Surrogacy in Maryland: The Complete 2026 Guide

Maryland has no comprehensive surrogacy statute — which usually signals a state where everything depends on your attorney and the county. Maryland is a partial exception, for an unlikely reason: its birth registration law names gestational carriers and builds a procedure around them, added in 2021. With the parentage order in time, Health-Gen. § 4-208 has the carrier's information sealed on separate state forms and the certificate registered per the court's order — mechanics below.

The rest of what the state offers:

• No genetic requirement. Practitioners report Maryland permits gestational surrogacy whoever the gametes came from — with no marriage or gender requirement, including for single intended parents.
• Pre-birth parentage orders as the norm, entered on petition, usually without a hearing.
• Decades of practice. AAAA reports that gestational surrogacy has been practiced here for decades with courts upholding the agreements — though no statute guarantees enforceability.
• Serious fertility infrastructure across the Baltimore–Washington corridor, including one of the country's largest donor egg programs.

What it does not have is a statute confirming that carrier compensation is permitted — that position rests on an argument your attorney should walk you through, stronger for gestational than for traditional arrangements. And one point to know early, reported by practitioners rather than set by statute: an order rests on a party's Maryland residency or a Maryland birth — not on the IVF clinic being here.

Maryland has no comprehensive statute governing gestational surrogacy agreements or establishing their enforceability. What it has instead: a 2007 Court of Appeals decision that reads the parentage statutes through the state's Equal Rights Amendment, and a birth registration statute that names gestational carriers explicitly — added by the General Assembly in 2021.

What the statutes and published cases establish

• The birth records statute has a dedicated gestational carrier pathway. Md. Code, Health-Gen. § 4-208(a) defines "gestational carrier" outright. Where parentage is determined by a court, the carrier's identity and medical information go on forms provided by the Secretary, the order is attached, and Vital Records "shall immediately" seal the forms and register the certificate of birth in accordance with the order of the court.
• Two routes, decided by timing. The sealed-forms route works where the order is in hand for the original filing; where it comes later, § 4-211 provides the new-certificate route. Ask counsel to sequence the petition against the delivery date.
• The foundational case. In In re Roberto d.B., 399 Md. 267 (2007), the Court of Appeals held that Maryland's Equal Rights Amendment requires the paternity statutes to be "construed to apply equally to both males and females," and that a trial court may order a certificate containing only the father's name. Three judges dissented. Read its scope carefully: the intended father there was genetically related, so the decision is authority for removing a non-genetic carrier from the certificate — not a holding that non-genetic intended parents acquire parentage. That broader position rests on practice built on top of the case.

What practitioners report in routine cases

• Agreements upheld in practice. The Academy of Adoption & Assisted Reproduction Attorneys reports: "Maryland surrogacy agreements can be enforced in Maryland. There is no statutory mechanism guaranteeing enforceability; however, gestational surrogacy has been practiced in Maryland for a number of decades with the courts upholding the agreements."
• No eligibility test in practice. Practitioners report no marriage, gender, or genetic-connection requirement — including for a single intended parent. AAAA states that "Maryland permits gestational surrogacy, no matter whose gametes are used, including donor sperm, eggs or embryos."
• Pre-birth orders are routine, entered on petition, with a post-birth order available in the same case if requested. A hearing is not usually required.
• Residency or birth — not the clinic. Practitioners report an order is available where only the carrier resides in Maryland, or where only the intended parents do; where the only Maryland connection is the birth, pre-birth relief may depend on the judge; and where the only connection is the IVF clinic, an order is not available. These are reported outcomes, not a rule stated in a statute, court rule, or published decision — have counsel confirm the specific court.
• Consistency, timing, and formats. AAAA reports that results do not vary by venue — treat that as the reported norm rather than a guarantee. Out-of-state orders are generally honored but must be registered. Expect the certificate about a month after delivery. Same-sex parents are listed as "Parent and Parent."

Needs case-specific advice

• Traditional surrogacy. AAAA reports it "is permitted in Maryland, but may be legally risky": because the carrier is the genetic mother, a second-parent or step-parent adoption is needed to terminate her rights and establish parentage for a spouse of the biological father — which pulls the arrangement into the adoption rules below, and the 2000 Attorney General opinion discussed there is at its most adverse for paid traditional arrangements. Ivy's programs are gestational.
• Compensation is the part of Maryland law that needs your attorney, not a guide. Two statutes bear on payment. Fam. Law § 5-3B-32 provides that "a person may not charge or receive, from or for a parent or prospective adoptive parent, any compensation for a service in connection with: (1) placement of an individual to live with a preadoptive family; or (2) an agreement for custody in contemplation of adoption," with narrow exceptions for counseling, hospital, legal and medical charges, pregnancy-related transportation, court-appearance expenses, and physician-certified living expenses — a misdemeanor. Criminal Law § 3-603 bars selling, bartering, or trading a minor for value — a felony, up to five years or $10,000 per violation.

