Raising red flags on the impact of commercial surrogacy, doctors at AIIMS have published a case of a 42-year-old woman who died in the 17th week of her pregnancy owing to a medical history of tuberculosis, hydrocephalus and depression. The surrogate, carrying twins, was referred to AIIMS in September 2018 from a private hospital for medical termination of pregnancy (MTP).
The case has been published in RFP Journal of Hospital Administration, and highlights the need for stringent surrogacy laws. The Surrogacy (Regulation) Bill, 2019, which has been introduced recently, seeks to completely ban commercial surrogacy in the country. It also provides for the constitution of surrogacy boards at national and state levels.
“Her body was brought to the mortuary of department of forensic medicine & toxicology for post-mortem. The surrogacy regulation law 2018 was also framed to regulate commercialisation of surrogacy. In this case, a financially challenged woman became a surrogate without providing previous disease history, which later led to complications. The woman died due to non-compliance of surrogacy regulatory laws,” said Dr Abhishek Yadav, assistant professor, department of forensic medicine and toxicology, AIIMS.
Surrogacy is a contract in which a woman bears a child for another couple; the child may be genetically linked to her in case she donates her ovum. According to doctors, for a woman to be chosen as surrogate, she has to undergo inquisitive laboratory and medical examination, provide any past history of medical conditions and family history of diseases.
The investigation further revealed that during the second trimester, she was admitted to a private hospital for treatment of vomiting. She gave a history of consuming 15-20 antidepressants and was advised to undergo genetic counselling. But her condition worsened and she had to be shifted to the emergency, where she died.“As per the guidelines of ICMR, which were followed before the approval of Surrogacy Regulation Bill, she was not a suitable surrogate to carry foetus. Still, somehow, she was chosen to carry babies,” added Dr Yadav.
According to the new bill, a certificate of essentiality should be issued after securing a certificate of proven infertility of one or both members of the intending couple from a district medical board; an order of parentage and custody of the surrogate child passed by a magistrate’s court; and insurance coverage for a period of 16 months covering postpartum delivery complications for the surrogate.