intended mother’s] voice when I tell her ‘it worked we are pregnant,’” she quoted one surrogate as writing.

That was over a decade ago, but the sentiment is still alive. Amber Miller, a mother of three who has carried two babies for others, told me she realized she wanted to be a surrogate after she gave birth to her first child at age 21. Needing IVF to conceive with her current husband “just solidified” the desire. She delivered her first surrogate baby for “two amazing dads” in 2022 and her second earlier this year. She regularly visits both boys, who she told me know her as “Auntie Amber.”

“I can’t change the world, but I can change a family’s world, and that’s my why,” she said. For her, the money was “a great boost”—it paid for home repairs and vacations and gave her family a nest egg—but her surrogacy wasn’t ultimately about that.

As a religious person, Drane said she believes her inspiration to pursue surrogacy came from God. When I asked whether she would have done it even if she hadn’t been paid a dime, her response was an unequivocal, “Yes, absolutely.”

I asked how much she earned for her three surrogacies. The answer: $20,000 for each. At the time, that was standard, although the industry has changed, and first-time surrogates can now expect to earn $50,000–$60,000 or even more. $20,000 isn’t pennies, and adjusted for inflation, it was worth around $30,000 in today’s dollars, but when weighed against the scale of pregnancy—the doctor visits, the symptoms, the length of nine months, and the pain of childbirth—it isn’t all that much.

Why even bring in money?

All of this does invite the question: why complicate things with money at all? If it isn’t about that, why not opt for an altruistic (unpaid) model, as many countries, such as the UK, do?

A common response goes: imagine that you have a great job. You’re lucky enough to spend all day doing work that you love for a cause you believe in. Don’t you still deserve to be compensated for your time and labor?

As Drane put it, “Do you go to your job every day and say, it’s okay, I enjoy what I’m doing, no worries, don’t pay me?”

“I’d do it for free if my husband would let me,” Miller told me. “But pregnancy and birth take a lot of time and effort. Add in all the hormones and doctor’s appointments and travel, it’s a lot on a family.”

Berend said she believes many people have “blinders” on when they consider this. In their own lives, they recognize that earning money at work is about “recognition and appreciation,” not just need, but when it comes to issues like surrogacy, they forget that.

With this argument, surrogates are able to insist on compensation while (theoretically) avoiding an overly mercenary appearance.

Not everyone is buying it, however.

“Most people I have informed about my being a [surrogate] have commented on doing it to ‘pay the bills,’” complained one woman quoted in Berend’s book. “Even my own mother!”

Miller has met the same assumption. “Most people that don’t know me think it’s for the money,” she told me. (She added that where she lives, “a very red county” in Texas, she believes people also quietly judge her for carrying a child for a gay couple.)

Attitudes like this are an irritant to many surrogates. Berend told me that she believes what she called the “ethos of surrogacy” crystallized in response to negative perceptions of it on the part of “lay people” and the media.

Surrogacy in the news

When journalists turn their attention to surrogacy, their articles usually feature dollar signs in the headlines and highlight stories that paint a seedier picture than you’ll get from the love-and-life discourse you’ll find in forums and Facebook groups.

In September 2026, CBS News reported on a woman, “Judy,” who was promised $120,000 to carry a child for a “single father.” While that was technically true, she later learned he was Xu Bo, a Chinese billionaire who reportedly had already fathered more than 100 children through US surrogates—not exactly who she’d been picturing.

Although she felt misled, she went through with the pregnancy anyway. According to CBS, she “felt bound by her contract” and “needed the money.”

Another surrogate, McKenna West, made headlines in August 2026 for alleging that the IPs who hired her had tried to pressure her into terminating her pregnancy when a scan found the child had a heart defect. She relocated to Texas, which has some of the strictest abortion laws in the US, before giving birth. She subsequently entered into a custody battle with her intended parents, whom she has said she does not trust to care for the child given that they sought to terminate the pregnancy.

Stories like this are unpleasant, but they pale in comparison to the worst scandals around surrogacy, which involve child abuse.

In October 2026, prosecutors announced charges against Silvia Zhang and Guojun Xuan, a couple in Arcadia, California, who had 21 children, all of whom were born to paid surrogates. They are accused of being severely abusive, allegedly having instructed their nannies to beat their children, which prosecutors say they watched via 32 motion-activated cameras in their mansion.

Nathan Hochman, the Los Angeles County District Attorney, has said that Zhang laughed while watching footage of one of the children being struck with a shoe. He has also said that Xuan once instructed a nanny to strike a child harder and joined in himself on at least one occasion. He charged the couple with multiple felonies, including conspiracy to commit child abuse.

The couple has pleaded not guilty to the charges. Xuan’s attorney told ABC7 Eyewitness News that Hochman’s comments were a mischaracterization and that Xuan’s “desire to have so many kids emanates from his altruism.”

