Surrogacy is often viewed through the lens of medical procedures, legal steps and logistics. But beneath all of that, it’s a deeply human process, one that involves real emotions for both surrogates and intended parents. While many people prepare for the physical aspects of the journey, fewer expect how important mental and emotional well-being will be along the way. Understanding these emotional layers can help both parties feel more grounded, more supported, and more connected to the experience from start to finish.
In this article, we’ll explore why mental health matters during surrogacy, the challenges that can arise, and practical tips for protecting emotional well-being throughout the journey.
Why Mental Health Matters for Surrogates and Intended Parents
A Highly Emotional Journey
For surrogates
Carrying a baby for someone else is not a simple act. Even when a surrogate is fully committed to the process, it is still an experience that touches deep emotional ground. The idea of nurturing a life that will be placed into another family’s arms is powerful. It requires clarity, preparation, and emotional strength. At the same time, the surrogate’s body goes through all the usual hormonal changes of pregnancy, which can intensify emotional responses, even when everything is going well.
Estrogen and progesterone levels rise significantly in early pregnancy. These shifts can influence mood, increase fatigue, and make certain emotions feel stronger or harder to manage. Most surrogates are aware of this going in, but that doesn’t mean it’s always easy to handle day to day. Feeling irritable, tired, or emotionally fragile doesn’t mean something is wrong. It’s part of what the body does to maintain and support pregnancy. Learn more in our guide on the emotional effects of surrogacy.
For intended parents
For many infertile couples, surrogacy becomes a deeply emotional option after years of unsuccessful treatments and personal loss. The emotional journey is different but no less intense. Many have faced a long road before turning to surrogacy, often involving infertility, loss, or years of uncertainty. Placing their trust in someone else to carry their child can bring both relief and anxiety. There’s often a fear that something could go wrong, or that they won’t feel fully included in the experience. These emotions are common and valid, even when the relationship with the surrogate is positive and respectful.
Emotional complexity is not a problem. It’s a reality. Recognizing this from the start helps both surrogates and intended parents navigate the process with more honesty, empathy, and awareness.
Mental Health Affects Physical Health
For Surrogates
There is a direct connection between emotional stress and physical well-being. For surrogates, high levels of anxiety can disrupt sleep, affect appetite, and increase physical tension in the body. In some cases, stress hormones like cortisol can interfere with the body’s ability to rest and recover, making pregnancy feel more exhausting than it needs to be. These effects are not dangerous in themselves, but they’re a reminder that emotional care should never be overlooked.
When surrogates have support, these symptoms are easier to manage. Being able to talk to someone, take time to rest, or express a concern without judgment all contribute to a more balanced experience. Feeling emotionally safe helps the body stay physically steady.
For Intended Parents
Intended parents also feel the physical impact of emotional strain. Chronic stress can lead to difficulty sleeping, fatigue, and reduced focus, especially if they are managing work, family, and the logistics of the surrogacy process at the same time. Without support, these pressures can pile up. With support, they become much easier to handle.
Mental health is not just a side topic in surrogacy. It is a central part of what allows the experience to unfold in a healthy, respectful, and human way.
Common Mental Health Challenges for Surrogates
Emotional Ups and Downs During Pregnancy
Even in a well-supported surrogacy journey, pregnancy can bring emotional highs and lows. These shifts are often related to hormonal changes that happen naturally as the body adjusts to carrying a baby. A surrogate may feel calm and focused one day, then suddenly experience irritation, sadness, or emotional fatigue the next. These reactions are not unusual, and they do not reflect doubts about the decision to become a surrogate. They are simply a part of the pregnancy experience.
Fatigue and physical discomfort can also influence mood. As the pregnancy progresses, the body works harder to support the growing baby. This can lead to disrupted sleep, changes in appetite, or feelings of exhaustion that affect mental resilience. When energy is low, emotional regulation becomes more difficult, and even small challenges can feel overwhelming.
It is also common to experience moments of emotional contrast. A surrogate may feel happy and proud to help another family, while also feeling the weight of physical strain or temporary emotional vulnerability. These ups and downs do not mean something is going wrong. They are a normal part of healthy pregnancy, and with the right tools and support, most surrogates navigate them successfully.
Managing Relationships and Boundaries with Intended Parents
A strong relationship between a surrogate and the intended parents can make the journey smoother and more meaningful. However, maintaining that relationship can also present emotional challenges. Every person involved brings their own expectations, communication style, and emotional background. Misunderstandings can happen, especially if boundaries are not clearly defined early on.
