You do not lose control of your body as a surrogate, but you do agree to a shared plan. By signing a contract that clearly outlines medical decisions in a surrogacy contract, you protect your autonomy while giving intended parents the reassurance they need to move forward.
This mutual understanding lets you can focus on a healthy pregnancy without the stress of last-minute disagreements or confusion in the delivery room.
In this guide, we will cover exactly who has the final say in medical procedures, what rights you always keep, and how we ensure you feel safe and supported every step of the way.
Don’t wait another day—start the process by reaching out. You can receive the protection and support you deserve. Contact us online to connect with a specialist.
Who has the final say in medical decisions during a surrogacy contract?
One of the biggest misconceptions about surrogacy is that intended parents (IPs) "own" the pregnancy and can force a surrogate to undergo medical procedures against her will. This is not true.
In the United States, bodily autonomy is a fundamental right. A surrogacy contract cannot empower a doctor or an intended parent to physically force you to have a C-section, an amniocentesis, or an abortion. However, the contract is a binding legal agreement regarding intent.
Reviewing common gestational surrogacy contract clauses can help you better understand how this intent is documented.
And while no one can force a medical decision upon your body, the contract will outline consequences—usually financial—if you breach the agreement you made regarding specific medical scenarios.
This is why the legal phase is so critical; it helps you and the IPs align on moral and medical views before an embryo transfer.
What medical rights do surrogates keep under contract?
Even with a signed contract, you retain specific medical records access rights and bodily autonomy that are legally protected.
Different states have different statutes, but the core principle remains that a gestational carrier is a patient with the right to informed consent. For example, states like New York have established a "Surrogate’s Bill of Rights" to explicitly protect the health and welfare of surrogates.
Because laws vary, check surrogacy laws for your state to understand how your local legislation protects your autonomy.
Regardless of where you live, a strong contract ensures you have the right to a doctor who prioritizes your health and the right to be fully informed about any medical procedure.
Medical record access in the surrogacy contract: what’s included?
Transparency is crucial to a successful surrogacy journey, but privacy still matters.
A common question is: Can intended parents see all my medical records? Generally, your contract will grant IP access to medical records relevant to the pregnancy. This creates trust and keeps them informed about the health of their developing baby.
Our blog on whether or not intended parents can read records explains how we balance transparency with privacy, keeping your unrelated history remains confidential.
Medical information sharing usually includes OBGYN visit notes, ultrasound results, lab work related to the pregnancy, and delivery records. Discussing records with doctor regarding unrelated medical history (like therapy or podiatry) usually remains confidential under HIPAA unless it directly impacts the pregnancy.
This allows intended parents to feel connected without violating your medical privacy in surrogacy.
How the surrogacy contract handles doctor and hospital choice
Choosing the right provider is a collaborative effort. Because the intended parents are typically paying for the medical costs, the contract often gives them the right to approve the physician and the delivery hospital.
Choosing your OB and doctor surrogacy providers is discussed during the matching phase to ensure it works for you. Establishing a clear surrogacy hospital plan early in the process prevents confusion in the delivery room and confirms the facility is within a reasonable distance of your home.
- Network: The provider generally needs to be covered by your surrogacy-friendly insurance policy.
- Comfort: IP approval of doctors is often flexible; if you have a trusted OB, many IPs are happy to agree to that provider if they are board-certified.
- Choice: Your contract will detail the hospital choice for your surrogacy so you aren't forced to travel unreasonable distances for care.
Midwives, home births, and the contract: what’s allowed?
Most surrogacy contracts are drafted with the expectation of a hospital birth under the care of an OBGYN. This is primarily because IVF pregnancies are highly invested endeavors, and IPs often prefer the immediate access to emergency technology that a hospital provides.
That said, you have options if you voice them early.
If you feel strongly about using a midwife birth option or a birthing center, you can be matched with intended parents who share that philosophy. We can help you navigate preferences regarding home birth as a surrogate if that is your goal, though hospital births are standard.
While home birth surrogacy is rarer in contracts due to perceived risk, it is possible if all parties agree beforehand.
What the surrogacy contract says about medications and supplements
Surrogacy involves more medication than a traditional pregnancy, specifically during the IVF process to prepare your uterus.
Your contract will likely have a clause requiring you to follow the doctor’s orders regarding medications.
This includes:
You agree to take estrogen and progesterone as prescribed to maintain the pregnancy. You may need to follow an over the counter (OTC) medication restrictions protocol, requiring approval before taking certain over-the-counter medications. There are often supplement approval requirements to verify herbal remedies are safe for the baby.
This isn't about control; it's about the safety of the pregnancy. The contract helps define the medication approval process and places medical decision-making authority relies on expert medical advice rather than guessing.
Caffeine, alcohol, and lifestyle clauses in surrogacy contract
You might see clauses in your agreement that restrict caffeine, ban alcohol and tobacco, or limit exposure to environmental toxins. These "lifestyle clauses" are standard.
They aren't there to judge you; they are there to provide the intended parents with peace of mind. Whether or not lifestyle restrictions are appropriate in modern contracts is up to interpretation, but generally, these are mutually agreed upon to ensure a healthy pregnancy.
- Alcohol: Standard contracts prohibit alcohol before pregnancy meds start and throughout the pregnancy.
- Caffeine: You will often see caffeine restrictions with surrogacy clauses limited to recommended daily amounts (e.g., one cup of coffee).
Emergency medical situations: what the contract says
No one wants to think about emergencies, but a good contract prepares for them. In a life-threatening emergency involving you, your life takes priority.
Medical professionals are ethically bound to save the patient on the table. Contracts also cover high risk pregnancy legal rights to clarify decision-making in urgent scenarios.
If you are incapacitated, your contract will likely designate who has the authority to make decisions—often your own partner or next of kin regarding your health, while the IPs make decisions regarding the baby.
NICU and high-risk birth scenarios in the surrogacy contract
While you make decisions for your body, the intended parents make decisions for the baby once they are born.
A NICU requirements contract clause explicitly states that the IPs have the legal authority to make all medical decisions for the child if the baby is born premature.
For more context on these specific high risk birth scenarios, speak directly with your attorney.
How American Surrogacy supports medical clarity in your surrogacy contract
Navigating these legal and medical waters can feel overwhelming, but you never have to do it alone. At American Surrogacy, we prioritize your safety and autonomy.
One of the major advantages of American Surrogacy is our dedication to transparency and surrogate-first support. We ensure:
You are matched with IPs who respect your medical provider restrictions and preferences. You have your own separate legal counsel (paid for by the IPs) to advocate for your rights. Every clause is explained to you in plain English before you sign.
Ready to feel confident in your surrogacy journey? Let’s talk
You deserve a surrogacy partner who empowers you to make informed choices about your body and your future.
Imagine moving forward with surrogacy feeling confident in your financial and medical plan. It’s more achievable than you realize. Contact us today to take the next step.