Birth Centers, Adoption and Surrogacy: How to Truly See Non‑Birthing Parents

Becoming a parent through adoption or surrogacy is every bit as real, and often more logistically complex, as becoming a parent through pregnancy and birth. Yet families who build their families in nontraditional ways are still too often treated as an afterthought in perinatal care.

This topic is deeply personal to me. Our fourth child joined our family through an international adoption. We had a strong agency and felt well supported during the process itself, but once our child was home, we were very much “figuring it out on our own.” I empathize with non‑birthing parents (intended parents, adoptive parents, step‑parents) who show up in birth and newborn care spaces and don’t see themselves reflected in policies, language or support.

For birth centers, adoption and surrogacy are not edge cases. They are real, growing paths to parenthood. Thoughtful operational planning can be the difference between a family feeling dismissed, unheard or invisible... or feeling welcomed, anchored and fully seen.

Recently, I interviewed two leaders in this space: Kelsey Bigelow, founder of Famally, a resource for non‑birthing parents, about her private domestic adoption experience, and Jessie Jaskulsky, founder of Surrogacy Reimagined, about what the surrogacy journey feels like for intended parents and where birth centers can better support them.

Q&A: Inside a Private Adoption & Surrogacy Journey as a Non‑Birthing Parent

“From the inside out” experience

Q: Can you walk us through what it actually feels like—emotionally and logistically—to be a non‑birthing parent building your family through adoption or surrogacy, from “we’re doing this” through the first few months home?

Kelsey: I can speak as a mom who chose private adoption. Logistically, being a non‑birthing family is a huge project to manage. In the beginning, there are so many forms to fill out and trainings to attend. Paperwork we didnʼt even think weʼd need to find like our animals’ entire vet and shot records. It requires a lot of organization and patience. Having a very organized folder system of our paperwork was essential. With my background as a marketing and events manager, I was familiar with managing large projects and this felt like it worked well within my professional wheelhouse.

Emotionally, our adoption experience was extremely layered. We had already been going through a fertility journey for years before deciding on adoption. There was a lot of grief for both my husband and I, even though we were both in agreement on adoption being the best option for us. We also experienced wide swings from hope and excitement to disappointment and sadness during the waiting period. We knew each time we were being shown to a birth mother. We would be so excited that this could potentially be our baby and start dreaming of having the baby in our arms. Then we knew each time that we werenʼt picked by a birth mom, which was crushing. It was really easy to feel like something was “wrong” with us, like there was some reason we werenʼt getting picked. It was also really difficult when friends and family would check in on us and ask if we had any update on our adoption. I know that they meant well but every time we had to answer that nothing was happening and there was no update, it felt like I was disappointing them, in addition to my own disappointment.

Our adoption placement was a “stork drop” meaning our child was born and the birth family chose adoption in the hospital. From the time we learned about him until he was in our arms was less than 24 hours. That was a huge emotional rollercoaster of excitement, fear, and overwhelm. We were so excited to get that call and then the logistical ask of having a newborn in our home in such a short period became apparent. There was a very late night Target run trying to figure out what we might need for the next 24 to 48 hours. I had a lot of fear that maybe the birth family would meet us and decide they didnʼt like us anymore and change their minds and take him back. I also had a lot of self doubt for myself that we had gone for so long not getting picked and maybe I wasnʼt ready to do it.

Meeting him was hugely emotional. We met his birth family first and luckily had a social worker who knew both families with us who was able to help us navigate that first awkward conversation. It honestly felt like weʼd known them before. When the nurses brought our baby in, I canʼt even describe what the emotion was like. It was like he was the exact baby weʼd been waiting for for so long.

Post-placement, there was even more paperwork to fill out. It seemed to be a constant, never ending list of papers to fill out and keep track of. Because our son had come so quickly, my husband and I both worked the first week of having him in our home as we worked to prepare our professional teams for our parental leave. We were also scrambling to find childcare in a short period of time, reschedule things we had planned, and figure out how to continue life as normal for our oldest with this new newborn.

While we were navigating the logistics, we were also grappling with the haze of a newborn and all the emotional and physical labor of caring for a baby while trying to navigate bonding with someone we didnʼt know. It was so exciting and joyful to have him in our family at the same time.

Q: From the surrogacy side, what does it actually feel like—emotionally and logistically—to be intended parents building your family with a gestational carrier, from “we’re doing this” through the first few months home?

Jessie: For surrogacy, when someone decides to pursue this pathway to parenthood, it is often after many years of heartbreak. A lot of people arrive at surrogacy after years of infertility and loss, so they’re carrying a big emotional history into the process. In the beginning, most intended parents feel incredibly overwhelmed, they’re Googling everything, joining Facebook groups, and hearing completely different advice from different people while trying to decide what they want in a surrogate (geography, type of relationship, whether to use an agency or go independent, and so much more).

Once they’re actually in the process—matching, legal, medical—things get very real, very fast. Each intended parent processes that differently. For some, there are moments of relief; for others, there is a fresh wave of grief; hopefully most feel genuine excitement as they move through the process and get closer to bringing their baby home. What helps the most is being included as parents throughout: being acknowledged early, being part of communication with their surrogate, and being walked through what to expect in a way that actually reflects their path to parenthood.

Where systems fail families now

Q: Thinking about health care spaces in particular, what are some of the most painful or dismissive moments youʼve seen or experienced—for example at prenatal visits, at the birth itself, or postpartum follow‑up—when staff didnʼt know how to treat adoptive or surrogacy‑building families?

