Birth of a booming baby industry

July 12, 2010 7:01 AM

Couples from Western countries, such as Australia, the US, and the UK are turning to surrogates in India to carry their babies.

This practice is garnering its share of controversy, as it is being seen as exploitation of poor and uneducated women. This has led to calls for greater regulation from officials in India.

Also, see this previous post for more.

posted by reenum (45 comments total)

Since then, Anand, known as the milk capital of India after a hugely successful dairy cooperative, has emerged as the epicenter of the industry with about 20 women signed up as surrogate mothers for couples from abroad.

20 people is an epicenter?
posted by GenjiandProust at 7:18 AM on July 12, 2010 [2 favorites]

Wait, so is the US west of India, or is the UK? They're in opposite directions. And Australia is south of India.

Methinks you need another term for dividing groups by standard of living.
posted by Eideteker at 7:20 AM on July 12, 2010 [1 favorite]

"20 people is an epicenter?"

GaP, the real center is underground. This is just the epicenter.
posted by Eideteker at 7:21 AM on July 12, 2010 [4 favorites]

My husband lost his limbs working in the factory," Dave told Reuters. "We could not manage even a meal a day. That is when I decided to rent out my womb."

One one level I think is there difference? Renting your womb out to carry a baby or renting your arms, back and legs out to work in a factory. Both are dangerous, dehumanizing lines of work.

"Surrogate mothers are giving their (the eventual parents') lives a new meaning. For them the money they pay is just a token gesture that by no way substitutes their gratefulness," said Deepak Kabir, a Mumbai-based gynaecologist.

Wonder if Dr. Kabir sees his cut of the business as "just a token gesture" as compared to the real reward of helping others.
posted by three blind mice at 7:25 AM on July 12, 2010 [6 favorites]

surrogate mother from India - I just want to know is it legal
posted by KPAstrology at 7:33 AM on July 12, 2010

For their clients it's infertility or -- some claim -- educated working women turning to hired wombs to avoid a pregnancy affecting careers.

I also claim that feminists are destroying families, Elvis is still alive, and JFK never went to the moon.

Which of these statements will Reuters print next?
posted by fontophilic at 7:34 AM on July 12, 2010

I have to say, the logo for Surrogacy India is pretty cool. :)
posted by zarq at 7:43 AM on July 12, 2010

The documentary Google Baby explores what happens when surrogacy meets international outsourcing. The same process that can cost more than $100,000 in the U.S. can be done in India for $6,000. Director Zippi Brand Frank explains how the process works, and the questions it raises.

The only trailer I could find which is available to all of us is here.
posted by gman at 7:46 AM on July 12, 2010

Also, see this Marie Claire article for more info on the trend. It focuses on the same clinic highlighted in the "Womb for Rent" FPP linked here under "previous post".

How surrogacy came to be so popular in the choking backwater of Anand, a dairy community with a population of 150,000 in India's western state of Gujarat, is a long story. The short answer is Dr. Nayna Patel, 47, the clinic's director. A charismatic woman with flowing hair and a toothpaste-commercial smile, Patel single-handedly put Anand on the map when, in 2003, she orchestrated the surrogacy of a local woman who wanted to "lend" her womb to her U.K.-based daughter. The woman gave birth to test-tube twins — her own genetic grandchildren — and the event made headlines worldwide. Afterward, Patel was inundated with requests for surrogacy. She now has 45 surrogate mothers on her books, mostly impoverished women from nearby villages. Twenty-seven of them are currently pregnant, and each will be paid between $5000 and $7000 — the equivalent to upwards of 10 years' salary for rural Indians. More than 50 babies have been born at the clinic in the past three years, half to Westerners or Indians living overseas.

