How To Navigate The Complex Emotional Terrain Of Childbirth Via Surrogate

Surrogacy is a solution to one of the world's most difficult problems, but it is not without its own drawbacks.

By Jourdan Travers, LCSW | August 2, 2023

Surrogacy, a reproductive arrangement in which a woman carries and gives birth to a child on behalf of another person or couple, has provided a path to parenthood for many for whom it was previously closed. But the emotional complexities associated with the process often go unaddressed.

Surrogacy presents unique psychological challenges that require careful consideration. It demands significant physical and emotional exertion, extending beyond childbirth. Expecting parents and surrogates face ongoing challenges when adjusting to their new roles, presenting a need for continued support.

Surrogacy also has a great deal of impact on the children born out of it.

Here are two lesser-known psychological impacts of surrogacy which can help you fully appreciate the psychological implications of the process.

1. Emotional Bonding And Separation From Surrogate Mothers

The emotional bond formed between surrogates and the child they carry is a significant aspect of the surrogacy experience that deeply impacts the psychological well-being of surrogates.

Surrogates develop a deep connection with the growing fetus, experiencing its physical sensations and providing nourishment to the developing baby. However, when the child is born, surrogates face the challenge of separation, leading to feelings of grief and loss.

A study published in Human Reproduction compared the psychological well-being and prenatal bonding of surrogates to a group of expecting mothers. The findings revealed that surrogates experienced higher levels of depression during pregnancy and postpartum in comparison to the expecting mothers’ group.

Several factors were associated with higher levels of post-birth depression in surrogates:

  • Low social support emerged as a significant predictor, indicating that surrogates who lacked sufficient support from their social networks were more likely to experience depressive symptoms.
  • Another factor identified was the act of hiding surrogacy. Surrogates who felt the need to conceal their involvement in the surrogacy process faced an increased risk of post-birth depression. The need for secrecy may stem from societal or cultural judgments surrounding surrogacy, fear of social repercussions, or concerns over personal privacy.
  • Thirdly, criticism from others, negative comments, judgment, or disapproval from individuals within their social circles or the broader community can significantly affect surrogates' emotional state.

The findings of this study thus show the need for comprehensive psychological support and counseling services for surrogates, particularly during the post-birth period.

Emotional support via social circles, support groups, and counseling can help surrogates navigate the emotional challenges, develop coping strategies, and transition back into their lives with greater ease.

2. Identity And Role Confusion For The Children

An aspect of the process that is often overlooked is the potential for identity and role confusion in children who are born through surrogacy. Surrogacy involves a complex interplay of genetic, gestational, and social parenting, which can impact a child's sense of self and understanding of their origins.

Research in the field of developmental psychology supports the notion that children's understanding of their identity is influenced by their family structure and how they perceive their origins.

A study published in The Journal of Child Psychology and Psychiatry found that children born through reproductive donation have adjustment scores within the normal range, but children born via surrogacy may experience higher levels of adjustment difficulties compared to those conceived through gamete donation. Also, mothers who kept their child's origins a secret experienced increased distress.

To mitigate these issues, parents should create a nurturing environment that allows for age-appropriate discussions to help children of surrogacy develop a coherent sense of identity.


Surrogacy is a complex and emotionally charged process that can significantly impact the mental health and well-being of surrogates. It is imperative that everyone involved in the process receive adequate psychological support and counseling throughout the journey to equip them to navigate these challenges and promote their mental well-being.