I’ve already posted about our plans to travel to Utah to be there for the surrogate birth of our daughter. Needless to say, we are still working through a ton of details and logistics and unknowns about that trip. Regardless, I thought I would follow up that post with some of the things that we are thinking through about the labor and delivery process that will be here in only a few short months, as well as some questions that I’ve received.

Who will be there?

Obviously, our surrogate will be the star of the show and will be at the hospital. We also are relying heavily on our surrogate’s husband to be there for our surrogate emotionally and physically. The two of them have three children together so we assume they have this whole birthing thing down pat! We also will welcome any other people that our surrogate wants around her during the labor. We want her to be comfortable and we think that is most likely if we let her direct the show on this special day.

For our part, we are expecting that it will be just me and Mr. Starfish at the hospital. While we will have welcomed our first daughter only weeks before, we were told on the hospital tour that no one under 14 years of age is allowed in the delivery room. So we are planning on leaving our firstborn with a family member who is staying with us in Utah while we’re at the hospital.

Who decides on the hospital and doctor?

All of the details about doctors and hospitals are already mapped out in our contract with our surrogate, which was signed by all parties before the embryo transfer took place. We asked our surrogate for her preferences, and we proceeded with those with her doctor’s name and the hospital where she expects to deliver clearly written out in the contract.

Our attorney checked for us that her doctor was legit and met all of the qualifications for the highest level of care. Although we had no problems with our current surrogate, we did negotiate for a different OB-GYN with our first surrogate when our attorney uncovered that he was only a medical resident. Regarding the hospital, our attorney also ensured that it had the highest level NICU available.

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Some surrogates may prefer a home birth over a hospital birth. This never came up as a possibility with our surrogate, most likely because such differences are typically uncovered before a surrogate is ever matched with intended parents. Mr. Starfish and I were never comfortable with a home birth, and so our agency never showed us surrogate profiles that would have preferred that. But it’s my understanding that details such as a home birth and doula, if they are preferred by a surrogate and intended parents, are also clearly laid out in a contract at the inception of the relationship.

Who decides birth details such as pain medications?

The answer to this question is not very straightforward. At this point in time, I would tell you that anything that our surrogate wants to do (or not do) regarding labor pain and medications is totally her call. I feel very badly that she is going to endure such extreme pain to birth our daughter, and I want her comfortable during the experience.

But the full story on this question also gets tied in to the surrogate matching process. If Mr. Starfish and I believed strongly in any particular type of birth experience or medication (epidural, etc), our agency would keep this in mind when matching us and only show us surrogate profiles that matched our hopes and expectations.

All that said, I get the sense that our surrogate is a wonder-woman when it comes to labor. She told me casually at the 20-week ultrasound that she used no pain medication during her last delivery and that she had pushed that baby out within 45 minutes of arriving at the hospital. I am in awe of this woman, and I’m pretty sure that her delivery will be much smoother and less complicated than my own!

To whom does the baby go immediately after the birth?

Most intended parents strive to do skin-to-skin contact within minutes of the birth, and that is indeed our plan as well. We expect that the baby will go directly to me or Mr. Starfish immediately after she arrives. While this may sound a bit harsh toward the surrogate, it is my understanding that most surrogates actually prefer the baby to be placed with the intended parents right away and that they get a tremendous amount of satisfaction watching the bonding process between the baby and the new parents in those minutes after delivery.

We also will be given a private room separate from the surrogate after the birth. Our surrogate can relax and recover in the privacy of her room, while Mr. Starfish and I can continue the bonding process with our new daughter in a separate room. However, we don’t expect that we’re just going to go to our separate rooms and never look back after our daughter arrives! We fully anticipate that our surrogate will want to visit the baby, visit with us, and share in this special time.

What do you have to bring?

Apart from the regular hospital bag full of things like a receiving blanket and clothing for the baby, and toiletries and clothing for me and Mr. Starfish, we have to remember to bring a few extra things.

Perhaps the most important item is our surrogacy contract. Hospitals are still pretty new to the whole surrogacy thing, so we’ve been advised to be fully prepared for complications. Things will run a whole lot smoother if we have our contact in our hands to show to hospital staff, proving that our daughter is our daughter.

Another thing that we have to be certain to bring is a “pre-birth order.” This part is a little hazy to me (hopefully not to our attorney!), but my understanding is that this is another legal document that indicates that we are the parents of the baby and are to be listed on the birth certificate, and identifies our surrogate and her unique role in our situation.

I will also be bringing my laptop to the hospital, which has dozens of documents and spreadsheets and details saved regarding the surrogate pregnancy. Best to be over-prepared!

Already, we’ve discovered that a surrogate labor and delivery is WAY more complicated than a non-surrogate labor and delivery. For my own pending labor, I registered with the hospital in about 10 minutes online. That’s it. But for our surrogate’s delivery, we did an elaborate hospital tour at 20 weeks, we spoke to three different individuals at the hospital regarding logistics and a private room post-delivery, we’ve had to speak to two different social workers to figure out logistics, and we had to have our agency scout out pediatricians for us in Utah to use short-term while we’re out-of-state. Just within the past week, it occurred to us that we hadn’t checked that our insurance is accepted at the hospital. Sadly, we discovered that it is not and so that is a nightmare issue that Mr. Starfish has been battling recently. We also are aware that there are likely dozens of issues that we haven’t even thought about or even considered. Please let me know if you can think of any!