Some surrogates feel pressure to always appear positive or accommodating, especially when they sense that the intended parents are anxious or emotionally invested. This can lead to emotional fatigue or feelings of guilt when the surrogate needs space, rest, or privacy. It is important for surrogates to feel empowered to express their needs without fear of disappointing the intended parents.
Setting boundaries is not about creating distance. It is about creating clarity. When everyone understands what kind of contact is comfortable, how often updates will be shared, and what kind of emotional support is appropriate, it becomes easier to build trust. Open and respectful communication, supported by the agency when needed, helps everyone stay aligned and feel safe throughout the process.
The Post-Birth Adjustment
The days and weeks after delivery can bring a shift in emotional rhythm for many surrogates. After months of focus, medical appointments, and daily awareness of the pregnancy, the body and mind must transition back to their pre-pregnancy state. This transition can bring moments of fatigue, emotional release, or a need for quiet reflection.
While most surrogates do not experience sadness related to the separation from the baby, because they have been emotionally prepared from the start, some may feel a temporary sense of loss related to the end of the journey itself. Surrogacy is a unique and structured experience. Once it concludes, it is normal for some surrogates to feel the absence of that routine, especially if the process was intense or deeply meaningful.
In some cases, surrogates also notice that attention and communication drop off after delivery. While this is natural, it can feel abrupt. Maintaining respectful post-birth contact, when agreed upon beforehand, can help ease the transition. Support from the agency, a therapist, or a surrogate support group can also provide perspective and reassurance during this period.
Mental Health Tips for Surrogates
Before You Begin: Prepare Emotionally
Emotional preparation is one of the most important steps before beginning a surrogacy journey. While agencies typically handle medical screenings and legal contracts, it is equally important for surrogates to reflect on their emotional readiness. This means taking the time to think about personal motivations, expectations, and possible challenges.
Before starting, every surrogate should go through a psychological screening conducted by a licensed mental health professional. This is not just a requirement. It is an opportunity to explore questions such as, “Why do I want to become a surrogate?” and “How do I usually respond to emotional stress?” A strong sense of self-awareness helps create a stable foundation for the months ahead.
In addition to professional evaluations, building a support system is key. This can include close family members, friends, or other surrogates who understand the process. Knowing who to turn to for emotional encouragement, help with logistics, or simply someone who listens can make a significant difference in how the journey begins and how manageable it feels over time.
During Pregnancy: Protect Your Well-Being
Pregnancy brings physical and emotional changes that require consistent care. For surrogates, these changes can be even more noticeable because they are carrying a child for another family, which adds layers of responsibility and emotional focus. Protecting your mental health during this time means being intentional about how you manage stress, rest, and emotional boundaries.
Practices like guided meditation, slow breathing, or light prenatal movement can help calm the nervous system and make it easier to navigate emotional shifts. These moments of quiet do not need to be long. Even ten minutes of breathing or journaling in the morning can help create a sense of stability before the day begins.
Communication is another key part of emotional well-being. Staying honest with the intended parents about how you are feeling physically and emotionally can prevent misunderstandings. If something feels uncomfortable or stressful, sharing that information early helps build trust and prevents tension from growing over time.
Creative outlets can also support emotional balance. Some surrogates find it helpful to write about their experience, create a photo diary, or use art to express how the journey is unfolding. What matters most is finding ways to stay connected to yourself throughout the process.
If emotions become overwhelming or difficult to manage, talking with a therapist or connecting with other surrogates can provide relief and clarity. Feeling emotionally supported during pregnancy is not optional. It is part of what helps the journey stay healthy and positive for everyone involved.
After Delivery: Don’t Skip Support
Once the baby is delivered, the focus often shifts quickly to the intended parents and their new life as a family. For the surrogate, this moment marks the end of a long, structured experience. Even if the delivery went well and the emotional transition feels smooth, it is important not to overlook the mental and emotional needs that can arise in the weeks that follow.
Some surrogates feel a sense of closure and relief after delivery. Others experience a drop in energy or mood as their body adjusts hormonally and their daily focus changes. This does not mean they regret their decision. It simply reflects the body’s natural recovery process and the emotional space that opens up after a significant experience.
