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Top Surrogacy Labor and Delivery Questions Answered

All surrogates are mothers who have delivered a baby before. So all of these women will have a basic understanding on how labor and delivery works. But when it comes to a surrogacy delivery, there’s definitely some differences and details that need to be discussed long before the surrogate even matches with her intended parents.

In this guide I will cover the process and all the commonly asked questions about a surrogacy labor and delivery. Starting from who will be in the delivery room, who will hold the baby, to breastfeeding and more.

The Timeline and Process of Surrogacy Labor and Delivery

An Open Conversation During the Matching Process

At the very beginning of the journey, long before the surrogate gets pregnant, the surrogacy agency should have two separate private conversations with the surrogate and intended parents about the labor and delivery. The agency should be asking about their expectations and preferences for the big delivery day. Is the surrogate comfortable with the intended parents being in the delivery room at the hospital? Is it a deal-breaker for the intended parents that they be in the room for the delivery?

Once the agency has had these conversations, they can use this information to determine if the surrogate is a good match with the intended parents. Once everyone is on the same page, the agency can facilitate a conversation about the labor and delivery expectations over a match call. In essence, there should be no surprises when 40 weeks pregnant rolls around.

Arrangements with the Delivery Hospital

At the very beginning of the journey, the surrogacy agency will help the surrogate find a surrogacy-friendly OBGYN and delivery hospital. This means that they understand the typical protocols of a surrogacy delivery, and are willing to make accommodations for the intended parents to have a private space with their baby. They also need to acknowledge all the parentage documents, giving the parents full parental rights to their baby.

Who Will Be in the Delivery Room for a Surrogacy Delivery

As mentioned above, all of the details for labor and delivery should be worked out in advance, and should also be drafted in the contract between the surrogate and the Intended Parents.

Whether the parents are in the room for labor and delivery depends on the comfort level of the surrogate. During the initial onboarding process with the surrogacy agency, they should ask the surrogate her preference on labor and delivery protocols. If a surrogate wants privacy and prefers not to have the parents in the same room for delivery, then the agency can arrange to have the parents wait separately in another room. 

If the parents have a strong desire to be in the room for labor and delivery to watch their baby being born, they need to ask the surrogacy agency to find them a surrogate who feels comfortable with this arrangement.

Surrogates should always be allowed to have their own support person with them at delivery. This is usually a spouse or partner, but it can be anyone she designates as her support. I will say that nowadays the reality is sometimes hospitals have Covid restrictions put in place and don’t always allow more than one or two people in the room. This is all the more reason to make you’re delivering at a surrogacy friendly hospital, so that they respect the needs of the surrogate to have a support person outside of the intended parents.

What Happens in the Delivery Room When the Baby is Born

Traditionally when the baby comes out, the nurses put the baby on the mother’s bare chest for skin-to-skin. In a surrogacy delivery, the intended parents are either next to the surrogate in the same room or in another room, and they’re half dressed and prepared for skin-to-skin. If for some reason the parents were not able to make it to the delivery, then the surrogate will fill in with skin-to-skin until they arrive. Sometimes it happens that the surrogate went into labor early, and the intended parents couldn’t make it in time for the delivery.

Does the Surrogate Breastfeed the Baby?

Whether or not the surrogate will breastfeed goes on a case-by-case basis. Similar to the open conversation early in the journey about delivery expectations, there should also be a conversation about breastfeeding. The agency should be asking both the surrogate and intended parents how they feel about having the surrogate breastfeed during her stay in the hospital. Is the surrogate comfortable with breastfeeding the baby? Likewise, are the intended parents okay with it? There’s no right or wrong answer, it’s just what works best for their journey.

Another option is having the surrogate pump and the parents can bottle feed. Or a combination of breastfeeding, pumping and baby formula. Any lactation consultant will tell you the tremendous health benefits of the early colostrum and breastmilk, and some parents may not want their baby to miss out on them. A good way to look at it is just another continuation of care from from the surrogate while you are all staying in the hospital.

Both parties can also decide to continue the breastfeeding and pumping and a few days/weeks/months after delivery. There’s usually additional compensation for the surrogate if she continues to pump after delivery. If the parents live near the surrogate, she can continue to provide the “liquid gold” for the baby for as long as they want.

Does the Baby Stay in the Hospital Room with the Surrogate?

Typically the baby stays in a separate hospital room with the intended parents, giving the surrogate plenty of privacy afterwards and peaceful time to rest. Because the surrogate is usually not the one caring for the baby, she needs to be sure to pack things to keep her entertained in her surrogate hospital bag. Typically a surrogate only stays in the hospital for a day or two, and she gets discharged fairly quickly. This is assuming of course that there’s no post-delivery complications.

In situations where the intended parents don’t arrive on time, the surrogate may end up being the one to care for the baby for a while in the hospital. This is rare with domestic parents, but can sometimes happen with international parents. Also a rare scenario is that the hospital has no room to provide the intended parents with a separate room, and everyone has to share a space for a while. Just be prepared and flexible for any situations that may arise.

Does Everything Always Go to Plan on the Day of Delivery?

Nope, sometimes the protocols that were set in place at the time of drafting contacts just don’t come to fruition. All of the women who have ever delivered a baby know that there’s so many variables on the day of delivery and sometimes you gotta do what you gotta do to get through it.

See some examples of real life scenarios that often occur with surrogacy labor and delivery:
  • The surrogate had previously agreed to allow parents in the room for delivery, but on the day she changed her mind and requested a private room without the parents present.
  • The surrogate had previously requested a private room without the parents, but on the day changed her mind and felt comfortable with the parents in the room.
  • The surrogate goes into labor early and unexpectedly, and the parents are unable to make it on time to witness the delivery.
  • An unexpected c-section can happen without prior notice in which case all parties will have to follow the hospital’s protocols.
  • Covid restrictions in hospitals can sometimes hinder the birthing plan put in place by the intended parents and surrogates. Some hospitals will only allow one or two support people in the room with the surrogate while she delivers.
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