What to Expect with OB Care as a Gestational Carrier
Becoming a gestational carrier is an incredible gift - one that comes with unique medical care tailored to support both you and the baby you’re carrying. While much of the pregnancy experience is similar to carrying your own child, there are a few differences in the type of care and attention you’ll receive. Here’s an overview of what to expect from OB care as a gestational carrier.
1. Transition from the Fertility Clinic to the OB
In the early weeks of pregnancy, your medical care will begin at the intended parents’ fertility clinic. This is where the embryo transfer takes place and where you’ll (generally) have your first ultrasounds and bloodwork to confirm the pregnancy.
Once the pregnancy is established—usually around 8–12 weeks—you’ll “graduate” from the fertility clinic and transition into routine prenatal care with an OB (or sometimes a midwife, depending on the agreed upon preferences all around and the medical needs of the pregnancy).
2. Prenatal Visits and Routine Tests and Screenings
From this point, your prenatal schedule typically mirrors that of any pregnant person, and you will go through the same tests any pregnant person would.
Prenatal Schedule is typically:
Monthly visits until around 28 weeks.
Every two weeks from 28–36 weeks.
Weekly visits in the final month until delivery.
Routine Tests and Screenings may include:
First-trimester bloodwork and ultrasound
Genetic screenings (with intended parents usually making final decisions)
Gestational diabetes testing around 24–28 weeks
Group B strep test around 36 weeks
At these appointments, you can expect the usual blood pressure checks, weight monitoring, urine testing, measuring the baby’s growth, and listening to the baby’s heartbeat. The results of these tests are typically shared with both you and the intended parents if you have given them a HIPAA release to speak with the physician or if you have them on a phone call or video call during the appointment.
3. Extra Monitoring for Surrogates
While most prenatal visits are standard, some OBs provide additional ultrasounds or bloodwork for surrogates—especially in the early stages—to reassure both you and the intended parents. If the pregnancy involves twins or higher-order multiples (which is more common with IVF – although our agency only supports single embryo transfer to reduce that risk), expect more frequent monitoring.
4. Who Is the Patient?
You are the patient at these appointments and while you are carrying the intended parent’s baby, the OB will refer to you for everything because you are the patient. Legally, your medical information is yours, which means your OB and their staff cannot share details with your intended parents unless you give written permission. To allow your OB to communicate directly with them, you’ll typically need to fill out a HIPAA Release of Information form which is a standard form that gives your OB’s office permission to share your private health information with specific people such as your intended parents.
Some OB offices also welcome the intended parents to attend visits, either in person or virtually, so they can share the experience. If there is trouble with the OB office allowing virtual communication such as a phone call or video call during the appointment and the intended parents do not live locally to attend in person, this is a crucial time to communicate with the intended parents and see what their wishes are in regard to the care of their baby.
5. Communication with Intended Parents
One unique aspect of surrogate care is the extra layer of communication. You’ll not only be updating your OB, but also the intended parents and sometimes the agency or attorney. This can mean additional paperwork or permission forms for items like genetic testing, vaccines, or delivery planning.
Your OB’s office will usually be familiar with working alongside surrogates, but if not, be prepared to explain your role and make sure everyone is on the same page.
6. Delivery Planning
Toward the end of pregnancy, your agency or OB will help create a birth plan that accounts for:
The intended parents’ wishes (who holds the baby first, who cuts the cord, etc.)
Your comfort and preferences as the surrogate (who you plan to allow in the delivery room)
Hospital policies for surrogacy deliveries
Some OBs will schedule an induction or C-section depending on medical needs, while others wait for spontaneous labor. Either way, your care team will be focused on keeping you safe while ensuring the intended parents get to meet their baby as soon as possible. Your case manager through your agency will also be connecting with the hospital prior to the delivery to ensure the hospital is aware of the desires of you as the gestational carrier and the intended parents.
7. Postpartum Care
After delivery, you’ll continue seeing your OB for standard postpartum visits (usually at 2 weeks and 6 weeks). These visits monitor your recovery—physically, emotionally, and hormonally.
Since your role as surrogate ends with delivery, this postpartum support is especially important for your own well-being. Many OBs are mindful of the unique emotions a surrogate may feel and can connect you with additional resources if needed.
Final Thoughts
OB care as a gestational carrier is a blend of routine prenatal medicine and a unique partnership between you, the intended parents, and your care team. Expect a little more communication, more monitoring, and a lot of support to ensure a safe and healthy journey.
Being a surrogate is an extraordinary experience and having a clear understanding of what to expect with your OB care can help you feel confident and prepared every step of the way.