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Having Twins With a Surrogate — in India
March 19, 2012 5:20 AM   Subscribe

Having Twins With a Surrogate — in India
posted by wondrous strange snow (29 comments total) 1 user marked this as a favorite

 
Photos of the twins from the book's website Aaah! Mazel tov!
posted by alasdair at 5:40 AM on March 19, 2012


Adorable!
posted by ThePinkSuperhero at 6:17 AM on March 19, 2012


I'm not sure how I feel about this kind of arrangement when there is such a wealth and power disparity.
posted by empath at 6:19 AM on March 19, 2012 [11 favorites]


One girl is named India? Puleeze.
posted by Ideefixe at 6:23 AM on March 19, 2012 [1 favorite]


I don't think Arieff meant anything bad by doing all this--she even seems to have done a lot of things just to try to do it as well as possible. But I also don't think her eyes are totally open as to the fact that this is something that was not risk-free work to her surrogate, and that her surrogate was being presented with this huge amount of money to do something that could seriously damage her health--but with no other possible way for her to make that kind of money. No alternatives. I don't have a problem with surrogacy with informed consent, but I think it's just really hard to get informed consent from an impoverished person in a remote village in a developing nation. Maybe not impossible, but it doesn't sound like the author's head was really in a place to even be thinking about that.

The economic idea of it isn't fundamentally wrong, but the power problem is. Yes, a homeless person on the street might let you punch them in the face for $10, but that doesn't mean you should take advantage of that on the grounds that they're totally $10 better off in the end.
posted by gracedissolved at 6:43 AM on March 19, 2012 [17 favorites]


Infertility made me feel as if I had been cursed.
Wow. Really? I don't get that but then I have never really wanted children.
posted by govtdrone at 8:11 AM on March 19, 2012 [1 favorite]


I thought this article from the Guardian a while back did a good job of presenting the complexity of the issue.
posted by Sidhedevil at 8:31 AM on March 19, 2012


"Infertility made me feel as if I had been cursed. "
Wow. Really? I don't get that but then I have never really wanted children.

I don't really get it either. Why do people feel as if entitlement to have children should be some default state?

That said, the debate going on in the comments on the NYtimes makes no sense to me either. Of course most of these women wouldn't be surrogates if they had more money and better alternatives, but you could say that most people wouldn't be maids/trash collectors/all kinds of jobs if they had more money and those jobs have physical dangers as well. The article avoids some of the nastier debates I've seen in comment sections about Indian surrogacy though because it was just about surrogacy/IVF and not about also buying sperm/eggs.

India might not be a fertility powerhouse for long either. I think it's 90% of fertility issues that are caused by PCOS, which is considered a "disease of affluence" associated with modernization of food. India is quickly catching up to the US in rates of this disease.
posted by melissam at 8:53 AM on March 19, 2012


Is it cheaper to have a surrogate in India?
posted by Mental Wimp at 9:26 AM on March 19, 2012


Why do people feel as if entitlement to have children should be some default state?

It *is* the default state, regardless of whether or not it should be. The fact that people feel left out when they can't do something that 99% of the world can and does do should not really surprise you.
posted by tylerkaraszewski at 9:34 AM on March 19, 2012 [12 favorites]


At one end of this world, there is one woman who desperately needs a baby and cannot have her own child. And at the other end, there is a woman who badly wants to help her own family.

I think the author of this statement got the words "want" and "need" mixed up.
posted by amelioration at 9:40 AM on March 19, 2012 [31 favorites]


Twin pregnancies are difficult, prone to many complications, and in some cases life-threatening for the mother.

There is some seriously important information missing here. The surrogate bore twins. Did the surrogate have the option of terminating the pregnancy or selectively reducing one twin, at no cost to her, when she found out she was carrying two?

If not, then, to me, this arrangement seems like an appalling thing for this author to be crowing about. It's horrific. My wife bore twins, they came very early, she had to have an urgent c-section, and one of them died. The NICU we spent 70 days in with the surviving kid was chock full of parents of twins in similar situations.

With modern care, most twin pregnancies go OK. But the odds of something going very badly are wildly greater with twins than with a singleton. To force someone to carry twins to term to get a paycheck seems monstrous to me.
posted by gurple at 9:45 AM on March 19, 2012 [7 favorites]


Is it cheaper to have a surrogate in India?

Yes. First of all, the cost for out-of-pocket payments to health care providers is dramatically cheaper (in the US, the health care costs relating to surrogacy aren't covered by either the prospective parents' or the surrogate's health insurances, if any). Second, the costs of executing the surrogacy agreement are significantly lower in India than in the US. Third, the standard fees to an Indian surrogate are less than half of the standard compensation for living expenses, maternity clothing, etc., required by US surrogacy agencies.
posted by Sidhedevil at 10:30 AM on March 19, 2012 [2 favorites]


Third, the standard fees to an Indian surrogate are less than half of the standard compensation for living expenses, maternity clothing, etc., required by US surrogacy agencies should have continued with "even in those states where direct compensation to surrogates is not allowed." In many US states, direct compensation is permitted, and it is generally at least twice that of the standard compensation for an Indian surrogate.
posted by Sidhedevil at 10:34 AM on March 19, 2012


