Desi women have now joined desi men in the business of assisted fertility. When you combine Indian medical prowess with lots of poor people you get pharmaceutical testing, organ sales, and now a thriving business in surrogate motherhood [Thanks to wgiia for alerting me to this story].
This sector is now worth roughly a half a billion dollars a year and growing rapidly.
Daksha, a shy Gujarati woman in her early 30s, wants a child – but not for herself. The baby is for the “Britishers”, the couple seated in the lobby of the Indian fertility clinic. It is the first time that the British Asian couple, Ajay and Saroj Shah, from Leicester, have met Daksha. The 31-year-old is “loaning” her womb to them for 150,000 rupees (£2,000) and is candid about needing the money. Her shop job pays only 2,000 rupees a month. [Link]
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p>Daksha is getting paid six years of salary for this service, and the desi British couple involved have gotten away cheaply (why am I not surprised?). Another story gives a price almost twice as high for a Scandanavian couple:
Mehta is, in fact, renting her womb out to the couple for a cool Rs 4 lakh to Rs 5 lakh. [Link]
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p>Like everything else in India, however, local prices are far cheaper than prices in the west:
… it costs £100-300 to advertise for a surrogate mother in India versus the £1,000 charged by a British daily. Not surprisingly, an advertisement for a surrogate mother has been appearing in Indian newspapers and magazines in a dozen cities once a week for a couple of months [Link][One] couple … will be spending nearly Rs 10 lakh on the entire process, far less than the Rs 26 lakh to Rs 35 lakh they would have had to fork out at an in vitro fertilisation (IVF) clinic in California, which they had considered earlier. [Link] … They opted for the Indian clinics to save 2.5m rupees (£31,000). [Link]
At about £3,000 in Britain, an IVF cycle costs five times what you might pay in India. In addition, in Britain, the Human Fertilisation and Embryology Authority (HFEA) has outlawed payments, but a surrogate can be reimbursed for a maximum of £10,000 to cover expenses; the payments often fall between £4,000 and £10,000. [Link]
In the US, a single IVF cycle is six to eight times more expensive than in India, where it comes for Rs 50,000 to Rs 1 lakh — or half of what it costs in the UK. [I realize that these figures are inconsistent] The refinement of such techniques and their low cost is what is spawning the boom in surrogate motherhood. And it helps that the amount earned for bearing a child for somebody else can be as high as a middle-class office-goer’s salary for two years or so. [Link]
It’s not just cheap prices that attract foreigners:
Apart from the lower costs of surrogacy in India, there are other factors drawing patients from abroad. Indian medical guidelines allow doctors to implant five embryos into a surrogate mother; in Britain, the maximum is two and many European countries are moving towards a single embryo transfer.
In India, the surrogate mother’s right to the child is not given the same importance as in the west – she signs away her rights to the baby as soon as the child is born. By contrast, British law says that a surrogate mother who has provided the egg can claim the baby as her own at any time during the first two years of the child’s life.
