SURROGACY OBSTETRICS at Sky Ridge Medical Center Surrogacy Process flow& for OB/GYNs and Surrogates

SURROGACY - method of reproduction wherebyDefinitions a woman agrees to become pregnant and deliver a child for a contracted party.

GESTATIONAL CARRIER – the “surrogate” or woman who carries a pregnancy to delivery after having been implanted with an embryo.

TRADITIONAL SURROGACY – a woman is pregnant with her own biological child; the child was conceived with the intention of relinquishing him or her to be raised by others. The gestational carrier is often inseminated with the sperm of the intended father or donor sperm.

GESTATIONAL SURROGACY - the surrogate becomes pregnant via embryo transfer with a child usually not biologically related to her.

ALTRUISTIC SURROGACY – a situation in which no financial reward is paid to the woman for carrying and relinquishing the child.

COMMERCIAL SURROGACY – the gestational carrier is paid for carrying a child to maturity in her womb and relinquishing that child to others. There is generally a lengthy legal contract outlining all details of the arrangement.

INTENDED PARENT(S) - The individual or couple who are “intending” to parent the unborn child. This is often an infertile couple but may also be a single male/female or same-gendered couples.

ORDER OF PARENTAGE- Legal court order that declares the intended parent(s) as the legal parents and gives the intended parent(s) all medical decision making rights regarding infant(s). This legal document provides Sky Ridge with the authority to band intended parents to infant(s) and issue the last names of intended parents to infant(s) reflected in all medical charts.

• Order of Parentage deems all decision making rights, access to medical information, and access to infant to the intended parent(s). Gestational Carrier has NO rights to infant or information regarding infant, unless otherwise granted by the intended parent(s).

• If Sky Ridge does not obtain a copy of Order of Parentage prior to delivery, the birth of the infant(s) will be treated as a normal delivery and rights to infant will remain with Gestational Carrier up until Sky Ridge receives a copy of Order of Parentage.

Surrogacy arrangements and relationship between the Gestational Carrier and Intended Parent(s) vary depending on the individuals and parties involved.

• If a contracting agency is involved in, and assisted in arranging, the fertility treatments between Surrogate and Intended Parent(s) typically they assist in guiding the above mentioned parties through the hospital process. TALKING POINTS TO PREPARE PATIENTS WHO ARE GESTATIONAL CARRIERS FOR THE SKY RIDGE DELIVERY PROCESS:

• Always advise the Gestational Carrier to inform the hospital that she is a Surrogate when scheduling her tour, when completing pre-admission paperwork and/or presenting to Sky Ridge to deliver.

• We ask that the Surrogate and/or Intended Parent(s) contact the Sky Ridge Medical Center Mom/Baby Social Worker and request a personal tour prior to the birth of the infant. • Typically tours are requested around the 20 weeks gestation and can be completed with any number of individuals that the Surrogate and Intended Parent(s) deem necessary to understand the surrogacy delivery process at Sky Ridge. • • Topics commonly addressed in the tour include: • The process regarding Court Order of Parentage: Court document which can be obtained as early as 14-20 weeks gestation depending on attorney preference. • Individuals identified by the Surrogate and Intended Parent(s) to partake in hospital visitation. • Infant banding and security. • Insurance and billing. • Post-Partum accommodations for Surrogate and Intended Parent(s). • Tour of Labor and Delivery, Post-Partum and Nursery Units. • Overview of infant education and teaching that occurs after the infant is born. • Infant education and teaching always occurs with Intended Parent(s) as long as the Order of Parentage has been received by Sky Ridge. • Miscellaneous questions that the Intended Parent(s) or the Surrogate may have. • Preadmission paperwork is collected after the tour and Intended Parent(s) and Surrogate meet with specialized surrogate admissions coordinator. • Surrogate and Intended Parent(s) are provided a “Sky Ridge Medical Center Surrogacy, Labor & Delivery, and Post-Partum Hospital Plan Form” to complete together. The completed form is placed in the Surrogate’s chart. This form provides nursing/hospital staff insight into the plan of care for infant and Surrogate throughout hospital stay.

• The Order of Parentage is generally obtained by Intended Parent(s) and Surrogate between 20-35 weeks gestation. Once received, we will request that a copy be provided to the Social Worker or Admissions Coordinator. • Copy of Order of Parentage is held by Admissions and Social Work. Labor and Delivery attaches the Order of Parentage to the Surrogate’s prenatal records. • Surrogate and Intended Parent(s) should always bring extra copies of the Order of Parentage with them when they present to the hospital for delivery.

• Surrogate and Intended Parent(s) are advised to inform the Mom/Baby Social Worker and/or Admissions when presenting to deliver. Upon Social Work and/or Admissions receiving information regarding a surrogate delivery, the post partum unit is informed and all needed paperwork is confirmed and placed in the Surrogate’s and infant’s charts.