Unmarried Ohio residents J.F. (plaintiff) and E.D. were in a long-term committed relationship and wanted children, but E.D. was unable to conceive. J.F. entered into a surrogacy agreement with an egg donor, who provided genetic material, and D.B. (defendant), a gestational carrier. The genetic material provided by the egg donor was combined with material provided by J.F. and then implanted in D.B., who carried three embryos to delivery. Upon delivery, D.B. agreed to relinquish custody of the newborns to the intended parents, J.F. and E.D. The triplets were delivered prematurely via caesarean section and placed into a neonatal intensive-care unit (NICU). The intended parents traveled from Ohio to Pennsylvania to see the infants. However, the newborns required more care than originally anticipated. J.F. and E.D. returned to Ohio while the newborns were being treated at the NICU. D.B. did not like the lack of physical visits by J.F. and E.D. and revoked her consent to permit the intended parents access to the triplets, instead taking the triplets home after discharge. All calls from J.F. and E.D. to D.B. went unanswered. J.F. filed a complaint for custody and a motion for emergency special relief against D.B. After a number of hearings, the trial court struck down the surrogacy agreement and granted standing to D.B. in loco parentis and, alternatively, as the triplets’ legal mother. The court issued an order awarding joint legal custody to D.B. and J.F., gave primary physical custody to D.B., and granted J.F. partial custody and visitation rights. J.F. appealed.