What are the key pregnancy milestones and when do they happen?
A surrogacy pregnancy follows the same medical timeline as any other pregnancy. What is different is who is watching, who is told, and which steps in the gestational carrier agreement each milestone sets off.
Weeks are counted the way your clinic and her OB count them, from the start of a standard menstrual cycle, so a pregnancy is already about 2 weeks along on the day of transfer.
The milestones that matter most:
- Pregnancy test, 9 to 11 days after transfer. A blood test at the clinic or a local lab measures the pregnancy hormone hCG. A second test a few days later checks that the level is rising.
- Heartbeat ultrasound, about 6 to 7 weeks. The first ultrasound confirms the pregnancy is in the uterus, counts the embryos that implanted and looks for a heartbeat. Many agreements tie the start of monthly base compensation to this scan.
- Release to her OB, about 10 to 12 weeks. The fertility clinic hands care to the surrogate's own obstetrician.
- Anatomy scan, about 20 weeks. A detailed ultrasound checks the baby's organs, growth and the placenta.
- Viability, 24 weeks. The point after which a baby born early has a reasonable chance of survival with intensive care. Several contract terms are tied to it.
- Third trimester, from 28 weeks. Birth planning, the hospital, and support at home.
| Week | Medical event | Who is present | Contract or payment trigger | PLS support action |
|---|---|---|---|---|
| 9 to 11 days after transfer | Pregnancy blood test | Surrogate; results shared by the clinic | Transfer fee of $1,000 paid at transfer | Case manager shares the news with both sides as agreed |
| 6 to 7 | Heartbeat ultrasound | Surrogate; intended parents in person or by video if she agrees | Base compensation begins in monthly installments after heartbeat confirmation | Case manager confirms the result and the communication plan |
| 10 to 12 | Release from fertility clinic to her OB | Surrogate and OB | None in most agreements | Case manager confirms the OB has the clinic records |
| About 20 | Anatomy scan | Surrogate; intended parents if she agrees | Maternity clothing allowance of $750 ($1,000 for multiples), if not already paid | Nutrition consult with Julie Bendix, RD |
| 24 | Viability | Surrogate and OB | Several agreement terms tied to viability | Case manager reviews the third-trimester plan |
| 28 to 32 | Third-trimester visits, birth plan drafted | Surrogate, OB, intended parents | Housekeeping at $90 per week from 32 weeks | Case manager starts the birth plan with both sides and the hospital |
When does the surrogate move from the fertility clinic to her OB?
At about 10 to 12 weeks, once the fertility clinic confirms the pregnancy is progressing.
Before then, the clinic manages her medications and early ultrasounds. Her local monitoring clinic handles bloodwork and ultrasounds near her home. Once the clinic is satisfied, it releases her. She stops the pregnancy-support medications on the clinic's schedule and moves to her own OB for the rest of the pregnancy.
From that point, her OB is her doctor. The OB decides on her care, orders tests and plans the delivery with her. You are not the OB's patient and will not receive results directly from the office unless she authorizes it. In practice, she or your case manager shares them with you.
Can intended parents attend appointments and scans?
Usually yes, in person or by video, when the surrogate agrees.
The time to settle this is before pregnancy, not after. At the match meeting you talk about which appointments you would like to attend. Your gestational carrier agreement then sets the expectations. Some parents attend the heartbeat scan and the anatomy scan in person and join others by video. Some live too far away and join by video only. Some surrogates prefer to attend routine visits alone and share updates afterward.
Three practical points:
- Ask the OB office early. Some offices limit how many people can be in an exam room, or do not allow video during scans.
- Respect her time. A routine 15-minute visit is part of her week, not an event. Ask before you plan travel around it.
- Agree on who shares results. Decide whether she texts you after each visit, or whether your case manager relays the news.
For how most parents and surrogates set their rhythm, see communication expectations.
What support does the surrogate receive during pregnancy?
