Bringing Baby Home After A Surrogacy Delivery – Guide for Domestic and International Parents
It’s an emotional time when your baby is finally born with the help of a surrogate. You’ve likely had a long road to get to this point of being able to hold your baby, to look in their eyes, and to truly begin your journey as their parent. And while this is an exciting time that’s definitely worth celebrating, there are some legal and procedural steps you’ll need to go through to ensure that you’re officially parents in the eyes of the government. And preparing as much as you can in advance is the key to making this process go as smoothly as possible.
Let’s look at some of the most important legal and administrative tasks that will allow you to bring your baby home after surrogacy delivery, whether you’re going through a journey domestically within the US or as international intended parents (IPs) whose surrogate is delivering in the US.
Taking Legal Custody of Your Baby After Delivery
What do you need to do in order to take legal custody of your baby after delivery? The specifics vary from state to state, but tend to follow a similar process.
What is a Pre-Birth Order?
Most hospitals require specific documentation that establishes your legal parentage and allows you to take the baby home with you. This is usually done in the form of a pre-birth order. This document ensures that your baby’s birth certificate is properly filled out with your (the intended parents’) names when your baby is discharged from the hospital.
When Should You Complete a Pre-Birth Order?
The legal process and timing for pre-birth orders slightly differs by state as far as when the attorneys can file the paperwork. For example, in California and other surrogacy-friendly states, the pre-birth order is done while the surrogate is still pregnant.
In the cases where it’s possible to complete a pre-birth order, at around 25 weeks of pregnancy, a social worker who is an employee of the hospital will start working with the surrogacy agency case manager who represents the surrogate. They will need a birth plan, a copy of the legal contract, and pre-birth order to start the process.
What Steps Do You need to Take with Your Pre-Birth Order?
Pre-birth orders must be filed in family court and signed by a judge to be valid. If you’re working with a surrogacy agency that connects you with legal representation, your attorney will submit these documents for you. Once they’ve been signed by the judge, the surrogate and intended parents (if domestic) will receive original copies of the legal parentage.
If you’re in a state that allows for pre-birth surrogacy orders, your baby’s birth certificate will be ready to go with your names when your baby is discharged from the hospital. If you do need to complete any post-birth steps and you’re working with an agency, your attorney will take the required steps to update the birth certificate with your (the intended parents’) names.
Establishing Legal Parentage for International Parents
The pre-birth order and birth certificate will establish your legal parentage in the US, but the process of establishing parentage in your home country can vary. Some countries may require the non-biological parent to adopt the child through second-parent adoption, but this is not the case everywhere. In countries that accept the US Declaration of Parentage, you will probably have fewer steps to go through to establish parentage in your home country. Read more about establishing legal parentage here.
Health Insurance for Babies Born via Surrogacy
How should you handle health insurance for your baby who’s born via surrogacy? There are different considerations depending on whether you (the IPs) live in the US or abroad.
Baby’s Health Insurance for Domestic Intended Parents
For domestic IPs, your current insurance will cover your baby at birth, though you may also need to insure your surrogate with a surrogacy-friendly health insurance policy during her pregnancy, delivery and postpartum. A surrogacy agency can refer you to an insurance expert who can help you navigate what type of insurance makes the most sense for your situation.
Newborn Insurance for International Intended Parents
For international IPs, newborn insurance is critical since your baby won’t be placed on your surrogate’s insurance policy. The timing of when you purchase newborn insurance can vary from before the embryo transfer to during the second trimester. Every situation and insurance policy will vary, which is why it’s a good idea (if not strongly recommended!) to work with surrogacy specialists to make sure you are covered.
I think it’s essential to note that if you don’t secure newborn insurance, you may end up incurring medical costs that are not covered by any insurance. You may be asked to pay for checkups and screenings at the time of treatment, though many hospitals won’t send you a bill until later, so you might not know the full cost right away. NICU costs for babies born with special health needs can be especially costly, especially when paying out of pocket.
Special Considerations for International Parents
If you live outside the US and your baby is being delivered via surrogate within the US, you will have a few extra steps to consider regarding your baby’s citizenship and international travel back to your home country. Here are a few essential points to keep in mind:
Surrogacy Babies Are Born US Citizens with a US passport
Once you’ve obtained the baby’s birth certificate, you can begin the process of applying for their passport. You will need to obtain an expedited passport to be able to fly home with your baby. You can call or book online to make an appointment, and you will need passport photos of your baby. There are surrogacy-specific companies that can provide these types of expedited services for international parents, which can be referred from your surrogacy agency.
Note: This service may not be available at the passport office, so make sure you check ahead of time. Get more information on applying for a passport from the US Department of State.
Dual Citizenship for Surrogacy Babies Born in the USA
Surrogacy babies born in the US are American citizens. If you’d like them to become citizens of your home country, you’ll need to follow your country’s process to get dual citizenship. Be aware that in some countries, it’s not possible to keep both citizenships and they must relinquish their US citizenship.
Home Country Citizenship
If the baby is your biological child, you can register them as a citizen in your country with documentation or a DNA test. If you are a parent who is not genetically related to your child, then you may need to go through an adoption process outlined in your home country.
Travel Visas for Surrogacy Babies Born in the US
For some countries, you will need to travel to your country’s embassy to get the baby a visa to travel home with you. For these parents, you will most likely have to plan a longer stay in the US because timelines for travel visas can sometimes be unpredictable.