“It is a big relief for the foreigners who come to us,” says Dr Patel. “The whole experience places a strain on the couple and they do not want to be worrying about these things too.” [Link]
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p>Domestic demand is also growing, even though using a surrogate would have once been unthinkable:
“I have been seeing 10-15 cases of surrogacy a year as against five or six I got earlier. Two or three of them are foreign couples,” says Mumbai’s infertility specialist Indira Hinduja. Adds Krishna Kumar, another Mumbai-based infertility specialist: “The incidence of surrogacy has doubled in the last three to five years. The acceptance is increasing and more people are coming forward to seek surrogate mothers. They prefer it to adopting a child” [Link]… Sarla Apte, 22, who is to be married soon, is willing to seek a surrogate mother. Sarla doesn’t have a vagina and both she and her fiancé are open to the idea of using a surrogate. [Link]
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p>Along with increased demand comes a somewhat increased supply:
Several hundreds of middle and lower middle class married Indian women …, most of them between 30 and 35, make anything between Rs 2 lakh and Rs 5 lakh by bearing babies for foreign and Indian couples. Demand for their services outstrips supply. [Link]The hospital’s medical director, Nayna Patel, says she has 20 surrogates, including a family where a mother and her three daughters have each given birth to children for strangers. [Link]
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p>I was very surprised to hear of such a business in socially conservative India where you are not supposed to discuss “the sex” let alone rent out your uterus. Indeed, cultural factors do make surrogacy difficult — it’s practiced on the down low:
How does she, for instance, deal with questions that would be asked by neighbours and relatives during her pregnancy? While some … stay at home till they deliver, others live with the couple seeking a child when the signs of pregnancy become obvious. [Link]
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p>Indeed, it’s been only ten years since the start of surrogacy in India when:
Chandigarh’s Nirmala Devi spawned a nationwide debate by offering to rent her womb to her employer, as she desperately needed money to treat her paralytic husband and to secure the future of her own child. [Link]
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p>In this rush to make money, both legal and ethical issues remain unresolved:
The Indian medical research council, which oversees medicine in the country, does not have any guidelines to deal with foreign clients using Indian surrogates. But a study is being prepared to assess the issue. [Link]For all the growing hoopla about surrogate motherhood, several snags persist. The ICMR’s guidelines for clinics practising ART and their handling of surrogates are silent on the issue of foreign clients using Indian surrogates in India. So it’s not clear how legal this is. However, Dr R. S. Sharma, deputy director general, ICMR says: “Now with reproductive tourism in India growing, this issue must be addressed.”
Surrogacy throws up another problem. There is always a possibility that the surrogate and the baby will bond. Says psychiatrist Shah: “Post-partum blues are heightened in surrogate mothers.” Sunita, the Bangalore-based surrogate, confesses that she felt like keeping the baby. “I used to weep at the thought of having to give up the baby. I was sad after the baby went away,” she says.
“There are no laws on this. If the surrogate mother decides not to part with the child, there is nothing one can do about it,” notes Hitesh Parekh. And Anjali Chabria stresses that some women could be pressurised into surrogacy by their husbands for money. [Link]
Honestly, I’m not sure what a good regulatory outcome would be. Pregnancy is a difficult and arduous process, and I worry about exploitation. On the other hand, Indian women already get paid less for activities even more dangerous than pregnancy and I’m concerned that any laws passed will be to the benefit of the industry and not of the mother. One solution would be what the west has done for both organ donation and surrogacy – you can’t pay for the service, but you can cover expenses. That doesn’t seem realistic in India, and I’d rather this is done above board in clean clinics than in a back alley somewhere. I just don’t know …
Ennis, thanks for posting, that was a very interesting read.
I can’t believe in India they implant FIVE embryos. That’s unheard of and on EXTREMELY shaky ground morally. At my institution the limit is either 2 or 3 depending on maternal age and success of egg retrieval but everyone sort of lives by the rule “Don’t take in more than you can take care of.” I imagine the rates of selective abortion must be pretty high. (ie, reducing triplets to twins or singleton.)
Well that os because US is so hyper sensitive about abortion/fetus rights due to the extreme right wing Christian fundies.!! Any kind of “fertility-treatment” is going against the wishes of the “god”. One can stretch this argument to any ridiculous levels.
So, lets stop judging others MORALITY.
It’s not just a matter of God, RC. . .at the the point that you do the selective reduction for the embryos, if you don’t want to bring all five to term, it’s usually about 9-12 weeks and some experts think that the fetus can feel pain then. I’m politically pro-choice* but I also avoid unnecessarily torturing small animals, and I hope you do too. Since these pregnancies are the opposite of unplanned, it does seem like something worth thinking about. It also sounds like Rupa knows of what she speaks. I believe she’s a medical professional, and I expect my medical professionals to be practiced enough in thinking about ethics to be able to form an intelligent opinion on such matters, and have some ability to make judgement calls, if with an open mind. The hyper sensitivity of the United States is not solely due to rightwing Christians.
