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Saturday, June 19, 2021

Surrogacy: Just another normal delivery

Surrogacy has become a thriving $2.3 billion or Rs 13.8 billion (annual) industry in India.

Written by Aditi Raja |
July 14, 2013 10:01:32 pm

For 32-year-old Vadodara resident Asha Mehta (name changed),the decision to become a surrogate mother to a childless couple in Ahmedabad was taken during a period of financial strain.

In 2010,Asha’s husband,a clerk at a private accountant’s firm,was diagnosed with malignant lymphoma in the urinary bladder. The cost of the treatment and chemotherapy was unaffordable. “My neighbour,whose sister is a nurse at a fertility clinic,proposed the idea. At first,I rejected it completely. For a conservative community like ours,the thought of having to carry someone’s else’s child in your womb would mean ostracism from the family. My husband said he would rather die than sell my body,” she recalls.

But Asha wanted to explore the option,and she agreed after several sessions of counselling. Her husband took longer. “When I explained to him that both of us needed to be healthy and alive for the sake of our two children,he broke down and allowed me to go ahead,” she says. In the last three years,Asha has carried two surrogate pregnancies to term — both delivered twin boys,the last in 2012. She feels the strain on her body but is willing to do it again.

Surrogate mothers such as Asha are a part of a thriving $2.3 billion or Rs 13.8 billion (annual) industry in India. Last year,approximately 400 surrogate babies were delivered in Gujarat — and then handed over mostly to couples from the US,Britain,France and Israel. But neither Gujarat’s health and family welfare department nor its commissioner of health medical services knows the exact number of surrogacy clinics in the state,or,worse,which department is supposed to monitor them.

Commercial surrogacy was legalised in India in 2002 but there is no law that regulates the industry,except for guidelines laid down by the Indian Council of Medical Research (ICMR). With government agencies looking the other way,the practice of surrogacy abounds in many pockets in Gujarat,leading to fears of exploitation and abuse. For example,although ICMR guidelines say a woman should be used as a surrogate only once,doctors do not follow it. A surrogate mother-to-be should be between 25 and 45 years of age,married,and a mother of at least one child — but that guideline too is often flouted. “Since most of the women have had more than three pregnancies,including their own children,they develop chronic anaemia; 1-2 per cent have gestational hypertension and diabetes,which are the hazards of repeated pregnancies. Due to their economic condition and the pressure from family,they opt to become a surrogate every two years. But in doing so,they are putting themselves at risk,” says Ahmedabad-based gynaecologist Jagruti Sanghvi.

But such is the economic reality that the demand,and supply,for surrogate mothers will continue to increase. For every successful delivery,a surrogate is paid up to Rs 4 lakh (about $ 7,000) by the commissioning parents,in addition to the maintenance she needs during the gestation period. If the surrogate delivers twins,the couple must pay at least an additional 15 per cent of the decided amount. For the commissioning couples,especially from the West,this is about five times less than it would cost them in their own countries.

IVF experts in Gujarat also say that a growing minority is made up of couples,who wish to rent a womb,not because of medical reasons,but because they do not wish to let a pregnancy affect their careers. “As women with successful careers delay having children,this number is set to increase in the next five years. The recent case of Shahrukh and Gauri Khan opting to have a child through a surrogacy has led to greater acceptance of the idea. The number of people coming to us has gone up,” says Dr Manish Banker of Pulse Hospital,Ahmedabad.

In many clinics of Ahmedabad,surrogacy is pitched as the guaranteed option to couples who enquire about IVF treatment. As IVF is costly and its results uncertain,doctors nudge them towards surrogate pregnancy,which has “assured returns”. Some clinics even have a “money back” policy besides lower rates. “Many infertility clinics in the city as well as the state have made entered the business,despite not having adequate expertise. If it clicks,it brings in the money and if it doesn’t,they will try again,” says a city-based doctor. 

There is no dearth of women willing to bear children for others,and rather than clinics finding surrogates,the reverse is mostly true in Ahmedabad. Most surrogacy contracts provide maintenance for the woman during the pregnancy,but only to the extent required for the health of the child she carries. The priority in surrogacy cases is a baby – for the commissioning family,the surrogate as well as the doctor. There are no laws that govern the rights of a surrogate.

Surrogacy tourism has famously brought many foreign couples to Gujarat. It has earned Anand the tag of ‘baby farm’ ,with the dusty town once known for its milk cooperatives becoming famous for the Akanksha Infertility Clinic,run by Dr Nayna Patel. At any given point,the clinic has about 50 surrogates confined to its hostels,waiting to give birth to the children of infertile couples from across the world. Its wait-list runs into hundreds. Most of the potential surrogate mothers on its roll are from impoverished families.

Wahida (name changed),a native of Anand,for example,chose to become

a surrogate as her husband’s meagre earning of Rs 3,000 a month were inadequate to provide for three children. She became a surrogate mother to an American couple,who travelled halfway around the world to Anand in Gujarat in early 2009,to have a child. After a series of hormonal shots before the embryo transfer,Wahida,32,carried her first surrogate pregnancy to term in 2009. “When I met the doctor in the Anand clinic,she told me that I had to prepare myself to rein in my emotions regarding the child. I told her that I found it tough to raise the three children I have and wish no more for myself,” she says.

Wahida’s interaction with the American woman grew into a deeper bond as she chose to live in Anand to monitor the progress of her to-be born twins (she had daughters). “The lady and I loved to talk about food,music and she would show me fashion magazines that I loved to see. She told me how she would let her children know about me,” says Wahida,who lived for nine months away from her family and children,under the strict vigilance of the wardens at the clinic’s hospital. The American often got along Wahida’s youngest son to meet her but apart from monthly visits,her husband and two older children were kept away. Even a stroll in the garden was forbidden . “The bottom-line is that I have three children and I wanted to give them a life that will not force them to do what I am doing today,” says Wahida.

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