Another example of third-world exploitation? Globalization gone mad? The system certainly lends itself to the criticism that foreign women unwilling or unable to pay high Western fees happily exploit poor women at a 10th of the price it would cost back home. The system also avoids the legal red tape and ill-defined surrogacy laws women face in the U.S. (Not to mention that India, unlike some developing countries, has a fairly advanced medical system and doctors who speak English.) Or is it a mutually beneficial relationship? By some estimates, Indian surrogacy is already a $445-million-a-year business.

posted by zarq at 7:46 AM on July 12, 2010 [1 favorite]

One one level I think is there difference? Renting your womb out to carry a baby or renting your arms, back and legs out to work in a factory. Both are dangerous, dehumanizing lines of work.

at the wordplay level only renting out your womb gives a slightly unexpected twist to the concept of labor time.
posted by the aloha at 8:14 AM on July 12, 2010 [1 favorite]

Soon the only people who will be able to afford to have children are the very old & wealthy, and once the child is born they'll be handed over to a third-world nanny.
posted by Civil_Disobedient at 8:15 AM on July 12, 2010 [1 favorite]

you've been to the Upper West Side Civil_Disobedient?
posted by The Whelk at 8:54 AM on July 12, 2010 [4 favorites]

For fuck sakes, there is thousands upon thousands of orphaned Indian children that need adoption. I can sympathize with wanting to birth your own baby but at what point in the process is it even yours (donor eggs, surrogate, the father jacking off into a cup in a medical office) and not just something almost exactly like an adopted child: a little human you got from the store.
posted by wcfields at 9:02 AM on July 12, 2010 [3 favorites]

The system certainly lends itself to the criticism that foreign women unwilling or unable to pay high Western fees happily exploit poor women at a 10th of the price it would cost back home.

Except that the Indian women are paid approximately 10 years salary, whereas US surrogates are paid $100,000, which is less than 7 years salary even at minimum wage. Of course, that figure is apparently only what it costs in the US. My guess is that the surrogate is paid substantially less than that $100,000.

So I question whether this is particularly exploitative, especially because the genetic parents have a massive vested interest in insuring that the surrogate is healthy, happy, and well cared for during the pregnancy, so I would imagine surrogacy clinics would compete pretty heavily on offering the best living conditions and medical care possible for the surrogates in the run up to and during the pregnancy (assuming they don't already compete on this basis).

For fuck sakes, there is thousands upon thousands of orphaned Indian children that need adoption.

It's quite possible that this process is actually cheaper than an international adoption, which can range up to $30,000 or so, apparently.
posted by jedicus at 9:23 AM on July 12, 2010 [2 favorites]

(The point there being that if surrogacy is cheaper than adoption then the international adoption system is doing it wrong.)
posted by jedicus at 9:29 AM on July 12, 2010 [2 favorites]

For fuck sakes, there is thousands upon thousands of orphaned Indian children that need adoption.

Indian agencies prioritize adoptions as follows:

1) Indian families residing in India.
2) Indian families living abroad. ('Non-resident Indians,' or 'NRI's')
3) Non-Indians living abroad.

It is more difficult to adopt an Indian child if you are living outside of that country and not of Indian heritage. In addition, the agencies prioritize placement of healthy, non-disabled infants with resident Indian families and NRI's.

So yes, there are thousands of orphans that need adoption. But that doesn't mean they can be easily adopted.

I can sympathize with wanting to birth your own baby but at what point in the process is it even yours (donor eggs, surrogate, the father jacking off into a cup in a medical office) and not just something almost exactly like an adopted child: a little human you got from the store.

"Almost" matters a great deal to some people.

By definition, surrogate children are usually 50%-100% "yours" genetically, and 100% "yours" by law. With exceptions, adopted children are not your genetic offspring. Various state laws regarding adoption in the US may allow for the return of a child to it's birth mother at her request within a limited time period, although I don't know how that might apply to international adoptions.

I've commented about this topic in previous MeFi threads.

In addition, the cost of international surrogacy may be significantly lower than an international adoption.
posted by zarq at 9:39 AM on July 12, 2010 [1 favorite]

at what point in the process is it even yours

If by saying "yours" you mean 'your child and not that of someone else'. I which case I see no difference. Assuming a role as guardian for a child makes it yours, using "yours" in a very vague and broad sense of the word.

