Why do surrogates need a prior pregnancy?
Because a prior full-term pregnancy is the only reliable evidence of how your body handles pregnancy. No test, scan or exam can predict that as well as a pregnancy you have already carried and delivered.
A healthy full-term delivery tells a physician three things:
- Your uterus can carry to term. It has done it before, without the pregnancy ending early.
- You tolerated pregnancy without serious complications. Your records show your blood pressure, your glucose screening, whether you had preeclampsia or preterm labor, and how delivery went.
- You recovered. Your postpartum notes show how your body and your mood came back afterward.
There is a second reason, and it matters as much. A surrogate pregnancy asks you to go through nausea, fatigue, a changing body, delivery and recovery for another family. If you have done that once for yourself, you know what you are agreeing to. You are not guessing. That is why the rule is medical and psychological, not administrative, and why PLS, like agencies that follow ASRM guidance, does not make exceptions to it.
Mark Silverberg, DDS, MD, reads the prenatal and delivery records for every pregnancy you have had, and writes a physician medical summary for the intended parents' fertility clinic. Your prior pregnancy is the center of that review.
Does a premature delivery count?
Full term is 37 weeks or more. A pregnancy that ended before 37 weeks does not meet the requirement on its own.
That does not mean one early delivery rules you out. If you have also had a full-term pregnancy, the earlier delivery is part of your history, and Dr. Silverberg reads why it happened. A preterm birth caused by a one-time event reads differently from one caused by a condition that could recur.
A single delivery at 36 weeks is reviewed by Dr. Silverberg and the clinic; it is not an automatic no. If your only delivery was at 36 weeks, say so on your prescreen and send what you know about why labor started. The clinic's reproductive endocrinologist makes the final medical decision.
Does a miscarriage or stillbirth count?
No. A pregnancy that ended in loss does not meet the requirement, because it does not show that you can carry to term.
A loss is not automatically disqualifying, though, if you have also had a healthy full-term pregnancy. Many women who have carried healthy babies also had an early miscarriage. A single early loss usually does not disqualify you. Recurrent miscarriage, which ASRM defines as two or more losses, does. A stillbirth is reviewed in detail, with the records, to understand the cause. See miscarriage history and surrogacy and pregnancy complications for how those are assessed.
Do you have to be raising the child now?
Yes. PLS requires that you have carried at least one healthy full-term pregnancy and that you are currently parenting a child.
Raising a child now means you understand, from the inside, what the intended parents are working toward. It also means you have a daily life that a surrogate pregnancy has to fit around: school runs, work, childcare, a partner or a support system. Your case manager plans with that life in mind.
Parenting alone does not meet the requirement. If you are raising an adopted child or a stepchild and have never carried a full-term pregnancy yourself, you are not eligible. The requirement is about your own pregnancy history.
What does Illinois law say?
The Illinois Gestational Surrogacy Act requires that a gestational surrogate has given birth to at least one child. PLS applies the same rule to surrogates in every state where it works, and adds the requirement that you are parenting a child now.
Statute details on this page are pending review by counsel.
What can you do instead if you have not had a child?
If you have never carried a pregnancy to term, you cannot be a gestational surrogate now. There are two honest paths forward.
Wait, if your own family is still ahead of you. If you plan to have children, the requirement may be met later. Many surrogates applied after their own families were complete. When you have had a healthy full-term pregnancy and are raising your child, the requirements will look different for you.
Consider egg donation. Egg donation has no prior-pregnancy requirement, and PLS places egg donors as well. Nancy Block, RN, has worked in egg donation since 2000, when she founded The Center for Egg Options Illinois. One PLS case manager, Natalie Gaudio-Fricano, was a three-time egg donor before she became a gestational surrogate and delivered a boy for an international couple in October 2016. Her path is not everyone's, but it shows that the two are connected.
If you have carried a full-term pregnancy and are raising your child, start with the five-minute prescreen at See if I qualify.