In gestational surrogacy, a PBO (pre-birth order or post-birth order) refers to the legal order naming the Intended Parents as the legal parents of the baby born through gestational surrogacy. In many States in the U.S., the order is obtained before the birth of the baby (pre-birth order). In some States, the order is obtained shortly after the birth (post-birth order). In either case, the order is crucial in gestational surrogacy so that the Intended Parents are established as the legal parents of the baby, and to ensure that the names of the Intended Parents are placed on the baby’s birth certificate. The legal proceedings must be handled by an attorney licensed to practice law in the State of the birth, and who is experienced in the area of assisted reproduction technology law (ART law). There are at least a few attorneys in every U.S. State who can help with these important legal matters. You can check with the Academy of Adoption and Assisted Reproduction Attorneys (AAAA) to locate competent legal counsel in the State where your baby will be born. The applicable law and legal procedures are the law and procedure if the State where the baby will be born. Most often, this is the State where the gestational surrogacy lives and gives birth. Another important result of obtaining a PBO is that the rights and obligations of the gestational surrogate will be terminated. In this sense, the process is different from an adoption process where birth mothers have rights after the birth in order to make sure they want to give their baby up for adoption. This issue is not present in the gestational surrogacy process. The order of legal parentage is obtained before the birth so that the moment the baby is born, the Intended Parents take legal custody and have the rights and obligations to make all decisions regarding care and treatment for their newborn baby. Even in the case of a post-birth order, the hospital and doctors will recognize the Intended Parents as the custodial parents because the lawyers will initiate the process before the birth and make sure the hospital and other key people know that the Intended Parents shall have the right to make decisions for the baby at the time of the birth. This is another important aspect of what the lawyers do to ensure the rights of the Intended Parents, i.e., they make sure that the hospital staff and administrators know who the Intended Parents are and that they are the legal parents. The lawyers also make sure that the governmental authorities responsible for issuing the birth certificate create and issue the correct birth certificate with the names of the Intended Parents, or with one Intended Parent if single. Of course, the most important aspect of a gestational surrogacy pregnancy is the health of the fetus and the gestational surrogate. The next most important issue is the legal process to obtain the PBO.