Wombs for rent in India
Women are getting paid as surrogate mothers to help Western couples with
infertility problems.
Is such outsourcing a logical outgrowth of India's fast economic growth or
an ethically troubling trend?
Apr. 20, 2006. The Toronto Star. http://www.thestar.com
ANAND, INDIA--As temp jobs go, Saroj Mehli has landed what she feels is a
pretty sweet deal. It's a nine-month gig, no special skills needed and the
only real labour comes at the end < when she gives birth. If everything goes
according to plan, Mehli, 32, will deliver a healthy baby early next year.
But rather than join her other three children, the newborn will be handed
over to a U.S. couple who are unable to bear a child on their own and are
hiring Mehli to do it for them. She'll be paid about $5,000 (U.S.) for
acting as a surrogate mother, a bonanza that would take her more than six
years to earn on her salary as a schoolteacher in a village near here. "I
might renovate or add to the house, or spend it on my kids' education or my
daughter's wedding," Mehli said. Beyond the money, she added, there is the
reward of bringing happiness to a childless couple from the United States,
where such a service would cost them thousands and thousands of dollars
more, not to mention the potential legal hassles.
Driven by many of the same factors that have led Western businesses to
outsource some of their operations to India in recent years, an increasing
number of infertile couples from abroad are coming here in search of women
willing, in effect, to rent out their wombs. The trend is evident to doctors
such as Indira Hinduja, perhaps India's most prominent fertility specialist,
who receives an inquiry from overseas every other week. It can also be
detected on the Internet, where a young Indian woman recently posted an ad
on a help-wanted website offering to carry a child for an expatriate husband
and wife.
Then there is the dramatic example of Mehli's family. Two of her sisters
have already served as surrogates -- one of them for foreigners -- and so
has a sister-in-law. Mehli finally decided to join in, with the enthusiastic
consent of her husband, a barber. She is under the care of a local physician
who has become a minor celebrity after arranging more than a dozen
surrogacies in the past two years, for both Indian and non-Indian couples.
For some, the practice is a logical outgrowth of India's fast-paced economic
growth and liberalization of the last 15 years, a perfect meeting of supply
and demand in a globalized marketplace. Payment usually ranges from about
$2,800 to $5,600, a fortune in a country where annual per capita income
hovers around $500.
"It's win-win," said S.K. Nanda, a former health secretary here in Gujarat
state. "It's a completely capitalistic enterprise. There is nothing
unethical about it. If you launched it somewhere like West Bengal or Assam"
-- both poverty-stricken states -- "you'd have a lot of takers.''
Others aren't so sure about the moral implications, and are worried about
the exploitation of poor women and the risks in a land where 100,000 women
die every year as a result of pregnancy and childbirth. Rich couples from
the West paying Indian women for the use of their bodies, they say, is
distasteful at best, unconscionable at worst. "You're subjecting the life of
that woman who will be a surrogate to some amount of risk," said C.P. Puri,
director of the National Institute for Research in Reproductive Health in
Mumbai (formerly Bombay). "That is where I personally feel it should not
become a trade."
Both sides of the debate agree that the fertility business in India,
including "reproductive tourism" by foreigners, is potentially enormous.
Current figures are tough to pin down, but the Indian Council of Medical
Research estimates that helping residents and visitors beget children could
bloom into a nearly $6 billion-a-year industry. "It's definitely going to
increase with education and literacy, especially in a country like India,"
said Gautam Allahbadia, a fertility specialist in Mumbai who recently helped
a Singaporean couple find an Indian surrogate. He has received similar
inquiries from the U.S., Israel and Spain.
In the vanguard of the nascent industry is this small city, where
gynecologist Nayna H. Patel is presiding over a mini baby boom. But eight of
her recent and imminent arrivals won't be adding to Anand's population of
100,000: Three of the infants are destined for the U.S., two for Britain and
three for other parts of India. (Six more surrogacy attempts were
unsuccessful.)
Before Patel's practice began attracting national and international notice,
Anand was famous for decades as the milk capital of India, home to the
country's most successful dairy farmer co-operative. Now the town also
boasts about 20 young women who have volunteered to be implanted with
embryos at Patel's clinic. A few have already gone through the process once
and are eager for a second go-round.
Prospective foreign clients hear of Patel through word of mouth or informal
online networks and websites dealing with infertility issues. By the time
they contact her, and spend the time, energy and money to get here, they are
usually desperate for children and often emotionally battered from long
years of trying and failing.
Patel has set some criteria for those she'll help: only couples for whom the
baby would be their first and where the wife is either infertile or cannot
physically carry a child to term. Likewise, potential surrogates must be
between 18 and 45, and in good health. They also must already be mothers, so
that they know what awaits their bodies during pregnancy and are less likely
to be troubled about giving up the new baby because they already have kids
at home. The egg that contributes to the embryo is never one of their own,
coming instead from an anonymous donor or the intended mother, and then
usually fertilized in vitro.
Both parties sign a contract under which the intended parents pay for
medical care and the surrogate renounces rights to the baby, a provision
that relieves the fears of many foreign couples. In the U.S., for example,
where laws vary from state to state, the surrogate sometimes has a window of
opportunity after birth to stake a claim on the child. In Anand, volunteers
are repeatedly reminded by Patel and her staff that the fetuses in their
wombs are not theirs. They give up the newborns within one to two days after
delivering. Patel said no problems have arisen yet with too strong a bond
forming between surrogate and child.
