“NO PAIN, NO GAIN”: Outsourcing Surrogacy In India 11

This week´s blog is written by Kathleen Levacher. Kathleen is from France and has been involved with Development Perspectives since January. She completed a Masters in Anthropology in NUI Maynooth last Autumn.

In our globalised world, outsourcing products or their fabrication has become a common phenomenon. Cheap labour for the production of clothes, cars, technology and similar products is targeted for a bigger return in investment. Some countries largely excel at providing products for the rest of the world, such as India for example. It is one of the fastest growing economies in the world, where its service sector counts for 55.6% of its GDP, the industrial sector for 26.3%, and agriculture 18.1%.

Despite holding a phenomenal economic growth, India with a population of 1,237 billion (2012) has many social challenges to overcome in terms of human development. Having witnessed the conditions under which a big part of the population lives in, I can say that priorities do not seem to have been set in order to provide basic human rights to improve the inhabitant’s lifestyle and needs. According to the UN, 29.8% of the population in 2010 were living under the country’s national poverty line of $1.25/day, 217 million inhabitants were undernourished in 2012, 50% of the population live of agriculture representing 18.1% of the GDP.

It is in this climate of poverty that India has now become a hotspot for fertility treatments and notably outsourcing surrogacy. For those of you who aren’t yet aware, commercial surrogacy in India has been legal since 2002, and although numbers are hard to be accounted for, it is estimated that 3000 fertility clinics have been set up, where the surrogacy industry is estimated to be worth $400 million/year (according to the Business Insider, 30/09/13). Is it ethically reasonable to outsource the production of babies like we outsource the production of a piece of clothing?

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Many documentaries and articles have followed the process of fertility treatments in a particular clinic situated in Anand, Gujarat, West of India run by Dr Patel. She has been the spotlight in the media for providing surrogacy services, mainly to “Western” clients, and also for her plans to build the first state of the art “baby-factory” (Daily Mail, 01/10/13) at the cost of $6 million.

How does it work? Different scenarios presents itself for couples seeking to have a child through surrogacy. First of all, policies of the clinics demand that only heterosexual married couples use the services offered to insure the child’s safest future, excluding homosexual, unmarried or single parents. Then the parents have the choice of choosing donors in addition to surrogates if they cannot provide specimens themselves. Dr Patel then provides a number of surrogate mothers for the couple to choose from, with whom they have a chance to converse with, meet her family and question her fears and hopes. Surrogate mothers have to adhere to a number of requirements: they need to be healthy, young, having had at least one child with a successful pregnancy, and a supporting husband agreeing to the procedure. These women can be surrogates up to three times and cannot carry more than two children at a time (in the case of multiple embryos developing into foetuses, a “reduction” is performed). Once the surrogate is pregnant, she usually lives for the rest of the pregnancy in the surrogate house with other women performing the same services. Dr Patel makes sure the women are cared for, as they are under strict instruction to rest and stay relaxed. Their days consists of either watching television, chatting to the other women or learning new skills allowing each woman to leave more empowered and self sufficient. The price of having a child through surrogacy in India is significantly lower than for example the USA. Couples pay an average of $28,000 for the service in India against up to $100,000 in the USA. From this lump sum, the Indian surrogate gets on average $8000 (the equivalent of 15 year salary for most of the surrogate’s husbands earning $40/month) in the case of a successful birth.

However, what is the emotional and physical price the surrogates pay in exchange of helping a couple accomplish their dream of being parents? Is it really “a women helping another women” in a positive way for both involved?
In the reports I gathered, and documentaries I watched about surrogate mothers in India, all of them had the same reasons for becoming surrogates: buying a house for their family, providing a high level of education for their children so that their daughters wouldn’t have to resort to surrogacy. Indian women who are unaware of the procedures of surrogacy, approach Dr Patel’s services in the hope of a brighter future, and each step is explained to them. They are told of the risks involved in giving birth (caesarean, blood transfusions, possible removal of uterus or even death) where neither the clinic nor commissioning parents are responsible. But for Dr Patel: ”no pain, no gain” They are also told that their payment is monitored by the team in the clinic to insure it goes to good use. While living in the surrogate house, women can only see their family once a week for a day. Some of them are very discreet about their activities as in the Indian culture, carrying someone else’s child is equivalent to adultery and can bring great shame to their family. In some cases Dr Patel even advises the surrogate and her husband not to tell anyone she resorted to this practice.