Rest and self-care are essential in this phase. Taking the time to sleep, eat nourishing meals, and allow the body to heal helps the mind stay balanced. Emotional recovery also deserves attention. Checking in with a therapist or simply speaking with someone from the agency can provide helpful perspective. It is also beneficial to stay connected to your support system and to avoid isolation, even if that means only short conversations or messages with people you trust.
Some surrogates may also benefit from reflecting on the experience through writing or conversation. Talking about what went well, what felt challenging, and what they learned along the way can be empowering. Every surrogacy journey is unique, and taking care of mental health after delivery is part of closing that journey in a thoughtful and respectful way.
Mental Health Toolkit: Practical Daily Strategies for Surrogates
Simple Daily Rituals to Stay Balanced
Small daily habits can have a powerful impact on emotional well-being, especially during pregnancy. When practiced regularly, even simple rituals can help reduce stress, create a sense of control, and support mental clarity.
- Starting the day with a few minutes of quiet breathing or gentle stretching helps center the mind before outside demands begin. It can be as simple as sitting by a window, closing your eyes, and taking a few deep breaths. This kind of intentional pause creates space to check in with your body and your emotions.
- Keeping a small notebook for personal reflections or gratitude can also be helpful. Writing down one or two things that felt grounding or pleasant during the day, even something as simple as a nice meal or a short walk, can shift focus away from stress and toward calm.
- Many surrogates also find that managing sensory input makes a difference. Playing calming music, using a subtle scent they enjoy, or limiting time spent on news and social media can reduce emotional overload and support a more stable mood.
These rituals do not need to be perfect or time-consuming. What matters is consistency and the intention behind them. Taking small moments for yourself each day builds emotional resilience over time.
Emotional Regulation Techniques
During pregnancy, emotions can shift unexpectedly. This is due in part to hormonal changes, but also to the physical and emotional demands of carrying a baby. For surrogates, managing these changes with care and intention helps maintain stability and well-being throughout the journey.
1) Grounding with the five senses
One helpful method is the five senses grounding technique. This involves gently shifting your attention to the present by identifying five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This simple exercise can be done anywhere, and it helps bring focus back to the body and away from racing thoughts or anxious loops.
2) Using calming phrases
Another tool is the use of self-soothing phrases or mantras. Saying something like “This is temporary, and I can handle it” or “I am safe, and my body knows what to do” can interrupt a moment of emotional overwhelm. These phrases are most effective when repeated slowly and intentionally, either out loud or in your mind. Over time, they become internal signals of reassurance.
3) Physical comfort techniques
Physical comfort also plays a role in emotional regulation. Using warmth, texture, or gentle pressure to calm the body can help reduce internal stress. Wrapping yourself in a soft blanket, holding a warm drink, or placing your hand over your heart while breathing slowly are small gestures that send calming signals to the nervous system. These physical actions may seem simple, but they are powerful because the body responds immediately to touch and temperature.
5) Visualization exercises
Visualization is another technique that many find effective. This involves mentally stepping into a space that feels peaceful or familiar, such as a quiet room, a forest trail, or a place from childhood. By imagining the colors, sounds, and sensations of that space, the mind can shift away from stress and into a more regulated state. This is particularly useful at bedtime or during long waiting periods, such as before medical appointments.
These techniques are not about suppressing feelings. They are about giving yourself tools to navigate moments of intensity with greater calm and confidence. Practicing them regularly can make it easier to stay grounded and emotionally steady, even in a demanding process like surrogacy.
Support and Connection
Emotional well-being during surrogacy does not depend only on internal tools. It also relies on having people around you who can listen, encourage, and understand what you are going through. Connection to others is one of the most effective ways to reduce stress and maintain a sense of stability.
1) Check-in with someone you trust
For many surrogates, having a designated check-in person makes a big difference. This might be a close friend, a family member, or another surrogate who understands the unique aspects of the journey. Even a brief daily message or a weekly call can offer a sense of routine and reassurance.
2) Join a surrogate support group
Support groups, whether in person or online, provide a space where surrogates can share experiences, ask questions, and receive validation. Hearing from others who are on the same path can reduce feelings of isolation and offer practical insight. Some agencies also offer community resources or private forums where surrogates can connect safely and confidentially.
3) Keep your social connections gentle
Gentle social contact also matters. Spending time with people who make you feel comfortable, even for a short walk or a calm conversation, can help shift emotional energy. It is not necessary to be constantly social. What matters is being surrounded by relationships that feel emotionally safe.
