Surragacy Flashcards
What is surrogacy
When a woman carries andgived irth to a bay for mother person or couple
Traditional - surrogacies provides her own eggs to achieve a pregancy
Gestational surrogacy - when eggs of intended mother are used and there is therefore no genetic connection between the baby and surrogate
Why might someone embark on surrogacy
Fertility issue
same sex relationship
Prev birth trauma
Preparing for surrogacy
Finding a surrogate - may use friends or family or may use external agency
Fertility clinics cannot source surrogates for intended parents
Drawing up a agreement although not legally binding, it helps to ensure the surreal or and intended parents share the same etc=xpectations
Sexual health screening - intended parents could pass infectious diseases to the surrogate and the surrogate cold vertical transmit infectious diseases to the fetus/baby e.g HIV
Surrogacy and the law in the uk - finances
It’s illegal to pay for surrogacy in the uk
Altruistic surrogacy is legal
Intended parents are responsible for reimbursing any reasonable expenses that the surrogate incurs such as maternity clothes, travel expenses and loss of earning typically 10000 - 15000
Intended parents will also need to pay for any d§fertility treatment needed - e.g IUI,IVF,ICSI
Surrogacy and the law in the uk Altruistic- legal parents
Surrogate is the legal mother of the child unless the indetanded parents get a parental order from the court - even if the eggs and sperm used are the intended parents or donated
Once have parental order he surrogate will have no further rights or obligations to the child
If the surrogate is married or in a civil partnership, her partner will automatically be the second legal parent , unless it can be shown that her partner did not consent to he treatment
If surrogate is single, then the man providing the perm will automatically be the second legal parent at birth. However it is possible for the surrogate to nominate a second legal parent such as the intended mum r non biological father if you’d all prefer
Surrogacy and the law inte uk parental orders
Intended parents can start the process to obtain a parental order from 6 weeks until 6 months after the birth if certain criteria ave been met including
The child being in the car e
Having the consent of the surrogate
At least one IP or the IP, in the case if an individualised applicant being genetically related to the child
The parental order preocess is normally straightforward and its usual for a child to be cared for by the IPSs from birth with the surrogates consent
Pre conception counselling
All parties involved in the surrogacy arrangement should be offered counselling to discuss the implications and to entail challenges faced by them whe undergoing complex treatment cycles
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Antenatl care
Treat the same way as others
Coordinated but flexible approach
Suppor from established group
Decision making and consent
Pregnancy and birth planning- surrogacy should have comprehensive trust based agreements between the surrogate and IP - known as surrogacy agreements - whcihc cover most eventualities and desired outcomes - these should be reflected in birth planning and engagement with healthcare staff
Copy of completed birth plan should be filed in hospital records and brought to attention of the head of midwifery with consent
Privacy and confidentiality
Language and terminology
AN safeguarding
Where suspicion of commercialagreeent they should contact safeguarding
Should be seen onl with the surrogate having opportunity t be seen alone
If a surrogate changes her mind and wishes to keep the child herself or no longer wishes to transfer the chip to the IP then staff must respect this and should ensure accurate notes of the circumstances are kept
If the IP want to challenge thi situation then it will be a matter for family courts to decide
Intrapartum Care
Environment space an location
Immediate post birth planning and engagement - where possible such requests should be accommodated to prove immediate binding between the IPs and the baby, with skin to skin contact also being supported. Consider who will hold babay and cut cord
Use of names and title
Timely handover of the child
Postnatal care
Understand infant feeding intentions
Intended parents - support
Intended parents not treat like visitors
Babys can be discharged home with the intended parents with the surrogates written consent
Following discharge
Se pater postnatally and neonatal care wil need to be coordinated for surrogate ndintedndedparents with baby
Consider safe information sharing between different trusts
Communication between surrogates CMW and GP is vital
Communication between babys CMW,GP and HV is vital
PN care and mental health
Surrogate - still requires emotional support
Still require CMW for emotional support
Around 1/3 of surrogates experiences some difficulty immediately after handover of the baby but only 6% experienced difficulty 1 year postnatally
