Inside an unregulated industry: How one reporter covered a surrogacy tragedy

Surrogacy is largely unregulated in the U.S. There's no federal oversight, and in many states surrogacy exists in a legal gray zone - allowed only because legislators have never addressed it directly. Clinics, agencies, and psychologists often pass responsibility back and forth, leaving intended parents and surrogates to assume safeguards exist when, in fact, they often don't. The result is a patchwork system where some of the most sensitive and high-stakes decisions in reproductive health unfold with limited accountability.

Freelance journalist Emi Nietfeld brought these systemic gaps into focus in her feature for Wired, "The Baby Died. Whose Fault Is It? " The story traces the tragic stillbirth of a child born through a surrogacy arrangement, the legal and personal fallout between intended mother Cindy Bi and surrogate Rebecca Smith, and the broader implications for reproductive technology in the U.S.

Nietfeld's reporting offers lessons in navigating contested medical evidence, handling unequal access to sources, and responsibly framing both risk and regulation in stories that touch deeply personal lives.

Nietfeld spoke about how she approached the reporting process, what she uncovered about the surrogacy industry, and what advice she has for others covering reproductive health and science.

This interview has been edited for clarity.

How did you gain access to such sensitive materials and persuade people to talk?

I first met Cindy Bi through a founder she knew, and she was eager to have her story told. She'd been documenting everything - screenshots, emails, litigation filings - and was very forthcoming in sharing those with me.

One thing I've learned is that many people will say they want to tell their story, but very few come back with documents. Early on, I told Cindy that was something I'd need, and she had kept meticulous records. That gave me a foundation to build the reporting.

Once you had the documents, how did you fact-check medical and legal claims?

Condé Nast has a full fact-checking process, so we requested comments from people and institutions named. I also pulled the lawsuit filings directly from the California court system to confirm details. I spent two weeks adding hundreds of annotations to the draft which pointed to the original sources.

With medical and legal claims, I tried to be clear with readers: here's what one side alleges, here's what the other side disputes, and here's what can be confirmed in official records. For example, one party claimed in a lawsuit filing that she'd nearly died during a C-section, but without access to the medical records, I framed it as part of her legal filing, not as a verified fact.

How long did this story take to report, and how did you manage it as a freelancer?

I started talking to Cindy in October and got the official assignment in April. I thought it would be short, but it took much longer because of the sheer volume of documents. I wish I had applied for fellowship support - I did get help from the Freelance Investigative Reporters and Editors group, which was invaluable. In the end, even though it was my first long feature, I felt I owed it to the story to do everything I could: interview additional people, track down more sources, and follow the reporting wherever it led.

How did you ensure fairness when you had asymmetrical access to sources?

It was a unique situation, where one party was eager to talk while the other wouldn't go on the record, citing the confidentiality clause in their contract. I leaned heavily on documentation-restraining orders, legal filings, and direct quotes. I also tried to explain the reasoning behind people's actions when possible, even if they might come across negatively.

A principle I relied on was letting characters speak for themselves - through quotes from documents, through their own words-so that my voice didn't overshadow theirs. I tried to avoid unnecessary editorializing.

What systemic gaps did your reporting reveal about surrogacy?

The biggest surprise was the lack of regulation. There's no federal oversight, and in many states surrogacy is legal simply because there's no law saying otherwise. Clinics, agencies, and psychologists often point fingers at each other about who is responsible for screening or oversight. That creates situations where intended parents and surrogates assume safeguards exist - but often they don't.

That lack of oversight means people assume protections exist that don't. It's not just about this one case - there are many different permutations where agreements can fall apart, and people would be shocked at how little regulation exists in such a sensitive area of health and reproduction.

What did you learn about risk communication, especially around stillbirth?

I owe a debt to ProPublica's stillbirth reporting, which helped me see beyond surface-level sources like hospital websites. If you Google risks of surrogacy, you'll mostly find clinic websites. But the latest science is often in academic papers you'd only find by talking to experts. I spoke with specialists who helped me understand placental issues, gestational diabetes and even emerging science about how embryo DNA versus carrier biology can affect risks. I relied on experts to point me toward emerging science on placental issues and risks tied to both embryos and carriers. Having that grounding lets me discuss risks without sensationalizing and without overstating what remains unknown.

What advice would you give other health journalists covering reproductive technologies?

Be very aware of who your sources are and their conflicts of interest. In assisted reproduction, almost everyone knows each other - lawyers, doctors, agency reps. Their expertise is valuable, but it's not neutral. Also, remember this field is much less regulated than people assume - it's closer to plastic surgery in terms of oversight, and increasingly dominated by private equity. Seek out a wide variety of experts, and always ask for the most recent data, not just what's on a clinic's website.