Do not read those as inapplicable simply because one mentions adoption. In Roberto d.B. the Court of Appeals said, in the course of the opinion, that "surrogacy contracts, that is, payment of money for a child, are illegal in Maryland," citing both statutes and State v. Runkles (child-selling prohibition "not limited to payments connected with an adoption"). Dicta — but it is the state's highest court describing these statutes as reaching surrogacy payments.

What cuts the other way. A formal Attorney General opinion, 85 Op. Att'y Gen. 348 (2000), concluded that payments in traditional surrogacy "would violate both Maryland statutes in most circumstances" — but reasoned separately about gestational arrangements: because the intended parents would have the presumed right to custody, "there would be a strong argument that payments under the agreement were not for the purchase of custody of the child." Its caveat that no Maryland law then addressed parentage in this context has partly aged: the General Assembly added § 4-208's gestational carrier provisions in 2021, and AAAA reports that gestational surrogacy has meanwhile run for decades with courts upholding the agreements and that "in practice, Maryland allows paid gestational surrogacy, but it is not statutory."

The practical upshot: no statute naming surrogacy prohibits compensation — but none permits it either, so the position rests on an argument, materially stronger for gestational than for traditional arrangements. Have Maryland counsel review your structure against § 5-3B-32, § 3-603 and the Roberto d.B. language before signing.

• Donation, ART parentage, and what remains open. Maryland is not silent on assisted reproduction — Fam. Law § 5-1001 contains donor rules, § 5-1028 recognizes shared-intent ART parentage by affidavit, and Estates & Trusts §§ 1-206 and 1-208 address consent-based parentage — but none of it settles parentage in a gestational carrier case. In Sieglein v. Schmidt (2016) the Court of Appeals construed ART parentage beyond genetics but expressly left open whether it reaches gestational surrogacy; none of the decisions cited in this guide establishes a parentage rule for every configuration, particularly where neither intended parent has a genetic link. Donor arrangements should be papered by Maryland counsel rather than assumed.

General information, not legal advice. Maryland surrogacy agreements and parentage petitions should be handled by a licensed Maryland attorney experienced in assisted reproduction.

Maryland imposes no statutory eligibility test, and AAAA describes it as "very ART friendly." Three things to settle.

• Your family structure is very unlikely to be the obstacle. Practitioners report no marriage, gender, or genetic-connection requirement — including with a donated embryo, and including for a single intended parent.
• Where will the case be filed? Practitioners report that Maryland parentage orders rest on a party's Maryland residency or a Maryland birth — but not on the IVF clinic being the only Maryland connection, and where only the birth is here, pre-birth relief may depend on the judge. If your clinic is here but nobody lives here, raise it early rather than assuming the clinic anchors the case.
• Coming from out of state, or bringing an order in? Practitioners report out-of-state parentage orders are generally honored in Maryland but must be registered. If your journey crosses state lines — common in the DC metro area — have counsel plan which state's court is doing the work before the contract is signed.

Expect the Maryland birth certificate about a month after delivery. Our Surrogacy by State comparison shows how Maryland sits against the alternatives.

These are Ivy's quoted figures as of August 2026, not statewide averages:

• The surrogacy journey itself (~$140,000–$150,000). Agency fee, surrogate compensation, legal and escrow services, and health insurance — matching and contracts through pregnancy, delivery, and postpartum care. The Maryland parentage petition sits inside the legal line.
• IVF and embryo creation (~$40,000, billed by the clinic). Stimulation, retrieval, embryo culture, transfer, and optional PGT-A testing. Billed separately from the surrogacy budget above.
• Egg donation (if needed, ~$30,000+). Donor coordination, compensation, legal work, and related expenses.

Putting it together: surrogacy only ≈ $140,000–$150,000; surrogacy + IVF ≈ $180,000–$190,000; surrogacy + IVF + egg donation ≈ $210,000–$220,000+. For breakdowns and sample payment schedules, see our surrogacy cost guide and egg donation cost overview.

Unlike states that route a non-genetic intended parent through a post-birth adoption, practitioners report that a Maryland gestational journey is normally a single legal proceeding — so there is usually no second set of court costs to budget for. Confirm that with your attorney for your own structure rather than assuming it.

Your funds sit with an independent escrow company or attorney trust account, never with the agency itself — we've written about why in-house escrow is a red flag.

A Maryland journey follows the standard gestational surrogacy arc. What is state-specific sits at the parentage and birth-registration stages.

1. Matching. Counsel confirms which state's law applies and, if the journey crosses state lines, which court will do the parentage work.
2. Screening. Records review, IVF-clinic medical screening, and psychological evaluation; a partner is screened too.
3. Contracts. Each side has independent counsel — at Ivy the intended parents pay for the surrogate's; clinics require both, signed, before a cycle.
4. Cycle and transfer. Lining-preparation medications only: no ovarian stimulation, no retrieval, then transfer at the clinic.
5. Pregnancy. Payments flow from escrow on schedule, running monthly from confirmation of a fetal heartbeat; care moves to an OB around 8–10 weeks.
6. Pre-birth parentage order. Your attorney petitions the court; a hearing is not usually required. Timing matters — see the next step.
7. Birth registration. With the order in hand for the original filing, the carrier's information is recorded on state forms that Vital Records seals, and the certificate is registered in accordance with the order. Where the order is entered later, § 4-211's new-certificate route applies instead.

