More Americans are turning to surrogacy to build their families, as the practice becomes more common and more publicly discussed.

Why it matters: As it becomes more visible and accessible, ethical, legal and cultural tensions over surrogacy become harder to ignore.

How it works: A surrogate carries a pregnancy for intended parents — via IVF with an embryo that uses the donor or the intended mother's egg (gestational surrogacy, the much more common arrangement), or her own egg (traditional surrogacy).

• Surrogates who don't use their own eggs are often called gestational carriers.

It's an option for people who want biological kids but can't — or can't safely — carry a pregnancy.

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.
• 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 isn't just for the rich and famous anymore. As more public figures have opened up about pregnancy challenges, it's become something ordinary people actually picture for themselves, says Laura Meyer, reproductive endocrinologist at Illume Fertility.

The latest: Olympic gold medal 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.

Yes, but: Surrogacy remains controversial. Critics — from the late Pope Francis to feminist Gloria Steinem — have called it exploitative of women and children.

• A recent criminal investigation involving surrogate births of about 20 children underscores some of the risks.

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Without a federal law, surrogacy in the U.S. is governed by a patchwork of state regulations.

Zoom in: Washington is among the most surrogacy-friendly states.

• The 2018 Uniform Parentage Act — the first of its kind in the country — explicitly supports both gestational and genetic surrogacy and extends equal protections to married, unmarried, and LGBTQ+ families.

But confusing and varied local rules elsewhere can determine everything from whether agreements are legally binding to who is recognized as a parent at birth.

By the numbers: As of this year, surrogacy agreements are enforceable in 31 states (with some limitations), void in one, and unregulated in 17, Surrogacy360 tells Axios.

• Surrogacy is still practiced in most U.S. states, though, even where laws are unclear — that's according to surrogacy agency Creative Family Connections, which has a map about how laws for compensated surrogacy are practiced across the country.

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.

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.

• Because contracts involve so many potential risks, like one party changing their mind mid-way through the process, "we always encourage people to at least talk to an attorney … even in a state where it's not criminalized," Wong says.

The latest: The trend across the country has largely been toward more clear regulation that protects surrogates, intended parents and children.

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Surrogacy in the U.S. can cost $100,000 to $250,000 or more.

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: $30K - $65K (doesn't include additional expenses like travel)
• Agency fees: $15K - $45K (could include legal and other services)
• Legal fees: $15K - $20K (includes representation for all parties)
• IVF and other medical expenses: $25K - $50K (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/surrogacy benefits offered year over year, according to a 2026 Maven report.
• When insurance doesn't cover surrogacy, often intended parents purchase specific policies for surrogacy that can cost another $30K, 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.

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🌇 Tens of thousands of demonstrators turned out for the No Kings rally in Seattle, with organizers putting the crowd at around 100,000 and Seattle police estimating at least 75,000 attendees. (KING 5)

• Around 8 million people are believed to have participated across more than 3,300 events globally.

⚽️ Seattle Reign FC won its third game in four this season, beating Louisville 2-1 on Saturday. (Sounder at Heart)

Dick Foley, a Grammy-nominated member of The Brothers Four who grew up in Seattle's Madison Park and later became an Emmy-winning longtime KOMO host, died March 15 at 85. (Seattle Times)

👋 Melissa here. The opening of the Judkins Park light rail station on Saturday allowed me to finally catch the train close to home.

While the ride over Lake Washington is getting much of the attention, the view of Seattle as you head from Judkins Park toward the International District/Chinatown Station is also stunning.

My 2-year-old loved riding so much, he refused to walk with us to dim sum when we got off. "More train! More train, please!" he repeated.

• I should have planned a longer trip.

A new station also opened on Mercer Island Saturday as part of Sound Transit's Line 2, which now connects Seattle to the Eastside.