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Intrapartum experiences of gestational surrogates and intended parents in Australia: A qualitative study
Jutharat Attawet1, Leo Ng2, Evie Kendal3
1Department of Nursing, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Background:
Gestational surrogacy is an increasingly visible, though tightly regulated, pathway to parenthood in Australia, yet intrapartum care remains under-examined. Existing maternity models are grounded in woman-centred care and offer limited guidance for births involving surrogates and intended parents within a triadic care relationship.
Objectives:
To describe the intrapartum experiences of gestational surrogates and intended parents in Australia and to identify care processes that support or hinder respectful, inclusive practice.
Methods:
A descriptive qualitative study was conducted with purposive sampling. Seventeen participants took part between December 2024 and May 2025, comprising nine gestational surrogates and eight intended parents who had experienced a surrogacy birth in Australia within the previous five years. Semi-structured online interviews (60-90 min) were audio-recorded, transcribed, de-identified, and verified. Data were managed in NVivo 12 and analysed using Braun and Clarke's six-phase thematic analysis. Credibility was enhanced through independent coding, coding comparisons, analytic memos, and team review.
Findings:
Birth was described as a shared, yet distinct experience shaped by ritual, recognition, and institutional preparedness. Three themes, each comprising interrelated subthemes, emerged: (1) rituals of handover marking the transition of parenthood, (2) recognition and misrecognition in clinical settings, and (3) institutional variability and inequity leading to inconsistent inclusion and added advocacy burdens.
Conclusion:
Intrapartum surrogacy care requires attention to relational and clinical processes beyond conventional care. Findings support extending woman-centred care to a relationship-centred model recognising surrogates, intended parents, and infants. Clear guidelines, inclusive language, and surrogacy-aware documentation are essential for consistent, equitable, and respectful intrapartum care.
