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Postpartum depression is the most common problem that surrogate mothers can face after a surrogate birth.

Surrogacy is a beautiful, selfless gift of life for so many people and families struggling to conceive. Being a surrogate mother enables you to become part of these individuals’ journeys by creating families and making the dream of parenthood come true. However, it’s also true that it greatly impacts the life of the surrogate mother.

Following the birth of the baby, the surrogate may experience feelings of sadness, anxiety, irritation, and more. Such feelings and emotions are often normal for women who give birth, and it is recognized as baby blues.

Most of the time baby blues go away. However, if the feelings persist or the surrogate mother continues to feel a sense of loss, then she may be struggling with postpartum depression.

What Is Postpartum Depression?

Signs and symptoms of postpartum depression often include insomnia, fatigue, sadness, anxiety, irritability, and a sense of loss that lasts longer than a few days or weeks. Postpartum depression can last anywhere from months to years, and without treatment, symptoms can result in isolation, resulting in the surrogate detaching herself from friends and family. Although it can affect as many as 20% of the new-mother population, including surrogate mothers, there is no exact known cause for postpartum depression.

What Causes Postpartum Depression With Surrogates?

PPD has become quite common with surrogate mothers after birthing a child for another couple. For surrogates, this can also be an extremely trying time as their conditions are significantly different from those of a traditional birth mother.

Even though it is difficult to pinpoint an exact cause, there are a number of possible explanations for why a surrogate mother may experience postpartum depression following a surrogate birth.

Changes in Hormone Levels

One of the most widely held theories is that postpartum depression is the result of drastic and rapid changes in hormone levels following pregnancy and labor. After giving birth, a woman’s body undergoes a number of changes, including sudden drops in estrogen and progesterone levels. This drop may then spur a chemical change in the brain and lead to postpartum depression.

Genetic Predisposition

Some women may also be at higher risk of depression if they have a history of mental illness or manic-depressive disorder. Lifestyle choices can also lead to higher risk, such as a history of alcohol or drug abuse. Sometimes the depression can stem from situations out of the woman’s control as well, if she experiences stress from illness or loss, complications during the pregnancy, or lack of support from loved ones. Surrogate mothers especially can fall into the latter risk categories, as surrogacy can be a difficult choice for some friends and family to understand, with the surrogate mother going through pregnancy and birth of a baby for someone else.

Post-Birth Emotions

At the end of the surrogacy journey, following labor and birth and the daily experience of pregnancy, the surrogate can undergo a period of intense emotions. There is suddenly a shift in her daily routine, and the surrogate may be left with a feeling of loss from these changes. Prior to labor and birth, surrogates are in consistent communication with doctors and intended parents, but once the parents have their baby this communication often comes to a halt. As her life undergoes so many changes in such a short period of time, the surrogate may find herself struggling through postpartum depression.

Do Surrogates Get Postpartum Depression More Often?

No research states that a surrogate experiences depression more intensely than a traditional mother, but for some surrogate mothers the responsibility of carrying and birthing a baby that isn’t theirs to keep can be life-altering. This is part of why it is so critical for a surrogate mother to maintain communication with doctors and loved ones throughout the entire surrogacy process. Surrogates give so much meaning to others, especially the parents they are helping, but they also have a responsibility to themselves. It’s vital that they ensure their own health, safety, and happiness.

As the surrogate goes through the process, she needs to be open with how she is feeling so she can get the support she needs. This holds true following the birth of the baby as well. In order to be properly assessed and to receive the appropriate treatment, surrogate mothers should always schedule an appointment with a medical professional to discuss their symptoms and concerns.

Treatments for Surrogates Experiencing Postpartum Depression

Once a surrogate mother has been professionally diagnosed with postpartum depression, she can get help. There are a number of treatments available to help treat and alleviate the effects of postpartum depression, many of which may not even require medication.

Talk Therapy

Depression can be extremely lonely since it leads to isolation, so an effective treatment may simply be talking. Surrogates going through postpartum depression are encouraged to talk to friends, family, and professionals to combat not only the loneliness but the sadness that comes with it as well.

Speaking with others about how they feel allows the surrogate mothers to embrace relationships with others, and opening up to a professional in counseling or therapy can offer a safe space to discuss deeper thoughts or feelings the surrogate may not feel comfortable sharing with someone they know on a personal level. A mental health professional such as a psychiatrist, therapist, or counselor, can help the surrogate through the more difficult or complex aspects of postpartum depression.


Doctors may also be invaluable resources for surrogates with postpartum depression by prescribing the proper medication. There are now a number of medications available that can help address the symptoms of depression. Before any of these are taken or prescribed, it is important to schedule an appointment with a medical/mental professional for help.

How Surrogacy Can Affect Relationships and Family

Help can come in a variety of forms, and one of the most important ones often comes in the form of loved ones, but this can be complicated throughout the surrogacy process. To ensure a safe and rewarding surrogacy journey, the surrogate mother needs support and encouragement during all the steps of the experience, from the good to the bad and everything in between. In order to have this support, the surrogate should consider how surrogacy may impact her loved ones and family, and how the commitment affects her as well.

Everyone affected by surrogacy should talk about their questions and concerns, especially as it is common for the gestational carrier, or surrogate mother, to develop some level of attachment to both the baby and the baby’s parents. Once the baby is handed to the parents, the surrogate can then begin to feel that sense of loss that can pave the way to postpartum depression, so psychological and emotional support from her friends and family is critical to help her through the transition.

The Surrogacy Process at Joy of Life

Making sure that the surrogate mother has access to a support system is a crucial part of the surrogacy process. Before she becomes a surrogate, she will complete a psychological evaluation in addition to an interview, medical screening, and more. This is just the first step in the process. After she meets with the intended parents, she will move to step two where the pregnancy begins with an embryo transfer. Step three is the pregnancy itself, where the surrogate has regular obstetric appointments up to the birth of the baby. At every stage, the surrogate mother will have access to the compassionate, and empathetic team at Joy of Life®.

How We Help Surrogate Mothers With Postpartum Depression

Beyond just baby blues, postpartum depression is characterized by undue anxiety, sadness, fatigue, irritability, and a host of other symptoms. This phenomenon is experienced by thousands of new mothers every year. Both traditional and surrogate mothers with PPD might also experience feelings of great loss. However, symptoms can vary widely from person to person.

If the surrogate does go through postpartum depression, the Joy of Life® team wants her to know she will never be alone. Her selfless gift of life is one of the most courageous and beautiful things she can offer to a family seeking parenthood, and every member of the team understands and respects her for this decision. When she needs help, she will have access to the care she requires that includes medical professionals and a dedicated team of individuals that are ready to talk and offer support and guidance.

If you’re considering becoming a surrogate and have concerns about PPD, you can contact Joy of Life® Surrogacy. Our staff prioritizes the health and education of our surrogates throughout their entire journey.

Joy Millan

Author Joy Millan

I’m Joy, the founder and CEO of Joy of Life. With a professional background as a fertility clinician, I’ve spent thousands of hours working with surrogates and intended parents alike. As a mother of two, I often wished for more support and a deeper commitment to care for those embarking on non-traditional family-building journeys. This is why I established Joy of Life: to create a more robust, compassionate experience in parenthood for both parties involved with surrogacy. In 2021, I stepped back from daily operations at Joy of Life to fight cancer. Fortunately, the combined 20 years of experience from our incredible team has allowed me to focus on my health & recovery. I continue to provide company guidance and serve as the head liaison for our network of doctors, clinicians and caregivers.

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