The Journal. - Fertility Inc.: When the Surrogate Gets Left With the Bill

Episode Date: March 6, 2026

Reproductive technology is a modern miracle. It's made it possible for millions of people to become parents who might otherwise not have been able to. But growing demand has spawned a multibillion-dollar industry that’s largely unregulated in the U.S.  In our first episode looking at the wild west of the fertility industry, Ryan Knutson speaks with a three-time surrogate who ended up in a big legal battle. Nia Trent-Wilson was left with hundreds of thousands of dollars in medical debt after a family didn’t pay up after delivery. WSJ’s Katherine Long reports on how the industry fosters a dramatic power imbalance between surrogates and intended parents. Further Listening: - The Mystery of the Mansion Filled With Surrogate Children - America’s Maternal Health Crisis Sign up for WSJ’s free What’s News newsletter. Learn more about your ad choices. Visit megaphone.fm/adchoices

Over 10,000 times a year, someone in America says yes to carrying a child that isn't theirs. Nia Trent Wilson was one of them. Every time I tell somebody my story, like, I guess people are taking aback because it's not every day that you meet a surrogate. Nia lives in Houston and has her own 14-year-old son. She's also been a surrogate three times. The first experience was nothing short of amazing. The mom and the dad were at all of the appointments, and then I delivered the baby.

They named her after me. Her middle name is my name. What Nia remembers most from that time was how well the intended parents treated her. The delivery had been a complicated C-section, and the parents supported her during her recovery. They had it to where they paid out of pocket for me to have my own hotel slash recovery.

room with my own nurse, my own maid, my own chef, my own everything. And I'm just like, what is going on here? They really wanted to take care of you, it sounds like. Over the top, I've never had, like, I was not allowed to move. Like, it was almost unheard of. It's been a few years now, but Nia is still in touch with that first family. I go to a lot of the birthday party still. I go to a lot of family.

functions, I'm treated like family more than anything, and it's just an amazing experience for me. Nia sent his videos of her hanging out with a baby that shares her name. Carrie! Say Carrie. Cherit. Love you. I was able to create a family single-handedly, and to me, that became my superpower. You know, and I saw the way that I changed my intended parents, and I saw how thankful and how grateful they were.

it really, like, it really touched me. Nia went on to become a surrogate a second time and had another successful experience. So she decided to go for it again, a third time. How would you characterize the third one if you were to put it in a word or two? A nightmare. A nightmare.

The third surrogacy was a complete and total nightmare. I, and that's putting it nicely. That surrogacy would not only threaten Nia's life, but would also turn into a massive legal battle. You know, I think Nia's experience speaks as a testament to what can happen for a woman who choose to become a surrogate and the lack of safeguards that exist for those women. So I'm just grateful to be here, you know, to tell my story.

Welcome to The Journal, our show about, about money, business, and power. I'm Ryan Knudsen. It's Friday, March 6th. Over the next four Fridays, we're bringing you stories from the fringes of the fertility industry. Today, they took the baby,

she was left with the bill. This episode is brought to you by Volkswagen. Want to go electric without sacrificing fun? The Volkswagen ID4 is all electric and thoughtfully designed to elevate your modern lifestyle. It's fun to drive, with instant acceleration that makes city streets feel like open roads, plus a refined interior with innovative technology always at your fingertips.

The all-electric ID4, you deserve more fun. Visit vw.ca to learn more. SuvW, German engineered for all. Since the very first baby was born via surrogacy in 1985, the use of surrogates has exploded in America. And these days, people typically encounter the idea of being a surrogate, online. A lot of surrogates, their first entry into the world of surrogacy is through Facebook or Instagram or TikTok. Come along with me on my trip to get medically cleared as a gestational surrogate

for the second time. My colleague Catherine Long has been diving into how it all works. You know, there's a growing number of surrogacy influencers, people who are surrogates and posting about what they call their surrogacy journey. So I decided to start sharing my surrogacy journey, and I'm thinking, why not share it from the very beginning? I picked an agency. I'm going with for my next surrogate journey. Demand for surrogates is high right now, and there aren't enough people willing to do the job.

