Purpose for the program: The families in our communities are often told that adoption agencies and surrogate companies are forewarning their families that hospitals don’t understand their unique situations.  They are told to prepare themselves for insensitive comments and challenging attitudes.  Sadly, the level of care and understanding offered during these hospital stays are largely reliant upon the staff’s education about adoption and surrogate protocol.  With only 12% of adoptions now “closed adoptions”, the challenge of serving both birth-families and adoptive families within the BirthPlace ever present.   In surrogacy, families have a business agreement surrounding the pregnancy and delivery so there are multiple families involved in the hospital stay. Adoption and surrogacy can create unexpected challenges in the hospital setting.   As a hospital we owe all families who come though our birth unit a high level of respect and the skill necessary to meet them wherever they are in their pregnancy journey.   

Proposed change: Our hospital has developed a unique program to support the special needs of our unique families. The Family to Family Adoption Support Program was created to addresses this dynamic during adoption placements.  The Family to Family Adoption Support Program began in 2005 at Parker Adventist Hospital and has grown to include mandatory staff education, adoption-sensitive materials, and supportive guidelines to come alongside all parties involved in the adoption process.  We have found in the last three years that this program also serves our surrogate population. There are many similarities in the hospital dynamics for surrogate and adoption placements:

Each hospital can take the top five initiatives out of our established program and begin changing the culture in their facility. 

Implementation, outcomes and evaluation: In our facility we identified an area of weakness and developed both a support person role and the curriculum to support staff development.  The position of Adoption Liaison to support the families and implement this program. The program utilizes the Infant Adoption Initiative Training as mandatory for all staff in the BirthPlace. We also partner with pregnancy centers and clinics throughout the Denver area.   This outreach also impacts those considering utilizing a surrogate and thus delivering a child surrounded by a sensitive and educated staff.

Implications for nursing practice: The very heart of the program is the transition support in the BirthPlace.  During a unique delivery situation, the program supports all families involved to encourage healing and empowerment for all parties. 

Keywords: Adoption, Surrogacy, nursing, families, hospital-based, BirthPlace,