When a miscarriage happens during a gestational surrogacy, it is both an emotional and logistical challenge that affects the surrogate and the intended parents. Here’s a clear overview of what usually takes place:
1. Medical Management
Physically, the miscarriage process is much like any early pregnancy loss:
- Expectant management: allowing the miscarriage to proceed naturally, sometimes over days or weeks.
- Medication: drugs such as misoprostol may be prescribed to help the uterus clear more quickly.
- Surgical procedure: most commonly Dilation & Curettage (D&C), which ensures safety and sometimes allows tissue testing to look for underlying causes.
After the miscarriage, the surrogate typically has follow-up care with hormone checks and imaging to confirm recovery.
2. Emotional and Psychological Impact
Miscarriage during surrogacy can be particularly heavy because of the dual roles involved:
- For the surrogate: feelings of grief and even guilt are common, even though miscarriages are usually caused by biological factors outside anyone’s control.
- For intended parents: the loss can feel devastating, especially after the emotional and financial investment already made.
- Mental health risks: depression, anxiety, or prolonged grief may develop if support is not available.
Counseling and support groups are strongly recommended, and many surrogacy agencies provide these resources.
3. Legal and Financial Considerations
Most surrogacy contracts include clear terms for handling miscarriages:
- Compensation: if the loss occurs before a clinical pregnancy is confirmed, payment may not have begun. If it happens after, partial or full compensation is typically outlined. Some agreements include a specific miscarriage fee.
- Medical expenses: the intended parents are generally responsible for all costs related to medical care after a miscarriage.
The contract may also set expectations about recovery time and when a future embryo transfer might be attempted.
4. Healing and Next Steps
For the surrogate:
- Time is needed to heal both physically and emotionally.
- Support from counseling and peers is valuable.
- Self-care such as rest, good nutrition, and activities that bring comfort can aid recovery.
For the intended parents:
- Recognizing the surrogate’s experience with empathy is key.
- Gentle communication and shared grieving can help both sides.
Together:
- Agencies and legal advisors often guide next steps.
- Once medically and emotionally ready, the team may decide to try another embryo transfer.
Quick Summary Table
| Aspect | What Happens / What’s Offered |
|---|---|
| Physical Recovery | Natural process, medication, or D&C; follow-up appointments |
| Emotional Impact | Grief, guilt, anxiety, or depression |
| Support Available | Counseling, peer groups, empathetic communication |
| Legal & Financial | Defined in contract; compensation and medical costs covered |
| Next Steps | Recovery, then possible new embryo transfer |
Final Thoughts
A miscarriage in surrogacy is heartbreaking, but it is not the end of the journey. With proper medical care, legal safeguards, and emotional support, both surrogates and intended parents can move through the loss and decide together how to continue their family-building path.