So surrogacy agencies, the companies that connect surrogates with intended parents, have gotten creative about recruitment, by using online testimonials, for example. I spent a lot of time watching people who are trying to recruit women to become surrogates. And Catherine found that running through a lot of these posts was a central message. There was often an expectation that surrogates should be doing it for the right reasons.

You have a small part in changing someone's life forever. I think at the end of the day, there is an altruistic motive. They want to help people. They want to give the gift of childhood. And so... Not because they want to just make money. Right. There's something in your heart that tells you that you are meant to do this for someone.

And now here I am. Someone's hope, and that just feels incredible, and it's a privilege. It cannot be all about the money, and it really isn't. But of course, for a lot of surrogates, the money is a huge motivator. Surrogates can make anywhere from around $30,000 to over $100,000. One surrogate I spoke to at length talked about putting it in her child's college fund. And another surrogate I spoke to talked about putting it towards legal fees because an ex was trying to retain custody of their child and she was in court fighting that out. You know, people who become surrogates are not often destitute, but they are often struggling financially. For Nia Trent Wilson, who you heard from earlier, her first surrogacy made her $30,000.

The second time, the amount ballooned to $50,000, which she says felt like a significant bump. I said, whoa. Like, it was a big, and especially carrying twins. Oh, you carried twins the second time? The second time I carried twins. Oh, my God. That's not easy. That's not easy.

And you'll never guess I had twins at 36 weeks, and they were both almost eight pounds apiece. Wow. You're able to grow some really healthy babies. Yes. It was amazing. That high of helping the kids. to build families, and not to mention the money, convinced Nia to do it again, a third time.

At first, everything seemed great. Nia spotted an ad on Facebook for an agency called Angels Creation Reproductive Center, or A-C-R-C. It had glowing reviews on Google, and the agency told Nia that she could get paid $70,000 this time. Because I'm a three-time surrogate, so every time you have a surrogacy,

most of the time it's just going to keep going up. Mm-hmm. So again, I collected my medical records. I'm doing the whole intake process. Within weeks, the agency approved Nia and matched her with a gay couple in Washington, D.C. Their names were Jason St. Floor and Ricky Lovell Scott, a lawyer and a filmmaker. What were your initial impressions of them? That they're a nice, normal couple, and that they just really long for a child.

The intended parents each wanted a genetic child. baby, which means they each wanted a donor egg to be fertilized with their respective sperm and transferred into Nia's uterus. If it worked, it meant Nia would be once again caring twins. Doctors warned that caring twins' second time would be risky, but Nia agreed to try. She signed a surrogacy contract with the intended parents, and the embryos were implanted. A few weeks later, St. Flore and Scott joined Nia for a doctor's appointment to see whether the transfer had worked. At the doctor's appointment, they discovered that only one baby took. And when they discovered that only one baby took as opposed to two, they start calling me a baby killer.

A baby killer. Nia says that one of the intended parents started rolling on the floor, crying. Well, how did you feel in that moment? A mix of emotions, embarrassed, belittled, ashamed. Like, you know, like, and I'm already pregnant, so I'm already on all of these IBF medicine. So I'm mentally, like, vulnerable right now. Now you're calling me a baby killer and you're rolling on the floor. And I'm just like, what did I do wrong? And I have to remain strong because I do have this child. So I can't buy into the emotions for a lack of better terms. I have to,

you know, I, uh, you know, carry the baby with a level of decorum because I am. am responsible for this child. And I know that being sad or not okay, it's not okay for the baby. St. Flore and Scott did not respond to requests for comment. After that day in the doctor's office, Nia says the couple's attitude towards her shifted. And they started raising questions about the agreement that Nia had signed at the start of the process, their surrogacy contract. Catherine, what kind of a contract is a surrogate like neotypically tied to?

