Please note that the following FAQs were created in response to guidance issued by the Pennsylvania Department of Health (DoH) specifically for “pregnant same-sex female couples.” We updated the language here in 2021 to be more inclusive of all married couples. Additionally, in light of marriage equality and other developments in the law, we believe that the DoH’s 2016 guidance applies to married couples of all gender pairings. However, the DoH has not issued additional or more expansive guidance since 2016. Consequently, some of the language the DoH uses remains underinclusive (e.g., “mother’s worksheet,” as you will see below).

On May 31, 2016, the Pennsylvania Department of Health issued guidance to hospitals advising them that, for “pregnant same-sex female couples” who are married at the time of birth, the hospital should list both spouses as the child’s parents on their child’s birth certificate.  

What does this announcement mean?

It means that if you are pregnant and married, the same procedures and policies about birth certificates apply regardless of your or your spouse’s gender identity. So if you are pregnant and married when you give birth, you are entitled to put both your name and your spouse’s name on the child’s birth certificate.

If we’re both on the birth certificate, we don’t need to do an adoption, right?

Unfortunately, that’s not necessarily the case. Having your name on your child’s birth certificate is not always enough to fully protect your rights as a parent. Until the law in this area is more settled, we highly recommend that all couples who conceive using donors confirm their legal rights as parents through adoption—even if you’re married, and even if you’re both on the birth certificate. 

We are using a gestational carrier. Can we go on our child’s birth certificate without a court order?

No. When the person who gives birth to a child is not one of the child’s intended parents, the intended parents must either obtain a pre-birth court order or complete a post-birth adoption proceeding resulting in a court order in order to be listed on the birth certificate. 

What kind of gender labels are used to identify a child’s parents on the birth certificate?

On Pennsylvania birth certificates, each parent can choose to be listed as “mother,” father,” or “parent.” If you are pregnant, you should list your spouse on what the Department of Health calls the “mother’s worksheet,” which you complete at the birth facility.

Please note that Pennsylvania has worked toward transitioning its vital records systems to use non-heteronormative language, but not all birth facilities may be as up-to-date. If you list your spouse on the “mother’s worksheet,” but they are not listed on the birth certificate, you should complete a Birth Correction Form including a note that the birth certificate does not match the “mother’s worksheet.” The Department of Health’s Office of Vital Statistics and Records will work directly with the birth facility to correct your child’s birth record.

Who should I talk to if I have more questions about birth certificate issues, or if the hospital doesn’t follow these rules?

The Department of Health’s 2016 guidance about birth certificates asks each Pennsylvania hospital to designate a point person for handling questions about this issue. In addition, please contact the ACLU of Pennsylvania if you have any concerns or problems with a hospital recognizing your marriage. If you have questions, you can email us at