Still I think this is a better responds to what I think you are asking:

Parents who use a surrogate can influence the genetic makup of the child. For some this is a enormous difference.
posted by Hicksu at 9:43 AM on July 12, 2010 [1 favorite]

(The point there being that if surrogacy is cheaper than adoption then the international adoption system is doing it wrong.)

From how I read the numbers this is cheaper than local adoption. My sister and her husband paid more than $20,000 for the home study and such. There were tons of hoops to jump through.
posted by cjorgensen at 9:50 AM on July 12, 2010 [1 favorite]

Wait, so is the US west of India, or is the UK? They're in opposite directions. And Australia is south of India.

Pedant.
posted by mippy at 10:03 AM on July 12, 2010 [1 favorite]

One of my most difficult-to-defend beliefs is that prostitution should probably be legalized, because the current criminalization exacerbates the harm of sex work for women, while surrogacy should probably be illegal, because a surrogacy-market would be impossible without legal support.
posted by anotherpanacea at 11:18 AM on July 12, 2010

...while surrogacy should probably be illegal, because a surrogacy-market would be impossible without legal support.

And why would doing away with surrogacy be a desirable thing? This doesn't follow for me at all. Wouldn't this just be a case of government telling women what they can and cannot do with their reproductive systems?
posted by mr_roboto at 11:20 AM on July 12, 2010

"Wouldn't this just be a case of government telling women what they can and cannot do with their reproductive systems?"

No, you see, we must protect poor, delicate women from doing things that make them money and involve their vaginas. This is very important. Possibly more important than women being able to eat food.
posted by internet fraud detective squad, station number 9 at 11:35 AM on July 12, 2010 [2 favorites]

Wouldn't this just be a case of government telling women what they can and cannot do with their reproductive systems?

Governments aren't the only agents who can coerce people. Poverty, too, makes people vulnerable to coercion, especially in light of the massive relative poverty available globally. Given the the general income inequality between women who hire surrogates and women who act as surrogates, I have trouble distinguishing the actions of the market in this case from the actions of states that regulate and support such markets.

It's a near thing, though. As someone who can stomach arguments for markets in organs or adoption, I'm not quite ready to commit to a position that some markets are by definition "noxious" and an insult to the dignity of all women. But I still think it falls to proponents to show that the distribution of benefits outweighs the distribution of harms.
posted by anotherpanacea at 11:50 AM on July 12, 2010 [1 favorite]

Governments aren't the only agents who can coerce people. Poverty, too, makes people vulnerable to coercion, especially in light of the massive relative poverty available globally. Given the the general income inequality between women who hire surrogates and women who act as surrogates, I have trouble distinguishing the actions of the market in this case from the actions of states that regulate and support such markets.

With regard to surrogates, exploitation as a result of income inequality does happen. The reason for this is simple: women generally become surrogates for one of two reasons: they want to volunteer their wombs to give another couple an incredible gift, or they need the money. So there is a potential for abuse. I can't speak to conditions in India. But I can tell you that here in the US, the process is typically managed by a third party who tries to ensure that the process happens without coercion. Lawyer-vetted contracts are actually not uncommon. The experience for both parties is also different from state to state, depending on what is allowed by law. Some states outright ban compensated surrogacy. Others have no laws against it. In the middle are states that add restrictions. Like Texas, who only allow a married couple to enter into a compensated surrogacy contract.

But I still think it falls to proponents to show that the distribution of benefits outweighs the distribution of harms.

I used to interview women who acted as surrogates for couples (and in a handful of cases, singles) who wanted to become parents. Unless you are intimately familiar with the complexities of surrogate / donor couple relationships, I would caution you against assuming they are automatically harmful or coercive as a result of economic inequality. Most families and surrogates do not enter into such agreements lightly, and frequently do so with far more legal knowledge than you might expect.
posted by zarq at 12:26 PM on July 12, 2010 [1 favorite]

But I can tell you that here in the US, the process is typically managed by a third party who tries to ensure that the process happens without coercion.

