Four surrogates across the US have shared their experiences with the Guardian amid renewed public interest in commercial surrogacy, sparked by Lena Dunham's announcement that she used a surrogate and the legal battle involving McKenna West, a gestational surrogate who fled to Texas to avoid an abortion requested by the child's biological parents.
Liggia Spicer, a 34-year-old based in upstate New York, first considered surrogacy after hearing about a mutual friend who was looking into using a surrogate after battling cancer and undergoing a hysterectomy. She did about two years of research before deciding to proceed. Spicer worked with an agency, ConceiveAbilities, where she was matched with a couple after a "vigorous" screening process that included a background check, financial check, psychological screen, and a review of previous labor and delivery history. Most surrogacy programs require that a woman has given birth previously before becoming a surrogate.
Contracts and bodily autonomy
ConceiveAbilities provided Spicer with an attorney to assist with the creation of a surrogacy contract, an agreement that comes to pass before an embryo transfer and details the rights of the surrogate and the intended parents. It also addresses insurance, payment of medical bills, liability for medical complications, and the intended parents' presence during doctor's visits and at delivery.
West's case has raised questions about how much bodily autonomy carriers are afforded in surrogacy. West violated her surrogacy contract by refusing to get an abortion after the fetus she was carrying was discovered to have a congenital heart defect. She later fled to Texas, where abortion is banned, and gave birth to the child. West has sought conservatorship over the child, which would give her a say in the child's medical treatment. The US supreme court has declined to intervene in the case.
"As surrogates, we do things that we may not do in our own pregnancies, but at the end of the day, it's not our child," Spicer said. "As long as what we're being asked is safe to do."
Surrogates' motivations and concerns
Kristy Miller, a 38-year-old two-time surrogate based in Indianapolis, also worked with ConceiveAbilities. She spoke of the requests that a surrogate can make when being matched with intended parents. "I remember feeling very strongly that I wanted there to be a trusting relationship [with the intended parents]," she said. "I didn't want to feel micromanaged. I didn't want someone to be kind of dictating what I ate every day, or how I took care of myself."
Critics of surrogacy argue that the process treats women's bodies as a commodity. Under Vogue's Instagram post announcing Dunham's essay about her surrogate journey, one commenter wrote: "Let's not normalize buying humans." Another said: "The concept of rich people renting poor people's wombs will never not be strange." Dunham has spoken publicly about her fertility issues for years, including an Ehlers-Danlos syndrome diagnosis, nearly two decades of advanced endometriosis, and a total hysterectomy at 31 years old.
Spicer said: "It's important that everyone should decide what happens to their body, and I wanted to get pregnant to help another family." She added: "That's my decision." She now works as a surrogate engagement coordinator at ConceiveAbilities.
Compensation and misconceptions
Christine S, a 38-year-old former gestational surrogate in New York state, carried and gave birth to a child for a same-sex male couple in 2025 with New York Surrogacy Center. Christine, who declined to share her last name for privacy reasons, said she understands concerns about reproductive exploitation but believes that opponents of commercial surrogacy haven't been informed enough on the intricacies of the process in the US. "I think it's just [that] they don't understand enough about it," she said. "Because there are situations where there are women that are held against their will to breed, right? Like that is a legit concern. But I volunteered. I didn't do this against my will."
"And the journey of working with someone to be a surrogate, not only is it costly, but I also feel like [intended parents are] offering somebody an opportunity too. I had a job for a temporary amount of time, and it was a high-risk job, but it was also a high reward." Christine received $45,000 for carrying the child, in addition to coverage for her medical and legal fees. Spicer was paid $67,000, broken down and paid out over the course of the pregnancy.
Kimber Alston, a 36-year-old gestational surrogate based in Texas, is pregnant with her fifth surrogate child and in the middle of her ninth pregnancy overall. Her first experience as a surrogate was in 2018 for a same-sex male couple in Italy. Since then, she has embarked on surrogate journeys both independently and with agencies, and given birth to children who live in Paris and Mexico, among other cities around the world. She said she has formed close bonds with the intended parents she's worked with and frequently receives pictures and videos of the children she carried.
"What keeps me going is being able to help people have something that they couldn't have otherwise," she said. Alston, who also now works for a surrogacy agency she previously used, said that interacting with intended parents reminds her why she has chosen to be a surrogate multiple times. "I watch these couples every day come in and tell their stories; I'm in these match calls and watching them cry and not be able to have a child of their own," she said. "I'm like: 'If I could do it just one more time, I might as well just do it.'"
Multiple surrogates said the biggest misconception they see is the notion that surrogates get attached to the baby they are carrying, and may refuse to give the child up after delivery. "I have never known a surrogate who felt like 'mom' to the baby [they were] carrying," said Miller. "I think it's hard for people to wrap their head around that unless they are truly considering [surrogacy]."
Spicer emphasized the need for levity throughout the experience. "Honestly, I tell a lot of girls who want to be surrogates: 'You have to have a sense of humor. You have to just take things on the chin and laugh it off,'" she said. "You could tell them until you're blue in the face: 'I'm not attached to this baby,' and they still just don't understand."
