One of India’s fastest growing industries treats women as bodies for rent, says Bidisha
Infertile? Fancy a holiday? Visit India, where you can buy gems from Jaipur, see the Taj Mahal and collect a baby, your own flesh and blood, couriered to the country in a parcel, carried for nine months and birthed by a grateful Indian surrogate.
It may sound like the plot of a dystopian fantasy novel, but it’s happening right now in India’s booming gestational surrogacy trade. Indian surrogates are increasingly being used as incubators by infertile international and wealthy Indian couples. Embryos made from the couple’s combined eggs and sperm are injected into the surrogate fresh or after being frozen in the home country and sent by courier. The surrogate signs a contract ceding all rights to the child, is paid per baby, to which she has no genetic connection, and is looked after in one of the many new surrogacy clinics in India’s cities.
Concern about international surrogacy’s ethical, financial, legal, medical and cultural ramifications has been growing since it was legalised in India ten years ago. The most recent study is Kishwar Desai’s fact-based novel Origins of Love, but there are also the films Google Baby, Made in India and Womb For Rent: A Tale of Two Mothers and articles like Time magazine’s “India’s Rent-a-Womb Industry”.
The language of these alarmed studies is of short-term usage, cheap hire, easy purchase, temporary acquisition, casual appropriation. When I Googled “Indian surrogacy services” – exactly the same way couples shop for their own QuickPay baby solutions – I got more than 1.3 million links to clinics whose authenticity is hard to validate, whose sites are badly written and evasive and yet who seem to offer the world. One centre in Hyderabad has provided international surrogacy since 2008 and claims to have birthed just over 200 international surrogacy babies, with prospective parents coming from 21 countries. Chillingly, it boasts that it has “garnered trust and excellence in the international market of cross-border reproductive tourism”.
Surrogacy tourism is now worth $2.3 billion, according to estimates by the Confederation of Indian Industry. It is used mainly by infertile couples as a last resort, after suffering multiple failed IVF attempts or multiple miscarriages. Or else it is used in relatively rare cases where a woman has no uterus due to a birth defect, illness, disease or damage. In the former situation, where IVF has not worked, the problem is not with the gestational environment (which is what a surrogate provides), and could be solved by using high-quality donor eggs or embryos. However, clinics take advantage of couples’ fatigue, worry and ignorance and push the most expensive option: surrogacy.
Surrogacy costs purchasers between $25,000 and $30,000, an enormous amount when converted into rupees by Indian doctors, yet a fifth to a third cheaper than domestic surrogacy (if that is even legal in couples’ home country or state). However, it has only a 45 per cent success rate for fresh embryos, dropping to 25 per cent for embryos which have been frozen and couriered. Surrogates are generally between 21 and 35 years of age and must have had previous children with uncomplicated pregnancies. They receive between $3,300 and $6,500 for their services if they carry to full term, which most do not, as well as a monthly fee during the pregnancy.
On the surface it seems a win-win transaction – a willing Indian woman, cared for by doctors, giving globetrotting couples the baby they have tried for for years. If we have no qualms about wearing cheap clothes made by kids in factories overseas or having our houses cleaned, food delivered and cabs driven by low-paid workers of diverse nationality, then why quibble about surrogacy, just another convenient colonial-flavoured purchase of labour? After all, the surrogate gets enough money to pay for schooling for her own children, even for a small house. The parents and the surrogates are not friends or equals and never will be, since language, race, education, class, location and role divide them. But they both benefit, don’t they?
Surrogacy is banned in Sweden, Spain, France and Germany and looked at on a case-by-case basis in South Africa, the UK and Argentina. In these countries a woman is not seen merely as a gestational carrier for rent. But what is deemed demeaning for, say, French and Spanish women seems not to be given a second thought in India. Doctors will reassure purchasing couples that in using an Indian surrogate they are helping India’s poverty problem. Meanwhile India’s cities teem with millions of street children who would benefit from adoption or long-term sponsorship.
The Indian Council for Medical Research has not set down any legally enforceable guidelines, restrictions or taxation on this trade. Anything goes in this highly invasive procedure. For example, Indian doctors are allowed to implant a surrogate with up to five embryos; the limit is two in the UK and the norm in EU countries for similar cases is one. A move to consider legislative recommendations by the Indian Ministry of Women and Child Development four and a half years ago came to nothing.
Despite her crucial role, the surrogate is accorded the least relative benefit or power, which reflects the wider context in which women in India live. The poorest and most geographically and educationally marginal in particular suffer grievously from the country’s deep-seated gendered inequalities. Choices made from hunger, poverty and the desire to provide basics (food, shelter, water, transport, healthcare, education) for one’s family could hardly be said to be free, fair or equal. An investigation by the Indian Express this May found, unsurprisingly, that surrogates have only a basic level of education, and do it for strictly financial reasons.
While surrogates may be under family pressure to rent their wombs out for money, conversely their state may be seen as evidence of sexual lassitude; being pregnant with someone else’s baby (however the baby got into the womb), travelling to the city and being examined intimately by a doctor could easily be interpreted in their village as signs of wantonness, with potentially catastrophic consequences.
This June India came top of a list of the worst places to be a woman amongst the G20 nations. The study, carried out by the Thomson Reuters Foundation and based on the assessment of 370 gender specialists, placed India above Saudi Arabia, Indonesia and South Africa. The analysts cited the prevalence of sexual harassment and sexual violence, some of it perpetrated by police officers and other authority figures; endemic victim-blaming, perpetrator excusal and impunity supported by official apathy and corruption; sexual exploitation; child marriage; persisting dowry customs, female infanticide and female foeticide.
A surrogate may be grateful for the money, but what message does this trade send about her value? As surrogates, women usually receive the first proper medical checkups, pelvic exams, monitoring, rest, nutrition and quality care of their lives. When they bear their own children, no such help is available. Bearing another’s child, perhaps even a white child with whom she shares no genetic material, she can gain access to the highest quality of care and the best hospital, whose doors were barred to her before, and will be again once she reaches term.
If she can’t carry a child to term, as is statistically likely, the surrogate will be stripped of her perks and sent home. If she has feelings for the baby, too bad. The physical and emotional ramifications are trampled in the rush towards profit. The women may not even choose how and when they give birth, as that is decided at the doctors’ and purchasing couples’ convenience.
Public unease about this trade has gained little traction and no legal force against the growth of a business where clinics take advantage of the emotional desperation of purchasers and the financial desperation of surrogates. In the 25-45 per cent likelihood of a baby being produced, they leave the new parents to flounder in an international legal mire. The parents must act according to the adoption laws of their home country to have the baby recognised as theirs, to put their names on its birth certificate, be allowed to take it home and have it granted citizenship of their home country.
But, to the hundreds making money from this desperation, what does it matter when there are countless more couples willing to try – and millions of poor, rural, uneducated, disadvantaged Indian women with nothing to trade but their body parts?