What are the risks for the child (children) born of surrogacy?
Many discourses take place within the business of surrogacy, which this blog entry does not cover. However, one individual needed to shed light on is the babie(s) born through surrogacy. In the exception of the UK, most European countries seem to be wary of birth through surrogacy. More particularly, it has been brought to the attention of the Irish government that a lot of effort needs to be accomplished to define the grey areas of the laws concerning surrogacy. At present, only the birth mother is regarded as the official mother of the child, meaning that even a mother providing her eggs to the surrogate, has no legal right on her child. As a documentary featured in RTE showed, “Her body, my children”, a child born from a surrogate mother outside Ireland risks in being stateless especially when multiple donors are involved, leaving the child in a legal limbo. A child can result in being the product of up to 5 individuals: an egg donor, a sperm donor, a surrogate mother, and two commissioning parents which brings the notion of family to a whole new level.

Of course don’t get me wrong, I think it’s incredible that couples can now resort to so many different fertility treatments to finally become parents, but is it a coincidence that surrogacy has become so common in a country where laws are so shady and corruption is so prominent? Raquel said in her last blog entry that there is no such thing as coincidence. In a country where poverty, gender inequality and unequal access to education is such a challenge to overcome, what risks are involved in the business of surrogacy? What measures have been put into place to monitor the implications associated with this business, especially exploitation? Is it fair that unskilled Indian women should have to resort to using their body as a commodity to break their economic cycle? In one of the most natural processes, how does the surrogate mother cope with having to give away an individual she has cared for over a number of months to his/her parents? I’d love to hear your opinions as there are so many layers to this subject.






Documentary titles:

“Her body, our babies” RTE1 Feature on 13/01/14
“Google baby” 2009 available on Youtube
“Made in India” 2010
“House of Surrogates” BBC4 Documentary 03/10/13


“Indian Transnational Surrogacy and the Disaggregation of Mothering Work” Anthropology News Feb 2009

“A paper by the Iona Institute :The ethical case against surrogacy motherhood: what we can learn from the law in other European countries.”

“Globalisation and transnational surrogacy in India” 2014 edited by Sayantani DasGupta, Shamita Das Dasgupta

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11 thoughts on ““NO PAIN, NO GAIN”: Outsourcing Surrogacy In India

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  • Prashanti

    In india there are number of fertility clinics and surrogacy is legal in india too. Many of the couples are facing infertility problem. Lotus Kiran is the best hospital for the surrogacy treatment. They are providing best facilities, best treatment with well experienced doctors in affordable cost.

  • Ranveer

    India has become a major destination for foreign couples to hire surrogates to bear their children. This has been made possible by the legalization of commercial surrogacy in India in 2002.

  • Naoise

    Really interesting blog. You say that these women are resorting to ”using their body as a commodity”. I’ve always thought of surrogacy are a service and the woman as simply a service provider. In my opinion, it is the resulting child that is at risk of commodification. Surrogacy can be presented as a courageous and resourceful decision made by an empowered woman. How exactly do you think she becomes a commodity?

  • Boby

    Choosing a right surrogacy clinic is a very important and this should be taken very carefully and give much thought in looking for success rates of any fertility clinic, what types of data does the clinic provide, and what types of data can be use. It is very important to have this information before you going to spend your money

  • John Doyle

    Hi Kathleen, A well written piece indeed. Its not surprising that such practice is so successful here.. Im wondering, are there cases, or how many of the cases are women who have been forced into surrogacy by husbands who see this as an easy and quick way to make money. Considering a monthly wage of 40 US dollars and prevalent gender inequality, im sure there are those who would find this service a very attractive option