Surrogacy Blog

Surrogacy in the USA – Parents Guide Part 1 (Pre-trip)

Dear Intended Parents,

You have now entered the most exciting stage of your surrogacy journey! We hope that we have delivered on our promise and done everything possible to provide you with all the necessary information and also guided you through the numerous stages with the honors and respect this incredible journey deserves. This guide has been written to give Intended Parents a detailed description on the process of bringing your baby/ies back home. The process will vary slightly from country to country; however, the guide is extremely informative and relevant for all Intended Parents. Please note that in the USA, the birth registration process may vary from state to state, however we will advise you closer to the birth. Don’t forget to regularly update the Tammuz team. Good luck.

Preparing for the trip to the USA:

The recommended date to travel is from 36 weeks with a singleton pregnancy and from 32 weeks if your surrogate is carrying twins. We recommend that you provide Tammuz with your flight details, hotel or other accommodation information and that if changes are made that you notify us immediately.

Cellular Device/Mobile Phone-

We recommend you do your research before travelling and find out who are the best network providers in the state your surrogate lives in. Once you arrive, you can then purchase a SIM from the provider that has the best network exposure in that state. Note: WhatsApp communication will remain with your home phone number. Do not switch countries when prompted!

Baby supplies-

  • Infant car seat – you must have this installed in your car as it is a requirement for being discharged from the hospital.
  • Stroller – recommended to bring from your home country.
  • Bottles – at least four baby bottles.
  • Baby bedding (not cradle size) and blanket.
  • Baby laundry detergent – recommended to bring from your home country.
  • Milk formula– bring from your home country, enough to last for 2-3 months.
  • Diaper/nappy rash cream – recommended to bring from your home country.
  • Newborn diapers/nappys – recommended to bring four packs from your home country.
  • Cradle/Cot/Crib – Bring a travel cot from your home country and/or a portbale new-born bed that simply folds up.

Travel documents-

You must have the following documents:

  • Copies of your passports including the change of name page .
  • Eight passport photos.
  • The original surrogacy contract (before your trip, verify you have a signed digital copy of the contract).
  • International driver’s license.

Insurance for the baby-

David Shield

This insurance policy is valid for 24 hours from the day the baby is discharged from the hospital assuming/he/she/they are healthy.

Arrival in the USA-

Upon arrival in the USA, and assuming the baby is not yet born, we recommend that you spend as much time with your surrogate as possible. You will also need to go shopping and purchase all the previously mentioned items. At the hospital, it is advisable to familiarize yourself with the social worker and make sure she has received the court order (pre-birth order).

Surrogacy in the USA – Parents Guide Part 2 (Childbirth)

Recommended supplies for your stay at the hospital-

  • Baby bonnet (2-4)
  • Socks (4 pairs)
  • Diapers/Nappys
  • Changes of clothes (2 ZIP UP ONESIES)
  • Wet wipes
  • Q-tips (cotton)
  • Baby soap
  • Three cloth diapers
  • Thermometer
  • Baby cream/powder/oil
  • Blanket
  • Milk substitute
  • Bottles
  • Clothes for discharge from the hospital (warm clothing since it can get cold in certain states in the USA)
  • Sterilization device for bottles
  • It is recommended to pack comfortable clothes, hygiene products and towels to use whilst staying at the hospital

The birth-

After months of anticipation, the moment of the birth has finally arrived. We hope that you have made all the necessary preparations as requested by the Tammuz team, have settled in to your accommodation and are no longer jet-lagged! The date and method of the birth (caesarean or natural), are determined by your surrogate’s OBGYN.

After the birth, the baby is expected to remain in the hospital nursery for one to three days. In the USA, regular births generally take place in private rooms in the hospital, and the surrogate remains hospitalized in the delivery room. If she undergoes a Cesarean, the surrogate will be transferred to a private room following the operation.

If the surrogate agrees, the Intended Parents will be allowed to be present in the delivery room, even in the case of a C-section. It is also possible to have more than one guest present in the delivery room. Immediately after birth, the baby will be examined by a pediatrician and then handed to you, the new parents. You will only be assigned your own private room in the hospital if there are rooms available and the ward is not at full capacity. Generally speaking, you should be assigned a room until your baby has been discharged.

Whilst in the hospital, the baby will undergo a series of blood tests and be given a Vitamin K shot. It is then recommended by the doctors to give your baby additional vaccinations such as BCG and hepatitis B. You should notify the medical staff as soon as your baby is born whether you are interested in these vaccinations.

Please inform us as soon as possible after the birth. We’d also love some pics of you and your little one/s! Before being discharged from the hospital, you must bring your car seat capsule with you and place your baby in the capsule so the hospital staff can approve the seat and officially discharge you from the hospital.

Costs associated with the birth and hospital-

The costs associated with the surrogate’s hospitalization and the birth itself, especially a caesarian birth, can reach the tens of thousands of dollars. These costs should be covered by the surrogate’s medical insurance. It can be reasonably assumed that the costs associated with the birth will be higher than the maximum out-of-pocket limit defined in the surrogate’s insurance. All costs up to the out-of-pocket limit will be paid by you. Any remaining costs over the maximum out-of-pocket limit will be paid in full by the insurance company.

Costs associated with the baby once it is born-

Standard hospitalization: if the baby was born on or around it’s due date with no need for special treatment, then you will pay the cost of its hospitalization directly to the hospital. The average cost is approximately USD$2,000. In general, the payment is not made at the end of hospitalization but rather at a later date. Immediately upon the baby’s discharge, the David Shield insurance should be put into effect.

