Written by Shweta Rathod, MD — Doctor of Medicine : clinical experience in Obstetrics & Gynecology, labour room management, and IVF. Dr. Rathod writes Surrogacy4All’s pregnancy and obstetric content.
Medically reviewed by Rashmi Gulati, MD —
- Board Certified, Internal Medicine
- Medical Advisor, Surrogacy4All
- Privileges at Mount Sinai Hospital
Last updated: [14/09/2026]
Summary
A surrogacy birth goes smoothly when four things are settled before the surrogate’s due month: the parentage order is on file with the hospital, the hospital’s surrogacy protocol has been confirmed in writing, the newborn’s insurance and feeding plan are agreed, and everyone knows who will be where on the day.
This checklist covers each, in the order it happens, from a physician’s view.
Surrogacy4All is NYS-licensed (GSP220903), physician-led, operating since 2006, with programs from $120,000.
| Fact | Value |
|---|---|
| Parentage order | Obtained during pregnancy in pre-birth-order states, filed with the hospital by 32–34 weeks |
| Hospital notification | Written surrogacy delivery plan lodged with labour and delivery and the nursery |
| Who is present | As the contract states, usually the intended parents and the surrogate’s support person |
| Newborn insurance | Intended parents’ plan from birth, add within the plan window (usually 30 days) |
| Feeding | Formula, pumped milk under a separate agreement, or both |
| Birth certificate | Issued in the intended parents’ names under the order (pre-birth states) |
| License / registration | GSP220903, FDA FEI 3021544308 |
Step 1 — The Parentage Order
By 32–34 Weeks
In pre-birth-order states, the order is granted during the second or third trimester and a certified copy is sent to the hospital’s legal or social-work department along with the delivery plan.
The hospital then knows in advance that the intended parents are the legal parents, which governs wristbands, consent for newborn care and discharge.
In post-birth-order states, the hospital is notified of the pending petition and the surrogate consents to the intended parents’ involvement.
Step 2 — The Hospital Delivery Plan
A one-page document agreed by the surrogate, the intended parents and the hospital’s social worker should cover:
- Who will be in the delivery room
- Whether the intended parents want a room of their own
- Who makes decisions for the newborn
- Feeding preferences
- Skin-to-skin contact
- Circumcision, if requested
- Discharge arrangements
Many hospitals provide a second room when available.
We draft this from the contract and send it at 30 weeks.
Step 3 — Insurance for the Baby
The newborn is added to the intended parents’ health plan from birth. Most plans allow 30 days, but the hospital will bill from day one, so the plan’s member services should be told of the expected date in advance.
In post-birth-order states, the surrogate’s plan may be billed initially and reconciled; the insurance guide explains the mechanics.
Step 4 — The Day of the Birth
The surrogate’s OB manages labour as for any delivery.
The intended parents are present as agreed and receive the baby after birth, with skin-to-skin if they wish.
The newborn is cared for under the intended parents’ consent, while the surrogate receives postpartum care in her own room.
Hospital staff experienced in surrogacy births handle this routinely; the delivery plan is what makes it routine.
Step 5 — Feeding and the First Days
Feeding options may include:
- Formula
- Pumped milk under a separate milk agreement with an allowance
- A combination of formula and pumped milk
The intended mother may also induce lactation, which our induced lactation guide covers.
Pumped milk for the hospital stay is arranged in the delivery plan.
Step 6 — Discharge and Documents
The baby is discharged to the intended parents, while the surrogate is discharged separately.
The birth certificate is issued in the intended parents’ names under the pre-birth order, usually within one to two weeks.
International parents then apply for the US passport.
In post-birth-order states, the certificate is amended after the order.
Step 7 — After the Birth
Postpartum care for the surrogate continues with her OB.
Final compensation is paid from escrow after delivery, and our support continues for at least eight weeks.
For intended parents, important next steps include:
- Scheduling the pediatrician visit
- Confirming health-plan enrollment
- Arranging travel home for out-of-state families
Frequently Asked Questions
Q. Who Is in the Delivery Room in a Surrogacy Birth?
A. Whoever the contract says, usually the intended parents and the surrogate’s support person.
Q. Do Intended Parents Get a Hospital Room?
A. Many hospitals provide one when available; it is requested in the delivery plan.
Q. Whose Insurance Covers the Baby?
A. The intended parents’ plan from birth.
Q. Whose Name Is on the Birth Certificate?
A. The intended parents’, under the parentage order in pre-birth-order states.
Q. Can the Surrogate See the Baby?
A. As she and the intended parents agree; most do.
Q. When Is the Delivery Plan Sent to the Hospital?
A. Around 30 weeks, with the parentage order.
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