Back on topic–great post, Ennis. I always wonder to what extent the baby picks up taste in food and music in the womb, and since this womb is related to it neither by genetics nor by nurture, it’s a particularly interesting situation.
*since my personal stance of being thoroughly pro-life is based on my religious beliefs, and difficult to defend without invoking certain religious beliefs. Just to be clear.
Is this the new mercantilism?
Outsourcing reproduction?!! I can’t wait to see Kerry making this his election plank in ’08.
M. Nam
Makes me wish I was born a girl.. so I could rent out my womb and make some extra cash for beer..
I dont care about anyone’s political affiliation. My point is that MORALITY evolves with time and one MUST be careful before judging someone else’s morality.
Should I assume that you are vegeterian?? and dont EAT chickens just ’cause they taste good.
However I do agree with Ennis about lack of firm legal guidelines about this in India is sacry and potentially exploitative.
RC, abortion is not what’s at issue here. The problem is that it is, in fact, a big problem to implant more embryos than someone is potentially willing to take care of. That is why IVF centers keep extremely detailed records of hormone levels, maternal age, # of eggs retreived and implanted, and eventual outcome. A 42 year old woman who only wants one child for whatever reason is warned that there’s a small chance that implanting three embryos may result in triplets or twins. We ultimately leave it up to the mother to decide how many she wants to implant, but it is a completely informed decision, and there are policies in place at most institutions limiting the number of embryos implanted. Twins and triplets are cute and fun but the truth is multiple gestation is riskier than singleton gestation. The fetuses (fetii?) have to share resources only meant for one fetus. Their development is retarded and complications can be severe.
It’s very common for an unwanted post-IVF multiple pregnancy to undergo termination of one or more fetuses. No one (least of all ME, trust me) is trying to take away a woman’s right to an abortion but if it’s a preventable situation and dangerous to the mother and fetus to have a multiple gestation, why even put her through it? Shotgun implantation of successfully created embryos seems like a good idea (hey if we implant a whole bunch, at least one of them’ll implant in the uterus!) but it’s irresponsible and dangerous. Ask any IVF specialist. (And by the way IVF specialists and obs in general tend to be a pretty liberal bunch.)
There are also potential immigration issues as well:
RC,
You have spent time in India, that is what I gather from your comments from past.
On zero-order, first-order, almost everything in India is done on a shot-gun approach. It is endemic.
Just try to get a ticket @ the cinema theater or cross a street. At some point, it will have to change slowly in every sphere of life.
Regarding issue discussed in this thread, I am just learning by reading comments who know what they are talking about.
Pro-life vs. Pro-choice debate is quite complicated in US, if one looks closer.
Why is this a bad thing? Morality aside. It’s a deal that benefits both parties so why is the British couple being implied as taking advantage of poor Daksha?
I am however curious to understand the need for people to have a child thru surrogacy rather than adoption. I am having a hard time relating. Isn’t it easier to adopt a child already born and who needs parents then go thru the whole process of getting a woman impregnated? Is it truly all about the ultimate need to produce our own?
Surrogacy gives a child that is related to both (or sometimes one) parent in the end – it’s the genetic connection that is important to many. The same can be said about why people use IVF rather than adopting.
Any debate in the US happens within the pre-defined “liberal” and “conservative” boxes. I am not a US citizen, just a US resident and I think outside these boxes. Never mind .. i think we are talking past each other. (BTW, I am aware of issues about IVF)
Meanwhile, Indian politicians are holding parliamentary sessions to decide which city/road to rename. Its scary that this kind of stuff is unregulated.
nice post.
I think it is. My uncle ended up having six daughters trying for that one elusive son. He has finally stopped but will not adopt a male child.
Is it truly all about the ultimate need to produce our own?
I don’t know if its just about wanting to produce our own. A lot of factors are at play here. As complicated as this whole surrogacy procedure is, adoption can be just as if not more complicated, especially in terms of time.