Private Label Surrogacy (PLS) treats the surrogate as a partner in the journey. Her support during pregnancy is written down, not left to goodwill.
- Her case manager. Natalie Gaudio-Fricano or Jenni Symons checks in on a set schedule. Both have carried as gestational surrogates, so they know what the second trimester feels like and what questions come up at 34 weeks.
- Nutrition. Julie Bendix, MPH, RD, LD, CLC, a registered dietitian and lactation counselor, provides at least six nutrition consults across the journey.
- Mental-health support is part of her compensation package.
- Monthly allowance. A monthly allowance of $300 runs through the pregnancy to cover incidental costs.
- Maternity clothing. A maternity clothing allowance of $750, or $1,000 for multiples.
- Help at home. Housekeeping at $90 per week from 32 weeks.
- Lost wages for her, and for her partner, when appointments or medical restrictions keep them from work.
- Life insurance. An extended life insurance policy of up to $750,000.
PLS also checks in regularly on her health and keeps you informed.
Which payments are tied to pregnancy milestones?
Payments run from escrow, under the schedule in the gestational carrier agreement. The independent licensed escrow agent releases each payment. PLS never holds client money.
On the current PLS schedule, base compensation is $60,000 for a first-time surrogate (proposed, up from $55,000) and $65,000 to $70,000 for an experienced surrogate. A typical total package runs roughly $68,000 to $78,000. Confirm with Nancy.
The milestone payments that matter during pregnancy:
- A medication start fee of $500 and a transfer fee of $1,000, before pregnancy.
- Base compensation in monthly installments after heartbeat confirmation. Confirm the installment schedule with PLS contract practice.
- An additional $5,000 for twins or $10,000 for triplets, if more than one embryo implants.
- Housekeeping from 32 weeks, at $90 per week.
- Lost wages, as they arise.
For the full package, see surrogate compensation.
What happens if there is a complication?
Her OB manages it, and she decides on her own care. The agreement sets out what follows.
The surrogate keeps authority over her own body and medical treatment throughout. If her OB recommends bed rest, extra monitoring or an early delivery, that is a medical decision between her and her doctor. Your role is to be informed, to be supportive, and to rely on the terms you agreed in advance.
What the agreement covers:
- Bed rest or work restrictions. Lost wages for her, and for her partner if they must take time off to care for the family.
- Hospital stays. Covered by her health insurance or the policy bought for the journey. See surrogate health insurance for how coverage is checked before match.
- Multiples. A twin pregnancy carries higher risks and more monitoring. See twins and multiples.
- Pregnancy loss. The agreement sets what is paid and what happens next.
PLS's role is coordination. Your case manager makes sure both sides hear the same facts, at the same time, from the right person. Nancy Block, RN, a former OB/GYN and fertility nurse, can explain what a diagnosis usually means and what questions to ask.
How do you prepare for the third trimester and birth plan?
The third trimester is when the practical planning happens.
- The birth plan. Your case manager starts the birth plan with you, the surrogate and the delivery hospital at about 28 to 32 weeks. It says who is in the delivery room, who makes which decisions, how the baby will be fed and where you and the baby will room. See the surrogacy birth plan.
- Parentage paperwork. Your attorney files the parentage paperwork before birth so the hospital knows who the parents are. Reviewed by counsel.
- Your travel. Plan to be within reach of the hospital in the final weeks. Babies do not follow the due date.
- The baby's needs. A pediatrician, a car seat, and health insurance for the newborn.
- Feeding. If you would like breast milk, talk with her about pumping well before delivery. Julie Bendix can advise on infant nutrition after the birth.
- International parents. Your attorney handles the baby's documents for travel home. Start early.
For the full sequence from match to birth, see the surrogacy process.
Sources
- ACOG (American College of Obstetricians and Gynecologists), guidance on prenatal care and pregnancy dating. https://www.acog.org
- ASRM (American Society for Reproductive Medicine), guidance on gestational carriers. https://www.asrm.org