The Email That Changed Everything
It was 2 AM in London when the email arrived. My wife, Sofia, was asleep beside me, exhausted from another round of failed fertility treatments. I was scrolling through yet another surrogacy forum, the blue light of my laptop the only illumination in our Kensington flat. The subject line read simply: “RE: Your inquiry from London – Houston Surrogacy Options.”
Three months earlier, we’d hit what felt like the final wall. After seven years, four miscarriages, two ectopic pregnancies, and more tears than I could measure, our doctor in London had gently suggested we consider other paths. “Your uterus simply cannot sustain a pregnancy,” she’d said, her hand on Sofia’s. “I’m so sorry.”
We were broken. But not defeated.
I’m Arjun Patel, and this is the story of how my British wife and I, an American expat living in London, built our family through gestational surrogacy in a city I’d never considered: Houston, Texas. It’s also a guide for every international intended parent wondering: Can I really have a baby in Texas? The answer, we discovered, is a resounding yes—if you know how to navigate the journey.
Why Houston? The International Advantage
When most international couples think of US surrogacy, they think California, maybe New York or Connecticut. Houston wasn’t on our radar until it was the only place that made sense.
Here’s what we learned about why Houston works for international parents:
1. Medical Excellence Without Coastal Prices
The Texas Medical Center is the largest medical complex in the world. The surrogacy costs? 20-30% less than California. For international parents paying out of pocket (as most do), that’s significant.
2. Direct International Flights
George Bush Intercontinental Airport has direct flights to London, Frankfurt, Tokyo, Dubai, Mexico City, São Paulo, and more. When your carrier goes into labor, you need to get there fast. Direct flights matter.
3. Time Zone Convenience
Houston is on Central Time. For European parents, that’s a manageable 6-7 hour time difference. For Asian parents, it’s workable. For Australians, it’s… well, nothing’s perfect, but the direct flight to Sydney helps.
4. Established International Protocols
Houston agencies and clinics have systems for international parents: escrow accounts in multiple currencies, translators, international legal coordination, even help with temporary housing.
5. 24/7 City
Houston doesn’t sleep. When you’re calling from Dubai at 3 AM your time (7 PM Houston time), someone answers. When you need a pharmacy at 2 AM Houston time, it’s open.
First Steps: The Reality Check
Before you even look at Houston, you need to understand your home country’s laws. This is the most important—and most overlooked—step for international parents.
The Home Country Assessment
Every country treats children born via surrogacy abroad differently:
Friendly Countries (Recognize birth certificates fairly easily):
- United Kingdom (but with specific requirements)
- Canada
- Australia (varies by state)
- Most European Union countries (with paperwork)
Complicated Countries:
- China (officially doesn’t recognize, but citizens do it)
- Japan (requires adoption proceedings)
- Italy (legally complex)
- Many Middle Eastern countries
Extremely Difficult:
- Germany (surrogacy is illegal, bringing child home is very difficult)
- France (similar challenges)
- Some Asian and African nations
Our situation: The UK allows surrogacy but requires a parental order after birth. The child isn’t legally ours until a UK court approves it. We needed a Houston solution that would satisfy a London court.
Action Step #1: Hire a family law attorney in YOUR country first. Have them explain exactly what you need from the US process. This costs £500-£1,000 and saves £10,000-£20,000 in corrections later.
Building Your International Team
You need a team on both sides of the ocean. Here’s who we had:
In London:
- UK Surrogacy Lawyer – Specialized in international cases
- Immigration Lawyer – For getting our baby back to the UK
- Financial Advisor – For currency exchange and international payments
- Therapist – Specializing in fertility and international medical journeys
In Houston:
- Surrogacy Agency with international experience
- Reproductive Endocrinologist at a top fertility clinic
- Family Law Attorney specializing in international parentage
- OB-GYN for our gestational carrier
- Pediatrician for after birth
- International Parent Coordinator (some agencies provide this)
- Translator (if needed)
- Temporary Housing Contact
The Agency Choice: Your Most Important Decision
Not all Houston agencies are created equal for international parents. Some have never worked with international clients. Others have dedicated international programs.