Once a surrogate agrees to match with a parent, they will sign what's called a gestational surrogacy agreement. What that agreement does is give the intended parents the parental rights over the children the surrogate is caring. The surrogate agrees not to seek those parental rights. And the surrogate also might, depending on the contract, agree not to engage in certain activities during the pregnancy. What are the things that a surrogate could do that could result in a breach of contract? I mean, the surrogate could use drugs. The surrogate could engage in risky sexual behaviors. Surrogate could travel more than 50 miles away from her home. Surrogate could, in some extremely restrictive contracts, drink water out of a plastic water bottle.

Some contracts are very worried about that. So what happened in Nia's case? From my reading of the records that Nia has shared with me and the numerous conversations I've had with her, it seemed like from that point, Ricky and Jason started taking steps to probe whether Nia was in compliance with her contract, possibly in order to try to find her in breach.

Nia could sense that something was off, so she started documenting all of her interactions with the intended parents. They repeatedly asked her to take drug tests, which all came back negative. At one point, somebody called Nia's medical provider, and they said that it was a doctor's office, and they asked the medical provider to fax Nia's medical records to them. The person calling said their name was Gregory Lewis. When Nia found out about this, she phoned the medical provider herself.

It was a medical testing company called LabCorp. Nia recorded that call. Yesterday, there's a call from a person named Gregory Lewis. Yes. I don't know who Gregory Lewis did. Okay, but he gave us the account number. It turns out that Gregory Lewis was the name of the notary the intended parents had used for Nia's surrogacy contract.

And the address that this Gregory had given to... given to the medical provider, was actually an address associated with one of the intended parents, Jason St. Floor. If somebody has access to my records, I want to know why it was released. Nia interpreted that as the couple trying to access her medical records without authorization.

At another point, Nia got an unexpected visit at home. A social worker showed up at Nia's door and claimed that somebody had made a report that she was using drugs. she denies that she did and nothing amounted from that social worker visit. Nia suspected it was the intended parents who called the social worker, and she started to worry what could happen to her own son if St. Floor and Scott kept making these kinds of claims.

I was going to lose my child in the process of having all of this because these are some serious allegations that you're putting on me. A few months later, Nia got a diagnosis that made things even worse. At an ultrasound, Nia learned she developed a very serious, condition called placenta accreta. It's when the placenta embeds too deeply in the uterine wall. The diagnosis meant Nia could lose her uterus or even bleed to death during delivery. I asked Nia what went through her mind when she got that news.

Is that I would never be able to do this again, that like my whole surrogacy career, you know, is just done for and that I just don't want to die. And that's when I, you know, as scary as it sounds, is that I start making preparations like with my mom, my son, and my will, everything. And so I wanted to make sure that all my affairs were in order. Those are some of the things that went through my mind. Then, a few weeks later, Nia went into labor. She let the intended parents know. I'm telling the intended parents that, hey, I'm in the hospital.

I'm thinking I'm about to give birth. They start arguing. They said you weren't supposed to come. The baby wasn't supposed to come to this day. How did the baby come early? What did you do? And I'm just like, are you kidding me right now? Nia was bleeding internally and was rushed to an emergency C-section.

I go to delivery. I'm on this cold table and they're going to deliver the baby. And the doctor, he's like, hey, I'm going to see how much of this I can salvage or, you know, or whatever. They're like, we don't know what we're walking into. And the next thing, you know, I just wake up for maybe about half of a second, and they're like, Mia, tell the baby goodbye. And I'm like, you know, I tell the baby bye. The baby was a girl, and she was quickly whisked away.

Nia was not doing well. And they turn up the sedation even more because they're like, it's bad. And they're like, you know, so the crash card start coming in there, everything. That's the only thing I remember. and I know I was in surgery for a total of maybe six hours to save my life. Nia's internal bleeding was bad. The doctors had to remove her uterus and fallopian tubes. She'll never be able to carry a child again.

