Once a taboo topic, the process of using a gestational carrier is being demystified thanks to a growing number of candid celebrities.
Defying logic, parenthood can be both the most universal of human experiences and the most individual.
While every prospective parent charts a journey that's uniquely their own, the broad themes and emotional ride tied to caregiving, pregnancy and fertility are deeply relatable. It's a shared journey that’s ripe for connection, comparison, and, unfortunately, also judgment.
It's this concept that drives a public fascination with celebrities, their children, and how they have those babies: Stars are just like us and nothing like us.
Khloe Kardashian and Chrissy Teigen are no strangers to parenting in the public eye and, in recent years, became two of a growing number of celebrities to openly welcome babies via surrogate. Both women have spoken publicly about the nuances of their own experience, alongside stars including Paris Hilton, Maria Menounos, Tan France, Anthony Rapp, Jesse Tyler Ferguson, Adrienne Bailon, Erin Andrews, Casey Wilson and Rebel Wilson.
Keough, who has been public about her struggles with Lyme disease, says that factored into her decision to go with a surrogate.
"I think it’s a very cool, selfless, and incredible act that these women do to help other people," Keough shared. "I can carry children, but it felt like the best choice for what I had going on physically with the autoimmune stuff."
Before that, Kim Kardashian, Gabrielle Union, Elizabeth Banks, Katey Sagal, Andy Cohen, Anderson Cooper, Priyanka Chopra, Jamie Chung, Hilaria Baldwin, Neil Patrick Harris, Lance Bass and more had already added their names to the rapidly expanding list of stars turning to surrogacy to expand their families.
Now, a once taboo topic is evolving into something more hot button. As refreshingly candid dialogue from Hollywood's A-list is helping to demystify and bring awareness to the practice, it's not without a fair share of detractors. Get a crash course in the basics of surrogacy and what the stars have said about their experiences, below.
What Is Surrogacy?
A surrogate pregnancy is characterized by a woman agreeing – typically by a legal contract and in exchange for payment – to carry and give birth to a baby on behalf of another couple or person.
The most common form of surrogacy is called "gestational surrogacy," in which the surrogate is formally referred to as a "gestational carrier." In this scenario, which was first introduced in the 1980s, the carrier has no biological connection to the baby and undergoes the process of in vitro fertilization to implant an embryo that is often comprised of an egg and/or sperm from the intended parent(s). If the intended parent is single or a couple in a same-sex relationship, a donor egg or sperm from a third party would be used.
"We decided to have kids and it's a lot harder for gay guys, although we tried!" Neil Patrick Harris' husband, David Burtka, joked in a 2015 interview with Wendy Williams. He explained that there were two women involved in the process as they welcomed their fraternal twins, Gideon and Harper, in 2010.
"There was two different women involved. There was an egg donor, a wonderful woman who was anonymous. We took two of our best guys and implanted them into her egg, two different eggs, and then implanted them into another woman," he explained. "So, a surrogate who just carried the babies."
One child is biologically Harris' and the other is Burtka's, though they were born at the same time. Burtka teased that, while they never had the children's DNA tested, they each appear to have inherited distinct personality traits from their respective fathers.
Oftentimes, gestational carriers and intended parents are matched by an agency, with both parties first completing a screening process. While the specific qualifications vary by agency, the screenings usually include mental health and background checks as well as, for the potential surrogate, a health screening. There are also various online groups and platforms where surrogates and intended parents can match themselves, if desired, while some intended parents opt for a "Identified Surrogacy" using a carrier that they already know personally.
In a less common surrogacy practice referred to as "traditional surrogacy" which dates back to biblical times, the surrogate mother also serves as the egg donor and carries a baby that is genetically her own with the intent of giving the child to its intended father or parents after the birth. Due to its complicated nature, this scenario is often treated legally as adoption and does not involve financial compensation.
While surrogacy laws vary between states and countries (surrogates in the UK, for example, are legally prohibited from being paid – this is referred to as an "altruistic surrogacy"), qualified gestational carriers in the U.S. have usually already given birth at least once and can be compensated within the ballpark of $30,000 to $50,000 per surrogate pregnancy.
