Contractual rights of both the intended parents and surrogate are key provisions to include in a surrogacy contract. In addition to this, medical decisions are also crucial to specify in the agreement. It is important to have all medical agreements specifically stated in the contract so all parties involved know what to expect and are clear on the terms.

An important medical decision to make is the choosing of medical providers. This is an obvious one, yes, but both the surrogate and the intended parents should be in agreement about who will be the medical providers during the surrogacy. The reason such agreement is essential is because when it comes time to make medical decisions, it will be important for all parties to pay close attention to the physicians' advice and recommendations. If there is agreement on the doctors, then there will be a common goal to follow the advice of the medical providers. Medical providers can include, but are not limited to, the reproductive endocrinologist (the infertility physician) and the obstetrician.

The surrogacy contract should also address the issue of medical decision-making. Even though the surrogate has the right to make decisions concerning her body and physical wellbeing, she is agreeing in the contract that it is her intention to follow the decisions of the intended parents when it comes to the pregnancy. An example would be if the intended parents requested genetic testing or if the intended parents requested that the surrogate take medication or refrain from taking medication.

Once there is a pregnancy, there may be other matters to address. For example, if there is a pregnancy with a serious birth defect, will the intended parents wish to terminate the pregnancy? If the surrogate conceives triplets, what will the intended parents wish to do - consider maintaining the pregnancy or consider selective reduction? The intended parents must work closely with their agency and get to know their surrogate so that these issues, if they arise, may be solved in a positive and synergistic manner.