Nia says the doctors moved her to the orthopedic floor to recover so that the parents, St. Flora and Scott, wouldn't be able to find her. In the end, St. Flora and Scott went home with the baby. But Nia's nightmare was far from over. I knew that after I had the hysterectomy and they had the baby, they walked away. I said, oh yeah, they're not going to pay me. And I was right. They didn't pay me.

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Business. Despite the fact that surrogacy is a multi-billion dollar industry, it's largely unregulated. And that makes the contract between the surrogates and the intended parents super important. Because if conflict arises, it's what's in the country. contract that matters. One of the key things the contract does is lay out the terms of when and how the surrogate gets paid. In Nia's case, the intended parents, Jason St. Flore and Ricky Scott, initially put $95,000

into an independent escrow account. That should have been enough money to cover just about everything, had the pregnancy gone smoothly. But it didn't. For instance, after Nia's placenta accreted down. diagnosis, her doctors put her on eight weeks of bed rest. According to Nia's contract, the intended parents should have put more money into the escrow account to cover her lost wages and child care costs. They also should have compensated Nia for any complications,

like her hysterectomy. According to legal documents, the intended parents didn't do any of that. And by the time Nia delivered the baby, the escrow account was nearly empty. My contract says, like, after I delivered, the full amount is due, and the full amount due to me, still with the complications, with the rest of the money owed, it was almost like $75,000. Wow. You're still old $75,000 and there was nothing left in escrow. With the escrow account depleted, there wasn't enough money to pay for NIA's health insurance. Meaning, Nia didn't have coverage during her C-section in roughly six-hour surgery. Ultimately, Nia is now on the hook for all the medical bills, $182,000.

What recourse is there for a surrogate who has an experience like this where they're not paid what the contract says they're owed? Well, I mean, the most immediate recourse would be for her to hire an attorney and sue the parents. There's a couple of issues with that in this case. I mean, one that's common to most surrogates is that, you know, as, as we've discussed. Surrogates often are not the most financially liquid people. It's difficult for them to find an attorney who's going to take a case on contingency. The number of attorneys who feel confident practicing surrogacy law is quite small, and often those attorneys are

practicing law in such a way that privileges relationships with parents and surrogacy agencies over surrogates. Ania had another problem. In her case, the parents weren't even worth suing. Because it turns out, According to Catherine's reporting, Jason St. Floor and Ricky Scott were broke. What I know from legal records is that in the months preceding his contract with ACRC, Ricky Level Scott took out a $60,000 loan. He only paid $7,000 of that loan. It's not clear to me whether that money was going towards the surrogacy journey, whether he took that $60,000 and put it into NIA's escrow account.

But it does speak to a pattern. of this couple taking out loans or not paying what they owe and then facing very little judgment. The lender, SoFi, tried to sue Scott but had to drop its claim because it couldn't locate him to serve him the complaint. Eventually, Nia was able to find an attorney to help pursue the surrogacy agency, ACRC.

She alleged that the agency breached its contract with her by matching her with unsuitable parents. ACRC denies the allegation. Nia sent me email chains and text messages she had with the agency and the parents. And what was apparent to me was that the agency that Nia had worked with, they had stepped back from taking any kind of active role in managing her relationship with the parents. Right, what's amazing to me about this story is that, like, she could see what was happening around her, and yet she felt like there was nothing.

