Montreal, QC, July 25, 2025 – A groundbreaking study has revealed that individuals acting as gestational carriers, commonly known as surrogates, are at a heightened risk of developing new mental illnesses during and after pregnancy. This research, conducted by ICES, McGill University, and the Research Institute of the McGill University Health Centre, sheds light on the mental health challenges faced by surrogates as the practice of surrogacy becomes more prevalent.
This study is the first of its kind to utilize extensive Ontario-based health data to examine these mental health issues. Despite existing guidelines mandating mental health screenings, the research discovered that nearly 20% of gestational carriers had a pre-existing mental illness diagnosis before pregnancy. Some of these conditions were severe enough to potentially disqualify them from serving as surrogates.
“Our findings underscore the importance of adequate screening and counselling 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,” stated Dr. Maria Velez, the study’s lead author and a prominent scientist affiliated with ICES, McGill University, and the Research Institute of the McGill University Health Centre.
Study Highlights and Demographics
The study, published in the prestigious JAMA Network Open, analyzed 767,406 births at over 20 weeks’ gestation in Ontario, Canada, spanning from 2012 to 2021. The research focused on women without a known mental illness before pregnancy. The comparison groups included 97.6% who conceived naturally, 2.3% via in vitro fertilization (IVF), and a small fraction, 0.1%, using gestational carriers.
Gestational carriers were more likely to have previous childbirth experiences, live in lower-income areas, and exhibit higher rates of obesity and chronic hypertension. These factors may contribute to the increased mental health risks observed in this group.
By the Numbers
The incidence rate per 100 person-years of new-onset mental illness was 5.2 among non-gestational carriers with unassisted conception, 5.0 among non-gestational carriers who conceived by IVF, and 6.9 among gestational carriers.
The study also highlighted that mental illnesses diagnosed through emergency department visits or hospitalizations were more prevalent among gestational carriers compared to outpatient diagnoses.
Implications for Mental Health Support
The findings raise significant concerns about the mental health support available to gestational carriers. Dr. Velez emphasized the critical need for timely follow-up care, noting, “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.”
The researchers hope that their study will influence future guidelines to ensure comprehensive mental health support for gestational carriers, both during and after pregnancy. This could involve enhanced screening processes and more robust postnatal care frameworks.
Looking Forward: Policy and Practice
As surrogacy continues to rise in popularity, this study’s findings could have far-reaching implications for policy and practice in reproductive health. The need for improved mental health protocols is evident, and experts suggest that healthcare providers must prioritize mental health as integral to the surrogacy process.
Historically, mental health considerations in reproductive medicine have not received the same attention as physical health. However, this study underscores the necessity of a holistic approach to surrogacy that includes mental well-being as a core component.
Future research may explore the long-term mental health outcomes for surrogates and the effectiveness of various support interventions. As the conversation around mental health in surrogacy evolves, it is crucial for stakeholders to advocate for policies that protect and support the mental health of all involved.
In conclusion, while surrogacy offers a valuable option for many families, the mental health of gestational carriers must be a priority. This study serves as a call to action for healthcare systems to address these risks and ensure that surrogates receive the comprehensive care they need.