This is an FPP about Indian surrogacy, which hardly has a good record for other varieties of "potentially-noxious" market... but even in the US, we have the example of Mary Beth Whitehead and Baby M.
posted by anotherpanacea at 2:25 PM on July 12, 2010

I'm quite aware of Baby M's case, and many others, thank you.

Also, not only do I know what the FPP is about, but I was responding to your own comment. You made general statements that were not restricted to India but directly compared them to markets in which "state" governments such as ours "regulate and support" surrogacy.
posted by zarq at 2:51 PM on July 12, 2010

You've asked me not to assume a harm unless I am "intimately familiar with the complexities." You are intimately familiar with the complexities. You've listed a number of unhappy examples that suggest that you think there's a harm.

So I'll ask you: why shouldn't we assume that commodifying women's reproductive labor is generally harmful to women as a class, and that the laws that enforce pregnancy contracts are unjust?

All we'd need to do to change the way in which states "regulate and support" reproductive markets would be to enforce the surrogate mother's rights as an equal parent. Why would it be a bad thing if those Indian mothers had claims equivalent to that of the genetic parents on the children they bore? The state could refuse to enforce contracts that explicitly treat women's wombs as commodities. The equivalent is refusing to enforce racist restrictive covenants: why shouldn't it?
posted by anotherpanacea at 3:13 PM on July 12, 2010

Renting your womb out to carry a baby or renting your arms, back and legs out to work in a factory. Both are dangerous, dehumanizing lines of work.

Are people up in arms about the women willing to do the work? Because to me all the scorn and indignation should be aimed at the couples who decide they are above the natural process.

By definition, surrogate children are usually 50%-100% "yours" genetically,

That completely ignores epigenetics.
posted by Chuckles at 3:25 PM on July 12, 2010 [1 favorite]

Why would it be a bad thing if those Indian mothers had claims equivalent to that of the genetic parents on the children they bore?

One reason is that the Indian mother could easily extract a higher price in exchange for not exercising her parental claim after the child is born, in effect forcing a renegotiation after the fact. This would probably kill the market for surrogacy, much like it's virtually dead in US states that don't enforce surrogacy contracts, which effectively gives the surrogate mother the parental claim you describe.

Or, if you allow enforcement of a contractual provision negating the Indian mother's parental claim, then such provisions would be added to the surrogacy contract as a matter of course.
posted by jedicus at 6:23 PM on July 12, 2010

What happens if the child is disabled? I'm concerned that the clinic might act improperly out of a desire to protect its income and avoid complications.
posted by Joe in Australia at 6:23 PM on July 12, 2010

What happens if the child is disabled? I'm concerned that the clinic might act improperly out of a desire to protect its income and avoid complications.

Presumably this could be fixed in a couple of ways. One is intensive screening and elective abortion. The other is contractually requiring the genetic parents to take the child regardless of any disability. I think that might be a sensible non-negotiable term to require by law.
posted by jedicus at 6:35 PM on July 12, 2010

This would probably kill the market for surrogacy, much like it's virtually dead in US states that don't enforce surrogacy contracts, which effectively gives the surrogate mother the parental claim you describe.

I understand that... but why would it be bad?
posted by anotherpanacea at 7:04 PM on July 12, 2010

I understand that... but why would it be bad?

Because it would close off an avenue for women to a) do what they wish with their own bodies while b) seeking fair compensation for it in a system that gives them legal protections. Remember, contracts cut both ways. Without enforceable surrogacy contracts, surrogates can't enforce their pay any more than genetic parents can enforce their claim to the child.
posted by jedicus at 7:18 PM on July 12, 2010

Governments aren't the only agents who can coerce people. Poverty, too, makes people vulnerable to coercion,

Well, lets just eradicate poverty then. Problem solved!

That completely ignores epigenetics.