Our agency, Global Family Paths Houston, stood out because:
- 40% of their clients are international
- They have a dedicated international department
- They provide a “concierge” who meets you at the airport
- They have relationships with consulates in Houston
- Their legal team knows international requirements
- They have translated materials in 8 languages
- They offer video calls in your time zone
Questions to ask potential agencies:
- “How many international clients from [YOUR COUNTRY] have you worked with?”
- “Can you connect me with past international clients?”
- “What’s your process for getting the baby’s passport?”
- “How do you handle international wire transfers?”
- “What happens if the baby needs to stay in NICU and our visas expire?”
- “Do you have relationships with our country’s consulate in Houston?”
Red flags we encountered:
- Agency that said “all our contracts are in English, take it or leave it”
- Agency that couldn’t explain the passport process
- Agency that wanted full payment upfront (reputable agencies use escrow)
- Agency that said “we treat international and domestic clients the same” (you need more hand-holding)
The Legal Labyrinth: Three Countries’ Laws
Here’s where it gets complex. You’re dealing with:
- Texas law – For the surrogacy agreement and birth
- US Federal law – For the baby’s citizenship and passport
- Your home country’s law – For bringing the baby home
The Texas Part: Getting the Birth Certificate Right
Texas law is favorable for international parents. The pre-birth order establishes you as legal parents. But there’s a catch for international couples:
Both names on the birth certificate?
- Married heterosexual couples: Yes, both names
- Married same-sex couples: Yes, both names
- Unmarried couples: Maybe, depends on circumstances
- Single parents: Yes, your name
The crucial detail: The birth certificate must match your passport names EXACTLY. If your passport says “Jonathan Michael Smith” but you go by “Jon Smith,” use the full name. We learned this the hard way and had to amend.
Our experience: We’re a married heterosexual couple. Our pre-birth order listed us as “Intended Parents.” The birth certificate lists “Parent 1: Arjun Patel” and “Parent 2: Sofia Patel.” No “mother/father” designation, which helped with UK paperwork.
The US Federal Part: Citizenship and Passport
This depends on your situation:
If one parent is a US citizen:
- Baby is automatically a US citizen
- Apply for Consular Report of Birth Abroad (CRBA) and US passport
- Relatively straightforward
If neither parent is a US citizen (our situation):
- Baby is NOT automatically a US citizen
- Baby gets a US birth certificate (because born in US)
- Baby needs a passport from YOUR country
- This is where it gets tricky
The process for non-US citizen parents:
- Get the Texas birth certificate (takes 2-4 weeks)
- Apply for your country’s passport for the baby at your consulate in Houston
- Get a US visa for the baby to leave the US
- Sometimes: Get the baby’s US Social Security Number (optional but helpful)
Our timeline:
- Birth: June 15
- Birth certificate application: June 16
- Birth certificate received: July 10
- UK passport application at British Consulate: July 12
- UK passport received: July 26
- US exit visa application: July 27
- Exit visa received: August 2
- Flew home: August 3
Total time in US after birth: 7 weeks
The Home Country Part: Getting Your Child Recognized
Every country is different. The UK requires:
- DNA test proving genetic relationship (if using your own gametes)
- Application for parental order within 6 months of birth
- Court hearing
- New UK birth certificate issued
Cost in UK: £5,000-£10,000 in legal fees
Time: 6-12 months
Important: Some countries require that NO payment was made to the surrogate beyond expenses. Houston agencies work on a compensation model. This can conflict. Your home country lawyer MUST coordinate with your Houston lawyer.
