Surrogate mothers: Outsourcing pregnancy in India

The practice of renting a womb and getting a child is like outsourcing pregnancy. This trade's business volume is estimated to be around $ 500 million and the numbers of cases of surrogacy are believed to be increasing at galloping rate in India.

MeriNews, By Joseph Gathia, June 23, 2008

India - THE MINISTRY of Women and Child Development is examining the issue of 'surrogate motherhood' in India for bringing up a comprehensive legislation. But surrogate motherhood - as an arrangement, in which a woman carries and bears a child for another person or persons, but takes no ownership of the child born - has also raised moral, ethical, social and legal questions about both the woman and the 'commissioned baby'.

To understand the issues involved, let us see the case of Surekha. She is seven-months pregnant like any other expecting mothers, except that the child she is carrying isn't her own. When Surekha gives birth to this child in India, the newborn will be immediately be handed over to its biological parents, Non Resident Indians (NRIs) who live in Canada and who have been unable to bear a child on their own. In return for renting her womb, Surekha will be paid one lakh rupees.

This practice of renting a womb and getting a child is like outsourcing pregnancy. The business volume of this trade is estimated to be around $ 500 million and the numbers of cases of surrogacy are believed to be increasing at galloping rate.

The exact extent of this practice in India is not known, but inquiries revealed that this practice has doubled in last few years and normally women from small towns are selected for this kind of outsourcing pregnancy.

Surekha's husband Madan (name changed) says his meagre income of Rs 2,000 per month as a casual worker is not enough to run the family and educate children. He says that the extra money will allow him to invest in his children's education and to buy a new home.

The medical opinion is divided on this kind of outsourced pregnancy. Dr Gupta reminds that, "This is not like donating a kidney. Bearing a child is an emotional issue. It is hard to force nine-month-pregnancy on any woman." She cites dozens of cases of couples that have spent a small fortune on failed in-vitro fertilisations or experienced repeated miscarriages and have had no option but to turn to surrogacy.

The practice first got momentum in America. Although the extent of the practice in America is unclear, a 1992 estimate calculated that as many as 4,000 babies have been born to surrogate mothers. The cost differences are clear-cut, however. In the US, surrogate mothers are typically paid $15,000, and agencies claim another $30,000. In India, the entire costs ranges from $2,500 to $6,500.

An interesting case has been reported from Britain. After two fruitless years of searching in Britain, including offering $17,000 for a surrogate, Bobby and Kalwinder Bains took out advertisements in Indian newspapers. The couple has found an Indian surrogate mother, who they are paying $720 for implantation of the embryo, $9,000.

The amounts are still nearly three times cheaper than what surrogacy in Britain would cost. Now the couple has started a website to help link up prospective parents and surrogate mothers from India.

Some 75 per cent of the clients are NRIs from Britain, America, Japan, and Southeast Asia. They come to India for the same reason many corporations do - it's cheaper.

While commercial surrogacy (or outsourcing pregnancy) is a growing industry in India where the embryo is transferred to the womb of the surrogate woman via in vitro fertilisation (IVF) Razia Ismail, a former United Nation's Children's Fund (UNICEF) media officer and now coordinator of India Alliance for Child's Rights has expressed certain concerns.

"You have no idea if your surrogate mother is smoking, drinking alcohol, doing drugs. You don't know what she's doing. You have a third-party surrogate mother agency as a mediator, but there's no one monitoring her in the sense that you don't know what's going on."

Another fear is that rich Western and NRI couples, who because of the lack of time, will come here looking for surrogate mothers and will simply outsource their pregnancy jobs to Indian girls at a price that is a fraction of what they have to pay in their own countries.

Few other questions that remain unresolved - Is it legal in India to become surrogate mothers? Will the child born to an Indian surrogate mother be a citizen of this country? Who arranges for the birth certificate and passport that will be required by the foreign couple at the time of immigration?

An enterprise known as reproductive outsourcing is a new but rapidly expanding business in India. Clinics that provide surrogate mothers for foreigners say they have recently been inundated with requests from the America and Europe, as word spreads of India's mix of skilled medical professionals, relatively liberal laws and low prices.

Nor is it entirely accepted in other parts of the globe. Movements to allow for surrogate motherhood have been rejected by voters in places like Sweden, Spain, France, and Germany. Other nations that allows it, including South Africa, Britain, and Argentina, employ independent ethics committees to evaluate surrogacy requests on a case-by-case basis.

Commercial surrogacy, which is banned in some states and some European countries, was legalised in India in 2002. The cost comes to about $25,000, roughly a third of the typical price in America. That includes the medical procedures, payment to the surrogate mother, which is often, but not always, done through the clinic, plus air tickets and hotels for two trips to India (one for the fertilisation and a second to collect the baby).

There are no firm statistics on how many surrogate mothers are being arranged in India for foreigners, but anecdotal evidence suggests a sharp increase. It is for this reasons even some of those involved in the business of organising surrogates want greater regulation.

In India, a small town Anand, in Gujarat, is pioneer in surrogate motherhood.

"After IT services, it seems it's now the turn of babies to be outsourced from India," says Sushma Mehta, a woman activist from Ahmedabad who is involved with a woman and child development project.

Under guidelines issued by the Indian Council of Medical Research, surrogate mothers sign away their rights to any children. A surrogate's name is not even on the birth certificate.

Surrogacy is an area fraught with ethical and legal uncertainties. Critics argue that the ease, with which relatively rich foreigners are able to 'rent' the wombs of poor Indians creates the potential for exploitation. Although the government is actively promoting India as a medical tourism destination, what some see as an exchange of money for babies has made many here uncomfortable.

An article published in The Times of India questioned how such a law would be enforced: "In a country crippled by abject poverty," it asked, "how will the government body guarantee that women will not agree to surrogacy just to be able to eat two square meals a day?"

There is growing evidence that surrogacy being used in India and that the services of women are being marketed for surrogate motherhood. Are wombs for renting - and are babies' commodities to be planted and harvested? What role does money play? Present official guidelines do not provide clear standards of answers. The government of India is moving to address the issue and Ministry of Women and Child Development is holding consultation across the country, which is indeed a step in right direction.