These days it’s not uncommon to hear about a baby being born via surrogate, especially among the rich and famous, like Kim Kardashian, Gabrielle Union, Andy Cohen and Sarah Jessica Parker — all of whom openly used surrogacy to add to their families.

Surrogate births in the U.S. have quadrupled in the past 10 years — and a new documentary, Made in Boise (premiering on PBS Independent Lens on Oct. 28), follows the lives of four women who chose to be gestational carriers for families who weren’t able to carry their own. The doc aims to show what the process was truly like, and to clear up any misconceptions about it.

“I saw how not being able to have a baby is really heartbreaking,” says the film’s director, Beth Aala. “For the majority of families that choose this route, it’s a last resort.”

In the latest issue of PEOPLE, the four woman speak about their experience and why they chose to be surrogates — and whether they’d ever do it again.

Nicole Williamson, a married mom of two, and her husband had already decided they didn’t want more kids. Still, pregnancy had always been easy for her, so she signed up to be a surrogate. “I thought, ‘These people are having this horrible time and I can have babies easily, so I’ll help them,’ ” she says.

During her second time as a gestational carrier, she felt disappointed by the process. “I didn’t get enough support from the agency and had to do a lot of coordinating with the intended parents on my own,” says Williamson. 

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The experience prompted her to open her own agency, A Host of Possibilities, in 2013; she now matches families with surrogates worldwide (“70 percent of our clients are now from Europe or Asia,” she says), with a focus on building family-like connections between the parents and their carrier.

“It’s a lot like matchmaking,” she says. “I won’t take anyone who just wants a business transaction. I think it’s important for families and surrogates to have a good relationship, during and after.”

As for any misconceptions about the process, Williamson wants people to know that the surrogates are not “moms”: “They never use their own eggs, and have no DNA connection to the baby,” she says.

The process for being accepted as a potential surrogate is also complex and thorough. “First and foremost, these women have to really want to help somebody have a family,” she says. “They can’t just be in it for the money.”

First-time surrogates are compensated $28,000 to $38,000 in Boise (it can be higher in other states) and Williamson says they must be financially stable and not on any government assistance. She also requires them to have already delivered one full-term baby and undergo mental and physical evaluations. She provides surrogates with their own legal counsel to guide them through the process.

Once the child arrives and is given to the intended parent, there’s a feeling Williamson can’t explain. “There’s a crazy feeling — I can’t describe the moment you see the parents hold their baby for the first time,” she says. “Like, ‘I helped them. We did it together.’ ”

Surrogate Sammie Diaz, 29, who carried a son for a gay couple living in Seattle, agrees that women interested in doing this should actually want to help complete a family, and that financial gain shouldn’t be the only motivation — despite it being helpful.

“Pregnancy is pretty harsh on your body, so you have to go into it knowing you’re taking a risk with your health,” she says. “I had hip pain and migraines, but then I would picture David and Todd holding their baby, and it would get me through it.”

She adds, “It was just so incredible to see the three of them together.”

Her relationship with the happy dads remains close; they speak regularly over the phone, and she recently met their son Milo, 18 months, for the first time since his birth. “He’s the cutest!” she says.

“We always say ‘I love you,’ ” Diaz says of her bond with the family. “They’re so grateful that sometimes I’m like, ‘You guys, don’t . . . I’m blushing!’ “

Diaz says she’d love to do it again, and is hoping to match with another family soon. “I wish I could help everyone that wants to have a baby but can’t,” she says.

Chelsea Frei, a 37-year-old mom of four, says she decided to be a surrogate to help her get through the pain of losing a child who was stillborn. Three years ago she met Ernesto, now 47, a gay man from Spain, via Skype. Ernesto had two viable embryos, using donor eggs and his sperm, and was looking for the right person to carry them.

“I just got a really warm feeling from him,” Frei says. “I’d interviewed with other people and didn’t connect with them. He’s very close with his family and really values that part of his life. He was very honest about how he was going to parent and what life would look like for his twins.”

She says she had no qualms about carrying for a single man. “I just felt confident that he had the heart and was ready for these babies. I know how much thought he’d put into having children,” she says. “It wasn’t a quick decision, and he’d been through so much to even get to me.” 

Cindy Floyd, a 45-year-old NICU nurse in Boise, was initially drawn to surrogacy after meeting the parents of premature twins who had a long stay in the NICU. “I just remember the family saying, ‘If it wasn’t for our surrogate, we’d never have been parents.’ That hit home for me,” she says. “I have two kids, and my pregnancies went well, so I called the agency to see if I could even do it, because I was 42.”

Floyd went on to carry a baby for another man from Spain, and will never forget the feeling of passing his child to him for the first time. “Passing the baby to Julian and seeing him glow was so awesome,” she says.

Floyd adds that while the money wasn’t the main draw, it certainly was put to good use. “We bought a camper,” she says. “And that’s really helped out family too, because of all the time we’ve spent together in it.”

To watch Made in Boise, tune in to PBS Independent Lens on Monday, Oct. 28.

To read more about the lives of surrogates, pick up the new issue of PEOPLE, on newsstands Friday. 

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