One of the questions we hear often from intended parents is, “What happens if something goes wrong during the pregnancy?”
It’s a completely understandable concern. After all, most intended parents have already walked a difficult road to get to surrogacy. Many have experienced infertility, pregnancy loss, failed IVF cycles, or years of uncertainty before finally arriving at this chapter of their family-building journey. The thought of facing another obstacle can feel overwhelming and discouraging.
The reality is that while most surrogacy pregnancies progress beautifully, pregnancy itself is never entirely predictable. Even when a gestational carrier has had uncomplicated pregnancies in the past and has passed extensive medical screening, unexpected situations can still arise. The good news is that complications do not automatically mean a “bad” outcome. In fact, many surrogacy journeys that experience bumps along the way still result in healthy babies and healthy surrogates.
One of the greatest benefits of working with an experienced and ethical surrogacy agency is knowing you have a team beside you to help navigate those moments if they occur.
Pregnancy Complications Can Happen in Any Pregnancy
Sometimes intended parents worry that because their baby is being carried through surrogacy, complications are somehow more likely to occur. In reality, the majority of complications we see during surrogacy are the same complications that can happen in any pregnancy.
Pregnancy is a remarkable process, but it is also incredibly complex. Every woman’s body responds differently, and no physician can guarantee a completely complication-free pregnancy. What matters most is early detection, appropriate medical care, and having a support system in place to help everyone navigate the situation.
One example is a subchorionic hematoma, often referred to as an SCH. These are relatively common in IVF pregnancies and can cause bleeding or spotting during the first trimester. Understandably, seeing blood can be terrifying for both intended parents and the gestational carrier. However, many SCHs resolve on their own with monitoring and go on to result in healthy pregnancies.
Other complications, such as gestational diabetes or elevated blood pressure, may develop later in pregnancy. While these diagnoses can sound intimidating, modern prenatal care allows physicians to monitor and manage these conditions very effectively. Additional appointments, dietary changes, medications, or increased monitoring may be recommended, but many women with these diagnoses go on to have healthy deliveries.
In more complicated cases or situations where some might need more attention, a gestational carrier may be placed on activity restrictions or bedrest. This can create additional stress and logistical challenges, especially for a woman who is caring for her own family while carrying for another. Fortunately, surrogacy contracts are designed with these possibilities in mind and often include provisions for lost wages, childcare, housekeeping assistance, and other forms of support if they become necessary.
The Emotional Side of Complications
One aspect of complications that isn’t discussed often enough is the emotional impact they can have on everyone involved.
For intended parents, complications can bring feelings of fear, helplessness, and anxiety. Many describe feeling as though they have no control over what is happening, particularly if they live far away from their surrogate. Every phone call, every ultrasound appointment, and every update can feel incredibly significant.
For gestational carriers, there can also be a tremendous emotional burden. Many surrogates care so much about the intended parents they are carrying for and may worry that they are somehow letting them down if complications arise. Even though these situations are rarely within anyone’s control, emotions can run high when everyone shares the same goal of bringing a healthy baby into the world.
This is one of the reasons communication becomes so important during difficult moments. Having compassionate, transparent, and honest conversations helps everyone stay connected and supported throughout the process.
What About Premature Delivery or NICU Time?
Another common concern intended parents have is the possibility of a premature birth or a NICU stay. While most babies are born healthy and at term, some babies require additional medical support after delivery. Whether due to prematurity, breathing difficulties, low birth weight, or another medical concern, a NICU stay can be an emotional experience.
At Delivering Hope, we believe in preparing for the unexpected. That is why we require every gestational carrier to have access to a Level III NICU within a reasonable distance of where she plans to deliver. A Level III NICU is equipped to care for babies who are born prematurely or who require specialized medical treatment after birth. While we hope that these resources are never needed, having a plan in place provides peace of mind and helps ensure that both the baby and gestational carrier have access to appropriate medical care if circumstances change unexpectedly.
One of the realities of pregnancy is that even low-risk pregnancies can occasionally take an unexpected turn. By planning ahead and identifying appropriate medical resources before delivery, families can feel more confident knowing that if additional support is needed, the right team is already in place. While a NICU stay is rarely part of anyone’s birth plan, many families who experience one eventually look back and see it as just one chapter in the larger story of bringing their child safely home.
How Delivering Hope Supports Families During Unexpected Challenges
We believe our role as your agency extends far beyond simply matching intended parents and gestational carriers and getting them from point A to point B. When complications arise, our team helps facilitate communication between everyone involved. We help ensure that intended parents stay informed, gestational carriers feel supported, and important information is shared clearly and appropriately. Sometimes that means helping coordinate conversations with medical providers. Other times it means simply being available to answer questions, provide reassurance, or help families understand what to expect next.
We also help navigate the practical side of things. Pregnancy complications can create unexpected expenses, scheduling challenges, insurance questions, or travel concerns. Having a knowledgeable team available to help coordinate these details can reduce stress during an already emotional time.
Most importantly, we provide support. When emotions are running high, it helps to have someone in your corner who understands both the medical and emotional aspects of the surrogacy journey.
Preparing for the Unexpected
One of the most important things Intended Parents can do is remember that preparing for potential complications does not mean expecting them.
Having comprehensive legal contracts, properly funded escrow, appropriate insurance coverage, and a strong support team in place creates a safety net. It allows everyone to focus on the pregnancy itself, knowing there is a plan if additional support is needed.
While no surrogacy journey is entirely predictable, preparation can make even unexpected challenges feel more manageable. Every surrogacy journey is unique. Some unfold exactly as planned, while others include unexpected twists and turns. What we’ve learned through years of supporting families is that complications do not define the outcome of a journey. More often than not, they are simply obstacles that are navigated together.
At Delivering Hope, we believe intended parents deserve honest information about both the joys and the challenges of surrogacy. Our goal is never to promise a perfect journey, but rather to make sure that you are informed, supported, and cared for every step of the way.
Because when challenges arise, you shouldn’t have to face them alone!
-Angela Kratzberg, Intended Parent Director