Uh, no, inheritable epigenetic markers still come from the parents. You may be confused about what epigenetics actually is, since a lot of people apparently think it refers to anything passed down from mother to child, all the way up to memes and whatnot. But mostly it refers to things like methylation and chromatin packing in DNA that can be passed down without technically being part of the "genome"
posted by delmoi at 7:24 PM on July 12, 2010

I think this trend is pretty much totally fucked up, for almost exactly the same reason that markets on body organs - especially in the developing world - are totally fucked up.

To position it as an issue of women's reproductive rights (in the developing world context) is pretty ingenuous with regards to the issues of coercion, lack of regulatory oversight and risks outlined above. It is *so* much more than that.

To put out other injustices and exploitation in developing countries as bad or worse than this doesn't obviate its shaky ethics - two wrongs don't make a right. If the problem is bad factories and no state pension, fix the factories and the pension; don't farm out risky medical procedures to desperate people in the developing world with no other options.
posted by smoke at 7:34 PM on July 12, 2010

E.g here's a transcript from an Australia 60 minutes-style show (just as execrable as 60 Minutes).

The sense of entitlement and ignorance on display is breath-taking.

Choice quotes:

"LISA: She's wanting this for us. It's really bizarre, it's like you’re going shopping in the most surreal shopping experience of all time."

"LISA: There are women in this world that are willing to carry a child for someone else that they have no biological link to, full biological babies, my eggs, Nik's done his job, it's our baby and she hands it over at the end. She just wants to create a family for us." (my emphasis)

"But through all this, they had no contact with Farrah, the woman who'd carried their babies.

LISA: I'm still thankful to her and grateful that she offered her services and her mind and her body to do this for us. I saw her just leading up to birth and she was huge. Like, she would have been in a lot of physical discomfort.

So I've got gratitude to Farrah, especially for creating our family for us

MONIQUE WRIGHT: Where does this leave Farrah then?

NIK: It leaves Farrah in a very wealthy state. No matter how, whatever happens, she's got more money than she’ll ever see in her life.

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."

I reiterate: fucked up.
posted by smoke at 7:53 PM on July 12, 2010

The other is contractually requiring the genetic parents to take the child regardless of any disability. I think that might be a sensible non-negotiable term to require by law.

When we were in a custody dispute with our daughter's birthfather, I compulsively read up on adoption law and the history of every famous custody case etc etc etc when I couldn't sleep at night. One interesting thing I learned is that one reason we (in the US--I know nothing about other parts of the world and would be interested to hear) have had cases where a surrogate decides to keep a baby she's carried, and it's a big legal battle, is that there is nowhere in the country where people can make a binding agreement about the adoption of a baby prior to the baby's birth. In most (all?) states there is a waiting period after the birth before a birthmother can surrender her parental rights.

Where surrogacy comes in is that the law has been loathe to allow surrogates and the people who hire them to make binding contracts prior to the child's birth for fear that it would set a precedent that would pose a challenge to one of the fundamentals of adoption law, which protects the right of birthmothers to wait until the baby is born to make a final decision about adoption placement.

So, I think in the US at least, there's be resistance to this kind of pre-birth contractual obligation on the part of the genetic parents, which might then imply the possibility of a similar obligation on the part of the surrogate, which could potentially be extended by analogy to birthmothers, which, there is a strong consensus, would be really fucked up.
posted by not that girl at 9:37 PM on July 12, 2010

(The point there being that if surrogacy is cheaper than adoption then the international adoption system is doing it wrong.)

I just read Blue Ribbon Babies and Labors of Love by Christine Ward Gailey, one of the best books on adoption I've read (Amazon link). In her study, international adopters paid twice as much or more than other adopters for, for instance, home studies which were often done more quickly and less rigorously than the home studies for domestic private or public adoptions. Neither international adopters nor the agencies who facilitate international adoptions come off very well in her study, but in a nutshell one of her findings is that international adopters tend to be significantly more affluent than other adopters, and they pay more for the privilege of being screened less invasively (there are caveats and exceptions, of course).

