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Surrogacy: nurses and other healthcare staff offered guidelines

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A surrogate pregnancy review has offered a practical guide for midwives and health professionals overseeing these cases for the first time.

The review is published in The Obstetrician & Gynaecologist (TOG) (Burrell C, O’Connor H Surrogate pregnancy: ethical and medico-legal issues in modern obstetrics.The Obstetrician & Gynaecologist. 2013;15:113-9).

Healthcare professionals, surrogates and commissioning parents currently have no guidelines advising them on surrogacy.

A key point in the review addresses one of the subject’s most controversial issues not covered by law or guidelines.

It recommends that the hospital’s risk management and legal team should be informed regarding whether they are prepared to discharge the surrogate mother and baby separately.

If they are not, it says, the baby and surrogate should be discharged together, and this should be clearly documented.

The review highlights recent changes in UK laws, the guidelines and legislation offered and the legal requirements for parenthood and parental rights.

New laws came into effect three years ago, allowing same sex and unmarried couples the same legal rights as married heterosexual couples to request parental orders.

Review authors forecast that obstetricians and midwives will consequently soon see more surrogate pregnancy cases.

There is currently no guidance about eligibility for treatment, no standard screening and no formal requirement for counselling, unlike IVF pregnancies.

The review’s guide for healthcare staff managing surrogate pregnancies covers pre-pregnancy counselling, antenatal care, labour and delivery and postnatal care.

One surrogacy loophole is that commissioning parents and the surrogate mother can sign a lawful surrogacy agreement which is legally unenforceable.

UK law states that the surrogate is the legal mother and the commissioning parents acquire custody by applying for an adoption or parental order.

If the surrogate changes her mind, she is normally allowed to keep her baby.

This makes the postnatal period the most anxious time for the surrogate and intended parents.


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Readers' comments (1)

  • I am a solicitor who specialises in surrogacy cases, and thought I should highlight that some of the legal information provided in this article is inaccurate and potentially misleading. It is not possible to sign a legally binding surrogacy agreement. If the surrogate changes her mind (which happens incredibly rarely - statistically in 0.02% of cases) she is not 'normally allowed to keep her baby' - in fact there have been only two reported cases in UK legal history of such a situation and both were determined by the family court on the basis of the best interests of the child. In one case care was awarded to the surrogate but in the other care was awarded to the intended parents. There is more information about the law on surrogacy at

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