Additionally, the intended parents are responsible for payment of medical bills and other expenses associated with the pregnancy, including the IVF procedure itself. According to Forbes, a single IVF cycle can cost between $15,000 and $30,000, with no guarantee that it will result in a healthy pregnancy and birth. Start to finish, including the early research and application process, GoStork.com estimates that most surrogacy journeys last between 18 and 24 months.
Interestingly, surrogates who are hired to carry celebrities’ children are reportedly not paid higher than the standard rate. In a 2017 interview with The Cut, attorney Stephanie Caballero of the Surrogacy Law Center in Carlsbad, California, explained that a higher salary could be perceived as unethical.
"If you pay a surrogate, let’s say who’s giving birth for Kim [Kardashian] and Kanye [West], $100,000, that looks like coercion,” she said. "I mean anybody, you would raise your hand and say, 'Sure, six figures? I'll carry your baby!' And you don't want somebody to come forward like that. You want a woman who has raised her hand and said, 'This is something that I want to do. I have uneventful pregnancies; I love being pregnant. I want to help somebody and give them a baby.'"
At the time, it had been reported that Kim and her then-husband were paying a surrogate $45,000 to carry their third child, after Kim had experienced medical complications during her previous two pregnancies. In 2019, the former couple reportedly used a different surrogate to welcome their fourth child.
The Kardashian Effect
Kim was among a relatively early group of high profile celebrities to speak at length about the experience, along with documenting aspects of it on Keeping Up With the Kardashians.
"You know, it is really different. Anyone that says or thinks it is just the easy way out is just completely wrong. I think it is so much harder to go through it this way because you are not really in control," Kim told ET in November 2017. "Obviously you pick someone that you completely trust and that you have a good bond and relationship with, but it is still ... knowing that I was able to carry my first two babies and not, you know, my baby now, it's hard for me. So, it's definitely a harder experience than I anticipated just in the control area."
Despite admittedly "hating being pregnant," Kim said she still found it challenging to see someone else carry her child.
"I thought this was going to be so easy, but you know, even in how much I hated it, if I could do it myself I would have preferred that," Kim said of pregnancy. "So, that inner struggle is kind of hard, but I am just rolling with it and it is what it is."
Years later, Kim's sister Khloe Kardashian welcomed her second child via surrogate amid a cheating and paternity scandal involving her ex, Tristan Thompson. Khloe's journey was documented on the family's new reality series, The Kardashians, with the reality star expressing feelings of unpreparedness for the complicated emotions that can come with surrogacy.
"I definitely was in a state of shock from my entire experience in general," Khloe said of her time in the hospital welcoming her son, Tatum. "I felt really guilty that this woman just had my baby and then I take the baby and I go to another room and you're just sort of separated. I felt it's such a transactional experience... I wish someone was honest about surrogacy and the difference of it. But it doesn't mean it's bad or good. It's just different."
Chrissy Teigen's Deep Connection
Just like each pregnancy can be different, surrogacy experiences can also vary widely between families.
Chrissy Teigen and husband John Legend chose to pursue a unique path in expanding their family from two to four children in 2023, ultimately going through with a surrogate pregnancy that overlapped with Teigen's own pregnancy at the same time. (Two years earlier, it was revealed that Alec and Hilaria Baldwin had gone a similar route with their fifth and sixth children.)
The result for Teigen and Legend was two babies, born five months apart, and a deep-rooted affection for her child's gestational carrier, Alexandra. The couple even chose to honor her in naming their son that she carried: Wren Alexander.
"I knew she was a perfect match for us the moment we spoke to her. All our wishes and dreams aligned. I wanted to be her friend, I wanted our children to play, I wanted dinner together, I wanted to lay my head on her belly and be able to feel the hiccups and kicks. I wanted them to be in our lives for as long as time would allow,” Teigen shared of her surrogate in a statement announcing the news of Wren’s birth.
"We want to say thank you for this incredible gift you have given us, Alexandra," she concluded. "And we are so happy to tell the world he is here, with a name forever connected to you, Wren Alexander Stephens."
A Profound Transformation
In a loving tribute, Anthony Rapp shared a handful of classic maternity photos he and fiancé Ken Ithiphol< had taken along with their gestational carrier during her pregnancy with their son, Rai Larson, in 2022.