At one point, she called an international adoption agency to see if she could interview some of the staff. The person who answered the phone mistook her for a potential adoptive parent, and she decided to run with that. In the conversation, she threw up as many red flags as possible ("It's going to be really hard for me to take the required pre-adoption courses, I'm working very long hours and don't usually get home until quite late.") but the staffer didn't blink an eye--by the time they got off the phone, she'd been told that if she was willing to pay $10,000, she could have her home study done and approved in two weeks, with no home visits, and with a waiver of the required training so long as she would read the materials and have a phone call about them with a staffer. She had no way of knowing how typical this was, but even as an anecdote it's pretty appalling.

Her study is more nuanced than that--it's the best analysis of class issues in adoption I've ever seen--and I'm certainly not doing it justice. I was just reminded of it by your comment about the costs of international adoption.
posted by not that girl at 9:48 PM on July 12, 2010 [2 favorites]

I, most likely not being able to have my own child at least without serious medical intervention, would love to adopt. But adoption costs a fortune, which could easily be spent on the first year or two of the child's life instead. Yet, there are women here in the US who can't stop opening their legs and have 5 kids and sit on their asses collecting welfare. The "system" is screwed up all the way around.

Disclaimer: I realize not all women on welfare just sit on their asses. But I know one who does.
posted by IndigoRain at 12:54 AM on July 13, 2010

Yet, there are women here in the US who can't stop opening their legs and have 5 kids and sit on their asses collecting welfare.

What is this, the fifties? You should keep horrible stereotyping comments like that to yourself.
posted by smoke at 2:04 AM on July 13, 2010 [1 favorite]

Or let me know how I can get some welfare! C'est impossible since "welfare reform" to have a kid, see the kid, AND get welfare. It's welfare-to-work all the way; too bad that you make less than you spend on daycare or might want to see your 3-month-old.
posted by internet fraud detective squad, station number 9 at 7:16 AM on July 13, 2010

"Because to me all the scorn and indignation should be aimed at the couples who decide they are above the natural process."

Why do you assume these parents hold themselves above the natural process? I have a genetic disorder that means pregnancy is much more likely than normal to result in miscarriage, and I probably won't be able to walk due to hip dislocations, and my uterus could fall out. If I am considering arranging a surrogacy in the future, I don't think that means I think I'm "above the natural process." And the assumption that I do is super ableist.
posted by vim876 at 9:43 AM on July 13, 2010

Because it would close off an avenue for women to a) do what they wish with their own bodies while b) seeking fair compensation for it in a system that gives them legal protections.

The system can and should act just like ordinary prenatal adoption with the birth-mother explicitly reaffirming her pre-natal intention to surrender her parental rights after birth. It could do that without "telling women what to do with their bodies" since they could still surrender their parental rights if they chose, and without "denying them fair compensation" since the changes I'm suggesting would put surrogates in a *better* bargaining position. For one thing, surrogates would be more likely to capture a larger percentage of surrogacy fees if they had more control of the process. You're being disingenuous here.
posted by anotherpanacea at 7:45 PM on July 13, 2010

India's surrogate mothers face new rules to restrict 'pot of gold': World centre of 'surrogacy tourism' will introduce radical legislation to regulate £1.5bn industry
posted by homunculus at 8:40 AM on July 30, 2010

From homunculus' link. I wanted to list out what the proposed bill would regulate, since that's scattered throughout the Guardian article:

Radical legislation is to be introduced to bring some order to this booming but almost unregulated sector.

* One measure will make it compulsory for prospective parents to carry proof that any infant born to a surrogate mother will have automatic citizenship in their home countries in an attempt to avoid messy legal battles.

* A second will stop clinics that perform the clinical procedures from sourcing, supplying and taking care of the surrogate mothers themselves.

* The bill limits the age of surrogate mothers to 35, imposes a maximum of five pregnancies, including their own children, and makes medical insurance mandatory.

* The draft bill bans post-natal contact between a surrogate mother and the child she has borne. The bill makes any such contact a criminal offence punishable by fines or imprisonment of up to two years "or something appropriate like that", Sharma said.

Good for them.
posted by zarq at 11:27 AM on July 30, 2010