Gestational Carrier Delivery: What Do I Do Now?

Background: Surrogacy is becoming increasingly more common in the United States.  Recent publications and high profile gestational carrier deliveries have opened the discussion for many to consider surrogacy as an option to have a family. While surrogacy presents a viable option for childbearing, it can be stressful for all involved.  Issues  surrounding surrogacy include physical, psychosocial, economic and legal concerns.  Clear policies and procedures that outline the legal processes coupled with an advanced practice nurse acting as a care coordinator are integral to effect smooth care and promote satisfaction for the birth mother and intended parents.

Case: Several gestational carrier deliveries (domestic and international) will be discussed to demonstrate nursing care related to both birth mother and intended parents.  The CNS collaborated with lawyers, physicians and all parties involved from mid second trimester and into the postpartum period.  Legal processes were determined and explained, and desires of involved parties were incorporated into individualized care plans.  Communication with nurses and unit managers occured through detailed checklists and review of case specifics.  Nursing care was directed at providing maternal and neonatal care to appropriate parties, with an emphasis on enhancing the birth experience for all.

Conclusion: Due to assisted reproduction technology and changing family dynamics, surrogate pregnancies will continue to rise.  Nurses play a key role in addressing the issues of gestational carriers and their families, as well as those of intended parents.  Optimal outcomes will occur only through clear policy development, coordinated multidisciplinary efforts, and fair equitable care with a focus on meeting physical and psychosocial needs for all involved.

Keywords: Surrogacy, gestational carrier, role of advanced practice nurse, nursing care