The politics and ethics of the surrogacy industry are at once divisive, controversial and complicated. Is it as detached and exploitative as the “Rent-a-Womb” label suggests or are there mutual benefits for all involved?
India is one of a small number of nations that allow commercial surrogacy. Georgia, Russia, Thailand, Ukraine and a few US states also allow women to be paid to carry another person’s genetic child through a process of in-vitro fertilisation (IVF) and embryo transfer. “Fertility tourism” is a booming industry and India is the preferred destination for those seeking this procedure. The income generated from India’s 3,000 specialist clinics comes primarily from nationals of Britain, the US, Australia, Japan, and others besides, and amounts to an estimated $400 million – $1 billion a year, according to a UN-backed report from July 2012 and BBC sources. Some see this as a win-win situation, giving the gift of life to those who cannot conceive, whilst giving a level of economic freedom to families that they could otherwise only dream of. However, there are many who believe that this is, simply, yet another manifestation of the exploitation of the poorest in our world.
The Akanksha clinic is one of the best known surrogacy clinics, so much so that the small Gujarati town where it is based, Anand, has been labelled India’s “surrogacy capital”. Owned by Nayana Patel, she firmly believes that surrogacy of this kind is mutually beneficial. In her opinion, “The surrogates in Anand have become empowered through giving this beautiful gift to others…With the money, they are able to buy a house, educate their children and even start a small business. These are things they could only dream of before”. For someone who has “produced” over 500 surrogate babies and taken the time to build such an institution, in which upto 100 women stay in a hostel together for the full term of pregnancy and are provided with the medication and care they need, she has a strangely detached view of the process. In her own words in a BBC interview, she states simply that, “I feel that each and every person in this society is using one or the other person,” and that, “These surrogates are doing the physical work agreed, and they are being compensated for that. They know that there is no gain without pain”.
The money these women receive is indeed life-changing and far exceeds the wages available to either men or women in their position, both geographically and societally. These women receive $8,000 for the delivery of a baby, $10,000 for twins and $600 if she miscarries in the first 3 months. The clinic receives around $30,000. However, many women’s rights groups vehemently attack this practice as exploitative, claiming that many poor and uneducated women are lured by agents, who are hired by the clinics themselves, into signing contracts they do not fully understand.
In this regard, it is interesting to consider the views of the women involved. From Reuters and BBC interviews, it is apparent that the surrogate mothers see their choice as a huge sacrifice they are making so that their own children will not have to undergo such a fate. This sacrifice involves both social stigma in their community, and so the need to uproot themselves and their family when they complete the pregnancy, as well as the rigours of pregnancy, which are confounded by the strict laws of having to stay in the surrogacy hostel for the full term of the pregnancy, only being allowed to see their family once a week, and being forbidden sexual intercourse throughout. Moreover, their is the intense emotional pain suffered when their baby is simply taken away from them. Having carried and nurtured this life for 9 months inside of them, they may get to see the child for a few moments before it is taken away. What is more, current legislation means that surrogate mothers, unlike in the West, have no rights to the baby and their name is not even put on the birth certificate, meaning their is little hope of them ever having contact again if the parents do not desire it. Tellingly, one mother told the BBC, “Not in my entire life do I want my daughter to be a surrogate mother.”
The fact that new legislation is to be introduced is a welcome chapter in this story and, seemingly, tacit admission that exploitation has been allowed to take place in recent years. One only has to look back to a case last year where a surrogate mother’s death in childbirth was recorded by police as “accidental death”, with no further investigations taking place and to a recent government-funded study of 100 surrogate mothers that found there was “no fixed rule” related to compensation and no insurance for post-delivery healthcare. “In most of these cases, the surrogate mothers are being exploited,” says Ranjana Kumari, director of the Centre for Social Research that conducted the study.
The Assisted Reproductive Technologies Bill to be introduced will adversely effect the “surrogate business”, due to stricter laws on who can be a surrogate mother and who can use these services. However, the protection of these women who are giving up so much must be a priority. Let us hope that the bill passes in its entirety.