Combined with advocacy from infertility and LGBTQ+ organizations, these developments encouraged lawmakers to create legal frameworks that allowed surrogacy under regulated conditions rather than prohibiting it entirely.
In re Baby M:
How the Surrogacy Access Revolution Prompted Reaction and Reform in Family Law
Reforming Surrogacy Law
Opinion on why surrogacy should be legal, 30 September 1988, USA Today
Over time, legal reform replaced earlier restrictions as states increasingly moved away from outright bans and toward regulated surrogacy agreements. Advances in reproductive technology, particularly the growth of gestational surrogacy in the 1990s and 2000s, reduced some concerns raised in Baby M, because surrogates were often no longer genetically related to the child.
Cartoon on where a baby should go after the Baby M case, 30 September 1988, USA Today
Perspective about why surrogacy laws shouldn't happen, 30 September 1988, USA Today
One major development in regulating surrogacy access was the Uniform Parentage Act (UPA), which created a legal framework for recognizing parent-child relationships beyond traditional biological ties. The UPA, originally drafted in 1973, was initially adopted in 16 states and currently enacted in California, Connecticut, Maine, Rhode Island, Vermont, and Washington.
"The UPA lays the foundation of surrogacy contracts and synthesizes ideas from several states. Although every state has a different policy, most follow a basic legal structure, and then states, in implementing their own parentage laws, go on to prescribe these terms in more detail."
- Nick Stanley, Author, 24 September 2018, Freedom of Family: The Right to Enforceable Family Contracts
Later revisions responded to gaps exposed by cases like Baby M, gradually incorporating surrogacy into state law through clearer rules governing its use and enforceability. For example, in 2017, the act was revised to address provisions around reproductive technologies, significantly impacting couples who could not conceive children, including same-sex couples. Over time, the UPA framework contributed to a more consistent legal approach across states, helping establish when and how surrogacy agreements could be enforced.
Baby M with Bill Stern, 16 January 1987, The Sentinel
Overall, the Baby M case marked a turning point in the surrogacy-access revolution by exposing the lack of legal structure governing paid surrogacy. While the immediate reaction was restriction and invalidation of agreements, the long-term reform was the development of regulated legal frameworks that made surrogacy more accessible under the law. This shift reflects a broader transformation in family law, where surrogacy moved from legal uncertainty and prohibition toward structured regulation that enabled its recognition as a legitimate form of reproductive access.