Is "Reproductive Tourism" Exploiting India's Poor?

Illustration for article titled Is "Reproductive Tourism" Exploiting India's Poor?

Writes Amana Fontanella-Khan in XX, "Reproductive tourism in India is now a half-a-billion-dollar-a-year industry, with surrogacy services offered in 350 clinics across the country since it was legalized in 2002." It's a far cry from Baby Mama.


Surrogacy, in America, is normalized. No one blinked and eye when a surrogate gave birth to twins for Sarah Jessica Parker and Matthew Broderick; the inevitable class tensions were gently lampooned - and conveniently resolved - by Tina Fey and Amy Poehler. And while nothing involving maternity can ever be treated with the rakish dash recent rom-coms have shown the sperm donor, more pop-cultural mainstreaming seems both inevitable and in some wise desirable, too.

Reproductive tourism in India has been booming in the last few years: clinics provide everything from in-vitro fertilization to surrogacy, with good medical care, in a conveniently anglophone environment. The reasons for India's popularity from the western customer's perspective are obvious: the cost of surrogacy is a fraction of that in the States, and the industry is largely unregulated. What's more, parents who might have a harder time finding a surrogate in this country - think same-sex couples - face fewer hurdles in India, where the fees can make the difference between poverty and relative economic stability. And, as a New York Times story reported in 2008, prospective parents like that the Indian surrogates are, in the words of one fertility doctor, "'free of vices like alcohol, smoking and drugs.'"

However, as is inevitable, with this lack of regulation - and this level of dependence on the resulting income - comes fallout. Writes Fontanella-Khan,

The surrogates, many of whom are cooped up in "surrogacy homes" away from their families for the duration of the pregnancy, are often in dire financial straits. One woman told a journalist that with a $4,000 debt and an alcoholic husband, she had first considered selling a kidney to get herself out of debt, but decided that the $ 7,000 surrogacy fee was the better option. In another disturbing case, an upper-class Indian woman hired a surrogate to carry her child and invited her to live in her home during the pregnancy. The client accused the surrogate mother of stealing and not only kicked her out of the house but coolly informed her that she didn't want her services anymore and that she should terminate the pregnancy. Surrogates get paid only on delivery of the baby, so this kind of situation is economically devastating for a surrogate. It can also severely compromise the ethical and religious beliefs of surrogates who may not wish to undergo an abortion.

There's also an issue of local acceptance, particularly in rural areas from which many surrogates are drawn. Writing in Marie Claire, Abigail Haworth writes of one such young woman,

Vohra says she's not ashamed of being a surrogate, but most locals are very traditional and don't understand. "They think it's dirty - that immoral acts take place to get pregnant," she whispers, explaining their disbelief that she could conceive a child without having sex. "They'd shun my family if they knew." Vohra comes from a village 20 miles outside Anand, but she has temporarily moved to the town with her husband and two children, a 12-year-old daughter and a 7-year-old son, to hide what she is doing. "We told our neighbors we were coming here for work, which is not strictly a lie."


Naturally, the "exploitation" question is a loaded one, calling into question as it does women's abilities to make their own decisions and gain a measure of financial empowerment. As one woman tells Marie Claire,

This is not exploitation. Crushing glass for 15 hours a day is exploitation. The baby's parents have given me a chance to make good marriages for my daughters. That's a big weight off my mind.


That said, as the XX article makes clear, there is no "choice" when that choice is not informed - and it's crucial both that women be made aware of the realities and risks of the process, and be protected by legislation. This may be closer to fruition: the issue of reproductive rights - and specifically an Assisted Reproductive Technology Bill - is on the parliamentary table.

And what of the dynamic between surrogate and mother? Is there a bond? Contact? Affection? Or are the cultural hurdles too high - and is this a deficit or a benefit for the average American mother? Certainly, a few lines in the Marie Claire story are telling. Says one surrogate - chosen in part because, like all women at the clinic, she's given birth before and is theoretically less likely to become attached to the baby, "It won't even have the same skin color as me, so it won't be hard to think of it as Jessica's." And indeed, "when they find an empty ward upstairs and sit on the beds to talk, the women struggle for words. It's as though they both realize the gap between their lives is so vast, there's simply no sensible place to begin." On the other hand, in the same story, we learn that "Five weeks before the baby was due, Karen flew to India and moved in with Mondal so they could go through the final weeks together. "Karen became like my sister," says Mondal." Karen sends her surrogate photos of her son weekly. In other words, it's case by case: much as is true anywhere. That there is far less question of the complex custody cases that sometimes arise in America might, arguably, facilitate the question on a practical level - even as it complicates the question of emotional obligation.


To suggest that surrogacy, in India or anywhere else, is "easy" is insulting to everyone involved. "Easier" is not saying much, and takes on only few of the most material facets of the process. The emotions, the power dynamic, the redefinition of roles - to say nothing of the reality of the child's experience - is complex the world over.

Surrogate Mothers: Womb for Rent [Marie Claire]
India, The Rent-A-Womb Capital Of The World [XX]
India Nurtures Business Of Surrogate Motherhood [NY Times]



Sometimes I wonder how people used to deal with infertility before they had all these options. Did they just accept it? Did it make them crazy? Was it less of an issue, because so many women died in childbirth, and their families were so often called on to care for children a recent widower couldn't handle?

And what about the infertility treatments and surrogacy options available today? They make it possible for people to become parents, but at what financial and emotional cost? How do they affect the ability of states and religious organizations to recruit foster parents for the abused and neglected children who are already living among us? Is there a point where people should accept that they can't always get what they want, no matter how badly they want it?

I don't understand what makes someone decide "Well, here's an idea— I can have someone thousands of miles away be my surrogate." I'm not trying to insult anyone who has used a surrogate— I literally can't imagine feeling that way. It's such an extreme length to go to. It would make me insane to use a surrogate in India for so many reasons. There's the distance involved, and the economic disparity. The issue of the clinics/homes— how could I be sure that she was being treated well? How could I know that she wasn't smoking or drinking? What if she had some awful medical complication because she was carrying my child, and the experience ended up making her life more difficult? I just couldn't do it.