Fewer than one in ten hospitals in New South Wales and Victoria have policies to guide surrogacy births, new research has found, prompting urgent calls from experts for national standards.
The study, published in the Journal of Law and Medicine, reviewed 112 metropolitan hospitals across both states and found only 10 had surrogacy birth care policies. Researchers say the lack of clear guidelines leaves health professionals, surrogates, and intended parents navigating inconsistent care, legal uncertainty, and emotional stress.
Lead author, Charles Darwin University (CDU) Lecturer in Nursing (Faculty of Health), Kabir Sattarshetty, said surrogacy is becoming an increasingly common pathway to parenthood, yet hospitals are unprepared.
"Without clear policies, hospitals risk excluding intended parents from delivery rooms, delaying newborn bonding, and creating confusion around feeding and decision-making," Mr Sattarshetty said. "Families deserve clarity and consistency during one of the most significant moments of their lives."
The report highlights cases where intended parents have been prevented from entering the birth suite, or surrogates were unable to be discharged without the baby. In some hospitals, staff encouraged surrogates to initiate breastfeeding, overlooking the intended parents' need to learn bottle-feeding.
Co-author, Surrogacy & Donor Legal Services Director (VIC) and surrogacy lawyer, Sarah Jefford OAM, said these situations are avoidable. "Too often, intended parents are sidelined at the very moment they should be bonding with their baby," Ms Jefford said. "Clear, family-centred policies would prevent distress for everyone involved."
Researchers warn the lack of surrogacy birth care guidelines also risks undermining newborn health outcomes, with key practices such as skin-to-skin contact, parental bonding, and neonatal care protocols inconsistently applied.
The study calls for urgent development of national guidelines to provide hospitals with a consistent framework for surrogacy care.
"Surrogacy is no longer a passing phenomenon; it is firmly embedded in our social and medical landscape, and all indicators suggest it will continue to expand. Unfortunately, our health system has not kept pace," Mr Sattarshetty said.
"Comprehensive policies would protect surrogates, support intended parents, and - most importantly - ensure babies born through surrogacy have the best possible start to life."
