Preparation for Childbirth and the Process of Transferring the Child from the Surrogate Mother
In most modern surrogacy arrangements, the pregnancy is gestational. The surrogate (or gestational carrier) does not provide the egg, so she is not genetically related to the baby. The embryo is created via in vitro fertilization (IVF) using the eggs and sperm of the intended parents or donors, and then transferred into the surrogate’s uterus. Many intended parents choose to work with a surrogacy agency to coordinate the medical, legal, and logistical aspects of the process.
Because the surrogate is not genetically related, many legal and emotional complexities are simplified, though still significant. In addition, the legal status of surrogacy varies widely across jurisdictions: some countries permit compensated surrogacy, some only altruistic surrogacy, and some ban it altogether. This means that intended parents and surrogates must plan carefully in advance, especially concerning which country or state’s legal framework will apply.
Preparing for Childbirth: Medical and Psychological Readiness
Before any embryo transfer or pregnancy begins, the surrogate must undergo extensive medical and psychological screening. These typically include:
- A full medical history, physical exam, and assessment of her reproductive system (e.g., uterine evaluation, ultrasound, sometimes hysteroscopy).
- Blood tests (hormones, infectious disease screening, blood type, genetic carrier screening).
- Psychological evaluation to confirm mental health stability, readiness, and informed consent.
- Review of previous pregnancies and obstetric history (ideally, the surrogate should have had at least one uncomplicated delivery).
Sometimes agencies or clinics require a “mock cycle”, where the surrogate is given the same medications she would receive for embryo transfer to test how her body responds (lining growth, hormones). If all parameters respond well, the real transfer cycle is scheduled.
Synchronizing Cycles and Hormonal Support
To optimize the embryo implantation chances, the surrogate’s hormonal cycle must often be synchronized with that of the egg donor or intended mother (if she uses her own eggs). The surrogate typically receives estrogen and progesterone supplements to prepare her uterine lining. After the embryo transfer, progesterone support usually continues for several weeks to support early pregnancy.
Prenatal Care and Monitoring During Pregnancy
Once pregnancy is confirmed (typically by blood HCG tests about 9 days after embryo transfer) and a fetal heartbeat is detected on ultrasound (around week 6), the surrogate proceeds with routine prenatal care. But in many surrogacy programs, this care may be more frequent or more specialized than for average pregnancies, due to risk management and oversight by the fertility clinic and the intended parents.
Transferring the Child: Medical, Legal, and Practical Steps After Birth
One of the most delicate parts of “transfer” is establishing legal parentage. In jurisdictions where surrogacy is recognized, a “pre-birth order” may allow intended parents to be declared legal parents even before the baby is born. In others, a post-birth court procedure or adoption is required. The surrogate often signs relinquishment documents under the contract. In some places, until legal transfer is complete, the surrogate remains the legal parent. If there are cross-border surrogacy arrangements, immigration, or citizenship paperwork must be managed, too. The timing of official documents is critical, including how the baby’s name appears on the birth certificate, who signs, and who has rights to medical decisions.
Below is a suggested list of preparations to handle in the final weeks before birth:
- Confirm hospital arrangements, consent, and staff awareness of surrogacy.
- Ensure all legal paperwork, court orders, and parental declarations are ready.
- Plan logistics of transport, lodging, and neonatal support.
- Prepare for postpartum care of the surrogate (medical, emotional).
- Prepare for newborn care handoff, including necessary supplies and contact with pediatricians.
These steps form a safety net so that the moment of birth and subsequent transfer proceed smoothly.