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Out of State Birth
In some surrogate arrangements it is necessary to plan for an out of state birth. In most cases this planning is due to unfavorable surrogacy laws in the surrogates state which make it prudent to deliver elsewhere. While delivering out of state for the sake of the birth certificate and/or surrogacy legalities may be important it is also important to consider a few things while making the decision to move forward with this type of arrangement.
The first thing to think about when deciding if an out of state birth is right for you is how you plan to deliver. If you are in favor of a natural birth with few interventions then it may be important to you to discuss with your OB and your Intended Parents how the birth will be planned.
Will it be a natural birth, letting labor start spontaneously or will it be an induction? If you decide on a natural birth then planning on being in the state where the delivery must occur ahead of time is key. If this is the case consider when you will have to be in that state. Look at your past delivery history and speak to your OB to help make this decision. However be prepared that your Intended Parents may want you to be "in state" sooner than you alone would anticipate. Sometimes the fear of delivering earlier than anticipated may add complications to the planning of when you will actually NEED to be in the delivering state. You must also remember that every pregnancy, labor and delivery is different and although based on past experience you may not have delivered until a set date that it doesn't guarantee that will be the par for course this time.
If it is agreed on when you would be "in state" the next thing to consider is whether or not you will go alone. What will happen with your children if you have any. Will they come with you? Will they stay at home? What about daycare? School? Will your significant other come with you? Will he/she stay at home? With this in mind it is important to speak with your Intended Parents about potential expenses as they will be paying for any lost wages, daycare costs, hotel costs, food, travel, etc.
Deciding when to go to the delivering state and how it is arranged can be complicated if you factor in all of these issues. You must also remember the emotional toll it may take on you being away from home for an extended period of time, especially if you are going alone and leaving your family behind.
If you and your Intended Parents decide on an induced labor there are many things to consider with this option as well. You must keep in mind that most hospitals will not induce a pregnancy prior to 38 or 39 weeks with out medical cause. If it is an elective induction an amniocentesis will be required. Please consider that even if the induction is past the hospitals set gestation date and/or your amnio is positive for lung maturity that doesn't necessarily mean that your body is ready for labor. You must prepare yourself for possible complications from the induction which may include a surgical birth. When deciding on an induction you must be aware that your birth preferences may be put at risk for the sake of timing the birth in the state of choice.
The second point to consider is the possibility of pre-term labor. If pre-term labor occurs what will be the course of action? Will you plan to go to the state of choice at the onset of pre-term labor and wait? Again how will you feel being away from your family for an extended period of time? What will your family at home do with out you? How would it affect you and your family emotionally?
Or do you forgo the previous plan to deliver out of state and stay home? What will happen with the birth certificate and the legal issues if you do deliver in state? Will it mean legal trouble for you or your IP's? Will it just be a matter of more time and money to amend the birth certificate? How do your Intended Parents feel about this?
Another point that is related to the above is the possibility of unexpected complications that call for immediate delivery, for example the onset of pre-eclampsia, toxemia or if your water breaks unexpectedly. Will you cancel plans for the out of state birth and deliver locally or will you still attempt to travel to the other state? Consider the safety issues when deliberating this possibility.
Lastly you must consider what will happen when it is time for the birth. You will have to make plans for your family, will your significant other attend the birth? Will he/she acquire lost wages? Remember an out of state birth will require more missed work than a typical birth, because you must accommodate time for traveling. Also you must decide whether or not your children will come with you? If not, who will care for them in your absence? If they come with you where will they stay while you are in the hospital? Will they miss school while away from home? As well don't forget to consider your pets.
A few more points to give thought to for the birth are what may happen if there are complications with delivery. What will be your plan if you are required to stay for an extended period of time in the hospital after delivery. Will your significant other and/or children stay out of state with you the entire time? Will they have to return home with out you? How will you handle transportation if they return earlier than you do? While speaking of transportation how will you return home? Keep in mind that you will have just delivered a baby and most likely will not be equipped to travel as normal. Will you fly home, drive, take the train? Will you be traveling alone?
As you can see planning an out of state delivery can be overwhelming and stressful. It is important that all of these issues are addressed prior to committing to a match where an out of state delivery may be required. It is imperative that all parties have open communication and are in agreement on these points in advance. However remember even with the best laid plans complications can occur.
Written by Alicia~in~MI
Independent Gestational Surrogate to Boy/Girl Twins 2003
Agency Faciliated Gestational Surrogate to Boy 2006
Clinic Matched Egg Donor 2004