What to Expect During Your Surrogate’s Pregnancy as Intended Parents

Receiving confirmation of your surrogate’s pregnancy is a significant milestone. While you are not physically carrying the baby, you are actively preparing to become parents. This transition brings a unique dynamic; you may feel excitement, anticipation and, at times, uncertainty about your role.

In this guide, we outline what typically happens during a surrogate pregnancy. We’ll cover how to stay connected to your surrogate, how to handle potential complications and what you can do to get your home ready for your baby’s arrival. If you have questions about the surrogacy process, you can fill out our form to speak with a specialist.

Your Role as Intended Parents During Your Surrogate’s Pregnancy

While your surrogate carries your baby, your life is likely a whirlwind of anticipation. It is a unique, sometimes challenging position to be in — you are legally the parents, yet you are experiencing the pregnancy from the sidelines.

Your role while your surrogate is pregnant centers on support. Be there for important milestones and keep the lines of communication open. At the same time, respect your surrogate’s space and daily life. Showing up consistently while honoring her autonomy helps create a partnership built on trust.

Understanding the Surrogacy Pregnancy Timeline by Trimester

As the surrogate pregnancy progresses, each trimester introduces new milestones and responsibilities. Over the next nine months, you will shift from “intended parent” to “parent.”

Understanding the surrogate pregnancy process can help you stay meaningfully involved and prepared at every stage. Here’s what happens during a surrogate pregnancy:

First Trimester

Your surrogate will typically remain under the care of your fertility clinic for the first 10 to 12 weeks. During this time, she will continue hormone support until the placenta fully takes over. Monitoring appointments will confirm that the pregnancy is progressing as it should.

At the end of this period, she will “graduate” from the fertility clinic and move into the care of her OB-GYN. These early weeks can feel uncertain, but regular updates and clear communication can help you stay informed.

Second Trimester

The risk of pregnancy loss drops significantly in the second trimester.

Around week 20, your surrogate will have a detailed anatomy scan to check the baby’s physical development. If you didn’t use preimplantation genetic testing for aneuploidy during the in vitro fertilization process, this is usually when you’ll find out the baby’s sex.

Even if you are miles away, we can coordinate with your surrogate so you can join the appointment via video call. Seeing the first images of the baby moving often makes the process feel much more real.

Third Trimester

In the final weeks, your focus shifts from medical updates to the practicalities of the birth. You can prepare by:

Finalizing travel and lodging near your surrogate’s hospital
Completing pre-registration forms to ensure the facility is prepared for a surrogacy birth
Packing essentials for yourselves and your newborn
Confirming delivery room preferences with your surrogate and your American Surrogacy specialist

Medical Appointments and Decision-Making: Who Decides What?

Your surrogate maintains full bodily autonomy throughout the pregnancy. She chooses her own OB-GYN and makes daily health decisions regarding her diet and activity level.

To ensure everyone is on the same page, American Surrogacy’s pre-screening process matches you with a surrogate whose lifestyle and values already mirror your own. These expectations are clearly defined in your surrogacy contract, which includes protocols for emergencies or medical complications.

Because this is a shared experience, intended parents can often attend doctor appointments. Most surrogates want you to be there for key doctor visits and ultrasounds so you can stay informed and connected to the baby’s development.

What Happens if There Are Pregnancy Complications?

Complications like gestational diabetes or preterm labor can happen during the surrogate pregnancy process. In these cases, the primary goal is the safety of the surrogate and the baby.

If your baby requires a NICU stay, you are the legal parents and will make all medical decisions for the child. The surrogate’s medical team will focus on her recovery.

American Surrogacy helps bridge the gap during these high-stress moments by coordinating with the hospital staff and your surrogate’s medical team. This allows you to focus on your baby’s care while we handle the logistical updates and communication.

