Yehezkel M. From Baby M to Baby M (Anji): regulation of international surrogacy agreements. Journal of the Forensic Anthropologist. 2013;287:288. Gestational surrogate may face postpartum depression and problems related to the child`s abandonment to intentional parents.  Immediate postpartum depression was observed with rates of 0 to 20% in the disease substitutes. Some surrogate mothers report negative feelings with the child`s abandonment immediately after birth, but most negative feelings dissolve after a while. The creation of an international policy framework is probably an ambitious goal, but the World Health Organization – and more specifically the Pan American Health Organization (PAHO), which influences public health issues in South America – could play a leading role in creating consensus and guidelines for harmonizing the commercial policy of surrogacy. These policies should be aligned with public health principles, while recognizing the unique values and culture of the region when provisions are established to protect all parties involved in a surrogacy agreement. Many decisions still need to be made and answers to questions such as whether there should be age requirements for surrogate mothers, how often a person can act as a surrogate mother, the number of eggs to be fertilized, the type of ethical economic compensation and the state that is required to offer citizenship to the newborn when surrogacy exceeds the limits that must be treated in such a framework. Virginia requires prior authorization of a surrogacy contract by a court. If the contract is approved, then the intentional parents will be the legal parents. If the contract is cancelled, the surrogate mother and her husband, if they exist, are called the legal parents and the parents who intend to acquire the parental rights can only be acquired by adoption.
If the contract has never been approved, the substitute may submit a consent form that gives the child rights. But if it does not, the rights of the parents will vary depending on whether one of the intentional parents has a genetic relationship with the child. Depending on the circumstances, they may have to adopt in order to obtain the rights of the parents. Despite all the above, if the surrogate mother is the genetic mother, she can terminate the contract within the first six months of pregnancy.