International Adoption Procedures:
If your baby has genetics from an egg or sperm donor or a partner, that parent may have to follow legal procedure in your country to adopt the baby. This is also applicable in some states within the USA.
Special Considerations for LGBTQ Intended Parents
For LGBTQ intended parents, one of the biggest questions you may have is whether you can both have your names listed on your baby’s birth certificate. The answer to this question varies depending on the state where your surrogate lives and delivers and the state and country where you live. You can read more about some of the frequently asked questions about parental recognition here.
Make sure that you’re well informed and have a plan for this process well in advance. It’s possible that one parent may need to adopt your baby after you’ve arrived home. Working with a surrogacy agency and an attorney will help you prepare any required paperwork or legal steps to make this process as smooth as possible.
Document and Travel Checklist for Intended Parents with a New Baby
Because it’s rare for surrogates to live in the same place as IPs, you will likely need to travel to where your surrogate is giving birth and travel home with your baby afterwards. What documents and other items will you need for these trips? Here’s a checklist to help you plan:
Document Checklist for Pre- and Post-Birth:
- Surrogacy contract drafted by a professional surrogacy and assisted reproductive technology attorney (ART attorney)
- Pre-birth order or post-birth order (depending on the state)
- Birth plan
- Birth certificate (make sure to receive several copies)
- Passport for your baby (if your home country is outside the US). Remember to check to make sure if your home country requires a travel visa for your baby.
Travel checklist post-birth
- A car seat and stroller are a must for travel. The hospital will not let you leave until you’ve shown them proof that you have a carseat that’s installed properly.
- Baby formula and feeding essentials
- Travel sleeping bassinet
- A diaper bag with change of clothes and diaper changing supplies
- Pacifiers to help with baby’s ear pressure on the airplane
Traveling Home with a Newborn Baby
Babies born via surrogacy are usually born in the hospital where the surrogate lives, which is often in a different state or country from where you live. This means that once your baby is born, you will be traveling home with a newborn. There are a few considerations to keep in mind when planning for this journey.
Preparing for Car Travel with Your Newborn
Traveling by car gives you more control over your route and schedule, though it may add more time to your journey. Here are a few points to keep in mind if you decide to drive home with your newborn:
- The hospital will require you to have an infant car seat that’s installed properly if you’re planning to drive.
- Make sure you plan your route and potential stops. If your travel home involves driving for many hours across multiple states, you may want to plan an overnight stop somewhere to give your baby time out of the car seat and allow you more time to cuddle and bond with your baby.
- You will want to pack some essentials for the journey, including: a flat pillow or other surface you can use to make diaper changes more comfortable, diapers and baby wipes, formula and bottles, and a baby blanket. Don’t forget about the things you’ll need for yourself, including water and snacks!
Preparing for Plane Travel with Your Newborn
Traveling by plane can be faster (and for international IPs it’s probably the only realistic way to get home), but there are a few downsides to be aware of. Some airlines have restrictions on when they allow infants to fly and plane travel often involves exposure to more people (and therefore germs), so you’ll need to weigh what makes the most sense for your situation. If you’re planning to fly with your newborn, here are a few points to keep in mind:
- You can request an authorization note from your baby’s doctor at their three-day checkup that allows them to fly.
- You may want to check your car seat in your luggage and bring a baby wrap or sling that you can wear through the airport and on the plane. This keeps your baby close and covered and makes it a little easier to move around.
- Whenever possible, try to time feeding along with the plane’s takeoff and landing to help protect their ears from the changing air pressure.
- Some international flights have bassinets in the bulkhead, so you may want to check with your airline to see if you can reserve seats that will give you easy access.
- Make sure you review the most up-to-date policies on traveling with liquids and formula. You can obtain a note from your pediatrician to be able to bring more liquid formula on the plane. Newborns cannot drink powder formula yet, so being able to bring liquid is a must.
Independent Journeys vs. Surrogacy Agency Assisted Journeys
When going through your surrogacy journey, you are likely weighing the options between navigating it independently or with the assistance of a surrogacy agency.
An independent journey is when you choose not to hire an agency to find you a surrogate or manage your paperwork or logistics. In these cases, you might choose to do it yourselves or hire someone to do it for a much smaller fee than what agencies charge. You might also find your own surrogate and hire an attorney to assist while managing all of the logistics yourselves.
Choosing to work with an agency means you’ll have a team that helps to manage the bulk of your legal and logistical processes. This can help reduce your stress and the time you need to spend on administrative details. The typical agency charges around $30K–$50K for these services.
Ultimately, it’s up to you to do your research and choose the option that you feel most comfortable with. I’d just offer a word of caution to anyone choosing the independent journey, simply because there’s very little room for error when it comes to the legal process of parentage. And as I’ve mentioned a few times in this article, having an agency’s support can be especially beneficial when you’re navigating complex and unfamiliar systems like health insurance and the US legal system.
Be Proactive and Prepared So You Can Celebrate this Milestone with Minimal Stress
This time of welcoming your new baby should be filled with joy. You’ll be much more comfortable focusing on this milestone if you’ve been proactive and prepared for all these legal and logistical details well before your surrogate goes into labor. While it is possible to do this on your own, a good surrogacy agency will make sure you’re well prepared and covered in all cases to take legal parentage of your baby. And then you’ll be ready to focus on the real adventure of being a parent!
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