I dunno, surrogacy is one thing if you have a personal relationship with the person, but making it strictly an economic transactions seems way too much like using human beings as livestock.
posted by empath at 10:40 AM on March 19, 2012 [2 favorites]


But if a woman is in charge of her body, who's to say what use she puts to it? It's still sort of cultural tourism, I think. Rather than find some woman in the States, the author goes all exotic and gets not just babies, but a book deal! And it's not likely that the Indian woman is going to blab to a reporter what the procedure was really like or how she felt about parachute parents. Media class privilege.
posted by Ideefixe at 10:45 AM on March 19, 2012


It *is* the default state, regardless of whether or not it should be. The fact that people feel left out when they can't do something that 99% of the world can and does do should not really surprise you.

Ha, if 99% of women were fertile and also bore children, we'd be in more trouble than we already are. There is no evidence that I can find that 99% of women of childbearing age are fertile, particularly in this day and age, when PCOS rates have climbed to 35% in some populations.
posted by melissam at 11:14 AM on March 19, 2012


I don't think Arieff meant anything bad by doing all this--she even seems to have done a lot of things just to try to do it as well as possible. But I also don't think her eyes are totally open as to the fact that this is something that was not risk-free work to her surrogate, and that her surrogate was being presented with this huge amount of money to do something that could seriously damage her health--but with no other possible way for her to make that kind of money.
Well, it's something the women had already done previously, just for fun. I don't see how it's unethical to pay someone to do something they've already done for free.

Also, the risks of childbirth are not the same for all women, and the surrogate was going to be getting quality healthcare during the entire pregnancy, so chances are this pregnancy would be less risky then others.

Some of the articles on surrogacy I'd read in the past tended to seem kind of creepy, with the mothers seeming oddly self-centered and gave off a kind of creepy vibe of not caring the surrogates or maybe even not liking them of feeling jealous(?) I don't know. But this woman seemed to be very concerned about the woman who would actually be giving birth and caring for her kids, including being concerned with her health.
Wow. Really? I don't get that but then I have never really wanted children.
...
I don't really get it either. Why do people feel as if entitlement to have children should be some default state?
Why do some people act like these attitudes would be common? Of course most people want to have children. Not wanting to have children pretty unusual. From an evolutionary perspective, it makes sense that people, as well as their evolutionary predecessors would want children.
India might not be a fertility powerhouse for long either. I think it's 90% of fertility issues that are caused by PCOS, which is considered a "disease of affluence" associated with modernization of food. India is quickly catching up to the US in rates of this disease.
Is considered by who? Wikipedia says it appears to be genetic, although apparently obesity plays a roll in the level of expression of the allele. But that has nothing to do with how 'modern' the food is, but rather the quantity.

In any event, the legal and already existing infrastructure systems would play a much greater roll then relative fertility rates, most women can still give birth and be surrogates. Lots of American women are surrogates, I don't think it has anything to do with relative rates, the article said they chose India due to the cleaner legal situation.
There is no evidence that I can find that 99% of women of childbearing age are fertile, particularly in this day and age, when PCOS rates have climbed to 35% in some populations.
Looking at Wikipedia, PCOS apparently prevents ovulation, but in some cases simply diet and excessive can cause ovulation to return again, plus there are other treatments, (you can even remove eggs directly and implant them, skipping the ovulation issue.) From reading this, I don't know that a 35% PCOS rate means 35% infertility. 99% is probably pretty unlikely though.
posted by delmoi at 12:10 PM on March 19, 2012 [2 favorites]


Wow. I have a relative who literally just did this - like, is in India right now with the new babies. Timely article.
posted by LobsterMitten at 1:03 PM on March 19, 2012


I'm also conflicted about this. This sounds horrible and is clearly a different type of 'need' being fulfilled but you could replace surrogacy with prostitution and much of the justifications given wouldn't have to be rewritten. It's hard to determine the level of coercion of the surrogate since the client is coming from far away and has no way of knowing whose choice it was to enter into this agreement.

On the other hand, everything seems to have gone well and no one was hurt. So maybe I just need to accept that everything is for sale and there's nothing inherently wrong with that?
posted by chaz at 1:35 PM on March 19, 2012


I don't have a problem with surrogacy with informed consent, but I think it's just really hard to get informed consent from an impoverished person in a remote village in a developing nation. Maybe not impossible, but it doesn't sound like the author's head was really in a place to even be thinking about that.

On the contrary. She considered it -- using a US surrogate, with the same rights and legal protections, and at least theoretically the some of the same opportunities, as she has herself. She ruled it out.

We heard stories about surrogates changing their minds after the birth and keeping the children, while on the other hand, the [Indian] clinic and its director, Dr. Patel, had also been featured on “Oprah.”

This woman is either not very bright, or disingenuous in the extreme.
posted by pH Indicating Socks at 2:39 PM on March 19, 2012 [3 favorites]


I don't have a problem with surrogacy with informed consent, but I think it's just really hard to get informed consent from an impoverished person in a remote village in a developing nation. Maybe not impossible, but it doesn't sound like the author's head was really in a place to even be thinking about that.
Why, because poor people people from the third world are incapable of rational thought? They are incapable of judging the risks themselves, and decisions should be made for them, like children?

