Surrogate mothers yesterday took a large step out of the shadows, helped by the medical profession. Kings College Hospital announced it was planning the first NHS surrogate conception. At the same time the British Medical Association changed its position. For years the BMA said doctors should have nothing to do with surrogate pregnancies. Yesterday it published guidelines to inform would-be parents and surrogate mothers about the dilemmas they could face. Surrogacy is not going to go away. There is nothing to stop couples desperate for a baby who have tried every other route and failed turning to a friend or relative to act as a surrogate mother. The potential emotional upheavals surrounding surrogacy can be daunting. People planning to go through this need help, support and professional advice.

More significantly, a market in surrogate pregnancies is opening up. The BMA report cites cases of Eastern European women smuggled to the West and pressurised into pregnancy for cash or citizenship.

With surrogacy apparently becoming more common and more open to abuse and exploitation it is essential that doctors should not stand on the sidelines, but help to establish guidelines for good practice.

The two most important points are these. First, surrogacy for profit must continue to be illegal. The best way to make sure women are not exploited as surrogate mothers is to make sure there are open, transparent and well regulated ways for desperate couples to apply for surrogacy arrangements. Second, women offering to act as surrogate mothers and the would-be parents need to be aware how traumatic the experience can be, especially if the mother regrets her promise to give up the child. This is difficult moral terrain. Openness and debate are vital prerequisites if we are to have any hope of charting our way through it.