Most journeys take one to two years. Expect the certificate about a month after delivery.

Maryland has no comprehensive surrogacy statute, so your protections come from your contract, your own attorney, and escrow — but the state's birth records law does one thing for you directly.

• Sealed rather than printed — when the order is in time. With the parentage order in hand for the original filing, your identity and medical information go onto separate forms that Vital Records seals, and the certificate is registered per the court's order. Where the order comes later, a new certificate is issued instead. Ask your attorney which route your case will use.
• At Ivy, your attorney is paid for by the intended parents and works for you alone, including on the medical decision-making and termination clauses. Subject to Maryland law, you remain the patient and keep the authority to consent to or refuse care. A contract cannot compel a procedure or hand your consent to someone else.
• Gestational only. Traditional surrogacy — using your own egg — is a different legal situation in Maryland and carries risks that gestational arrangements do not. Ivy's programs are gestational, meaning the embryo is not genetically yours.
• Tell the team early where you plan to deliver, and promptly if that changes — practitioners report that Maryland orders rest on a party's residency here or a Maryland birth.
• Have your health insurance reviewed professionally before you sign. Many policies exclude surrogacy, and that review belongs at the contract stage, not after a positive test.

The application takes about ten minutes.

Maryland sets no statutory age, residency, prior-birth, or marital rule for gestational carriers. The requirements that decide whether you can carry come from clinics and agencies. Ivy's guidelines:

• Age 20–36. You can apply at 20; screening and matching take months, so you'll typically be 21 or older by the medical process.
• At least one healthy, full-term pregnancy of your own, currently raising your child.
• BMI of 32 or below.
• No more than 2 C-sections, and no more than 5 total deliveries. These come from IVF clinic requirements rather than from state law; the treating clinic reviews your obstetric history and applies its own criteria.
• No smoking, vaping, or THC use — at least 6 months clean, verified by clinic testing.
• Financially stable and not relying on public assistance.
• U.S. citizen or permanent resident (green card) with a stable living situation.

The clinic then screens too: communicable disease, a current normal Pap, obstetric records, the uterus, and written psychological screening.

After a vaginal delivery you can apply as early as 3 months postpartum; C-section recovery takes longer. Unsure whether something disqualifies you? Ask before you self-reject — the application is the fastest route to an answer.

At Ivy, first-time base compensation in Maryland is $40,000, with $45,000–$50,000 for a second journey and $55,000–$60,000 for a third or more — for proven surrogates, we're open to discussing beyond that. Total packages, with allowances and milestone payments, run $50,000–$100,000+. Payments are held by an independent escrow company or attorney trust account — funded before you start medications, and disbursed monthly from confirmation of a fetal heartbeat on your contract's schedule. The full structure is on our compensation page, and your personalized estimate comes before you commit to anything — start your application to get it.

No Maryland statute sets or caps what a gestational carrier may be paid. AAAA reports that Maryland permits both expenses and fees to be paid, that "in practice, Maryland allows paid gestational surrogacy, but it is not statutory," and that gestational surrogacy has run here for decades with courts upholding the agreements. No statute says compensation is permitted, and two provisions (Fam. Law § 5-3B-32 and Criminal Law § 3-603, with adverse language in In re Roberto d.B.) mean the payment structure belongs in front of Maryland counsel before anything is signed. The full analysis is in the legal section above. Confirm with your attorney how and when each payment is triggered, and what happens if the medical picture changes.

Maryland's fertility infrastructure runs along the Baltimore–Washington corridor:

• Shady Grove Fertility — Rockville, Columbia, Towson, Annapolis and other Maryland offices; runs one of the largest donor egg programs in the country
• Johns Hopkins Fertility Center — Baltimore metro, including Green Spring Station in Lutherville and Howard County; publishes gestational carrier information
• University of Maryland Medical Center — Reproductive Endocrinology — Baltimore; confirm carrier services directly

Locations and services change, so confirm current offerings directly with the clinic. Which clinic you use usually follows where your embryos are created, not where the surrogate lives: embryos can be shipped in, or she can travel to your existing clinic.

One Maryland point worth knowing: practitioners report that the location of your IVF clinic does not by itself support a Maryland parentage order. Tell your attorney where everyone actually lives.

• Statutes: Health-Gen. § 4-208 (birth registration; defines "gestational carrier" and sets the sealed-forms procedure where a court determines parentage), Health-Gen. § 4-211 (new certificate on a parentage, legitimation or adoption order), and Fam. Law § 5-3B-32 (compensation in connection with adoption).
• Case law: In re Roberto d.B., 399 Md. 267, 923 A.2d 115 (2007) — Maryland's Equal Rights Amendment requires the parentage statutes to apply equally to both sexes; a trial court may order a birth certificate naming only the father.
• Birth certificates: Maryland Division of Vital Records.
• Attorneys: the AAAA directory lists Maryland fellows.
• Compare states: Surrogacy by State, North Carolina, Tennessee, New Jersey, California.