Earlier this week we highlighted a report issued by the Centre For Social Research on surrogacy practices in India. A couple of commenters took me to task for that blog post, arguing that the India Today news story contained inaccuracies. So rather than speculate about the accuracy of the news account, I thought it best to make the entire study, including its objectives and methodology, available for everyone to read.

Here are the pertinent conclusions of the report, some of which are quite troubling (i.e., the overwhelming illiteracy of the surrogates as well as the fact that 86% of these women choose to be a surrogate to avoid or escape poverty):

The surrogate mothers, who are coming from poor family, have an average monthly income not more than Rs. 1,000-2,000 (35% in Anand, 42.86% in Surat and 40% in Jamnagar).

 The majority of the surrogate mothers has experience of giving birth and has at least two kids of her own (50% in Anand, 48.6% in Surat and 40% in Jamnagar); this implies that they are fertile women capable of reproduction naturally, who are made subject to reproductive assistance techniques to become surrogate mothers.

 The majority of the surrogate mothers are illiterate (51.7% in Anand and 8.6% in Surat) or have primary education (31.7% in Anand, 54.3% in Surat and 60% in Jamnagar); employed as domestic helpers (36.7% in Anand and 40% in Surat), construction workers (20% in Jamnagar) or nurses (40% in Jamnagar). Thus, they are economically vulnerable and desire for some money. Hence, the need of money is the driving force for them to become surrogate mothers.

 Most of the surrogate mothers are married (96.7% in Anand, 94.3% in Surat and 100% in Jamnagar) and live in nuclear family structure, which makes the surrogacy decision-making easier for the couple (95% of the surrogate mothers in Anand, and all the respondents in Surat and Jamnagar said that their husbands played pivotal role in taking the decision for surrogacy).

 Most of the time they use the money for educating their children (76.7% in Anand, 91.4% in Surat and 100% in Jamnagar) and also for building their own house or renovating the existing one (35% in Anand, 37.5% in Surat and 60% in Jamnagar).

 Most of them stay in rented houses (45% in anand, 71.4% in Surat and 100% in Jamnagar), which are kutcha (33.3% in Anand and 40% in Jamnagar) or semi-pucca (41.7% in Anand, 40% in Surata nd 20% in Jamnagar) with poor latrine facilities (55% of the surrogate mothers in Anand, 28.57% in Surat and 60% in Jamnagar said they had kutcha latrine facilities).

 Although, the husbands do not mind their wives to go for surrogacy, but after the baby is born and handed over, sometimes, the woman is not accepted by her family members. In 40% of the cases in Anand, 82.9% of the cases in Surat and all of the cases in Jamnagar the surrogate mothers have felt left alone by their family members and friends.

 Very often it is the agent who approaches the particular woman for surrogacy (97.2% in Surat and 100% in Jamnagar) and helps her to get in touch with the concerned clinic.

 Almost none of the surrogate mothers hold a copy of the surrogacy agreement. Only 1.7% in Anand and 2.9% in Surat stated that they have a copy of the contract.

 If the Intended parents do not wish to continue with the pregnancy due to some deformities in the baby or sex preference, in most of the cases the baby is aborted without any say of the surrogate mother. Only 2.9% of the respondents in Surat said that they had a say in the abortion decision under such conditions.

 The amount of money given to the surrogate mother is not fixed and is usually decided by the clinic. There is no fixed guideline and each clinic decides according to the money they get from the commissioning parents. The surrogate mother does not have any say in this matter and moreover, sometimes payment is delayed for months after she relinquishes the baby.

 Relationship between the surrogate mother and the commissioning parents, in most of the cases, remain harmonious, but from a distance. According to the surrogate mothers, the level of involvement for the commissioning parents with the entire pregnancy experience of the surrogate mother remains restricted to the initial stage of getting introduced to the former and making sure that surrogate mother delivers and relinquishes the baby as per decided. Majority of the surrogate mothers claimed that they shared a harmonious relationship with the commissioning mothers during the first stage of pregnancy (Anand – 86.7%, Surat – 88.6% and Jamnagar – 100%). However, the relationship between the surrogate mother and the commissioning parents seems to take a downturn as the pregnancy period advances to its completion; as towards the latter stage of pregnancy only 55% of the surrogate mothers we interviewed said that they shared harmonious relationship with the commissioning mothers; and for Surat it is 74.3%.

 Most of the surrogate mothers stay in the shelter homes (98.3% in Anand) during the pregnancy period. According to them, they do not want to disclose their pregnancy to the neighbours and surroundings, as social stigma is associated with it. On the other hand, the clinics also prefer them to stay in the homes instead of their respective villages in the interest of the surrogate baby, as the homes are better equipped to take care of the pregnancy-related issues.

