The emotional and psychological issues involved with the surrogacy process should be discussed with a mental health professional. Through counseling, the surrogate must come to an understanding of the psychological issues of pregnancy and surrogacy. Other issues the surrogate (and her partner if she has one) should discuss are the effects of carrying a pregnancy on her relationships (such as with children, friends, relatives, and employer/employees), as well as managing a relationship with the intended parents and the effect of becoming attached to the developing fetus.
The intended parents and the surrogate should establish the type of relationship they would like to have and discuss pregnancy expectations (especially in regard to number of embryos to be transferred, fetal reduction, therapeutic abortion, and prenatal diagnostic interventions) with the help of a mental health advisor. A respectful relationship should be developed between the intended parents and the surrogate, and the couple must also respect the carrier’s right to privacy. Nutritional and lifestyle choices must also be considered and discussed to reach an agreement of what is preferred, and what is not acceptable.
Third party reproduction carries several legal issues. Legal surrogacy contracts must outline in detail items like the fee paid to the surrogate, and may also include details of expected behavior to ensure a healthy pregnancy, required prenatal diagnostic tests, and agreements regarding fetal reduction or abortion in the event of multiple pregnancies or the presence of fetal anomalies. Many states allow the bypassing of adoption proceedings through declaration of parentage prior to the child’s birth.
Since surrogacy laws differ from state to state (and some do not have any laws regarding surrogacy), it is important to consult with an attorney who is knowledgeable in reproductive law in the specific state.