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Assisted Reproduction

The Dark Underbelly Of The Surrogacy Industry In India

Talk about a parade of horribles:

The poor surrogate mothers in Gujarat, who rent their wombs to augment the family income, have been confronted with the horrors of a pitiable payment and broken homes. The Centre for Social Research, an NGO, revealed after talking to nearly 100 surrogate mothers and 50 commissioning parents in Anand, Surat and Jamnagar in Gujarat, that surrogacy has not gone down well with their husbands and children.

“We found some disturbing trends. For instance, though the husbands do not mind their wives to act as surrogate mothers, the spouse and her children distance themselves from her after she returns home following the birth of the baby,” CSR director Dr Ranjana Kumari said. In Anand, around 52 per cent of the surrogate mothers said they were abandoned by their husbands and that most of them had to fend for themselves and their children.

Around 14 per cent women in Surat and 20 per cent in Jamnagar said their relationship with their husbands soured. Many surrogate mothers – 100 per cent in Jamnagar, 83 per cent in Surat and 40 per cent in Anand – revealed that they lost contact with friends and members of the family after opting for surrogacy.

Surrogacy had a bearing on family equations. Close to 77 per cent women in Anand, 86 per cent in Surat and 100 per cent in Jamnagar said it affected the way their households were run.

For surrogate mothers, surrogacy has not gone down well with their husbands and children. Surrogate mothers said they suffered on account of the secrecy involved in the entire process. Around 82 per cent of them in Anand, 89 per cent in Surat and all in Jamnagar said the secrecy involved in the entire process of surrogacy made them vulnerable to suspicions.

To make matter worse, the amount of money given to the surrogate mothers was never fixed and was decided arbitrarily by the clinic or the doctor, the study found. These mothers were often left with just a pittance. Of the Rs 12 to Rs 15 lakh for a surrogacy, the mothers get just about one or two per cent of the entire amount – that is not more than Rs 12,000 or Rs 15,000, the report said.

“Apart from being denied the promised amount, they are often paid in installments. Since most of them are illiterate, they lose count after a few installments,” Kumari said. In 97 per cent cases in Surat and 100 per cent in Jamnagar, most of the surrogate mothers were approached or targeted by agents or touts who make a killing through commissions.

It was also revealed that relationship between the surrogate mother and the commissioning parents remained harmonious in the beginning, but turned unpleasant towards the advanced stages of pregnancy because of hyperanticipation, monetary disagreements and other pretentious issues.

India has been a popular destination for surrogacy because of cheap medical facilities, advanced reproductive technological know-how and a hard-up population willing to make an extra buck to support their families.

The horrors were not restricted to poor payment. “It was found that surrogate mothers were made to undergo in-vitro fertilisation sessions 20-25 times for a successful impregnation. Current guidelines strictly prohibit this,” Kumari said.

Apart from NRIs, couples from the US, Russia, the UK, Sweden, Israel and Australia come to India for the cheap surrogacy offered.

If this report is accurate, India needs to take a fresh look at their surrogacy industry. Between the exploitation of these women to the inconceivable stigmatization and ostracization, significant and immediate reform is necessary. I still cannot get my head around the notion that some of these surrogates had to undergo 20-25 IVF procedures before achieving a successful pregnancy. That simply defies reason and should trigger a probe into the medical practices as well being employed by these clinics. For anyone considering surrogacy in India, this sobering article should give you pause.

Discussion

9 comments for “The Dark Underbelly Of The Surrogacy Industry In India”

  • Jon

    This story lacks any credibility. The findings are based on pure hearsay. Did this researcher speak with the clinics or doctors who are accused of such blatant exploitation? We’ll never know. While there is probably exploitation going on for sure, paying a surrogate 12,000 rupees to carry a baby to term is the most ridiculous statement I’ve ever heard – that is about 240 USD. Come on Andrew, please. I’m shocked you would perpetuate such crazy statements on your board. The fact of the matter is that for Westerners who use reputable clinics (like the ones that have been described at length on the Oprah show, New York Times, The Today Show, LA Times, BBC, and countless other media outlets) the average compensation for a surrogate varies from 6-10 thousand dollars (USD) for a succesful pregnancy. That is about ten times the per capita for an Indian. This is a lot of money for an indigent, uneducated Indian family to receive and most studies have shown that the positive impact of this windfall to the family is beyond what most Americans can comprehend. Bad story… Oh well…

    • Hi Jon,

      I wish these kinds of stories were aberrational, but they are not. While I cannot speak to the methodology employed nor have I reviewed the underlying data, the Centre For Social Research is not a fly-by-night operation. However, as I clearly pointed out in my commentary, “if this report is accurate”, it certainly is troubling. While I agree with you that these facilities satisfy a very important function in providing a low-cost alternative to the United States, the perils cannot be ignored.

      Beyond the anecdotal information provided in the article, I have had numerous clients experience problems in India. From egg donors awaking in the middle of egg retrievals to the co-mingling of embryos, there have been a disproportionate number of complaints about the practices being utilized at these clinics. Moreover, the issues are not limited to little-known clinics; but rather some of the most reputable facilities in India.

