Author Identifier (ORCID)
Micah Peters: https://orcid.org/0000-0002-1108-3783
Abstract
Background Surrogacy poses unique clinical, psychosocial, and organisational challenges. Midwives, often with limited experience, education, and guidance, may feel uncertain about providing appropriate care, potentially affecting the quality of care and experiences of surrogates, intended parents, and newborns. Objective This study explored how midwives navigate surrogacy birth care, with a focus on role clarity, involvement of intended parents, and preparedness across the intrapartum and postnatal continuum. Method An interpretative phenomenological design was adopted. Five midwives with experience in surrogacy births were recruited through professional networks and the Australian College of Midwives newsletter. In-depth interviews were conducted and analysed using reflexive thematic analysis. Findings Four interrelated themes were identified. Navigating uncertainty without guidance described midwives’ reliance on personal judgement in the absence of surrogacy-specific policies. Balancing multiple parents in the birthing space highlighted tensions when surrogates, their partners, and intended parents all sought presence and recognition during labour and birth. Carrying the emotional labour of ethical tensions captured the moral strain midwives experienced when negotiating competing rights and expectations. Finally, gaps in education and professional development reflected pa rticipants’ limited preparation for surrogacy care, compounded by the rarity of such cases. Conclusion This study highlights how midwives navigate surrogacy birth care without clear guidance, relying on personal judgement while balancing expectations of surrogates and intended parents. Their experiences reveal uncertainty, ethical strain, and limited preparedness, underscoring the need for surrogacy-specific education and organisational guidance to support equitable, inclusive, and women-centred care.
Document Type
Journal Article
Date of Publication
2-1-2026
Volume
39
Issue
1
Publication Title
Women and Birth
Publisher
Elsevier
School
School of Nursing and Midwifery
Funders
Swinburne University of Technology
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Attawet, J., Ng, L., Qiu, Y., Kendal, E., Ojabo, M., Jefford, S., & Peters, M. D. (2026). ‘Making it up as we go’: Midwives’ perceptions of preparedness and role clarity in surrogacy birth care. Women and Birth, 39(1), 102168. https://doi.org/10.1016/j.wombi.2026.102168