Surrogates more likely to be diagnosed with mental illness, study finds 

Montreal, QC, July 25, 2025 – People who are gestational carriers (or “surrogates”) appear more likely to be diagnosed with a new mental illness during and after pregnancy, according to new research from ICES, McGill University, and the Research Institute of the McGill University Health Centre. 

As the number of births by surrogacy increases, this is the first large study using Ontario-based health data to explore the mental health challenges faced by some surrogates. 

Despite guidelines requiring mental health screening, the researchers found that nearly 1 in 5 gestational carriers had a prior mental illness diagnosis before pregnancy—including some with serious conditions that may have made them ineligible to carry a pregnancy for someone else. 

“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,” says lead author Dr. Maria Velez, an adjunct scientist at ICES, associate professor at McGill University, and scientist at the Research Institute of the McGill University Health Centre. 

The study, published in JAMA Network Open, included 767,406 births at more than 20 week’s gestation in Ontario, Canada between 2012 and 2021 among women without known mental illness before pregnancy. Comparison groups included 97.6% (748,732) who were conceived without assistance, 2.3% (17,916) by IVF and 0.1% (758) using gestational carriers. 

Gestational carriers were more likely to have previously given birth, resided in a lower-income area, and had higher rates of obesity and chronic hypertension. 

Adequate mental health support needed 

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 findings were even more pronounced for mental illness that was newly diagnosed through an emergency department encounter or a hospitalization, compared to an outpatient mental illness diagnosis. 

“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,” says Velez. 

The authors say that they hope this study will inform future guidelines that ensure adequate mental health support for gestational carriers during and after pregnancy. 

FOR FURTHER INFORMATION PLEASE CONTACT: 
Misty Pratt
Senior Communications Associate, ICES
[email protected]
343-961-6982 

ICES is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on BlueSky and LinkedIn: @ICESOntario 

The Research Institute of the McGill University Health Centre (The Institute) is a world-renowned biomedical and healthcare research centre. Affiliated with the Faculty of Medicine and Health Sciences of McGill University, The Institute is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to provide complex care to its community. The Institute supports over 700 researchers and close to 1,400 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities, including the Centre for Translational Biology, the Centre for Innovative Medicine and the Centre for Outcomes Research and Evaluation, offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at advancing precision health throughout the life course. The Institute is supported in part by the Fonds de recherche du Québec (FRQ). rimuhc.ca