• Posted July 29, 2025

Surrogate Moms More Apt To Suffer Mental Illness

Women who carry a baby for someone else — also known as gestational carriers or “surrogate moms” — may be at higher risk for mental illness during and after the pregnancy, new research shows. 

“Our findings underscore the importance of adequate screening and counseling of potential gestational carriers before pregnancy about the possibility of a new-onset mental illness, or exacerbation of a prior mental-illness during or after pregnancy,” said lead author Dr. Maria Velez. 

She's an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES) and associate professor of obstetrics and gynecology at McGill University in Montreal.

The findings were published July 25 in JAMA Network Open.

As the researchers explained, it’s long been known that “pregnancy is a period of increased vulnerability for psychological well-being."

However, “the mental health of gestational carriers is understudied,” they noted.

In the new report, Velez’ team tracked the mental health of new mothers involved in more than 767,400 births recorded in the Canadian province of Ontario between 2012 and 2021.

The vast majority (97.6%) of these pregnancies involved women who needed no assistance in conceiving or carrying a baby. However, 2.3% required help via in-vitro fertilization (IVF) and 0.1% involved surrogacy. 

None of the women had any known history of mental health issues prior to their pregnancy. Their post-pregnancy mental health was tracked for a median of 4.5 years. (Median means half were tracked longer, half for a shorter time.)

Compared to women who carried their own baby, surrogate moms were more likely to have already given birth, and they were also more likely to live in a low-income area and have obesity and/or high blood pressure.

While the overall rate of new-onset mental health issues was low among the women, surrogate moms were 43% more likely to develop a mental illness for the first time compared to moms who conceived and carried their own baby, the research showed. 

They were also 29% more prone to new-onset mental illness compared to women who’d used IVF to conceive. 

Mental illnesses included in the study included anxiety disorders, psychosis, substance use disorder, any self-harm event or other mental illnesses.

Just how might the surrogacy process harm a woman’s mental health? 

The authors cited several factors.

"Potential risk factors for new-onset mental illness among gestational carriers include the emotional effect of separation from the newborn, maintaining relationships with the intended parents and child, and societal scrutiny about their decision to pursue gestational carriage,” they wrote.

In Ontario, at least, people who are considering gestational carriage are typically screened for pre-existing mental illness. 

However, the new findings “underscore the importance of counseling gestational carriers, who themselves have reported unanticipated health and/or mental health complications,” the researchers said.

For many women, postpartum mental health issues are often under-treated, the researchers added.

“Unfortunately, fewer than half of those who visit the emergency room for mental health concerns after childbirth receive timely follow-up care which leaves many, especially gestational carriers, at risk during a vulnerable period,” Velez said in a McGill news release.

More information

Find out more about gestational surrogacy at the Cleveland Clinic.

SOURCES: McGill University, news release, July 25, 2025; JAMA Network Open, July 25, 2025