that she could do. Yeah, that's right. I mean, some of the text messages she shared with me between her and the agency, it sounded like she was asking them over and over again. Like, what can you do? Like, how can you help me? Every time that something will go on, I was reporting it. I was telling them, like, and that's what upset me a lot with the surrogacy agency

because I'm telling them what's going on. I'm email and I'm calling. And I'm like, I'm in fear for my life. I have maybe at this time two, three police reports with stalking, harassment, and nothing. In an email, ACRC said the agency had remained in communication with Nia throughout the surrogacy process, and that they provided assistance when concerns were raised. When Nia finally had her day in court, the head of the agency testified in court that really the only thing the agency cared about when they chose to contract with Ricky and Jason

was whether Ricky and Jason would be able to fully fund. the escrow account. In other words, whether they'd be able to put up Nia's $70,000 fee and some extra money on top of that. And they were. And at that point, the agency considered them cleared. They were good to go. In court, ACRC's CEO, Shen Li, said the agency believed the intended parents' ability to place so much money at once into the escrow account was sufficient proof of their financial suitability. Ultimately, the judge sided with NIA and ordered ACRC to pay her $41,000. In his ruling, the judge called out the power imbalance between surrogates and agencies. He said that ACRC was able to make money by treating NIA's body as a, quote, profit-venturing

business, and that the company itself didn't take on much risk during the surrogacy. In an email to the journal, the CEO said, quote, ACRC remains committed to ethical and responsible surrogacy practices into supporting both surrogates and intended parents through what is often a deeply personal process. Nia is still deeply in debt from her third surrogacy. She says she's thinking about the entire industry a lot differently now. My perception of it has changed because now, if you do wrong, there's nobody to report you to, there's nobody to shut you down.

They're just like, oh well, and you can continue to keep ruining people's lives and just pick up shop and go across the street. and start it all over again. I mean, it's kind of amazing because, like, successful surrogacy is, like, the highest high. Like, you bring life into this world. You know, you can help a family become a family, you know. But then also, like, it has the lowest low. Right.

And it can also ruin lives as well. Yes. Absolutely. I can't even imagine what that almost have been like for you. And I think I still haven't fully processed it because believe it or not I'm still trying to deal with everything right now So I've had like no break believe it or not Like I'm still trying to work through everything that's going on right now

What I left this story with was a feeling that there's very few protections For women who choose to be surrogates Many of them Many of them bear children and have excellent relationships with the families they work with, and it's not a problem. But the minority who have truly terrible experiences, there's very little that can be done to prevent that. And it also speaks to, I think, the way that the fertility industry has encouraged and in some ways institutionalized an imbalance of power between people who are trying to have children and the people

who are helping them do so, people like Nia, the surrogates who are stepping up and choosing to make this part of their livelihoods. kind of makes me think about what you said in the beginning about how all the agencies and the people that are promoting surrogacy say, make sure you're doing it for the right reasons. It should just be that you want to give a gift to somebody. I mean, at the end of the day, this is a business, and it's governed by contract law. It's not a gift. Next Friday, we're continuing our investigation into the fertility industry and how it can all go wrong. I looked at my husband, and he just goes, our money's gone.

This time, for the intended parents. And I was like, no, there's got to be a mistake. Like, we're fine. There's got to be a mistake. There was absolutely no mistake. Our money was gone. That's all for today. Friday, March 6th. The journal is a co-production of Spotify

and the Wall Street Journal. The show is made by Catherine Brewer, Victoria Dominguez, Pia Gedkari, Isabella Jopal, Sophie Kodner, Matt Kwong, Jessica Mendoza, Annie Minof, Laura Morris, Enrique Perez de la Rosa, Sarah Platt, Alan Rodriguez Espinosa, Heather Rogers, Pierce Singey, Lisa Wang, Catherine Whalen, Tatiana Zamiz, and me, Ryan Knudson. This episode was produced by Jiva Kvurma and edited by Colin McNeulty.

Our engineers are Griffin Tanner, Nathan Singapok, and Peter Leonard. Our theme music is by So Wiley, and the theme in today's episode was remixed by Peter Leonard. Additional music this week from Catherine Anderson, Peter Leonard, Bobby Lord, Nathan Singapok, So Wiley, and Blue Dot Sessions. Fact-checking this week by Mary Mathis and Kate Gallagher. Thanks for listening. See you Monday.