Mental Health Evaluations in Surrogacy: Insights from Karyn Rosenberg on The Surrogacy Space Podcast

Feb 19, 2025

In a recent episode of “The Surrogacy Space” podcast, I had the pleasure of interviewing Karyn Rosenberg, LCSW, PMH-C, a psychotherapist, hypnotherapist, and EMDR therapist who specializes in supporting individuals and families in the fertility and surrogacy journeys. Based in both Florida and North Carolina, Karyn offers valuable mental health support to surrogates, intended parents, and those navigating the emotional complexities of surrogacy. While she primarily works with clients in these two states due to licensure requirements, Telehealth has allowed her to extend her services to clients across the country.

One of the key topics we discussed was the role of mental health evaluations in surrogacy. Karyn emphasized that these evaluations, while not designed to diagnose any psychopathology, are crucial for ensuring both surrogates and intended parents are fully prepared for the emotional and psychological aspects of the journey. She follows the American Society for Reproductive Medicine (ASRM) guidelines, which she considers the gold standard in fertility and surrogacy support.

For Surrogates: What’s Involved in the Evaluation?

The evaluation for surrogates is thorough and designed to assess their overall mental health and readiness. Karyn begins with a psychosocial background assessment, which includes understanding the surrogate’s upbringing, education, career, support system, stress management, and medical history. This includes prior pregnancy losses, any pregnancy complications, and postpartum experiences. Partners or spouses of surrogates are also required to participate in the evaluation.

A key element of the evaluation is mental health screening. This includes reviewing any history of depression, anxiety, trauma, or prior psychiatric hospitalizations. Karyn also ensures that surrogates understand the sensitive topics of abortion and pregnancy reduction, emphasizing that while surrogates may have personal feelings about these issues, the wishes of the intended parents must take precedence. The goal is to align expectations and create a clear understanding of the emotional responsibilities involved.

These evaluations typically last about an hour, with an additional 45-minute psychological testing component (such as the MMPI or PAI) to assess mental health in more depth.

For Intended Parents: What’s Assessed?

Intended parents also undergo a psychosocial assessment, which mirrors that of the surrogate’s evaluation. This includes background information, family dynamics, education, work history, stress management, and their support system. Karyn digs deep into the emotional aspects of their surrogacy journey, discussing the complexities of their desires for the relationship with the surrogate, their views on pregnancy termination and selective reduction, and their plans after birth.

One significant part of the intended parent evaluation involves discussing how they will disclose the child’s donor conception to the child. Karyn provides valuable resources for age-appropriate conversations, advising transparency from the start—especially as anonymity becomes less realistic in an age where DNA testing is so accessible.

The Importance of Early Evaluations

Although not legally required, Karyn stressed the importance of these evaluations. They provide a vital space for important, sometimes difficult, conversations that may not otherwise occur. Surrogates, for example, may return for counseling during or after pregnancy to address the emotional challenges they face. While rare, evaluations may result in a recommendation not to proceed with a match if there are significant concerns about compatibility or psychological readiness.

Karyn encourages all parties to schedule evaluations early in the process to prevent last-minute stress and ensure everyone feels emotionally prepared.

Takeaway

In conclusion, mental health evaluations in surrogacy are essential for establishing a healthy, open, and supportive relationship between all parties. Karyn’s approach aligns with ASRM guidelines and provides a comprehensive, holistic view of what it means to be psychologically prepared for the journey. Whether you’re a surrogate, intended parent, or someone considering surrogacy, understanding the mental health aspect of the process is key to a successful experience.

If you have questions or want to learn more about the mental health aspects of surrogacy, feel free to reach out to me at [email protected]. You can also listen to the full podcast episode with Karyn Rosenberg here.

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Mental Health Evaluations in Surrogacy: Insights from Karyn Rosenberg on The Surrogacy Space Podcast

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