What is in a surrogate birth plan?
A surrogate birth plan is a written agreement about the day of delivery. It tells the hospital, the intended parents and you what will happen, who will be there and where the baby goes. It covers the same things as any birth plan, plus the questions that only come up in surrogacy.
The plan starts from what you agreed at your match meeting and in your contract. Your case manager drafts it with you and the intended parents and sends it to the hospital before delivery.
| Decision | Options | Who decides | When it is documented |
|---|---|---|---|
| Who is in the delivery room | Your support person; one or both intended parents; no one else | You, with the parents' wishes in mind | Birth plan, before delivery |
| Pain relief | Epidural, other medication, none | You and your OB | Birth plan; can change in labor |
| Who cuts the cord | An intended parent, your support person, or the doctor | Agreed between you and the parents | Birth plan |
| Where the baby goes first | Skin-to-skin with an intended parent; to the parents after the newborn checks | The intended parents, with your agreement | Birth plan |
| Whether you hold the baby | Yes, no, or decide on the day | You | Birth plan; you can change your mind |
| Photos and video | Allowed or not; who takes them; what is shared | You and the parents together | Birth plan |
| Pumping colostrum and milk | Yes, for how long, or no | You, agreed with the parents in advance | Contract and birth plan |
| Your family's visit | Whether your partner and children meet the baby | You and the parents | Birth plan |
| Contact after discharge | Updates, photos, visits | Both sides | Contract and match agreement |
Medical decisions in labor, including a C-section, are made by you and your OB, based on your health and the baby's. The birth plan states preferences. It does not override medical judgment.
How PLS prepares the hospital
You deliver at a hospital near your home. Before delivery, Private Label Surrogacy acts as hospital liaison, so labor and delivery staff are not learning about the surrogacy at the nurses' station.
Your case manager sends the hospital three things:
- The pre-birth parentage order, so the hospital knows who the legal parents are.
- The birth plan, so staff know who may be in the room and where the baby goes.
- The intended parents' contact details, so the hospital can reach them when you go into labor.
That way, the staff know who the parents are, who may be in the room, and that the baby goes to the parents, who are given their own room. You do not have to explain any of it while you are in labor.
Your case manager also contacts the hospital's social worker or patient services team before delivery to confirm the arrangements.
Who is in the delivery room?
The people listed in your birth plan, and the medical team. Usually that means your own support person, often your partner, and one or both intended parents if the plan says so.
You decide this in advance, and you can change it. If labor is harder than you expected and you want fewer people in the room, say so. The nurses will help. Your comfort in labor is not up for negotiation.
If you have a C-section, hospitals usually allow fewer people in the operating room, often only one. Agree in advance who would go in with you. Read about C-section compensation.
What happens to the baby right after birth?
The baby is checked by the medical team, as every newborn is. Then the baby goes to the intended parents, as the birth plan says. Many parents do skin-to-skin contact right away.
The intended parents and the baby are given their own room. The baby's pediatric care, feeding and decisions belong to the parents from birth. Under the Illinois pre-birth order, the intended parents are the baby's legal parents, and the hospital names them on the birth certificate.
If the baby needs the neonatal intensive care unit (NICU), the intended parents make those decisions and stay with the baby. Your case manager keeps you informed, if you want to know.
Your recovery room and support person
After birth, you recover in your own room with your own support person. You are a patient recovering from a delivery, and you are cared for as one.
How long you stay depends on how you delivered:
- Vaginal birth: usually one to two nights.
- C-section: usually two to three nights.
Use the time to rest. Your support person can handle visitors and messages. Your case manager checks in with you and with the intended parents, so neither side has to manage the other while you recover.
Your contract covers your recovery, including your lost wages and your partner's lost wages. Insurance and life insurance coverage continue as set in the contract.
Holding the baby, photos and goodbyes
Whether you hold the baby is your choice. Most PLS surrogates do, and many introduce the baby to their own family. Children often want to see the baby they have been hearing about for nine months, and meeting the baby helps them understand where the pregnancy went.
Photos are common. Many surrogates and parents take pictures together. The birth plan records what is allowed and what is shared.
Many surrogates also pump colostrum for the first feeds. If you plan to pump, ask the hospital ahead of time whether it can provide a pump and a lactation consultant. See postpartum recovery and pumping.
Saying goodbye at the hospital is often easier than surrogates expect, and sometimes harder. Both are normal. Talk about it ahead of time with your partner and children. See support for your partner and family.
Jenni Symons, who wrote this page, delivered as a surrogate in 2019 and 2021. She is now a PLS case manager.
Discharge, the birth certificate and the final payment
At discharge, you go home with the usual postpartum instructions from your OB. The intended parents are discharged with the baby, often on a different day.
Under an Illinois pre-birth parentage order, the hospital issues the original birth certificate naming the intended parents. You do not sign adoption papers, and you have no parental rights or obligations. Procedures differ outside Illinois; your attorney explains the process for your state.
Your final base installment is released after discharge. Payments come from the independent escrow account, not from PLS.
Support does not stop at discharge. Your case manager keeps checking in during recovery. If you pump, you are paid $200 per week. You also have a postpartum nutrition consult with Julie Bendix, MPH, RD, LD, CLC, the PLS registered dietitian and lactation counselor.
What if you deliver early or away from home?
Babies come early. The plan is built for it.
- Early labor at your own hospital. The paperwork is already on file, so the plan works whether the baby comes at 40 weeks or 34. The attorneys file the parentage documents during the pregnancy so they are ready before an early birth.
- Labor at a different hospital. Tell the staff you are a gestational surrogate, give them your case manager's number, and call your case manager. PLS sends the documents to that hospital.
- Delivery in another state. Call your case manager right away. Parentage rules differ by state, and the attorneys may need to file in that state.
- The intended parents are not there yet. International parents, or parents traveling from far away, may arrive after the birth. Your case manager and the hospital make sure the baby is cared for under the parents' instructions until they arrive.
PLS has handled hard nights before. On one night, the after-hours team rebooked a stranded surrogate's hotel, car and flight while another PLS surrogate was delivering twins.
If you are considering surrogacy, start with the prescreen: see if you qualify. For every step from application to delivery, see the surrogate process.
Sources
- American College of Obstetricians and Gynecologists (ACOG), patient information on labor, delivery and postpartum care. https://www.acog.org
- Illinois Gestational Surrogacy Act (2005), Illinois General Assembly. Pending review by counsel.
- SEEDS, Society for Ethics in Egg Donation and Surrogacy.