      There are other troubling stories as well, including accounts of babies being born not genetically related to their parents (http://articles.timesofindia.indiatimes.com/2010-07-21/mumbai/28288884_1_surrogacy-norwegian-embassy-clinic), twins not genetically related to each other (http://www.eggdonor.com/blog/2011/05/04/6-years-canada-india-surrogate-twins/) and Intended Parents trapped in India with children who are considered “stateless” (http://www.eggdonor.com/blog/2011/11/21/irish-babies-delivered-indian-surrogates-remain-stateless-trapped-india/). Currently, we have several clients pursuing claims against otherwise well-regarded Indian clinics and surrogacy facilitators for egregious acts of misconduct.

      Again, I acknowledge that for many couples India offers perhaps the only chance they will have to begin their families. So in no way am I suggesting that those who are constrained financially not consider India or that the Indian government outlaw surrogacy. Rather it is better to be fully informed of the risks and, armed with that information, take appropriate safeguards to mitigate exposure to the kind of concerns expressed in the study.

      • Jon

        Andrew,

        Most of the incidents you quoted relate to citizenship issues involving non-US nationals where surrogacy is illegal in their home countries. They do not document negligence on the part of the clinics. The Norwegian case in particular is well-known and very isolated. This woman knew exactly what she was doing.

        I am sure that abuses occur with some Indian clinics but none of these abuses compare to the shocking stories coming out of the surrogacy industry in the United States, where the financial stakes are significantly higher.

        Furthermore, all Americans having babies via surrogacy in India MUST pass through the rigor and scrutiny of US consulates/embassies in order to get the citizenship papers and repatriate their babies. Your readers should note that the American government is scrutinizing this process given the volume of applications they now receive. They know very well these clinics, at least the reputable ones, and while they don’t endorse them they will tell anyone inquiring that they are legitimate operations. Should anyone have any concerns they should contact the consulates in Mumbai or Delhi and request information on any advisories that have been issued against any clinics. They will find that there are none-to-date.

        • Jon,

          That is excellent advice. And while I acknowledge that we have a lot of work to do here in the States to get own house in order, I cannot agree that the incidents in India pale in comparison to the scandals that have impacted the United States. While the financial losses are certainly greater here in America per case, the frequency of problems is certainly no less. Beyond that, this report highlights serious issues of exploitation, stigmatization and ostracization among Indian surrogates that simply is not found as it relates to American gestational carriers.

          A couple of other nits. While there have been numerous cases of international couples having difficulties securing citizenship for their children delivered by Indian surrogates, there have been even more cases of Intended Parents experiencing serious issues with the IVF facilities and surrogate facilitators. So characterizing these cases as citizenship related is inaccurate.

          Also, it bears pointing out that perhaps a primary factor in these issues have been the role of surrogacy facilitators. There are a number of organizations that coordinate surrogacy cycles in India. A number of our clients have had significant conflicts with these reproductive tourism facilities, leading to several IVF clinics in India terminating their relationship with these organizations. So we really have a confluence of factors that have led to this perfect storm.

          Lastly, I can assure you that a number of these surrogates are earning the equivalent of $500.00 – or less. I have reviewed numerous contracts where the average fee for these surrogates range from 12,000 – 25,000 rupees. Whether or not this is the norm, I cannot say. In fairness, I have also seen contracts where the surrogate receives $6,000 – $8,000. Again, we are dealing with an unregulated field in which there is almost no uniformity between clinics or facilitators.

          The lesson in all of this is that anyone considering pursuing a surrogacy arrangement in India needs to due their due diligence before embarking on this path.

  • Jon

    Andrew,

    I know you are not a big supporter of the Indian surrogacy model, even though the truth is there are THOUSANDS and THOUSANDS of happy Westerners who have achieved their dream of parenthood using this model and of these thousands there are a scant few hearsay reports of exploitation, fraud, and worse. Most of these claims are nothing more than that: hearsay. And they never seem to make the light of day with the international media, which is always on the prowl for stories and evidence to discredit the international surrogacy business.

    There are two sides to this coin, especially when it concerns Westerners making accusations. You have a lot of Westerners who go to India, knowing its completely on the cheap and their sense of Western moral superiority and entitlement can result in some interesting anecdotes when they don’t get the results they want. I too can tell you horror stories of Westerners whose behavior is as egregious as some of the hearsay remarks about Indian surrogacy clinics and facilitators. Usually these incidents all revolve around money. Some Western clients, for example, feel that they are entitled to discounts or full refunds if the surrogates miscarry or they don’t get pregnant, despite having signed binding agreements which clearly stipulate the fees and responsiblities. When they don’t get what they want, they blackmail the clinics and will make the most damning accusations against them of fraud or worse, knowing full well that these clinics do not have the means to go after them in the West. This is precisely why you never see any of these hearsay stories make the established media, becuase the claims are usually groundless and can’t be substantiated.

    Regarding these facilitators you mention, I don’t think you see the irony in that statement. Let me explain. The “facilitators” you are referring to that are giving this model a bad name are ALL AMERICAN COMPANIES AND AGENTS, who give their American clients the false sense of security and control over their dealings with a third-world clinic when in fact, oftentimes, they are nothing more than wolves in sheep’s clothing. I can give you names, but I think you already know whom I am referring to.