The Financial Reality: More Than You Budget
We budgeted 150,000.Wespent210,000. Here’s where the extra costs came:
Expected Costs:
- Agency fees: $30,000
- Carrier compensation: $50,000
- Medical costs: $40,000
- Legal (US): $15,000
- Legal (UK): $8,000
- Total expected: $143,000
Unexpected International Costs:
- Currency exchange fees: $3,000 (bank and transfer fees)
- Extended stay in Houston: $15,000 (7 weeks in extended-stay hotel)
- Consulate/visa fees: $2,000
- Document translation/apostille: $1,500
- International FedEx: $800 (sending documents back and forth)
- Last-minute flights: $4,000 (when Sofia came early)
- International health insurance for baby: $3,000 (needed for UK application)
- DNA testing for UK court: $800
- Houston driver: $1,200 (we didn’t want to rent a car)
- International phone plan: $400
- Work disruption: Priceless (I took 2 months unpaid leave)
Total actual: $210,700
Payment Structure:
Reputable agencies use an escrow account. Ours was with a bank that had international transfer capabilities. We paid in milestones:
- Signing: 20%
- Medical clearance: 20%
- Pregnancy confirmation: 20%
- Each trimester: 10%
- Birth: 10%
Wire transfer tips:
- Use TransferWise (now Wise) or OFX for better rates
- Start transfers early—international wires can take 3-5 days
- Keep records of EVERY transfer
- Consider opening a US bank account if you’ll be there frequently
The Medical Journey: From Afar
Choosing a Clinic
We used Houston Fertility Institute because:
- They had an international patient coordinator
- They did video consultations in our time zone
- They could ship medications internationally
- They worked with our London clinic for testing
The process:
- Initial consult via video (10 PM London time, 4 PM Houston time)
- Medical records reviewed by Houston doctors
- Medication protocol sent to our London clinic
- Monitoring in London, results sent to Houston
- We flew to Houston for egg retrieval (10 days)
- Embryos created and frozen
- We returned to London
- Carrier did transfer (we flew for it, 5 days)
- Pregnancy monitored remotely
Time in Houston total: 15 days for medical procedures, plus 7 weeks for birth
The 2WW (Two-Week Wait) from Abroad
The hardest part was the wait for pregnancy test results. It was 3 AM in London when we got the call. Positive. We cried, then realized we had to wait 5 hours to call our families because of the time difference.
Our Gestational Carrier: An Ocean Away
Finding a carrier willing to work with international parents was crucial. Some carriers prefer local intended parents. Ours, Amanda, had previously carried for a French couple.
What made it work:
- Communication plan: Weekly video calls (Sunday mornings Houston time, Sunday afternoon London time)
- In-person visits: We flew over for key appointments (12 weeks, 20 weeks, 28 weeks)
- Local support: Amanda had a “buddy” (another carrier) who could go to appointments if we couldn’t
- Hospital access: We had online portal access to all medical records
- Time zone awareness: We never called at inappropriate times
Amanda’s perspective (she told me later): “I liked that you were international. You weren’t going to drop by unexpectedly. You trusted me. You had to. And when you did visit, it was special.”
The Birth: Getting There in Time
Amanda went into labor at 37 weeks. We got the call at 2 AM London time. We had a bag packed. We had a flight alert set. We still almost missed it.
Our plan (that worked):
- Always packed bags: One for Houston summer, one for hospital
- Flight alerts: Set for Amanda’s due date window
- Emergency fund: $10,000 for last-minute flights
- Local contact: Our agency coordinator had keys to our Houston apartment
- Work coverage: My colleague covered my clients, Sofia’s locum covered her practice
What actually happened:
- 2 AM: Call that Amanda’s water broke
- 2:15 AM: Called agency emergency line
- 2:30 AM: Booked flights (London to Houston, 10 AM departure)
- 3 AM: Called parents, arranged dog sitter
- 4 AM: Left for Heathrow
- 5 PM Houston time: Landed
- 6:30 PM: At hospital
- 11:47 PM: Our daughter, Priya, was born
We made it with 12 minutes to spare.
The Houston Stay: 7 Weeks in Medical City
We’d planned for 2-3 weeks. It took 7. Why?
- Birth certificate delay: Harris County was backed up
- UK passport delay: Summer holiday staffing at consulate
- Pediatrician visits: Priya needed weight checks
- Postpartum care: Sofia needed recovery too
Where we stayed: “Medical City Apartments” – furnished apartments near the Medical Center. $4,000/month. Included kitchen, WiFi, cleaning. Cheaper than a hotel, more space.
What helped:
- International grocery store: Phoenicia Foods had British tea and Indian spices
- Expat groups: Houston has large British, Indian, Chinese communities
- Delivery everything: Amazon Prime, grocery delivery, food delivery
- The Medical Center itself: Like a city within a city. Restaurants, pharmacies, even a hotel.