4) Rest is a valid boundary
Saying “I need rest” or “I need some quiet time” is not a sign of weakness. It is a healthy way to protect your mental space. The people in your life who respect and support that boundary are the ones who can truly help you stay grounded throughout the surrogacy process.
Caring for Your Body to Support Your Mind
Physical care and emotional balance are closely linked. When the body is nourished, rested, and supported, the mind is better equipped to manage stress, maintain perspective, and respond calmly to challenges. During pregnancy, this connection becomes even more important.
- Maintaining regular meals and consistent sleep routines helps stabilize mood and energy. Skipping meals or staying up too late can increase irritability and make it harder to process emotions. Even if rest is sometimes interrupted by physical discomfort, prioritizing calm and regular bedtime habits supports deeper recovery.
- Staying hydrated is another key factor. Dehydration, even mild, can affect concentration, increase fatigue, and heighten emotional reactivity. Keeping a water bottle nearby and sipping throughout the day is a small habit that makes a real difference in overall well-being.
- Soothing sounds, like nature recordings or soft instrumental music, can help reduce mental tension, especially at the end of the day. Creating a calming atmosphere before sleep by turning off screens, dimming the lights, and following a simple evening routine signals to the body that it is safe to relax. These cues are especially helpful when emotional intensity has been building during the day.
Taking care of your physical health is not just about avoiding illness. It is a foundation for emotional resilience. The more your body feels supported, the easier it becomes to process what you feel, think clearly, and stay present in the surrogacy journey.
Create Your Mental Health Emergency Plan
Even when everything is going well, it is helpful to have a plan in place for moments when emotions feel too intense to manage alone. A mental health emergency plan is a personal strategy you can turn to when you feel overwhelmed, anxious, or disconnected. The goal is not to eliminate difficult feelings but to respond to them with care and structure.
Recognize what grounds you
Start by identifying what typically helps you feel grounded. This might include taking a warm shower, going for a short walk, listening to calming music, or stepping outside for fresh air. Having a list of these simple actions written down makes it easier to access them when your mind feels scattered or foggy.
Know who to contact
It is also important to know who you can contact when you need support. This may be a friend, a family member, your agency coordinator, or a licensed therapist. Keep their names and numbers easily accessible so you do not have to search for help when you are already feeling vulnerable.
Watch for early warning signs
Pay attention to early warning signs of emotional overload. These can include tightness in your chest, difficulty focusing, or the urge to withdraw from others. Recognizing these signs early allows you to act before the stress builds. Taking one small step, whether it is a conversation, a short break, or a breathing exercise, can prevent the situation from escalating.
A mental health emergency plan is not a sign of weakness. It is a sign of preparation and self-respect. Knowing how to take care of yourself in difficult moments gives you more control, more clarity, and more confidence throughout the surrogacy journey.
Mental Health Challenges for Intended Parents
While surrogacy offers hope and possibility, it can also bring emotional stress for intended parents. Many come to surrogacy after facing years of infertility, pregnancy loss, or other deeply personal obstacles. Even when the decision to pursue surrogacy is clear, the emotional weight of the past often continues to shape how they experience the journey.
A common challenge is the feeling of uncertainty. Intended parents are not physically present in the pregnancy, yet they are deeply invested in its outcome. This can create moments of worry or helplessness, especially during times when updates are limited or when medical appointments bring unexpected news.
Some intended parents also experience guilt or grief. While they are grateful for the surrogate, they may still carry sadness about not being able to carry the baby themselves. These emotions can be difficult to talk about, particularly when others expect them to feel only happiness.
Another challenge is the emotional intensity of each stage. Waiting for the embryo transfer, receiving pregnancy test results, or reaching key milestones can all trigger strong emotional responses. Even good news can be overwhelming. The emotional investment in each step is real, and it can be exhausting over time.
Finally, intended parents sometimes struggle with setting boundaries or knowing how involved to be. They may worry about asking too many questions or being perceived as controlling. This can create internal tension, especially if they are unsure how to express their needs while also respecting the surrogate’s space.
Mental Health Tips for Intended Parents
Caring for your emotional well-being during the surrogacy process helps you stay grounded, focused, and resilient from beginning to end. The journey can be emotionally intense, and it is important to take active steps to protect your mental health along the way.
