What to Expect in the Delivery Room: A Surrogacy Hospital Guide for Gay Dads

After months of planning, legal work, and anticipation, delivery day is almost here. For gay dads, the hospital experience during surrogacy is unlike anything else — it's joyful, emotional, and comes with a few unique logistics to navigate. Here's your practical guide to being prepared.

Birth plan conversations (32–34 weeks)

Around weeks 32–34, sit down with your surrogate to discuss birth preferences. This conversation should cover:

• Who will be in the delivery room (both dads? just one?)
• Your surrogate's comfort level with you being present during labor
• Whether she wants you in the room for a C-section (if planned)
• Who cuts the umbilical cord
• Skin-to-skin contact immediately after birth
• Photography and video preferences
• Post-delivery room arrangements — will you and your surrogate want separate rooms?

Every surrogate relationship is different. Some surrogates want the dads deeply involved; others prefer more privacy during labor and want you to come in after delivery. There's no right answer — only what works for your specific relationship.

What to pack for the hospital

You won't be a patient, so your packing list looks different from most hospital guides:

• Legal documents — Copies of your PBO, gestational agreement, and photo IDs. Your attorney should send these to the hospital in advance, but bring backup copies.
• Car seat — Installed and inspected before you arrive. The hospital won't discharge the baby without one.
• Going-home outfit — For the baby. Pack a newborn size and a 0–3 month size, since you don't know exactly how big they'll be.
• Diapers and wipes — The hospital provides some, but having your own brand is nice.
• Formula and bottles — Unless you've arranged for donor breast milk or your surrogate has offered to pump.
• Comfortable clothes for yourselves — You may be at the hospital for 24–72 hours. Bring changes of clothes, toiletries, and snacks.
• Camera or phone charger — You'll want to capture everything, and your battery will drain fast.
• A gift for your surrogate — Optional but a lovely gesture. Many intended parents bring flowers, a card, or a meaningful gift.

Navigating hospital staff

Most hospital staff in major Texas cities are professional and welcoming, but you may encounter staff who aren't familiar with surrogacy or same-sex parents. Here's how to set things up for success:

• Pre-register with the hospital — Your surrogacy agency or attorney should contact the hospital in advance to ensure your PBO is on file and the staff knows to expect two fathers as the intended parents.
• Ask for the charge nurse — If any staff member seems confused about your role, ask to speak with the charge nurse. They can clarify the PBO situation and ensure you're treated as the parents.
• Bring documentation — Having your PBO on hand (not just on file) solves most issues quickly.
• Stay calm and confident — You are the legal parents. The PBO is a court order. You belong there.

Skin-to-skin bonding

Skin-to-skin contact (placing the bare baby on your bare chest) in the first hour after birth is beneficial for the baby's temperature regulation, heart rate, and bonding. Gay dads can and should do skin-to-skin — ask the delivery team about it in advance.

Many hospitals now encourage immediate skin-to-skin with intended parents in surrogacy births. If the surrogate is comfortable with it, one of you can hold the baby skin-to-skin right after delivery. Take turns so both dads get this experience.

If your baby goes to the NICU

About 10% of newborns spend time in the NICU, and the rate is slightly higher for surrogacy pregnancies (often due to the higher likelihood of multiples or C-section delivery). If this happens:

• Your PBO ensures you have full parental access to the NICU
• Ask the NICU team about kangaroo care (skin-to-skin in the NICU)
• Ask about rooming-in options so you can stay near your baby
• The NICU social worker can help coordinate your access and support

A NICU stay is stressful but very common, and most NICU babies go home healthy within days or weeks. Having your PBO on file ensures there are no access barriers.

Post-delivery logistics

In the 24–72 hours after birth, you'll handle several important items:

• Birth certificate paperwork — The hospital's vital records staff will prepare the birth certificate application. With your PBO on file, both fathers should be listed. Review it carefully before signing.
• Social Security number — You can apply at the hospital. It takes 2–4 weeks to arrive by mail.
• Newborn screenings — Required by Texas law. These are done at the hospital before discharge.
• Discharge — The baby is discharged to you, the legal parents. Your surrogate is discharged separately under her own medical care.

LGBT-friendly hospitals in Texas

These hospitals have earned recognition for LGBT+ inclusive care through the Human Rights Campaign's Healthcare Equality Index or similar programs:

• Houston — Houston Methodist, Texas Children's Hospital, Memorial Hermann
• Dallas — Baylor University Medical Center, Parkland Health, UT Southwestern
• Austin — Dell Seton Medical Center, St. David's Medical Center
• San Antonio — University Health, Methodist Healthcare

When your surrogate chooses her OB and delivery hospital, ask your agency to confirm the hospital's experience with surrogacy births and same-sex parents.

Bottom line

Delivery day will be one of the most memorable days of your life. Preparation is your best friend: have your legal documents ready, communicate openly with your surrogate about birth preferences, and don't hesitate to advocate for yourselves at the hospital. When you hold your baby for the first time, everything else will fade into the background.