Stories like the Arcadia scandal are extremely damaging to paid surrogacy’s public image. However, most arguments against the practice are more mundane.

One of the most common is that it exploits the poor.

In 2024, the political writer Michael Lind published an article in The Telegraph criticizing Governor Gretchen Whitmer of Michigan for signing a bill legalizing paid surrogacy. The practice involves the “exploitation of poor women by well-to-do women and their husbands,” he wrote, “or by affluent gay couples.”

This claim has also been advanced by the CBC Network. In 2025, it submitted a letter to the Australian Law Reform Commission (ALRC) arguing that introducing a “financial reward” distorts the concepts of “consent, autonomy, and motivation,” and that a “woman in financial hardship may feel pressured to enter into an arrangement she would otherwise reject.”

This is the labor exploitation argument against paid surrogacy. The idea is that surrogacy is so taxing that many women would not pursue it without economic coercion—that, in other words, it is very much about the money, which delegitimizes it.

The anti-surrogacy coalition

Other groups have different critiques of paid surrogacy. Together, these groups form a surprising coalition.

Several religious bodies, such as the Catholic Church and Southern Baptist Convention, condemn it on religious grounds. Many radical feminists, such as Julie Bindel, believe that it is degrading to women, and some right-wing groups, such as the Heritage Foundation, allege that foreign nationals often take advantage of it to obtain US citizenship for their children.

One of surrogacy’s fiercest critics is Reem Alsalem, who currently serves as the Special Rapporteur on violence against women and girls for the United Nations Human Rights Council. (A Special Rapporteur is a UN-appointed independent expert.)

In 2025, Alsalem issued a report on “violence against women and girls in the context of surrogacy.” Her mandate is global, and much of her critique applies to the international surrogacy market rather than the US. For instance, when I contacted her, she told us that “most surrogate mothers globally [come] from low- and middle-income countries,” many of which have been “ravaged by war.”

I asked whether she believed her critique was applicable to the US. Her response: yes.

Alsalem argued that, for one thing, American surrogates are underpaid. “Even in the United States, surrogate mothers receive around 10%–27% of the cost of the surrogacy procedure,” she said, “despite them being the ones facing major risks.”

US cost breakdowns usually put base pay at the upper end of that range or somewhat above it, with most of the remainder going toward IVF, medical care, insurance, and legal fees. Data cited by Axios indicates that agencies pocket less than surrogates.4 (Their figures do, admittedly, come from Carrot, a fertility company.)

Alsalem also told me that both surrogates and their children face “significant health risks” that “do not disappear with tighter regulation.” The CBC Network shares this view; they have argued that the fertility procedures that surrogates undergo come with serious risks, and have been especially critical of the drug Lupron (leuprolide acetate), a hormonal suppressant.

Lupron is FDA-approved to treat conditions like precocious puberty. It can also be used to time hormonal cycles for IVF. This use is off-label, but common.5 The CBC argues that the impact of drugs like Lupron on surrogates has not been well-researched, and in their submission to the ALRC, wrote that the fertility industry has—more generally—“failed to perform any longitudinal studies” on the wellbeing of surrogate mothers or their children.

I found no evidence that for-profit fertility companies had funded any such studies. Academic researchers have conducted several, which have had mostly encouraging results. However, all were small and were conducted in the UK, which does not allow commercial surrogacy.6 7 I found no studies on the long-term health outcomes of paid surrogates in the US.

Drane flatly rejected most of the criticisms of paid surrogacy I raised with her. Her response to the idea that paid surrogacy exploits poor women was especially scathing.

“That is a lie,” she said. “I’ve had attorneys, I’ve had pharmacists, I’ve had people with master’s degrees. I’ve had nurses, I’ve had teachers, I’ve had stay-at-home moms. They’ve run the gamut, [the people] who have chosen to be surrogates, and I’m purposely using that word, chosen. Nobody’s being forced. Nobody’s being coerced.”

When I asked whether she’d ever worked with a client who wanted a US-based surrogate so their child would have American citizenship, she said she didn’t believe so. “They could give a shit about having a US passport,” she said, referring to her foreign clients. “They wanted to have a baby.”

As far as scandals like the Arcadia case go, no one I contacted questioned that they sometimes happen, but each said they are not representative of surrogacy at large. (Several brought up that case independently—without my asking—to stress that point.)

“Media portrayals are always negative,” Drane said. “It doesn’t matter if it’s surrogacy or another topic, they’re always going to be negative, because that is the clickbait. That is what gets people’s attention.”

The media “never talks about the thousands of other surrogacy cases that went off without a hitch,” she said. “Nobody wants to talk about those things. They only want to talk about the sensationalized stories.”

