What triggers bed rest coverage?
A written order. If your OB or the intended parents' fertility clinic orders bed rest or modified activity in writing, the bed rest provisions in your Private Label Surrogacy agreement apply.
The order should say what you can and cannot do, and for how long. "Modified activity" may mean no lifting, no standing for long periods, or working from home. "Bed rest" means you stay off your feet for most of the day. Either can stop you from working, and either can make it hard to care for your children or your home.
If your doctor tells you to rest, ask for it in writing before you leave the appointment.
What does bed rest coverage include?
Bed rest coverage pays for three things: the work you cannot do, the childcare you need, and the housework you cannot manage.
| Coverage | Trigger | Documentation | Typical cap |
|---|---|---|---|
| Lost wages | Written order that stops or reduces your work | The order, plus pay stubs showing your net pay | [BEDREST_WAGE_CAP] |
| Childcare | Written order that limits your ability to care for your children | The order, plus childcare receipts | [CHILDCARE_RATE] per week, to a cap of [CHILDCARE_CAP] |
| Housekeeping | Every surrogate from 32 weeks; earlier if bed rest is ordered | None from 32 weeks; the order if earlier | $90 per week |
| Transportation | Appointments you cannot drive yourself to | Mileage log or ride receipts | [TRANSPORT_TERMS] |
The childcare rate during bed rest, any weekly cap, and whether housekeeping begins before 32 weeks under a bed rest order are being confirmed with Nancy Block, RN.
All of these are paid from an independent licensed escrow account. The intended parents fund it before you start medications, so the money for bed rest is already set aside if you need it. For context, a first-time PLS surrogate carrying one baby receives a typical total package of roughly $68,000 to $78,000, built on $60,000 base compensation (proposed). Bed rest coverage is paid on top of that and does not reduce base.
Lost wages during bed rest
Lost wages during bed rest are calculated from your documented net pay, for the days the order keeps you from working. Net pay means what you take home after taxes and deductions.
To claim them, you submit:
- The written bed rest or modified activity order.
- Recent pay stubs, or tax returns if you are self-employed.
- The dates you missed.
The escrow agent checks the claim against your agreement and pays it. Your case manager helps you put it together. If you can work from home under a modified activity order, you are not losing wages for those days, so they are not claimed.
The full method is on surrogate lost wages.
Childcare and housekeeping during bed rest
Childcare. Your own children still need to get to school, eat and be picked up. If a bed rest order keeps you from doing that, childcare is reimbursed with receipts. It can be a daycare, a sitter, or a relative you pay.
Housekeeping. At PLS, housekeeping is not conditional on bed rest. Every surrogate receives $90 per week for housekeeping from 32 weeks of pregnancy, whether or not bed rest is ordered. If bed rest is ordered earlier, the agreement adds housekeeping coverage from the date of the order.
You can use it to hire a service or pay someone you know. See benefits and allowances for the full list of allowances.
Why strict bed rest is rare today
Strict bed rest used to be a common instruction. It is much less common now. The American College of Obstetricians and Gynecologists (ACOG) does not recommend strict bed rest for most pregnancy conditions. Studies have not shown that it prevents preterm birth, and lying still for weeks carries its own risks, including blood clots and loss of muscle strength.
So most surrogates who see an order see "modified activity," not weeks in bed. The coverage in your agreement works the same way for either kind of order. What matters is that it is in writing and that it affects your work or your care of your family.
Hospital bed rest before delivery
Some conditions, such as preeclampsia, preterm labor, or bleeding from a low-lying placenta, mean a hospital stay before delivery. The same provisions apply. Lost wages, childcare and housekeeping are covered while you are in the hospital, on the strength of the admitting physician's records.
Hospital stays are also when your partner may need time off to care for your children. Partner lost wages are part of your agreement. Ask your attorney how they apply to a hospital stay before delivery.
Your case manager keeps the intended parents informed in the way you agreed. Early pregnancy care is described in pregnancy to OB release.
Is there a limit on bed rest coverage?
Many surrogacy contracts set a maximum number of weeks for bed rest lost wages and childcare. The reason is practical: the intended parents fund escrow for a known amount before medications begin, and an open-ended line makes that impossible.
The standard PLS limit on bed rest coverage is being confirmed with Nancy Block, RN. Your own attorney, paid by the intended parents, negotiates the figure with your job, your pay and your childcare costs in mind. Ask what happens if bed rest runs longer than the cap.
If you are ready to start, the first step is the prescreen: see if you qualify.
Sources
- Private Label Surrogacy compensation schedule and contract practice, pending confirmation by Nancy Block, RN.
- American College of Obstetricians and Gynecologists (ACOG), guidance on activity restriction and bed rest in pregnancy.