What was hard:
- Time difference: Calling family at odd hours
- Work: Trying to work UK hours from Houston
- Isolation: Until we found other international parents in the same situation
The Other International Parents
In our apartment building, we met:
- A Japanese couple, here for 9 weeks
- A German couple, here for 5 weeks (their process was faster)
- A Chinese single mother, here for 12 weeks (complicated passport issues)
- An Australian couple, here for 6 weeks
We formed an impromptu support group. Shared tips. Watched each other’s babies. Cried together. Celebrated together.
Getting Home: The Paperwork Chase
This was the most stressful part. You have:
- Texas birth certificate
- Your country’s passport for baby
- US exit visa (if needed)
- Possibly: Social Security card
- Medical discharge papers
- Possibly: Additional home country requirements
Our checklist:
- ✓ Texas birth certificate (original + 5 certified copies)
- ✓ UK passport for Priya
- ✓ US visa (B-2 tourist visa for Priya to leave US)
- ✓ UK parental order application (submitted from Houston)
- ✓ DNA test results (for UK court)
- ✓ Pediatrician clearance to fly
- ✓ Flight booked with bassinet seat
- ✓ Car seat for UK taxi
The moment we cleared UK immigration with Priya in our arms, with her UK passport, with all paperwork in order—Sofia burst into tears. The officer smiled. “Welcome home, little one. And congratulations, Mum and Dad.”
Lessons Learned: Your Houston International Surrogacy Toolkit
Before You Start:
- Get home country legal advice FIRST
- Choose an agency with international experience
- Budget 30% extra for international costs
- Get international health insurance that covers pregnancy/birth in US
- Set up a US bank account if possible
During the Process:
- Visit Houston at least once before the birth
- Rent a furnished apartment, not a hotel
- Get a US phone number (Google Voice works)
- Make friends with other international parents
- Explore Houston—it makes the stay enjoyable
For the Paperwork:
- Order 5+ certified birth certificates
- Start passport application immediately
- Use a visa expediter if available
- Keep EVERY document in a folder
- Scan everything to the cloud
Emotional Survival:
- Therapy, therapy, therapy (online with your home therapist)
- Join international surrogacy groups online
- Video call with carrier regularly
- Celebrate milestones, even from afar
- Remember why you’re doing this
Why Houston Works for International Parents
- The Medical Center: Everything is in one place. Fertility clinic, OB-GYN, hospital, pediatrician, all connected by skybridges.
- Experience: They’ve seen international parents before. They know the drill.
- Support services: Translators, international banks, consulates, all in one city.
- Cost: Still more affordable than coasts.
- Direct flights: To almost anywhere in the world.
The View from London, Two Years Later
Priya is two. She has a British accent with a slight Texas twang when she says “y’all.” We FaceTime with Amanda every month. She calls her “Tummy Auntie Amanda.”
We’re expecting our second via Houston surrogacy next year. This time, we know what we’re doing. This time, we’re renting the same apartment. This time, we’re bringing Priya to meet her sibling in Houston.
Houston wasn’t just where our daughter was born. It was where we became parents. Where a city we’d never visited became part of our family story. Where medical excellence, legal clarity, and human kindness came together to give us what London couldn’t: our child.
For International Parents Considering Houston
If you’re reading this from London, Dubai, Tokyo, Sydney, or anywhere else wondering if Houston could be your path to parenthood:
- Yes, it’s possible—hundreds of international parents do it every year
- Yes, it’s complex—but the road is well-traveled
- Yes, it’s expensive—but often less so than other US options
- Yes, it takes time—plan for 2-3 months in Houston after birth
- Yes, it’s worth it—we have Priya as proof
Houston won’t just give you a baby. It’ll give you a story. Of medical marvels. Of legal navigation. Of a city that welcomes the world’s parents. Of a place where families are built across borders, across oceans, across time zones.
Welcome to Houston, international parents. Your table is waiting. Your medical team is ready. Your baby is coming.
Just remember to bring a jacket. The air conditioning is no joke.