"We had the absolute honor and pleasure of getting to know, and share many meaningful and joyful moments with, our gestational surrogate, Nikki," the Star Trek: Discovery actor wrote alongside the images. "She is truly one of the most incredible and awe-inspiring human beings we have ever met, and she and her family have profoundly transformed our lives."
The proud couple poses happily with Nikki in the professional shots, which even includes images of their hands placed gently on her growing belly.
Fighting the Stigma
Elizabeth Banks and husband Max Handelman welcomed their sons Felix and Magnus in 2011 and 2012, respectively, both via surrogate. Though the Pitch Perfect star was publicly open about the experience at the time, sharing that she suffered from a "broken belly" and was unable to carry children on her own, she acknowledged a shift in the public perception of women's fertility in a 2019 interview.
Until recently, she said in Net-A-Porter, "women's reproductive issues were things you would whisper about in small circles." Now, she continued, "there's #ShoutYourAbortion and IVF Facebook groups."
Still, Banks sensed that others had opinions on her choice to have children via surrogacy.
"I definitely think I'm still judged for what I've done and that people don't understand my choices, but I don't feel I owe anybody any explanation," she told the magazine. "And, if my story helps people feel less alone on their journey, then I'm grateful for that."
"There's nothing more that I wanted than to cook my own baby," she told Women’s Health. "The idea of it felt like surrendering to failure."
Moreover, Union admitted, she worried about being judged by others even after the baby arrived.
"People want to see the bump, hear that you got hemorrhoids – they want to know you're like them," she said. "I was like, 'This is going to seem like the most Hollywood s**t ever. Will I be embraced as a mom? It's terrifying."
Shifting the Narrative
In a strongly-worded missive aimed at critics of his own journey with surrogacy, Tan France pointedly addressed some of the most common criticisms that intended parents face.
"For all of those who are asking or really angrily saying we should have adopted instead of surrogacy. A lot of you have your own kids. If you're so upset about me having my own children, you can adopt. Please go ahead and adopt. It's a wonderful thing to be able to do. You don't know our story. You don't know why we are going through the surrogacy process instead of adopting," he began a statement in 2021, while expecting his first child with husband Rob France.
"And for those who are saying that I am exploiting a woman's body, I wanna make it really clear: I didn't just grab someone off the street and kidnap her and get her pregnant," he continued. "This was somebody that we care about very much, who wanted to do this for us, who was generous enough to help us have our absolute dream and to raise a family. So you don't really have to worry about our surrogate. I promise, she's fine. We are taking very good care of her. I promise, she wanted to do this. She wanted to do this for us because, even though as many said, the baby's not going to have a mother–believe me, we are gonna love this child so much more than one could ever possibly imagine. He will be plenty loved even without a mother."
While the decision to serve as a gestational carrier is deeply personal, it's not without risks.
As with any pregnancy, there's a chance of numerous physical complications including gestational diabetes, hypertension, pre-eclampsia and damage to reproductive organs, among countless others, followed by hormone fluctuations that can contribute to postpartum depression and anxiety. Additionally, according to the British Journal of Medicine, women undergoing IVF can face increased risks associated with carrying multiple embryos, and with the use of specific drugs and hormones that are part of the medical process.
On the topic of emotional and mental well-being, some surrogates have reported feeling a sense of loss or grief after the birth of the child, as well as complications or a breakdown in the relationships with their own family or the intended parents.
It's worth mentioning that, while many celebrities have hired gestational carriers to grow their families, there are no notable examples of a star serving in the role of surrogate, themselves. There are, however, a handful of social media influencers sharing their experiences on large platforms.
Public figure or not, no person is responsible for offering their personal reproductive choices up for public discourse. And while surrogacy is far from a perfect process, neither is traditional pregnancy, adoption, or anything in between.
But each story belongs solely to its owner.
With the use of surrogacy on the rise -- Fortune reports the industry was valued at over $14 billion in 2022, with Global Market Insights predicting it will achieve nearly 25 percent compound annual growth rate in the next decade -- there will undoubtedly be more stories to share in the coming years.
Surely Hollywood's A-list will continue to speak out, offering their amplified voices to a chorus of experiences on the topic -- but there should really be a microphone for their gestational carriers, too, should they want to speak about their journeys.