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'A woman has every right to hire out her womb'

By Shobha Warrier
November 10, 2015 10:04 IST
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'Surrogates are fully aware of what they are doing. You cannot be forced to become a surrogate through violent means. At best, surrogates can be forced by their circumstances take up this 'business'.'

'Couples coming from countries where surrogacy is banned are not given visas for fertility treatment in our country. This is because they cannot take the children back and the poor babies get caught in no man's land for no fault of theirs.'

Surrogate mothers

IMAGE: Surrogate mothers at a temporary home provided by the Akanksha IVF centre in Anand, Gujarat. Photograph: Mansi Thapliyal/Reuters

Shah Rukh Khan has had a baby through surrogacy.

So has Aamir Khan.

In fact, surrogacy has been a ray of hope for those couples who, for various reasons, could not otherwise dream of having their own child.

But, like everything else that lends hope, surrogacy -- where woman is hired to bear a child that is genetically not her own -- has become a lucrative business that has more fly-by-night players than legitimate professionals.

Surrogacy is legal in India and the industry is estimated to be as big as Rs 9 billion, and growing at 20 per cent every year.

The government recently decided to ban Indian women from being surrogate mothers to foreigners to stop 'commercial surrogacy.'

How will this decision affect surrogacy in India?

Gita Aravamudan, the well known writer-journalist who has written a much appreciated book on the subject of surrogacy, Baby Makers, discusses the impact of the government's decision with Shobha Warrier/

As someone who has done extensive research to write Baby Makers, a book about surrogacy in India, what was your reaction to the government banning foreigners from hiring Indian women as surrogate mothers?

Actually, the present proposal is to ban commercial surrogacy altogether for both Indians and foreigners. I think this will be disastrous, as it will push the fertility treatment industry underground.

Today, commercial surrogacy is well established in India with a huge estimated turnover of over Rs 9 billion.

Couples with fertility issues from India as well as abroad hire Indian surrogates as part of the treatment. Certainly the surrogates also benefit financially from the transaction. Banning it and pushing it underground will make surrogacy an unsafe procedure as many of the unethical practices which already exist will then come to the forefront.

A surrogate mother

IMAGE: Madhu Makwana, a first time surrogate mother, gets ready for her baby shower ceremony as her biological daughter Preeti, centre, sips from a bottle of milk. Photograph: Mansi Thapliyal

The government said this ban was to 'prevent Indian women from being exploited for profit.' In your research, did you come across the exploitation of Indian women for profit? Whose profit are they talking about?

The fertility clinics are certainly in it for profit. The surrogates who offer their services do it for money. But they are providing a service and, like any other service, this too has to be paid for.

The money the surrogates earn may be a pittance compared to what the couples spend on fertility treatment. But their role is also limited.

The surrogates are fully aware of what they are doing. You cannot be forced to become a surrogate through violent means. At best, surrogates can be forced by their circumstances take up this 'business.'

I came across many surrogates who were carrying babies for the second time for someone else. Quite a few told me that the money they earned (which could vary from Rs 500,000 to Rs 1 million for a pregnancy) had made a huge difference to their lives.

As for the couples who gain a child through this process, their joy knows no bounds.

Health industry estimates put the size of India's surrogacy business at Rs 9 billion and growing at 20 per cent per year. Do you see it as an industry now?

Of course it is! You only have to go to any of the well-established fertility clinics across the country to see what a flourishing business it is. And I don't see anything wrong with that.

A woman has every right to hire out her womb to make money for her survival. What we have to address is the issue of exploitation by many of the fly-by-night clinics which have jumped on to the bandwagon to make a quick buck.

Banning the business is not an answer. The solution lies in passing a properly thought out well-framed law which will weed out the exploiters.

It is said that many childless couples from abroad flock to India to rent a womb as the process is cheap and legal here. Is cost the only reason why foreigners come to India in search of surrogate mothers?

Surrogacy is banned or regulated in many countries because of religious or ethical concerns. People come to India for different reasons… mainly because of the affordable cost or because the option of surrogacy is unavailable in their own country.

Right now, couples coming from countries where surrogacy is banned are not given visas for fertility treatment in our country. This is because they cannot take the children back and the poor babies get caught in no man's land for no fault of theirs.

Over the years, many of the Indian fertility clinics have developed expertise in this field and now provide a bouquet of top class services. Right from in-vitro fertilisation procedures and embryo implantation to locating and maintaining a surrogate... everything can be done here.

A large English speaking population facilitates communication and the procedure is definitely cheap compared to the facilities available in Western countries.

Parents with their child delivered through surrogacy

IMAGE: Briton Rekha Patel, 42, holds her week-old-baby girl Gabriella, as her husband Daniele Fabbricatore, 39, watches with joy. Photograph: Mansi Thapliyal/Reuters

Do you feel poor young women are exploited for money? Are they exploited only by foreigners and not by Indians? Did you meet such women while researching for your book?

Yes, poor and illiterate women are exploited. Not by the Indian or foreign commissioning parents, but by the agents, touts, fraud doctors and other hangers-on in the unregulated fertility clinics which have mushroomed all over the country.

They are egg donors as well as surrogates who can fall into these traps.

I would say the exploiters are mostly the Indian middlemen. I have met surrogates as well as egg donors and commissioning parents too who have been cheated by frauds.

If they are exploited by others, what should be done to take care of them?

Stringent regulation is the only answer. Also, I feel it is important to get rid of the agents and touts who are the worst exploiters.

