What Black, Brown, and BIPOC Surrogates Deserve (And Why Most Agencies Fall Short)

From 2020 to 2023, there was a 400% increase in Black and Latina women entering the gestational surrogacy field. The industry is changing — but the protections, pay, and advocacy available to Black and BIPOC surrogates have not kept pace. This post is for every woman who has been curious about surrogacy but wasn't sure the industry was built for someone like her. It wasn't. But On Fertility Ground Surrogacy was.

The History No One in This Industry Talks About

Gestational surrogacy is made possible in large part by advances in reproductive medicine that allow embryos to be transferred into a surrogate's uterus. What many people don't know — and what the surrogacy industry rarely acknowledges — is that the surgical and gynecological techniques underlying these procedures were developed in the 19th century using the bodies of enslaved Black women, without consent, without compensation, and with no legal protection.

The most documented case involves J. Marion Sims, widely called the "father of modern gynecology," whose experimental surgeries on enslaved women named Anarcha, Betsey, and Lucy formed the foundation of techniques still used today. Research published in the Journal of Medical Ethics has documented how this history of exploitation shaped — and continues to shape — the relationship between Black women and reproductive medicine.

The surrogacy industry that exists today is built on that foundation. And it has, in many ways, continued to treat Black, Brown, and BIPOC surrogates as afterthoughts: lower compensation, less advocacy, and less protection at every stage of the journey.

What the Current Industry Offers Black, Brown, and BIPOC Surrogates — And What It Doesn't

In 2026, the surrogacy industry in California and across the U.S. remains largely unregulated at the agency level. Agencies are not required to meet specific standards of advocacy, communication, or post-birth support. The result is a wide range of experiences — and Black, Brown, and BIPOC surrogates consistently report worse ones.

Compensation Disparities

Many agencies provide "market rate guidance" to surrogates — a suggested compensation range that functions in practice as a ceiling. Industry data from SurrogateFirst shows that surrogacy compensation has risen overall in recent years, but there is no transparency requirement that ensures Black, Brown, and BIPOC surrogates are being paid at the same rates as their white counterparts. When agencies set compensation ranges rather than allowing surrogates to name their own rates, the risk of a racial pay gap being embedded in the process is real.

Matching Dynamics

The matching process at many agencies involves Intended Parents completing a preference questionnaire before seeing any surrogate profiles. These questionnaires may include preferences about the surrogate's background and values. This means some surrogates may be seen by a narrower pool of Intended Parent families based on factors unrelated to their qualifications. (See our deeper guide on what Black women need to know about surrogacy.)

Lack of Advocacy at Delivery

Research published in the American Journal of Obstetrics and Gynecology consistently documents that Black patients receive less pain management and less attentive care in clinical settings than white patients with comparable conditions. Without a birth doula or dedicated advocate in the delivery room, a Black surrogate is navigating the most physically intense moment of her surrogacy journey without someone who is specifically there to protect her.

Postpartum Abandonment

The CDC reports that the majority of pregnancy-related deaths in the U.S. occur in the postpartum period — not during pregnancy or delivery. For Black women, that risk is 2–3 times higher than for white women. Yet most surrogacy agencies close the surrogate's file within weeks of delivery. The period of highest medical risk is the period of least support.

What Black, Brown, and BIPOC Surrogates Actually Deserve

Here is what every Black, Brown, and BIPOC gestational carrier deserves — not as a premium service, but as the baseline standard:

1. The Right to Name Your Own Compensation

Your base compensation rate should be yours to determine. No agency should pressure you to lower your rate to make a match easier or to bring IPs in under budget. Your labor, your commitment, and your body have a value — and you are the only one qualified to name it. (See our full surrogate compensation breakdown.)

2. An Independent Attorney — Paid for by the Intended Parents

California law requires gestational carriers to have their own independent legal representation — separate from the attorneys representing the Intended Parents. Your attorney reviews every clause in your Gestational Surrogacy Agreement on your behalf. At OFG, this is not optional, and the cost is always borne by the Intended Parents.

3. Your Bodily Autonomy in Writing

Your Gestational Surrogacy Agreement should include a clear, enforceable bodily autonomy clause — stating explicitly that no medical procedure can be performed on you without your documented consent, and that Intended Parents have no authority over your medical decisions. This clause exists at OFG. It is not implied. It is documented and signed before any journey begins.

4. A Birth Doula in the Delivery Room

A birth doula is not an upgrade at OFG. It is standard for every surrogacy journey. Research from DONA International documents the outcomes improvements associated with doula support — including reduced interventions and better communication with medical teams. For Black surrogates navigating a documented history of medical bias, this advocacy is not optional. It is essential.

5. Six Months of Real Postpartum Support

At OFG, every surrogate receives a Postpartum and Wellness Allocation — funded at contract signing, before pregnancy begins. It can be used for a postpartum doula, pelvic floor physical therapy, mental health counseling, prenatal massage, or any wellness support your body actually needs. And I personally check in with every OFG surrogate every month for six months after delivery — not an automated email, not a form. Me.

6. A Profile That Goes to Every Qualified Family

At OFG, your profile is shown to every qualified Intended Parent family we work with. There is no racial pre-sorting in our matching process. You are presented as the fully qualified, considered individual you are — to every family.

Why OFG Was Built for This Moment

I founded On Fertility Ground Surrogacy because I refused to build another agency that perpetuates the gaps I've described above. Every policy at OFG — from the surrogate-set compensation to the bodily autonomy clause to the postpartum check-ins — exists because of a specific harm I identified in the industry and refused to replicate.

OFG is a boutique agency based in the San Francisco Bay Area, serving Black and Brown surrogates, LGBTQ+ families, multicultural families, and single parents by choice. We take fewer clients than large agencies because doing this work well requires actual attention — not case management at scale.

If you are a Black woman, a Brown woman, a BIPOC woman, or any woman who has looked at the surrogacy industry and wondered whether it was built for someone like you: it wasn't. But this agency was.