Kelsey: I felt really dismissed from our healthcare team once adoption became our decision for family building. We had been working closely with a fertility team up to that point and once adoption was the choice, they basically dumped us. There wasnʼt any follow up from their side on how we could pursue the adoption goal. It felt like I no longer mattered as a human because I wasnʼt trying to give birth, even though the conditions that had landed us in their offices in the first place hadnʼt gone away.

At the hospital when we were preparing for our sonʼs discharge, the hospital staff were dismissive of us as being an adoptive family. We felt like weʼd been thrown to the wolves in caring for him so suddenly and they didnʼt seem to understand our overwhelm. One of the nurses also tried to insinuate some pretty unsavory things about the birth family. Luckily, our social worker was there with us and assured us that those things were false and that sometimes people need to make up false reasons for why a family would choose to give up a baby. Whatever the staffʼs personal opinion was about adoption, they should have worked to help us enjoy the excitement of meeting our son.

Post-placement, we really lucked out with our pediatricianʼs office. We contacted them as we were driving to pick him up and they were really supportive of our situation. They were really helpful to us in newborn care the first few weeks and helped us so much with the newborn overwhelm. They were a great anchor in the first few weeks because they treated us like any other parents with a newborn, still asking how our mental health was doing, and patiently answered so many of our questions, while also being supportive of our situation.

What This Means for Birth Centers: Adoption, Surrogacy, and Operational Change

Kelsey’s story is exactly the kind of lived experience birth centers need to hear when thinking about birth centers, adoption and surrogacy and the role of non‑birthing parents in their care systems.

From both her answers and my work with birth centers, here are key takeaways and practical steps:

1. See yourselves as “family builders” in all forms

Instead of focusing only on pregnancy and birth, position your birth center as a place that honors all paths to parenthood: adoption, surrogacy, step‑parenting, donor conception and more.

• Make this visible in your website copy, tours, and community outreach.

• Use language like “We support all families and all paths to parenthood” and “We welcome non‑birthing parents and intended parents.”

2. Build policies and procedures for adoption and surrogacy scenarios

Don’t wait for a complicated situation at 2 a.m.

• Create clear policies for when the birthing person and legal parents are not the same (adoption, gestational surrogacy). This means understanding what parentage documentation looks like in your state.

• Outline who can consent to what, how staff communicate with both parties, and how to handle moments like skin‑to‑skin, feeding, photos and discharge.

• Include expectations around how staff speak about birth families, donors or carriers: no speculation, no judgmental language.

3. Design intake to recognize adoption, surrogacy, and non‑birthing parents

Your intake process should tell families: “We see you.”

• Add fields that identify if a family is building through adoption or surrogacy, or if there are step‑parents or multiple caregivers.

• Ask non‑birthing parents how they’d like to be addressed and documented (parent, mom, dad, papa, etc.).

• Build prompts into your charting so staff don’t default to calling the non‑birthing parent “support person.”

• For surrogacy, ask explicitly whether there is a surrogacy agency or attorney involved, and whether a pre-birth or post-birth parentage order is expected, so your team knows in advance how to handle consent and documentation.

4. Train staff to recognize the emotional load

Non‑birthing parents often carry years of fertility treatment, grief and the stress of a long adoption or surrogacy process.

• Offer training on the emotional and mental health needs of non‑gestational parents.

• Use stories like Kelsey’s to illustrate how it feels to be “dropped” by a fertility team or dismissed at discharge.

• Encourage staff to check in directly with non‑birthing parents: “How are you doing with everything right now?”

5. Structure postpartum care for complex family configurations

Postpartum care at birth centers can be more flexible and creative than in many hospital systems.

• Consider separate or joint visits for the birthing person and the baby with the adoptive or intended parents, especially when legal or travel issues are in play.

• Offer specific postpartum support and referrals for non‑birthing parents: bonding, attachment, feeding options, and mental health.

• Ask your payers how you should bill for counseling/education visits for a non-birthing parent and if they cover family or dyadic visits focused on infant health and bonding.

• Normalize that bonding with a baby you didn’t physically carry can be beautiful and also complex.

When birth centers, adoption and surrogacy are viewed together through an operational lens, the path forward becomes clear: policies, procedures, and training that name and include non‑birthing parents can transform individual experiences and, over time, shift how the system treats these families.

If even one family walks away from your birth center feeling fully seen, heard and supported in their unique path to parenthood, all of this work is worth it.

About Famally, Surrogacy Reimagined and How to Connect

Famally is a resource created specifically for non‑birthing parents who often feel overlooked in traditional perinatal care. It offers education, validation and community for families building their families through adoption, surrogacy and other nontraditional paths, so they don’t have to navigate these experiences alone.

Surrogacy Reimagined supports intended parents who are pursuing surrogacy, often after years of infertility, loss, or medical complications, by helping them understand the process, feel less overwhelmed and stay informed and included at every step.

If your birth center wants to better support non‑birthing parents, you can:

• Learn more about Famally and Surrogacy Reimagined and their offerings

• Explore ways to collaborate or be listed as a supportive provider for Famally

• Reach out to Kelsey directly for speaking, training or partnership opportunities at famallyresource@gmail.com.

• Reach out to Jessie for surrogacy-specific questions or to explore training or consultation at jessie@surrogacyreimagined.com