Top end clinics, like Nayana Patel's Akanksha at Anand in Gujarat, have a proper system in place. The egg donors and surrogates are continuously monitored. The surrogates are housed in special hostels where they get nutritious food and medical care plus a maintenance allowance. They sign proper legal contracts with the commissioning parents.

But I have also been to clinics run by fraud embryologists where the women are kept in terrible conditions and often not paid properly. Their health is also affected in such cases.

As a woman writer on the subject, do you see anything wrong in a woman willingly renting her womb to another person?

I think a woman has every right to rent out her womb to earn a living. If she can use her hands and legs to earn a living, why not her womb?

A surrogate mother with her husband

IMAGE: Karishma Barnar, pregnant with her second child as a surrogate, prepares to eat a meal with her husband Babu. Photograph: Mansi Thapliyal/Reuters

You must have met women who rented their womb to foreigners and also Indians. Did you find any difference in an Indian woman renting her womb to a foreigner and an Indian? After all, a childless woman is a childless woman whether she hails from India or America.

The truth is most of the surrogates have no interaction at all with the commissioning parents or with the babies they bear. Most often they meet the parents just once when they sign the contract.

The doctor introduces the embryo created with the genetic material of the parents into the womb of the surrogate. Most parents do not want the surrogate to either see or hold the baby (or babies) for fear that she might get attached.

Of course there are some (mostly foreigners) who rehire the surrogate as a wet nurse to feed the babies for a while. So she also makes more money that way.

It really doesn't make any difference to the surrogate whether the parents are local or foreign. In fact in terms of remuneration she may get better paid by foreigners who also give better tips.

After talking to many women, what according to you was the main reason why a woman rented her womb? Was it to get money?

Yes, money is the only reason. There are very few cases of altruistic surrogacy where a mother or sister lends her womb to a woman who cannot carry a baby in her own.

In its affidavit, the government said it did not support commercial surrogacy. Do you feel she should offer it only to her relatives and also free?

Altruistic surrogacy has major pitfalls. Searching for a relative or friend who is willing to lend her womb can be a daunting task. Also people hesitate as there is plenty of scope for blackmailing and souring of personal relationships in such situations.

A surrogate mother

IMAGE: Sharda, a first time surrogate mother, rests inside a temporary home for surrogates provided by the Akanksha IVF centre in Anand, Gujarat. Photograph: Mansi Thapliyal/Reuters

How do different countries look at this issue?

Catholic countries in Europe ban commercial surrogacy for religious reasons and do not give a visa to children born through a surrogate in a foreign country.

The UK allows only altruistic surrogacy.

Israel does not allow gays to hire a surrogate.

Some countries ban the sale of eggs or embryos.

The USA has different laws in different states. In California, where it is allowed, hiring a surrogate is very expensive.

Some Eastern European countries specialise in harvesting and selling eggs.

Thailand, like India, had an unregulated commercial surrogacy industry, but a series of mishaps made them put a complete clamp on it.

Instead of just banning foreigners from using Indian women as surrogate mothers, what should the government have done according to you?

As I said, the proposed ban is on commercial surrogacy in total and not just on foreign couples using Indian surrogates.

I feel the government should re-examine and update the Artificial Reproduction Technologies Bill which has gone through three avatars so far over 10 years and is still waiting to be tabled in Parliament. A lot of effort has gone into drafting this bill and it would serve the purpose much better than a ban.

Let me ask you about your book now. Is there any particular incident that caught your attention and led to you working on a book on surrogacy?

I wrote Baby Makers: The Story of Indian Surrogacy because the issue of hiring wombs has always intrigued me as a feminist, a writer and also as a mother.

I was intrigued about Anand in Gujarat morphing from the milk capital of India into a surrogacy hotspot.

Within a short span of about 10 years, surrogacy in India had ballooned from a marginalised medical procedure into a gigantic money-spinning industry. As a journalist I felt this was a story which needed to be investigated.

Writer-journalist Gita Aravamudan has written a much appreciated book on surrogacy called Baby Makers.I read that you (author Gita Aravamudan, left) researched this subject for almost two years. Were there any startling revelations?

There are not many statistics available in this field, so I did good old fashioned journalistic leg work. I travelled to various surrogacy centres, talked to doctors, commissioning parents, surrogates, touts and anyone else in the field who would talk to me.

I stumbled on some extraordinary stories by chance.

I met a couple who had been blackmailed by a fraud doctor who threatened to force the surrogate to abort if they didn't pay him extra. And a couple who knew the baby their surrogate bore had no genetic connection to them as the doctor had cheated and used someone else's embryo.

I met a surrogate who had borne two sets of twins... one for a Japanese couple and another for an Australian one. I also met a young Nepali egg donor who had been given an overdose of hormones to produce more eggs as she was beautiful and her eggs were in great demand.

When you finally sat down to write the book, were you writing the book for the woman who rents her womb? Were you likening her womb to a factory that manufacturers a product when you called them Baby Makers. Any particular reason for the title?

Baby Makers is a non-judgemental book which looks at surrogacy from every angle.

I chose a narrative fictionalised style of writing in order to bring in all the perspectives.

There are many baby makers. There are the couples who supply the genetic material, the embryologists who create test tube babies, the gynaecologists who insert the embryos into wombs and deliver the babies and most importantly the surrogates themselves.

There are the agents who source the surrogates, organise fertility tourism packages and facilitate ordering babies over the net. There are the courier companies which deliver the frozen genetic material from abroad to be used for implanting in Indian surrogates.

There are the egg and sperm and even embryo donors and their agents and doctors who have a separate fringe business going.

It is a very complex subject which needs to be addressed in its entirety.

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