I know many people from the US adopt from foreign countries because it generally tends to be a quicker and “easier” process than in the US. But there is also the issue raising a child from a different ethnicity.
That is a responsibility that some people cannot take on.
So they can adopt one from an ethnicity their own.
That’s an interesting question. when you have a child what are your responsibilities towards raising that child verses one you adopt who may be ethnically different to you.
I don’t think it’s any different. I think that it’s the same question you would have as a mixed-race couple who decide to have [beautifully] mixed children. Or a same-ethnicity couple who have different values from the mainstream of their ethnicity (btw, doesn’t this differ from family to family, group to group, community to community anyway, I mean I may share the same ethnicity as a Goan Christian, but we could have widely differing opinions on everything). The responsibility factor does not go up is what I’m trying to say.
I know this one family that has pretty much adopted a child from every country they have lived in (they’re working on #6 in South Africa) it’s great a mini-UN in the house. I want to be them.
I always thought it would be wonderful to adopt. I want a pudgy pudgy girl from Kenya who I can teach Gujrati to.
Well technically you can adopt a child of your own ethnicity…but adding these constraints makes the waiting period for adoption longer…
i am all for people adopting (of any race) …but i just want to point out that its not that simple (neither is the surrogate option described in this post) … raising a child is difficult … my point is when you raise a child of another ethnicity…how much are you responsible for raising that child to be aware/informed/proud of their ethnicity when you don’t have any idea yourself about that ethnicity?
ok, but one could make that argument about me, a thrid generation Kenyan Gujrati. I mean honestly, how much do I really know about being from Gujrat? or being Indian/South Asian?
Although my dad speaks Gujrati, he can barely read the language and has about as much knowledge about Jainism/Hinduism as his white collegues who have sent half a year in India. But somehow I don’t think he was thinking about these things when he decided to have kids. I don’t think he was thinking can I raise a child who will have a healthy appreciation of their ethnicity?
I am NOT discounting that there are things that need addressing over the years that would not normally arise in a same-ethnicity situation, I’m simply saying that it is not insurmountable by ANY means, and that it may very well be a non issue.
I also see parallels between this discussion and one about mixed-race marriages that result in mixed babies. If we were to follow this line of thinking that there exists a responsibility by parents to raise ethnically-aware/balanced children, then there are few people who could raised mixed children because it can be argued that these hybrid kids are a kind of their own.
Rani, I’m not trying to attack you, I actually find this discussion very stimulating, and as someone who really hopes to adopt one day, I appreciate it 🙂
There has been previous mention of cross-ethnic adoption on SM before: here and here
There’s a similar story about New York girls adopted from China in the NYT today.
“Rani, I’m not trying to attack you,”
i didn’t think you were 😉
i understand what you mean about children from mixed-race marriages but i don’t think the comparison is exactly parallel….there the parents would generally teach/show the child both sides and though this maybe confusing for the child (as in i am not like my mom or dad fully)….there is a difference than not being like any parent at all…
as far as your example of you & your dad…i concede, its a little bit more tricky…but let me ask you this is there a difference b/w
couple A (indian) raising their biological child as “american” w/ little or no indian tradition/heritage/culture couple B (white) raising an adopted indian child as “american” w/ little or no indian tradition/heritage/culture
to me there is… and i guess that’s the point that i was trying to make (in defending why people may go to what seems like extraordinary measures to have a biological child or adopt a child of their own ethnicity if possible)…
See i’ve seen the gammit. one of my ex’s parents decided to not teach their kids any Indian languages for fear that it would taint thier English. So he couldn’t speak his mother-tongue. i found this sad. But just as sad as the desi kids in kenya who can not speak Swahili (even though it is usually a third language for 90% of Kenyans).
he was sad he didn’t know the language too, but he understood that his parents did it out of love and he appreciates their heartfelt effort trying to do what was best for him.