Financial Responsibilities During Pregnancy

During pregnancy, your financial responsibilities typically include:

Monthly surrogate compensation
Reimbursements for approved expenses such as maternity clothing and travel
Medical costs not covered by insurance

At American Surrogacy, these payments are managed through a secure, third-party escrow account. This ensures funds are properly allocated and distributed on schedule. Escrow adds structure and protection for everyone involved, keeping your relationship with your surrogate focused on trust and shared goals.

Clear financial planning and professional oversight reduce uncertainty during pregnancy. We want you to focus on what truly matters: welcoming your baby.

What Legal Steps Happen Before Birth?

Toward the beginning of the process, you and your surrogate draft and sign a contract with independent legal support. This agreement outlines everyone’s rights, responsibilities, financial terms, medical decision-making, contingency plans and how often you’ll talk to your surrogate.

Because the contract is finalized before pregnancy, you have a clear roadmap to follow throughout the journey. This preparation is what prevents last-minute stress.

During the second and third trimesters, your attorney will file for the pre-birth order, when available in your state. This court order ensures your name goes directly on the birth certificate and confirms your right to make medical decisions for your baby immediately after delivery.

How to Emotionally Support Your Surrogate

Remember: Your surrogate has her own family, responsibilities and routines. You do not have to talk constantly to be supportive. What matters is showing up, communicating clearly and respecting her boundaries.

Every surrogate has a different preference for how much they want to talk, so we help you establish those boundaries during the matching process. This way, you can celebrate the milestones together without the stress of wondering if you’re reaching out too much or too little.

If you’d like, you can send gifts to your surrogate during pregnancy. While never required, many intended parents choose small, thoughtful gestures to say thank you. That could be something simple like a care package before a big appointment, a note on her birthday or flowers after delivery.

Preparing for Birth as Intended Parents

As the due date approaches, your focus shifts to preparing for the hospital and bringing your baby home.

A clear hospital plan helps everyone feel confident about what to expect. It outlines who will be in the delivery room, how and when you will spend time with your baby after birth and how the hospital staff should approach communication. You may also want to schedule a hospital tour so you understand delivery-day procedures.

Travel timing is another important piece. If you live out of state, you may want to arrive before the due date. Your surrogacy specialist will help you coordinate travel arrangements and think through what to bring for an extended stay.

It is also important to talk through NICU contingency planning. While most deliveries go smoothly, having a plan in place in case your baby needs additional medical care brings peace of mind. Your legal documentation, including your pre-birth order when available, helps ensure you can make medical decisions for your baby right away.

Finally, your team will help you prepare for the discharge process. This includes understanding hospital paperwork, confirming that your names will be listed correctly and knowing when you will be cleared to leave with your baby. Some families may need to remain in the birth state briefly while documentation is finalized.

How to Prepare for Your Baby During Surrogacy

Some intended parents feel disconnected from the journey because they aren't experiencing the physical changes of pregnancy. However, the nine months of pregnancy are vital for your emotional transition into parenthood.

Here are four ways to prepare for your baby during surrogacy:

Set up the nursery. Creating a physical space for your baby helps make the arrival feel real.
Consider taking parenting classes. Infant CPR and newborn care classes can help you feel more confident and prepared for those first few weeks at home.
Select a pediatrician. Search for a doctor who understands surrogacy and offers the medical support you’re looking for.
Plan your work leave. Finalize time-off plans with your employer so you can focus entirely on bonding with your newborn.

After the baby is born, you will no longer be preparing. You will be parenting.

Taking intentional steps now helps ensure that when that moment comes, you feel ready.

American Surrogacy Supports You Throughout the Surrogate Pregnancy

You don’t have to manage the surrogacy process on your own. American Surrogacy supports you through every step, from coordinating appointments to making sure payments are distributed properly.

Throughout the pregnancy, your specialist remains available to answer questions, help navigate decisions and step in if challenges arise. You always have a professional team behind you.

If you are ready to take the next step, fill out our form to receive free information. You can also call 1-800-875-BABY to speak with a surrogacy specialist today.