Seems like a very paternalistic attitude.
posted by delmoi at 2:50 PM on March 19, 2012 [1 favorite]


For the same reason that people don't like buying goods bought in sweatshops, delmoi. In a country with crushing poverty and few regulations, having a choice means something different than in a modern, industrialized country. India and china are getting there, but it's still something to be concerned about. It seems as if this woman wasn't very reflective about it, which is remarkable, since she seems to have written a book about the experience.
posted by empath at 3:32 PM on March 19, 2012 [3 favorites]


Informed consent isn't just about the ability to have rational thought. It's about the ability to actually choose, based on the information you have, to do or not to do something. You can have lots of ability to make rational decisions and not be able to use it in a given situation because of external, rather than internal factors.

I wouldn't say that a lot of poor people in the US have that ability, either. If you went and started making this offer to women who, for example, were stay-at-home parents in households facing foreclosure, I would see the exact same problem with it. It's not about brain power, it's about external pressures. The fact that someone of reasonable intelligence in desperate circumstances says "yes" to something does not, by itself, indicate that they are actually making a rational decision about the risks.

But paternalistic, seriously? I grew up in poverty and haven't yet gotten out of it. Even now, I'm quite thankful that nobody has actually offered me an obscene sum of money to do something dangerous/illegal/whatever because the first place my not-stupid-at-all brain would go is, "With that kind of money, I could move my disabled father into reasonable housing..." Thankfully, it's never come up.
posted by gracedissolved at 3:47 PM on March 19, 2012 [3 favorites]


Third, the standard fees to an Indian surrogate are less than half of the standard compensation for living expenses, maternity clothing, etc., required by US surrogacy agencies.

This seems somewhat exploitative to me. Coupled with the problem with over-population, paying an Indian woman half what one would require in the US, while that Indian woman is surrounded by over-reproduction without remuneration, emphasizes the privileged status of the US couple. I would rather the parents had adopted an orphan Indian child or donated the money they saved to care for poor Indian families. Not my call, I know, but I can't be wholeheartedly supportive under the circumstances.
posted by Mental Wimp at 3:55 PM on March 19, 2012 [1 favorite]


Oh man, I'm not ambiguous about it at all. I think it's a form of horrible exploitation and little better than buying organs from "donors" in third world countries.

Here's a transcript of a piece that ran in a crappy Australian equivalent of 60 minutes.

The attitudes on display are, I fear, all too common. Some highlights:

"it's like you’re going shopping in the most surreal shopping experience of all time."

The worst part:

MONIQUE WRIGHT: Nick, that sounds a bit heartless, saying that what she's left with now is just that she’s wealthier. I mean she has got to have physical issues that she would've been dealing with for several weeks as well as emotional ones – of which we don't know what they are.

NIK: See the thing is, we will never know. Now if she did, I'm very apologetic for that. She was employed for a certain amount of time, and that actually sounds really bad. But she was really just employed for a certain amount of time and after that, she gets her money, we go our separate ways, we get on with our life and she gets on with her life with her children.

MONIQUE WRIGHT: Is this how you feel about it, what it just a business transaction?

LISA: This is how I tell everyone now. Anyone who's looking at surrogacy in India, which is still a brilliant option at creating a family, it has to be business. Check your emotions at the door when you go, potentially to the point don't even meet your surrogate, so that you don't have any bonded connection, that it is purely a business transaction


*Shudder*. Commercial surrogacy is illegal in Australia, so we're at a very different place in this conversation than the US and other places. But I defy anyone to read that piece and defend this practice. The privilege coating everything the Australians say is so thick.
posted by smoke at 4:29 PM on March 19, 2012 [3 favorites]


So my own take on this is that I find it a bit unsettling when people from more economically privileged backgrounds in the West choose to work with Indian surrogates in order to save money, and far more unsettling when people from countries where surrogacy is highly regulated and surrogates' rights are protected vigorously choose to work with Indian surrogates because "they don't want any problems with the surrogate."

But I don't think I'm without bias in this, as I was part of my friends' twins being born via surrogate in the US (I was the egg donor).
posted by Sidhedevil at 5:47 PM on March 19, 2012 [1 favorite]


In the transcript smoke linked just above, the Australian newsmagazine includes the prospective mother describing the surrogate's asking for more payment for carrying twins as "blackmailing." In the US, additional compensation for multiple pregnancies is carefully spelled out in surrogacy contracts, so it seems like once again someone is trying to cut corners in an unregulated environment and getting angry when their bluff is called.
posted by Sidhedevil at 5:52 PM on March 19, 2012 [4 favorites]


Informed consent isn't just about the ability to have rational thought. It's about the ability to actually choose, based on the information you have, to do or not to do something.

Or, according to the Belmont Report, the principles of autonomy, beneficence, and equity must underly the decision. Coercive amounts of money violate all three principles.
posted by Mental Wimp at 10:28 PM on March 19, 2012 [2 favorites]


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