I also knew of a white couple who had adopted two desi kids. they were well adjusted amazing kids but they didn’t speak their mother tongue, but I didn’t find this sad at all. when we met this family, they asked if we would teach/mentor the kids a little about the culture/religion/customs etc. The kids were as interested as any other kids might have been. Again they appreciated the effort, and understood that their parents were trying to get them to learn something that they themselves could not teach…
it’s complicated.
and for me there really is no difference between couple a and b
great find Manish…
Money talks and money rules. Unfortunately, too much aggressive push towards money can only cause stories like these. More emphasis should be given to business ethics.
I can’t believe nobody commented on this:
I’m surprised that somebody with that physical characteristic could get married in India at all, unless as a beard for somebody gay. Clearly her fiance knows about this … I’m wondering, is this an arranged marriage? Does an arranged marriage system work for people with that level of non-standard physiology? Is there a dowry premium?
i dont know ennis… india is a very very different place… aristotlean logic does not necessarily apply… and beard or not, they’ll all end up living a life together as a couple. i’m going to sound like a moonswami here but i do believe that the sense of “dharma”/duty/obligation transcends corporal needs for many.
I can’t believe nobody commented on this:
Y’know, I did see that, and in my head I just assumed they were a couple from abroad looking at cheaper fertility options. (I am curious as to what she has though! It’s probably a congenital, obstructive defect (nothing chromosomal or hormonal, just a physical obstruction) but more interestingly perhaps Jamie Lee Curtis syndrome…. I always wondered what they would do in India with someone like this! )
Dharma starts once you’re married (and the man might well cheat as well). The question is, why would somebody get into an arranged marriage of this sort (if that’s what it is – if it’s a love marriage then that’s different).
And I just thought of something else! Once the patient has reached age of informed consent etc a gynecologist and a plastic surgeon will usually operate to reconstruct a vaginal cavity (of course they’re still infertile but can have intercourse with hetero partner now), but it doesn’t sound like she’s had that done yet, because she..uh, “doesn’t have a vagina.” I wonder how they’re planning to have sex.
If they’re planning on having sex, they can still do the things that two men can do, no? Still, I’m wondering about the if, precisely b/c the implication is that she hasn’t had this surgery. Maybe they’re planning on jumping straight to kids, no sex …
Don’t tell desi parents about this option, we’ll never hear the end of it.
Of course, but there’s something to be said for the option of vaginal intercourse for a woman.
That…wow. Sounds like my idea of a nightmare.
you might be interested in Atwood’s “The HandMaid’s tale” . Here’s an excerpt from this link .
I’ve just seen the operatic adaptation, but i’m sure there are folks out there who might have an Angle on this. Pray illuminate.
Oh yeah. We had to read that book in high school. Gave me nightmares for weeks. What was the opera like?
they had surtitles so i could follow along – but i think those who’ve read the book might have enjoyed it more – more because there is the thrill of recognition of a character you’ve imagined in print
other than that – the subject matter isnt exactly entertainment – the only stimulus i got was in drawing up the parallels between the fictitious Gilead and the post-9-11 united states – it is a stretch but the adaption leveraged that to some extent – i also felt the adaptation (or maybe it was atwood’s vision originally) tried to position canada as the benign neighbor to gilead to which the slave-girl wanted to escape to – but that might be just in my eyes. the music i do not remember, but some of the visuals and the stark costumes i remember vividly – on the whole, ok
fyi, i did a quick search and found this review. Mind you, this is from the year 2000. The last para caught my eye.
Note also, this opera was originally a Danish production.
I am married but no cildren. I was the last child of my parents, and my sister and brother had gone from home by the time I remember them. I newer know my grandparents. And now my parents are dead too. My hustbands family lives in Denmark. So I have only distant family. I have always hoped for children and now I see surogasy as my last hope. Having a family is more inportant then enything. In the end mony is not importand.
It gives new meaning to the term “Cheap Labor”