1) Create space for emotional reflection
Start by creating space to process your emotions. This can mean setting aside time each day to reflect on how you are feeling or speaking regularly with a therapist or counselor. When emotions are not acknowledged, they often build quietly. Naming what you feel, even briefly, helps reduce tension and brings clarity.
2) Stay meaningfully involved
Stay engaged with the surrogacy process in ways that feel meaningful to you. Attending medical appointments when possible, maintaining agreed-upon communication with the surrogate, or tracking pregnancy updates can help you feel more connected. If you are unsure how involved to be, your agency can help you define the right balance.
3) Step back when needed
Give yourself permission to step back when needed. Surrogacy is a long process, and it is natural to feel emotionally tired at times. Taking breaks from planning or conversations about the baby does not mean you care less. It means you are protecting your energy. Moments of rest help you return to the experience with more presence and patience.
4) Surround yourself with the right people
Surround yourself with people you trust. This might include your partner, a close friend, a counselor, or someone who has already gone through a similar journey within an intended parents support group. Having one or two people you can talk to openly is often enough to feel supported, especially during moments of doubt or uncertainty.
5) Be flexible with your expectations
Finally, manage your expectations with compassion. There will be moments of joy and moments of uncertainty. Accepting that not everything will go according to plan allows you to stay flexible, calm, and emotionally available for the experience as it unfolds.
When to Turn to Your Agency for Mental Health Support
Support Is Part of the Process
A surrogacy agency is not just a coordinator of medical steps or legal documents. It is also a source of emotional support. If you are feeling overwhelmed, unsure, or emotionally tired during any stage of the journey, your agency should be a place you can turn to without hesitation.
You do not need to wait until you reach a breaking point to ask for help. Whether you are dealing with a communication issue, feeling unusually anxious, or simply needing to talk something through, your agency is there to listen and guide. Many surrogates feel relief just knowing they can speak to someone who understands the process from both a personal and professional perspective.
Even short check-ins can help prevent small worries from turning into bigger stress. Agencies that provide regular emotional follow-up throughout the pregnancy contribute to a more balanced and supportive experience.
Asking for support is not a sign that something is wrong. It is a way to stay grounded, cared for, and connected during a journey that can be emotionally intense, even when everything is going well.
Ways Your Agency Can Help
No one goes through the surrogacy process without experiencing moments of emotional intensity. Whether you are a surrogate or an intended parent, it is reassuring to know that you are not expected to manage everything alone. A strong agency offers more than coordination and logistics. It provides consistent emotional support tailored to the needs of everyone involved.
For surrogates
The agency is often the first place to turn when something feels emotionally difficult or unclear. Whether you need to talk to someone about your experience, set a boundary, or resolve a miscommunication, your agency is there to listen and act. Many agencies work with licensed mental health professionals or can refer you to trusted therapists who understand the emotional landscape of pregnancy and surrogacy. They can also check in after delivery to ensure you feel supported as you adjust to the end of the journey.
For intended parents
The agency can also be a critical emotional resource. It is common to experience anxiety, uncertainty, or emotional tension during the process, especially if you have been through fertility challenges. Agencies can help you stay connected to the process, communicate openly with your surrogate, and manage emotional pressure as different stages unfold. If you ever feel unsure about how to navigate a conversation or need help processing your emotions, your agency should be a trusted place to turn.
In every case, having professionals who understand the emotional weight of surrogacy makes the journey smoother and more human. Reaching out for support is not a disruption to the process. It is part of what makes it work.
Why Choose Surrogacy by Faith
At Surrogacy by Faith, emotional support is more than a service. It is part of the agency’s core values. From the first consultation to the post-birth transition, every step of the process is designed with care, respect, and understanding for what intended parents and surrogates are experiencing.
What makes this agency truly unique is the lived experience of its team. Every member has been a surrogate herself. This brings not only compassion but also deep, practical knowledge of what the journey really feels like. When you speak to someone on the team, you are speaking to someone who understands your questions, your concerns, and your hopes because she has experienced them personally.
The agency also offers thoughtful emotional follow-up, clear communication practices, and support resources tailored to both surrogates and intended parents. Whether you are looking for reassurance, guidance, or simply someone who will listen, you will find that this agency knows how to care for the human side of surrogacy.
To begin your journey, you can fill out the Intended Parents Form, while those considering becoming a surrogate can explore the Surrogate Application Form.