Axios Boston

April 23, 2026
Hello, Thursday.
- Today, our colleague Carly Mallenbaum dives into the rise of surrogacy nationwide, and health officials warn about a measles case that passed through Boston.
🌧️ Today's weather: Isolated rain showers, with a high of 61 and a low of 39.
Today's newsletter is 912 words — a 3.5-minute read.
1 big thing: Surrogacy goes more mainstream


More Americans are turning to surrogacy to build their families, as the practice becomes more common and more publicly discussed.
Why it matters: As surrogacy becomes more visible and accessible, ethical, legal and cultural tensions become harder to ignore.
How it works: A surrogate carries a pregnancy for intended parents — typically via IVF with an embryo that uses a donor or the intended mother's egg.
- That's called gestational surrogacy, and the surrogate can be referred to as the gestational carrier. (When a surrogate uses her own egg, that's called traditional or genetic surrogacy.)
It's an option for people who want biological kids but can't — or can't safely — carry a pregnancy.
- It's "not something I would recommend for somebody who doesn't have a medical indication or a reason to do it," says Laura Meyer, reproductive endocrinologist at Illume Fertility.
By the numbers: U.S. clinics reported more than 11,500 gestational carrier cycles in 2023 — nearly seven times as many as were done in 2004, when the American Society for Reproductive Medicine (ASRM) began tracking the data.
- And pregnancies via gestational carrier increased by 55% from 2017 to 2020, according to a national analysis cited by ASRM.
- Yes, but: Births from gestational carriers account for only 13.7 per 100,000 deliveries nationwide between 2017-2020, and less than 2% of fertility treatment cycles.
State of play: Surrogacy has undergone a quiet cultural transformation.
- What once seemed like an inaccessible or poorly understood method of family-building has become something more people actually picture for themselves, because there are more public figures talking about pregnancy challenges and surrogacy, Meyer says.
The big picture: The topic of surrogacy remains fraught, because it involves complex health and rights implications for everyone involved — surrogates, intended parents, donors, and the children born.
- Figures from the late Pope Francis to activist Gloria Steinem have opposed surrogacy because they saw it as exploitative of women and/or babies.
What they're saying: Because for-profit surrogacy agencies and fertility clinics measure success by the birth of a "healthy" child, that can skew incentives and create power imbalances, says Emily Galpern, a consultant for the Center for Genetics and Society.
- Intended parents pay far more than surrogates receive, Galpern says.
The other side: Meyer says agencies build in "a lot of care," including counseling with social workers and psychologists to align expectations.
2. 🔙 BTMU: Measles alert at Logan
🏥 A passenger who passed through Logan Airport last week had measles. (WCVB)
- Anyone who was in Terminal C between midnight and 2:30am on April 14 may have been exposed.
Seven Allston Car Wash employees who were detained by immigration officials last year filed a federal complaint against the Department of Homeland Security yesterday. (GBH News)
- A complaint is typically the first step toward a potential lawsuit.
New Hampshire officials found the body of 61-year-old Kent Wood, a missing hiker from West Roxbury, on Tuesday on a Franconia Notch trail. (CBS Boston)
Former Cambridge City Councilor Paul Toner, who was charged with seeking sexual conduct for a fee in connection with a brothel ring, agreed to serve nine months of pre-trial probation to resolve the charge. (Globe)
3. Navigating uneven state surrogacy laws

Without a federal law, surrogacy in the U.S. is governed by a patchwork of state regulations that can determine anything from whether agreements are legally binding to who is recognized as a parent at birth.
Why it matters: More Americans are turning to surrogacy to build their families.
Major differences between state laws include:
- How a surrogate must be compensated (if not considered "altruistic").
- Who becomes the legal parents of a child born via surrogate.
- Whether genetic surrogacy (when the surrogate uses her own egg) is even allowed.
The bottom line: Often, surrogacy agreements happen across state lines, so multiple state laws might need to be considered.
4. The steep cost of surrogacy
Surrogacy in the U.S. can cost from $100,000 to more than $250,000.
Why it matters: High costs and limited insurance coverage make surrogacy inaccessible for many people seeking to build families.
By the numbers: According to data compiled by fertility benefits company Carrot, average costs for surrogacy include:
- Surrogacy compensation through an agency: $30,000- $65,000 (doesn't include additional expenses like travel).
- Agency fees: $15,000- $45,000 (could include legal and other services).
- Legal fees: $15,000-$20,000 (includes representation for all parties).
- IVF and other medical expenses: $25,000- $50,000 (more if you do multiple cycles and transfers).
Between the lines: Coverage for surrogacy is improving, but major gaps remain.
- Employers reported a 39% increase in adoption or surrogacy benefits offered year over year, according to a 2026 Maven report.
- When insurance doesn't cover surrogacy, prospective parents often purchase specific policies for surrogacy that can cost another $30,000, per data collected by RESOLVE: The National Infertility and Family Building Association.
Options for reducing costs are limited, especially if you're unable to negotiate every step of your process.
- Working with a known surrogate — a friend or family member — can eliminate fees, though it comes with its own emotional and legal complexities.
- Some grant and assistance programs exist, but they don't serve all intended parents.
Deehan is out.
Steph is contemplating setting an allergy season reminder on their phone for next year.
This newsletter was edited by Jeff Weiner.
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