Lou Portero

Urban Health Today

Research published in <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836835">JAMA Network Open</a> reveals that women serving as gestational carriers experience significantly higher rates of new-onset mental illness compared to other pregnant women, highlighting important considerations for reproductive health counseling and support services.
The comprehensive study by Maria Velez and colleagues from McGill University analyzed 767,406 pregnancies in Ontario, Canada, between 2012 and 2021. Among these, 758 involved gestational carriers who were compared with women conceiving naturally and through in vitro fertilization. The research found that gestational carriers developed new mental illnesses at a rate of 6.9 per 100 person-years, compared to 5.2 for unassisted conception and 5.0 for IVF recipients.
After adjusting for factors including age, income, obesity, and chronic conditions, gestational carriers showed a 43% increased risk of mental illness compared to women with unassisted conception and a 29% increased risk compared to IVF recipients. The elevated risk persisted throughout pregnancy and extended into the postpartum period, with the median diagnosis occurring approximately 2.4 years after conception.
The study population revealed distinct demographic patterns among gestational carriers. These women were more likely to be parous, with 91.2% having previous children compared to 57.9% of the natural conception and 34.1% of the IVF groups. They also demonstrated higher rates of obesity at 36.1% versus 17% in both comparison groups and were more likely to reside in lower-income areas.
Particularly concerning for women’s health providers, gestational carriers required emergency department or hospital-based mental health care at nearly double the rate of IVF recipients. This finding suggests more severe mental health crises requiring immediate intervention during a vulnerable reproductive period.
The research identified potential contributing factors, including emotional challenges of maternal-infant separation, complex relationships with intended parents, and social scrutiny surrounding surrogacy decisions. Additional analysis revealed that the mental health impact was most pronounced when comparing gestational carriers to women cohabiting with their infants at 12 months postpartum, suggesting separation-related psychological stress.
Current guidelines require psychological evaluation by qualified mental health professionals before gestational carrier approval, yet 19% of carriers in this study had documented mental illness histories. This raises questions about screening effectiveness and the need for enhanced psychological support throughout the process.
The findings emphasize the importance of comprehensive mental health monitoring extending beyond typical postpartum care. While standard recommendations suggest screening up to one year postpartum, evidence indicates women may experience mental health symptoms up to four years post-delivery, particularly relevant for gestational carriers given their elevated risk profile.
 
<div class="post-references"><h3>References</h3>Velez MP, Dayan N, Vigod SN, et al. New-Onset Mental Illness Among Gestational Carriers. JAMA Netw Open. 2025;8(7):e2523428. doi:10.1001/jamanetworkopen.2025.23428
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836835
</div>

Research published in <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836835">JAMA Network Open</a> reveals that women serving as gestational carriers experience significantly higher rates of new-onset mental illness compared to other pregnant women, highlighting important considerations for reproductive health counseling and support services.The comprehensive study by Maria Velez and colleagues from McGill University analyzed 767,406 pregnancies in Ontario, Canada, between 2012 and 2021. Among these, 758 involved gestational carriers who were compared with women conceiving naturally and through in vitro fertilization. The research found that gestational carriers developed new mental illnesses at a rate of 6.9 per 100 person-years, compared to 5.2 for unassisted conception and 5.0 for IVF recipients.After adjusting for factors including age, income, obesity, and chronic conditions, gestational carriers showed a 43% increased risk of mental illness compared to women with unassisted conception and a 29% increased risk compared to IVF recipients. The elevated risk persisted throughout pregnancy and extended into the postpartum period, with the median diagnosis occurring approximately 2.4 years after conception.The study population revealed distinct demographic patterns among gestational carriers. These women were more likely to be parous, with 91.2% having previous children compared to 57.9% of the natural conception and 34.1% of the IVF groups. They also demonstrated higher rates of obesity at 36.1% versus 17% in both comparison groups and were more likely to reside in lower-income areas.Particularly concerning for women’s health providers, gestational carriers required emergency department or hospital-based mental health care at nearly double the rate of IVF recipients. This finding suggests more severe mental health crises requiring immediate intervention during a vulnerable reproductive period.The research identified potential contributing factors, including emotional challenges of maternal-infant separation, complex relationships with intended parents, and social scrutiny surrounding surrogacy decisions. Additional analysis revealed that the mental health impact was most pronounced when comparing gestational carriers to women cohabiting with their infants at 12 months postpartum, suggesting separation-related psychological stress.Current guidelines require psychological evaluation by qualified mental health professionals before gestational carrier approval, yet 19% of carriers in this study had documented mental illness histories. This raises questions about screening effectiveness and the need for enhanced psychological support throughout the process.The findings emphasize the importance of comprehensive mental health monitoring extending beyond typical postpartum care. While standard recommendations suggest screening up to one year postpartum, evidence indicates women may experience mental health symptoms up to four years post-delivery, particularly relevant for gestational carriers given their elevated risk profile. <div class="post-references"><h3>References</h3>Velez MP, Dayan N, Vigod SN, et al. New-Onset Mental Illness Among Gestational Carriers. JAMA Netw Open. 2025;8(7):e2523428. doi:10.1001/jamanetworkopen.2025.23428
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836835
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gestational carriers developed mental illness at rates of 6.9 per 100 person-years, compared to 5.2 for unassisted conception