Prolonged hospitalization: if the costs associated to the baby’s care are high, then you can purchase American health insurance. The process of purchasing the insurance takes several weeks and goes into effect retroactively from the day of birth. See below for details:

American health insurance for the baby-

Should your baby require additional health insurance due to a longer stay in hospital, please contact us immediately and we will work with our partner insurance experts from the EMS Agency (the surrogacy agency) to purchase your baby’s insurance. The insurance qualifies under the Affordable Care Act, better known as Obamacare. You’ll be required to send us the following information to start the insurance application process:

  • Baby’s full name and DOB
  • Both parents’ names
  • Surrogate’s name
  • Name and address of the hospital
  • Name and contact details of the social worker from the hospital

At a later date, you will be required to produce additional documents and forms, pursuant to the insurance company’s instructions, including the baby’s birth certificate and/or confirmation of birth from the hospital, SSN (Social Security No.) and more.

Please note that in order to avoid your application being rejected by the insurance company, make sure that all dealings with the insurance company (including transfer of signed documents, all payment requirements and collection of receipts, etc.) are conducted only by the insurance experts from the EMS agency.

The cost of your baby’s insurance is very similar to that of your surrogate’s insurance and is broken down once again in to the two categories of a monthly premium, (several hundreds of dollars per month), and your deductibles (the maximum out-of-pocket expense that costs several thousands of dollars depending on the policy).

Please ensure you keep all of your receipts of payment so you can be reimbursed by National Insurance where applicable.

Social Security Numnber (SSN)-

To apply for your baby’s SSN card, you will need the following documents:

  • Baby’s birth certificate
  • Baby’s passport
  • The summary documents of your stay in hospital
  • International driver’s license
  • Court order

Confirmation shall be sent to your hotel address no later than 1 week after the submission of your application.

Surrogacy in the USA – Parents Guide Part 3 (Postnatal)

Congratulations! You should now be very busy with the many joys of parenting, such as feeding your baby, constantly changing his/her diapers and also experiencing the occasional projectile vomit! Now that you have had several days to get used to this, it is time to start thinking about the legal process and bringing your baby home. It is important to note that each time you receive an official document, you will be required to have them approved with an official Apostille Stamp, regardless of which country you come from.

Issuance of the birth certificate:

The process of issuing a birth certificate can vary from state to state so please use the below information as a guide only.

Your attorney will hand deliver your pre-birth order to the social worker at the hospital. The hospital will then register your baby’s birth with Vital Records listing you as the parents. We would then advise you to call Vital Records on a daily basis to see if your baby is officially registered in their systems. As soon as you have confirmation that your baby is registered, and your birth certificate is ready for collection then we recommend you visit the nearest Vital Records to where you are staying and bring the following documents with you in order to collect your baby’s birth certificate:

  • Copies of your passport
  • Original surrogacy contract
  • Copy of the pre-birth order
  • Medical summary of your baby’s stay in hospital
  • Airline tickets

We recommend you request 3-5 copies of your birth certificate and as a general rule we advise that you keep all of your documents on you at all times whilst in the USA.

All of the aforementioned information only applies to Intended Parents who have been issued with a pre-birth order. In the very rare case where an Intended Parent is unable to be issued with a pre-birth order, then your surrogate’s name and the biological father’s name will be placed on the birth certificate. Then we will connect you with a local attorney in that state who will start the process of having your surrogate’s name removed from the birth certificate. This process can take up to 6 weeks therefore you are advised to travel home, and your attorney will send you an updated birth certificate with only the biological father’s name on it when the court approved the waiver of paternity order. Where the field is for the mother it will read ‘not listed’. Please note you will be required to sign all of the court application documents before you leave. To then have the other parent’s name added to the birth certificate please consult with your attorney.

Apostille Stamp approved documents-

Once again, we can’t stress enough the importance of the Apostille Stamped documents. We recommend you have all documents Apostille stamped in the same state as the birth otherwise the process can be problematic and, in some states, impossible.

Issuance of your baby’s U.S. Passport-

Once you have your baby’s birth certificate the process in obtaining your baby’s passport is relatively straight forward and simple. First you must call or book online to make an official appointment.

Phone: 18774872778


The appointment should be made at the nearest passport agency. The link will show your nearest office. When making the appointment, you must select the option of an expedited issue of passport for the purpose of flying abroad at the closest date of up to 14 days; hence the reason we require you to provide a copy of your itinerary clearly stating that the baby’s ticket home is within the next 2 weeks. When filling out the application form you will be required to give your baby’s SSN. If you don’t have it then please use 7 0’s in the field.

Appointment at passport office-

On the day of the appointment, please arrive at least half an hour before your scheduled time. You will need to bring with you the following documents:

  • Original birth certificate.
  • Intended Parents’ passports.
  • Two passport photos of the child. With regards to the photograph, please ensure that the baby’s eyes are open and that it is taken on a white background with no other visible objects in the photo.
  • Your baby’s airline ticket with the name of the child, including date of departure within two weeks from the day of the meeting. Please note that if you have purchased return airline tickets, you will need to update the return flight ticket and add your child to the reservation.
  • Printed DS-11 form (U.S. Passport Application.
  • Application confirmation you received during the registration process.

The cost of passport issue as of January 2019 is USD$165. Once you have been issued with your baby’s passport, you will need to check on your government website to see if USA citizens are automatically granted a 90-day tourist visa. If so, in many cases you will need to simply register for this visa. Once you return to your home country, you may then contact a local attorney to guide you on the process of applying for citizenship by descent and also your baby’s second passport.

The Tammuz Team wishes you a safe trip home!

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