    Finally, I am outraged at your comments about surrogates being paid R12,000 for a surrogacy, which is the equivalent of 240USD and your insistence that you have clients who can attest to this. If this is true, I can only appeal to your sense of decency and conscience and please report the names of these clinics to the appropriate Indian governmental agencies so they can conduct an investigation. Additionally, please contact the appropriate US Department of State agencies in India to alert them to what you know. What you are describing is not business at all; any surrogate who accepts terms such as those is a slave and should be given all the protections available to her by the various international treaties to protect women who are exploited in such a horrible manner. Please kindly go public with your information, there are also many international media outlets who would like to know the identity of any clinics who are privy to such a practice.

    • Jon,

      Thank you for taking the time to share your insight and experience. Your voice is important in furthering this dialogue and making the other side of the story known so that consumers can make informed decisions.

      I share your concern about these surrogacy facilitators. Quite frankly, in every situation where my clients have experienced problems, one of these organizations was involved. Whether they are merely a symptom or the cause of the problem remains unclear. It seems that everyone has a finger to point which is what makes the entire situation so murky and appear to be perilous.

      Lastly, we have been proactive in addressing these abuses and exploitative practices. As you know, India is still debating their surrogacy laws so the situation remains quite fluid. As matters stand now, there are no direct laws on point nor is their any enforcement or regulatory agency tasked with weeding out these shady operators. Until these rules are finalized, I suspect we will continue to hear more horror stories and reports like the one described by The Centre for Social Research.

  • beautifuleyes

    According to the Actual data collected regarding payments to the surrogates “Regarding one of the most crucial factors i.e. payment received by the surrogate mothers under the surrogacy agreement/contract, in Anand, majority of the surrogate mothers (91.67%) mentioned that they received between Rs. 3-3.99 lakhs for being a surrogate mother. However, in Surat, around 74.29% said that they received between Rs. 2.1-2.99 lakhs; and in Jamnagar all the respondents said that they received up to Rs. 2 lacs for being surrogate mothers. ” BUT ALL MEDIA REPORTS OUTRAGED AT THE ‘EXPLOITATION’ ARE QUOTING THIS—— “How are the commissioning parents charged for the surrogacy service? On average the clinics charge around Rs. 12-15 lakh for the surrogacy service. There is no fixed guideline and the cost varies according to the clinic‘s own criteria. Most of the times, the commissioning parents from abroad are ready to pay the amount which is required in India, because it is much cheaper than in their countries. The clinics usually claim that a fair share of the money received from the commissioning parents go to the well being of the surrogate mother during her pregnancy, however, this is not the case – the clinics keep a big share for themselves and give ONLY 1-1.5% of the TOTAL amount to the surrogate mother as compensation. 1% OF 15 LAKHS IS RS 15000
    I posted this on the CSR Facebook page – Got this response
    CSR is claiming in response to this query on their facebook page that YOU the MEDIA HAVE MISQUOTED THEM.Can you please CLARIFY- WHAT IS THE TRUTH? “The CSR study report says that the surrogate mother gets Rs. 2.5 to Rs. 3 lakh in total for one child (pg. 47, para 2 of the report)as mentioned by the respondents and the concerned clinics/hospitals under the study. No where it has been mentioned that she gets Rs. 12,000/-. It has been misquoted. It has been told in the press conference that a surrogate mother gets Rs. 10,000/- – Rs. 12,000/- in some surrogacy centres of Delhi after the embryo transfer and once the pregnancy is confirmed. The facts mentioned in the report is 100% accurate to the best of our knowledge and understanding. We don’t intend to malign any doctor/clinic or hospital for that matter.’”.
    MY response:
    “Please READ your own report. The quote IS from your report(pg 75-76,Sec 4.7 Surrogacy clinics). It is a slanderous lie and I hope you will publish a retraction and apology in each of the media reports that you have linked to on this page.”
    Link to the entire report below:
    http://www.womenleadership.in/Csr/SurrogacyReport.pdf
    PLEASE GET THE FULL PICTURE BEFORE YOU JUMP TO CONCLUSIONS.

  • beautifuleyes

    ALSO POSTED THIS:
    ‎”It was found out during the field visits that in order to be impregnated successfully the surrogate mothers were tried 20-25 times with IVF sessions, although it is strictly prohibited by ART guidelines. ”
    Huhhh????? what is an ‘IVF session’. Do you have any idea what you are talking about???? 25 IVF cycles -ie 25 Embryo transfers would take about 75 months – over 6 years to complete. If you are talking about the number of clinic visits for endometrial lining checks by trans vaginal ultrasound and for injections and blood tests and medical check ups- that is normal for ART cycles and certainly not ‘strictly prohibited by ART guidelines”
    Haven’t got a response yet.
    Read the report-I think they are clueless about what IVF really involves and they are confusing cycles with clinic visits.

    • I have made the entire report available so readers can draw their own conclusions. While it does appear that the initial news report contained some inaccuracies, there are numerous other findings in the CSR report which remain troubling.

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