Axios Cleveland
March 31, 2026
1 big thing: Surrogacy goes more mainstream
More Americans are turning to surrogacy to build their families, making ethical, legal and cultural tensions 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.
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 began tracking the data.
- Yes, but: Less than 2% of all fertility treatment cycles are meant for genetic carriers.
State of play: Surrogacy has become something more people actually picture for themselves, because there are more public figures talking about pregnancy challenges and surrogacy, Meyer says.
The latest: Olympic figure skater Alysa Liu was born via surrogacy. And singer Meghan Trainor recently shared that medical complications from her first two pregnancies led her family to surrogacy for their third child.
- But the headlines on surrogacy aren't all celebratory: Reaction to Trainor's baby news was mixed, and a recent criminal investigation involves the surrogate births of more than 20 children.
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.
2. Laws are all over the map
Without a federal law, surrogacy in the U.S. is governed by a patchwork of state regulations that can determine everything from whether agreements are legally binding to who is recognized as a parent at birth.
By the numbers: As of 2026, surrogacy agreements are enforceable in 31 states (with some limitations), including Ohio, void in one, and unregulated in 17, Surrogacy360 tells Axios.
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.
- And whether genetic surrogacy (when the surrogate uses her own egg) is even allowed.
Between the lines: Some state regulations have barriers for intended parents who are single, unmarried, not a heterosexual couple and/or not genetically related to the child.
- And, often, surrogacy agreements happen across state lines, so multiple state laws might need to be considered.
What they're saying: A growing number of lawyers "have begun to specialize in advising either intended parents or being the separate counsel for a surrogate," says Ming Wong, an attorney and the director of community justice and access at the National Center for LGBTQ Rights.
The latest: New surrogacy regulation was enacted in Massachusetts, Michigan and Illinois last year, and in Oregon and Hawaii this year.
3. The steep cost
4. The Terminal: Rounding the bases
Axios Cleveland
