Surrogacy birth experience in the UK

In the overwhelming majority of UK surrogacies, the intended parents are present for the birth, usually in the delivery room if everyone feels comfortable with this.

Preparing for a surrogacy birth

It is important to liaise with the hospital before the birth to ask if they have a surrogacy policy.  If so, you can explore how it will apply to your situation, and if not you can encourage the hospital to think through in advance how they will accommodate you all.  Arranging a meeting with the head midwife (or whoever else is appropriate) is sensible to talk this through, and it may be helpful to draw their attention to the Department of Health’s guidance for healthcare professionals. If you want to manage things differently from the norm, you should try to get things agreed in writing and keep a record with your birth plan. If you are working with Brilliant Beginnings we will help you to do this by liaising with the hospital and, where needed, helping them create or develop their surrogacy policy to accommodate you.

You also need to make sure you have spent time as a team talking through your birth plan so that everyone knows each other’s thoughts on how you hope the birth will go.  The surrogate’s wishes will take priority over any birth plan during the labour itself but it is still good to have a plan.  You should think about:

• Where the birth will take place
• Making sure all the delivery professionals know that this birth is a surrogacy birth
• Who will be there to support the surrogate as her birth partner, and the style of support she would prefer
• Where the intended parents will be staying and when they plan to get to the area if they don’t live locally
• Whether one or both intended parents will be present at the birth (including how this varies depending on the type of birth e.g. natural, assisted, planned caesarean, emergency caesarean and whether you need an exemption from standard hospital policies) and where everyone will stand
• Pain relief options
• Who will be told the sex of the baby first
• Handling of the baby immediately after the birth including cutting the cord, who will hold the baby first and next, whether the baby should be cleaned first, skin to skin contact, whether the surrogate wants to hold the baby (and when)
• Whether you will have the help of a doula or hypnobirthing partner
• Whether wider family and friends will be in the waiting room
• Who will care for the baby in hospital and how they will be accommodated (and whether this needs an exemption from standard hospital policies e.g. fathers being able to stay on the ward if you are a same-sex couple or a single dad)
• Who should be consulted if the baby needs special care
• Hospital discharge arrangements, including what will happen if either the surrogate or the baby has to stay in hospital for a period of time
• How the baby will be fed
• What the baby’s name band will say
• What visitors will be allowed
• Making sure that any written consents the hospital wishes to put in place are dealt with sensitively and in a timely fashion

At Brilliant Beginnings, as well as the support our team offers, we routinely offer independent professional counselling for surrogates in preparation for the birth as well as after the birth, if you feel you need it, at no cost to you.

The birth

The birth can be an incredible moment in the surrogacy journey for everyone involved. For intended parents, it is the moment they finally get to meet their baby.  Assuming there are no health issues, the baby can be handed to the intended parents immediately and they will often be offered skin-to-skin contact with their new baby in those first precious moments. 

How birth feels to a surrogate

The birth is often a very surreal time for a surrogate. This is the big milestone of the whole surrogacy journey for everyone involved, but it is also a critical time for the surrogate to feel in control, supported and not under pressure.

You could be feeling worried about things going to plan for your intended parents, or feel vulnerable and out of control as you experience pain and contractions. The relationship between all parties needs to be such that you feel happy birthing how you want. Births seldom go to plan and it is very important for everyone to understand that, even if things were agreed in the birth plan, they can be changed or adapted to ensure your health and wellbeing.  During labour and in the immediate moments post-birth, it is critical for you to have the support you need from your intended parents and birthing partner, as well as the professionals caring for you.

It is a very emotional and exciting time but you do have your heart and head pulling you in different directions.  You will be feeling proud in accomplishing what you set out to do but also drained and exhausted. Now this stage of the journey is coming to an end, the potential for a sense of emptiness is possible. You need to be aware that your body will react the same way as it would for any birth, for example you will need to be prepared for your milk coming in and think about how you will deal with that, as well as managing hormonal and physical recovery.

Your intended parents have put their trust in you to babysit their baby for nine months and you need to have the same level of trust in them to look after their baby going forward. Unless you are existing friends or family members who will see each other regularly in any event, it is very important that you have calls and catch ups with your intended parents arranged so you know when you are going to be able to hear how they are all getting on. The surrogacy journey continues past the point of birth, but in completely different ways for the parents and the surrogate and so it is important to spend time ensuring everyone involved understands the impact on you and how to support this.

If you are working with Brilliant Beginnings we will support you as a surrogate in the weeks after the birth, making sure you get settled and both you and your intended parents have the support you need at this sensitive time (including providing counselling if/when required).

What if things go wrong?

Although everyone hopes for the birth they have envisaged, not all births go to plan.  For example, if a surrogate needs an emergency caesarean it may not be possible for the intended parents to be in the room.  It is important to be flexible in your expectations and to look after and respect each other’s needs no matter what happens.  All surrogates need to know that what they have undertaken has been valued and, even when things do not turn out as everyone hopes, a surrogate must have the support before, during and after her surrogacy journey to be able to look back confidently and positively. 

Some deliveries are difficult, with complications or even tragic outcomes such as stillbirth, and this is a risk for any birth.  If something goes badly wrong, having professional support through an agency like Brilliant Beginnings, as well as healthcare professionals like your midwife and GP, can help ensure that you are all looked after and supported.  At Brilliant Beginnings we will do all we can to support you.  Our client managers will attend appointments with you to give practical and emotional support, help you communicate with each other and any professionals involved, help arrange other support as appropriate, as well as being a sounding board to help you work through what is happening.