What Disqualifies You From Being a Surrogate?
Not every disqualification is permanent. Here's the complete list of what surrogacy agencies screen for — and which factors you can work on versus which are firm cutoffs.
Updated April 2026
Firm Disqualifications
These are requirements that virtually all surrogacy agencies and fertility clinics agree on. They exist for medical, legal, or safety reasons and have very little flexibility.
Never given birth. You must have delivered at least one child of your own. This is universal across all programs — it proves your body can carry a pregnancy safely to term. There are no exceptions to this requirement.
Under 21 years old. Surrogacy requires emotional maturity, legal capacity, and a demonstrated pregnancy history. No agency will accept candidates under 21.
Not a US citizen or permanent resident. Due to the legal complexity of surrogacy contracts and health insurance requirements, most agencies require US citizenship or a green card. This is one of the harder barriers to work around.
3 or more C-sections. The medical risks of uterine rupture and placental complications increase significantly after three cesarean deliveries. This is a medical determination, not an agency preference. See our full guide on surrogacy after a C-section.
Active drug use. All surrogacy programs require candidates to be completely drug-free. Active use of any recreational drug, including marijuana, is a firm disqualifier. Most agencies require 12+ months clean before they'll consider your application.
Flexible Disqualifications
These factors may disqualify you at some agencies but not others, or they're things you can change over time. The key word here is flexibility — your specific situation matters more than a blanket rule.
Age 39-42. You're within the accepted range but on the upper end. Some agencies are more cautious about older candidates, while others specifically welcome experienced women in this age range. A strong medical history and overall health profile make a big difference here.
BMI between 33 and 35. Most agencies set their cutoff between 32 and 33, but some accept up to 35. If your BMI is in this range, even a small reduction can expand your options significantly. Some agencies will evaluate your overall health picture rather than relying on BMI alone.
2 prior C-sections. Most agencies accept this, but some are more cautious. How well your scars healed, how long ago your last C-section was, and whether you've had a successful VBAC all factor into the decision.
Living in a restrictive state. States like Louisiana, Michigan, and Nebraska have surrogacy restrictions. However, some agencies arrange for surrogates to deliver in surrogacy-friendly states. It adds complexity but doesn't necessarily close the door.
Minor pregnancy complications. Minor, well-managed complications like mild gestational diabetes or brief preterm labor that resolved are usually not dealbreakers. Significant complications like severe preeclampsia or placental abruption will receive closer scrutiny but don't automatically disqualify you.
Temporary Disqualifications
These are factors you can actively work on. If any of these apply to you today, they don't have to apply six months or a year from now.
Nicotine or occasional marijuana use. Most agencies require 6-12 months nicotine-free and 12+ months drug-free (including marijuana). If you can commit to quitting, this shifts from a disqualification to a timeline.
BMI over 35. BMI is changeable. Even modest weight loss can bring you into the accepted range. Working with your doctor on a sustainable plan can open the door within months.
Currently pregnant or breastfeeding. You can't begin the surrogacy process while pregnant or actively breastfeeding. Most agencies ask that you've finished breastfeeding at least 3-6 months before starting medications. This is purely a timing issue.
Family hasn't been told yet. Agencies want to see that your partner and close family support your decision. If you haven't had the conversation yet, that's something you can do whenever you're ready. Many families come around once they understand the process and protections in place.
Limited knowledge of the process. Not knowing how surrogacy works isn't a disqualification — it's a starting point. Agencies provide extensive education during screening. The fact that you're reading this means you're already learning. You can also check out our surrogate compensation guide to see what the financial side looks like.
Over 42?
Most agencies cap surrogate age at 42, though a few make exceptions for experienced surrogates with excellent medical histories and a proven track record. If you're over 42 and have been a surrogate before with no complications, it's worth inquiring — but options are limited.
What About Mental Health History?
A history of mental health treatment is not automatically disqualifying. Agencies look for current emotional stability, not a perfect history. Active, untreated mental health conditions — particularly those that could affect decision-making during pregnancy — will be evaluated during the psychological screening. Being on stable medication that's pregnancy-safe is generally accepted. The psychological evaluation is about ensuring you're in a good place to handle the emotional complexity of surrogacy, not about penalizing you for past challenges.
Find out in about 10 minutes.
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