Many intended parents want the very best for their surrogate—especially when it comes to selecting the surrogate delivery hospital. It’s natural to want a hospital with top-tier facilities, high safety ratings, and modern amenities. However, selecting the delivery hospital isn’t as straightforward as simply choosing the one you like most.
So, who decides where the surrogate gives birth? And what factors actually determine which hospital is best? This guide walks you through the key considerations that go into choosing a surrogate’s delivery hospital—and what role intended parents can play in the process.
Section 1: Who Decides the Hospital for Delivery?
The decision about which hospital the surrogate will deliver at is not made unilaterally. Instead, it involves thoughtful coordination between several parties:
- The surrogate’s OB (obstetrician): Most OBs are affiliated with one or two specific hospitals where they have delivery privileges.
- The surrogate herself: Her residential location and insurance coverage play a major role in determining what hospitals are available.
- The surrogacy agency or case manager: Agencies help ensure that the chosen hospital is compatible with the overall birth plan and that it aligns with insurance, legal, and medical considerations.
- Her insurance provider: Whether a hospital is in-network under the surrogate’s health plan can significantly limit or guide the final decision.
Section 2: Key Factors in Choosing a Surrogate Delivery Hospital
✅ 1. Proximity to the Surrogate’s Home
When labor begins, time matters. Choosing a hospital close to the surrogate’s residence reduces stress, allows for faster access to care, and lowers the risk of complications associated with long travel during labor. Most surrogates will deliver at a hospital near where they live.
✅ 2. Surrogate’s Insurance Coverage
Not all hospitals are covered by all insurance plans. If the surrogate has an HMO plan, she may be restricted to a limited number of hospitals. PPO plans offer greater flexibility but may still exclude certain hospitals. Ensuring that the delivery hospital is in-network is essential for avoiding surprise medical bills and keeping costs manageable.
✅ 3. OB’s Hospital Affiliation
Many obstetricians are only allowed to deliver at hospitals where they have existing privileges. If the intended parents request a different hospital that the OB does not work with, this could require switching doctors late in the pregnancy—something that’s rarely recommended. For this reason, the OB’s existing hospital affiliations are a key factor in the hospital decision.
✅ 4. NICU Level
Every intended parent hopes for a smooth, full-term delivery, but unexpected complications can happen. That’s why having access to a high-level Neonatal Intensive Care Unit (NICU) is an important part of birth planning—even for low-risk pregnancies.
Hospitals with a Level III or Level IV NICU can provide specialized care for premature or medically complex newborns. In fact, the surrogacy contract typically requires that the chosen birthing hospital be equipped with the highest-level neonatal intensive care unit (NICU) reasonably available.. This is especially important in twin pregnancies or when there is a known medical risk.
Section 3: Can Intended Parents Request a Specific Hospital?
Yes, intended parents are welcome to share their preferences regarding the delivery hospital. In fact, many do. Some may have personal experience with a particular hospital or want their child to be born in a specific facility.
However, intended parents should understand that any request must align with the surrogate’s insurance coverage, her OB’s hospital privileges, and geographic feasibility. If the preferred hospital is out-of-network or far from the surrogate’s home, it may not be a viable option.
The surrogacy agency or case manager will help facilitate conversations to find a solution that respects everyone’s needs—while always prioritizing the safety and comfort of the surrogate.
Section 4: What If the Baby Arrives Early or Unexpectedly?
Even the most carefully crafted delivery plan may need to adapt in the face of early labor or a medical emergency. If a surrogate goes into labor unexpectedly, she will be taken to the nearest appropriate hospital, regardless of the original plan.
That’s why it’s crucial to build the delivery plan around hospitals that are local to the surrogate. While it’s natural to want to select the “best” hospital, proximity is one of the most practical and important considerations.
Conclusion
When it comes to choosing a surrogate’s delivery hospital, the goal isn’t just to find the fanciest or most well-known option. It’s to find the right hospital—one that’s safe, supportive, in-network, and reasonably close to the surrogate’s home.
Intended parents should work closely with their agency and surrogate to explore options, express preferences, and understand what’s possible. With clear communication and thoughtful planning, everyone can feel confident heading into delivery day.