Digging into the dynamics of the surrogacy industry

Unfortunately, it’s hard to check either side’s claims. The research investigating health outcomes is too limited to be conclusive, and the question of whether surrogacy is about the money is also murkier than one would like.

A 2024 study published in Reproductive Biomedicine Online looked at 231 surrogates and found that they had above-average incomes and education profiles. The study’s authors were explicit that they believed their findings contradicted the claims of “both radical feminism and ultra-conservative Catholicism.” Their survey was, however, distributed by agencies and the administrators of surrogacy Facebook groups. It is possible this skewed the responses.

The CBC Network has also conducted its own research. In 2022, it published a study of 96 surrogates—recruited via social media ads—in Dignity, an open-access journal on exploitation and violence. (Dignity is peer-reviewed; its editorial board also includes several critics of surrogacy.) The study found that women whose pay exceeded their annual income were significantly more likely to say money had influenced their decision to pursue surrogacy and that many used it to pay bills or get out of debt.

In an October 2026 article for The Atlantic, the journalist Helen Lewis looked into all of this, attempting to evaluate how benign the surrogacy industry is or isn’t. Her piece featured one woman, Amanda Misbahu, who learned midway through her pregnancy (after a life-threatening complication required hospitalization) that the father had an extensive criminal history.

Like “Judy,” Misbahu felt obligated to continue. The experience was traumatic, and after giving birth, she sought counseling.

That story is less shocking than the Arcadia scandal, but it is still troubling. It also may not be representative. Lewis found Misbahu and several of her other subjects through the CBC Network. Fell confirmed this with me, and told me that many of the women who contact the CBC are “deeply troubled by what they have experienced.”

I asked how often the CBC heard from women who had negative experiences.

“I wouldn’t want to give a number without a systematic review of our records,” she told me. “But for us, this isn’t simply a question of counting how many women come forward. One woman who has been harmed matters.”

The unfortunate fact is that it’s hard to get a clear picture of commercial surrogacy as an outsider. If you go looking for horror stories or success stories, you can find either, and there’s no easy way to gauge how common each is.

All of the advocates I contacted acknowledged that paid surrogacy has pitfalls. They disagreed with the critics about how serious these were, but none claimed surrogacy was perfect.

To protect women—as well as children and IPs, they said—the industry needs more safeguards.

Screening procedures for surrogates and clients

Surrogacy agencies typically have screening procedures, which include:

• Medical screenings
• Mental health screenings
• Background checks

It’s routine to check whether women have conditions that will make fertility treatments or pregnancy risky, as well as whether they’re getting into surrogacy for the right reasons or are doing it out of desperation. Ideally, these screenings go both ways. Reputable agencies also vet IPs to catch people who might be abusive, as the Arcadia couple allegedly were.

However, these procedures are not legally required in every state.

There is, in fact, virtually no federal legislation covering the fertility industry in the US. That means that surrogacy is a well-regulated industry in some states, such as New York, while being largely unregulated in others.

Fell has described California, for instance, as a “Wild West,” and the fertility attorney Stephanie Caballero told NBC Los Angeles that the state’s “only requirement to open a surrogacy business is obtaining a business license.”8 Ethically run agencies in the state have screening procedures, but implementing them is voluntary, not mandated.

Notably, the couple in the Arcadia scandal opened their own agency, Mark Surrogacy Investment, which they ran from 2021 to 2025. Hochman has said there is “no evidence the firm ever arranged a surrogacy that didn’t involve Xuan and Zhang.” Put another way, the couple had only one client: themselves.

Although opening an agency for one’s personal use is very unusual, doing so was (and is) perfectly legal in California.

An explosion of growth

Drane readily admitted the existence of “unethical agencies” in unregulated states. She told me that the surrogacy industry was growing quickly, with “agencies popping up literally every single day.”

California public records show filings for more than 135 corporations, limited liability companies (LLCs), and limited partnerships (LPs) with “surrogacy” in their names between January 2020 and October 2026. This is probably an undercount, as not all agencies are named in that way. It is also more than double the number of companies (around 60) that appeared in the same stretch ten years earlier, from January 2010 through October 2016.

If surrogates insist that what they do isn’t about the money, the same can’t be said for all of these agencies. Drane believes many are started by people who think it’s a “quick, fast” way to earn a buck and are enticed by the nonexistent barrier to entry.

Some agencies, she told me, are actually operated by fertility clinics, the medical facilities that perform the IVF procedures that make surrogacy possible. “I would say that maybe 60% to 70% of these clinics are owned by private equity,” she said. “And what is private equity supposed to do? Find money. Go start an agency, you already have the patients.”

With this approach, she said, instead of each surrogacy “journey” having multiple overseers that act as checks on each other, the entire thing plays out in “one house.”

