Fewer than one in 10 hospitals in New South Wales and Victoria have policies to guide surrogacy births, prompting urgent calls from experts for national standards.
The research, published in the Journal of Law and Medicine, reviewed 112 metropolitan hospitals across both states and found only 10 had surrogacy birth care policies.
The lack of clear guidelines left health professionals, surrogates, and intended parents navigating inconsistent care, legal uncertainty, and emotional stress, according to researchers.
Surrogacy is becoming an increasingly common pathway to parenthood, yet hospitals were unprepared, said lead author, Charles Darwin University (CDU) Lecturer in Nursing Kabir Sattarshetty.
“Without clear policies, hospitals risk excluding intended parents from delivery rooms, delaying newborn bonding, and creating confusion around feeding and decision-making. Families deserve clarity and consistency during one of the most significant moments of their lives.”
The report highlighted cases where intended parents had 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.
“Too often, intended parents are sidelined at the very moment they should be bonding with their baby.
“Clear, family-centred policies would prevent distress for everyone involved,” said co-author, Surrogacy & Donor Legal Services Director (VIC) and surrogacy lawyer, Sarah Jefford.
The lack of surrogacy birth care guidelines also risked undermining newborn health outcomes with key practices such as skin-to-skin contact, parental bonding, and neonatal care protocols inconsistently applied.
Researchers have called for the 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,” said Mr Sattarshetty.
“Comprehensive policies would protect surrogates, support intended parents, and most importantly, ensure babies born through surrogacy have the best possible start to life.”
The research paper published in the Journal of Law and Medicine can be accessed here.
