The business of making babies

Controversial ... International commercial surrogacy must be challenged.
Controversial ... International commercial surrogacy must be challenged. 

Two years ago, when I first started researching material for my novel, which deals with commercial surrogacy in India, I had a very different plotline in mind. It was going to be a romantic, happy story of commissioning parents who get a much-longed-for child.

But the more I explored the issues around this very complex "business", the story changed dramatically. The plot still contains romance and joy, but it's layered with enormous ethical and moral problems, because the $2billion international "baby market" in India is functioning almost without any legal or medical supervision, entirely dependent on the goodwill of the parents, doctors, lawyers and surrogates involved.

Even though commercial surrogacy is banned in most of Europe and many countries around the world (where women are rightfully forbidden to loan, rent out or sell their bodies), hopeful parents from these countries flock to India, where they rent human wombs for nine months. But my sympathy lies with them as well - as they, too, in some ways are being exploited because of their desire to have their "genetic"' child.

Those who have made the maximum material gain are the doctors who are marketing the whole process all over the world as a "win-win" situation. After all, they claim, eventually the commissioning parents get their child, and the poverty-stricken surrogates earn small sums (about $4000) in return for giving up a year of their lives and a child they have nurtured in their wombs.

So the point of view in my story shifted away from the happy commissioning parents, towards the surrogates who come from the really deprived sections of Indian society. And I also began examining all the others for whom this has become a thriving business: the doctors and lawyers, the agents who round up the surrogates, the tourism business that has grown around it.

One discomfiting factor I discovered was the experimentation sometimes carried out on surrogates. After all, this is a lottery: no one quite knows for sure which embryo will be successfully implanted, so surrogates are pumped full of fertility drugs and more than one embryo is implanted. If that fails, some hospitals will try the same thing over and over again; I was even told of one woman who went through 25 cycles of fertility treatment.

While hospitals claim they have a wonderful success rate and take care of their surrogates very well, researchers working in this area claim that there are many unanswered questions. The truth is that even if something goes wrong, the surrogates are too poor to claim compensation.

Often the surrogates sign contracts that make caesarean sections almost mandatory. This is considered the best procedure to protect the child's safety, but it also means the birth can be timed for the convenience of the commissioning parents. The surrogates even agree to be put on life-support systems (if they're hurt or injured in an accident) in order to save the child's life. Few arrangements are made for postnatal depression or any psychological or emotional traumas the women might go through. It became quite apparent to me that the surrogates had very few rights.

Can money really make up for everything else? The parents or the doctors normally say the surrogates are very keen. The truth is that in most cases, the womb has become the only asset the women own - either producing children for their own families or for complete strangers. They have no control left over their own reproductive process, as now their families, especially husbands, encourage them to take on surrogacy as a "profession". They're allowed to do it at least three to four times.


And so the booming "baby factories" flourish in India, despite the fact that no law has even been presented in the Indian parliament that could monitor or regulate assisted reproductive techniques. For the clinics that are now speedily mushrooming all over the country, it's a complete bonanza. Soon it will be impossible to reverse the clock, or even consider altruistic surrogacy.

The only way to provide some checks to this highly exploitative, unmonitored practice is that the foreign couples coming to India must become aware and question the entire process. Simultaneously, governments should collectively set up a global body to monitor the practice, ensuring that all countries have a synchronised approach.

While we all want our own children, alternative options  - especially adoption - must be promoted more aggressively, so it can't be automatically assumed that assisted reproductive techniques are the only way to life.

Kishwar Desai is the author of Origins of Love (Simon & Schuster).