Drane’s estimate is higher than the data I could find, but regardless, the number of clinics affiliated with private equity is substantial. A 2026 report published in JAMA found that in 2023, the figure was 32.1%, as compared with 3.7% just ten years earlier.9 Side Hustles has contacted the study’s authors about how common clinic-run agencies are and will update this article with any response.

Pushing for regulation

Drane argued that more oversight would improve—although perhaps not entirely solve—the issues with paid surrogacy as she sees them, suggesting that it might have prevented the Arcadia scandal.

“There are agencies that are running amok, and I’m the first to raise my hand and say, you know what, every single agency needs a license,” she said. “You can’t go sell a house if you’re not a real estate agent, you can’t drive a car if you don’t have a license, you shouldn’t be running an agency without a license.”

When I asked her whether there was much of a push for legislation on a national level, she said no, citing the current political climate as the major barrier. Given “everything that’s going on in this country with women’s rights,” she told me, “nobody wants to do anything under this administration.”

Regarding what federal legislation would look like, she pointed to New York as an example. In addition to requiring agencies to be licensed by the New York State Department of Health, the state has created a “Bill of Rights” for surrogates. Among other guarantees, it obligates parents to pay for legal counsel for surrogates, something that Oleaga, an attorney, stressed the need for. (California requires independent counsel, but does not require IPs to pay for it.)

Even the CBC Network, which favors a ban on surrogacy, said it supports more rules as an interim step. Licensing and mandatory counsel “may improve procedural protections,” Fell said. She also recommended closing the US market to international IPs. While this would “not resolve the underlying ethical questions,” the CBC’s position is that it would be better than nothing.

In the course of researching this article, it struck me that many of the arguments against paid surrogacy were similar to those against selling one’s organs, especially the idea that people might do so out of economic coercion.

Fell also raised this point with me. “Consider the analogy to organ donation,” she said. “We do not permit people to sell their organs, even though people may willingly agree to do so and a regulated market could, in theory, include safeguards.”

It seemed to me that many of the arguments that the pro-surrogacy side deployed were, actually, applicable to organ sales. If a surrogate can claim that asking for compensation is part of her right to bodily autonomy and that screening eliminates the risk of coercion, can’t a kidney donor claim the same thing? If not, what’s the difference?

I posed this question to Drane. After all, like surrogacy, organ donation is something she has personal experience with. I expected her to say that surrogacy was different. She didn’t.

“I don’t know,” she said, after thinking for a moment. “Who am I to judge? I am not going to sit here and pass judgment on the decision that someone made because they wanted to sell their organs, or they wanted to sell their plasma, or get money for giving blood. I didn’t go into politics. I just know that we all have autonomy over our own bodies.”

That’s a straight answer, and one that’s consistent with a libertarian approach to the free market and bodily autonomy. Drane is not alone in thinking this way; there are prominent libertarian organizations, such as the Cato Institute, that both defend paid surrogacy and support a regulated organ market.1011

But this does reflect a vast philosophical gap between Drane and people like Reem Alsalem and the CBC Network’s leadership, a gap that may not be reconcilable.

So, is it about the money?

Let’s return to that initial question: is paid surrogacy about the money?

Ultimately, that doesn’t have a single answer. US fertility clinics reported more than 11,000 surrogacy cycles in 2023, which suggests that the pool of surrogates is large enough that it defies easy characterization.12 Some of the women involved probably are mainly driven by money.

But some, plainly, are not. The picture is, at least, complex—more so than most people realize. In one of her emails to me, Berend wrote that “even very smart colleagues” have said to her, “But ultimately, surrogates do it for the money, no?”

As an academic with no financial stake in surrogacy, she rejects that. She noted that surrogates typically only receive their base pay when the child’s first heartbeat is detected, and that many are not successful the first time.

“Explain why so many surrogates resolve to try and try again after failed transfers,” she wrote to me, “during which time they are pumped full of hormones, have invasive procedures, feel bloated and unwell, are anxious, etc.” In her view, if surrogacy were really a cash-motivated side hustle, more women would give it up before their base pay kicks in.

Whether or not that settles the question of motive, it does not make a very compelling case for becoming a surrogate if your primary motivation is financial.

In a strange way, it dovetails with the arguments against paid surrogacy: this is something that will probably be rough on your body, and it might never pay off—financially, at least. In the end, that may actually be the only thing its most ardent supporters and harshest critics can fully agree on.

Note on our reporting: In her reply, Reem Alsalem wrote that “the tone and content of the questions already give away the direction in which you are taking the article.” She nonetheless answered them. We have made the questions we sent her available at this link.

In addition to Amber Miller and Eloise Drane, Side Hustles contacted nine surrogates for commentary on what motivated them to pursue surrogacy. This article will be updated with any responses.