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The Surrogacy Cycle

by Abby RabinowitzThe Virginia Quarterly Review
March 31st, 2016

Children at Ulhasnagar train station (Wikimedia)

Untitled Document

Ulhasnagar, India, is in that part of the world where things are made. The city is known for making cheap knockoffs of American jeans, and babies are made here, too, by women who cannot read or write but can become pregnant and will do so for money, for clients they will meet once or twice, if at all. Until recently, these women bore children for foreigners who never saw this place.

Coming into the station from Mumbai, the train pulled up alongside a nullah—a broad, shallow, fouled river. On the shore, lines of cloth billowed in the hot, dry air. From the busy market in front of the station, we took a rickshaw to a street that was still being laid down and picked our way over the rubble. Sonali,* a widow of just six weeks when we met, in January 2014, stood in the doorway of her one-room house. She was slender, in a green kurta, and seemed watchful even as she smiled. Her mother-in-law was filling steel pots with the water that had just arrived, as it did every morning around eleven. “When I did the surrogacy, she did all the work,” Sonali said in Hindi. On the floor, her children played with the cat in a patch of sunlight.

Sonali showed us a photograph of herself and her husband, a young man with brilliantined hair and a maroon dress shirt that was too big for him. He had died on the railroad tracks—a rumored suicide—leaving the family with weighty home loans. Sonali had already borne a child—despite her husband’s reservations—for an Israeli couple, in December 2012, for which she had earned 2.5 lakhs, or about $4,600, which had not been enough to buy the house outright. To pay the loans, Sonali now planned to do a second surrogacy. She was also recruiting new surrogate mothers and egg donors for Padma, the neighbor who had recruited her in 2009. Padma in turn brought the women to a Mumbai surrogacy practitioner, Dr. Meenakshi Puranik, whom the women called “Madam,” as maids often call their mistresses.

Between 2010 and 2014, Padma says she recruited about twenty-five surrogate mothers who delivered babies, and “so many” egg donors, some of whom—like Sonali—donated eggs three or four times. 

For ten years, transnational surrogacy was a thriving business in India, enough so that the country became known in media outlets such as Slate as the “Rent-a-Womb Capital of the World.” India’s total assisted-reproduction sector has been reported as being worth $445 million or $2.3 billion, depending upon one’s information source. There is no reliable measure of commercial surrogacy’s distinct value; while legal in India since 2002, the industry has never been regulated. Since 2005, there have been repeated attempts to draft and pass comprehensive surrogacy legislation.

Then the Indian government effectively banned paid surrogacy for foreigners. In October 2015, the Indian government filed an affidavit in the Indian Supreme Court, arguing that commercial surrogacy on the part of foreigners invited the exploitation of poor women. Within days, the Indian Council of Medical Research (ICMR), a government regulatory body, ordered fertility doctors not to accept new foreign surrogacy clients. The Indian Home Ministry followed up by denying visas to foreigners seeking surrogacy. Swiftly, international surrogacy became not illegal, but virtually impossible. 

Arguably, the ban was inspired not just by concern for poor women, but by the unappealing narrative foreign surrogacy told about India—stories about stateless babies caught between countries and about women who had died during labor. Memorably, the Times of India reported that “deserted or dirt poor” women were delivering “vanilla-white babies from burnt-sienna wombs.” Jayshree Wad, the lawyer who filed the affidavit on behalf of the government, told the New York Times, “There is a common opinion about India which hurts very badly—that because there is poverty they sacrifice their womb by renting it for their family.” 

Critics say it is unlikely that banning foreign surrogacy clients will protect poor Indian women or end the practice. For one thing, surrogacy remains legal for straight, domestic Indian couples. For another, transnational surrogacy is notorious for its elaborate work-arounds. When the Indian Home Ministry abruptly banned gay foreign surrogacy clients in 2012, Indian fertility clinics shipped Indian surrogates across the border to Nepal. When Nepal also banned transnational surrogacy in 2015, as did Thailand, industry insiders told me they believed that Indian surrogates were being rerouted to African countries instead. They say that the ban will drive the practice underground. 

Surrogate mothers themselves protested the ban, according to reports out of Gujarat, and spoke in favor of the work on a popular New Delhi talk show. But Indian surrogate mothers have never had much control over how their story is told. For one, they do not write academic papers and rarely speak English. In the media, they tend to appear as one-dimensional characters, in one-off interviews. Their experiences are often framed in a binary, in which the women are cast either as winners of a life-changing sum of money or as victims forced by their poverty into “renting their wombs.” Both narratives oversimplify and distort the reality. Sociologists like Amrita Pande argue that this binary deprives these women of their agency, and that paid surrogacy should instead be framed as a form of work, no matter how problematic.

Viewing surrogacy as “work that can be exploitive,” as Pande suggests, rather than inevitable exploitation, makes it possible to imagine reforming rather than banning the practice—and, appealingly, women claiming a voice in that reform. Between 2010 and 2014, I spoke with thirty-three surrogate mothers and egg donors in the outskirts of Mumbai. They described choosing the work, within their limited field of choices, but also having little power over a deal in which they had the most to lose. Their stories did not conform to a popular “win-win” narrative, which concealed surrogacy’s real conditions. Instead of sharing a meaningful connection, the foreign intended parents and surrogate mothers I met knew little more about one another than workers and customers on the far ends of any other global supply chain. The question is whether this divide, which hurt the women, could ever be bridged.

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