Content Warning: This section of the guide includes discussion of ableism.

Surrogacy is the process whereby someone agrees to carry a pregnancy for another individual or couple after conceiving through in vitro fertilization. The Surrogate Mother focuses on a “traditional” surrogacy whereby the surrogate mother’s own eggs are fertilized by the intended father’s sperm (or that of a donor). In these cases, the surrogate mother is biologically related to the child. The alternative to traditional surrogacy is gestational or host surrogacy, whereby an already fertilized egg is implanted in the surrogate mother. In gestational surrogacies, the intended mother (or donor of the egg) is the baby’s biological mother.

McFadden’s novel shows how surrogacy can offer hope to individuals who are unable to conceive naturally. However, the conflict between Abby and Monica reflects the complex ethical, legal, and social considerations that make surrogacy a highly debated topic. Surrogacy agreements can be highly contentious since they involve balancing the rights and well-being of the surrogate, the intended parents, and the child. A lack of federal laws regulating the practice further complicates surrogacy agreements in the United States. Surrogacy laws vary widely by state, creating uncertainty about who is legally recognized as the child’s parent.