 Many of the times, the surrogate mother remains in anticipation (71.4% in Anand and 80% in Surat) and fear (63.4% in Anand, 74.3% in Surat and 100% in Jamnagar) of the surrogacy process before the pregnancy.

 The majority of the commissioning parents are well educated (46.7% of the respondents hold Master‘s Degree in Anand, 44.4% in Surat and 100% in Jamnagar), fully employed (96% in Anand, 72.2% in Surat and 100% in Jamnagar) and coming from the higher strata of the society.

 The clinic authorities claim that most of the commissioning mothers had missing uterus. However, there are other reasons for the commissioning parents to go for surrogacy including long term illness like diabetes, dysfunctional sexual organ (40% in Anand, 72.2% in Surat and 50% in Jamnagar), complications in previous pregnancy (33.3% in Anand, 61.1% in Surat and 100% in Jamnagar), repeated failed fertility treatment (20% in Anand and 27.8% in Surat) etc.

 The contract is signed between the surrogate mother and the commissioning parents, the clinics always attempt to escape from any legal hassle. Only 3.3% of the doctors and other concerned persons in the clinic in Anand and 5.6% in Surat said that they have been a part of such contract, in the rest of the places, only the surrogate mother including her husband and the commissioning parents remain a party to such contract.

 The commissioning parents come to India for surrogacy mostly because it is illegal in their own country (23.3% in Anand and 22.2% in Surat); Moreover, in India the entire surrogacy process is much cheaper than in other countries of the West (63.3% in Anand, 44.4% in Surat and 50% in Jamnagar).

 In most of the cases the surrogate mother is unknown to the commissioning parents and it is decided in the clinic which surrogate mother should match the particular intended parents. (only 3.3% of the commissioning parents in Anand knew the surrogate mothers from before).

 The majority of the commissioning parents belong to the nuclear family (90% in Anand, 61.1% in Surata nd 100% in Jamnagar) set up and have an equal say in decision making. 93.3% of the commissioning parents in Anand and all the respondents in Surat and Jamnagar told that the decision to opt for surrogacy was taken jointly by both the spouses.

 In most of the cases the commissioning parents are desperate to have a baby and they do not have any preference for children of a certain sex (93.3% of the commissioning parents in Anand, 77.8% in Surat and 100% in Jamnagar said that the sex of the child is not important). Moreover, some of them even do not hesitate to accept the child with deformities(63.3% in Anand, 66.7% in Surat and 100% in Jamnagar). However, such claims are made by the commissioning parents before the child is born; once a deformed child is born and the process of handing over the baby is about to happen, it is not certain whether the intended parents accept the baby or not.

 The decision to opt for surrogacy is jointly taken by the commissioning couple. Often, the extended family members cannot interfere in this matter, because the majority of the commissioning parents belong to nuclear family structure. Hence, very often intended parents‘ friends‘ opinion counts even more than their family members. However, the final decision is made by the commissioning parents and they are free to choose.

 Media coverage of surrogacy in general and advertisements by the surrogacy clinics seems to be the important factor influencing commissioning parents‘ decision making in Gujarat(93.3% in Anand, and 100% in each of Surat and Jamnagar).

 The contract signed between the commissioning parents and the surrogate mother does not mention anything about any insurance or emergency needs that the surrogate mother may require during the pregnancy; neither has it mentioned anything about her future after relinquishing the baby.

 Though most of the commissioning parents claim that the sex of the child is not important, on the other hand, they asking for getting the sex determination tests done in almost all cases(50% in Anand, 72.2% in Surat and 100% in Jamnagar). This may indicate the tendency of female feticide occurring in the clinics in the name of surrogacy.

 The commissioning parents‘ desperation to have a baby leads them to trust blindly the surrogacy arrangements that the clinics offer. Moreover, they are not concerned about the needs and conditions of surrogate mother other than her pregnancy related needs and hence, they do not develop any significant bonding with the surrogate mothers.

 The commissioning parents seem to be satisfied with the clinics‘ performance in conducting and supervising the entire process of surrogacy (93.3% in Anand and 94.4% in Surat). In both Anand and Surat, the concerned clinics have lavish hotels for the commissioning parents with all the state-of-the-art facilitates, which easily impress especially the foreigners, and they do not want to get into the intricate details of finding the surrogate mother.

 It is mainly the clinic and the commissioning parents who decide between themselves when to relinquish the baby after childbirth, whereas the surrogate mother does not seem to be having any say in this matter at all.

 The commissioning parents have fear of what if the surrogate mother changes her mind and refuses to relinquish the baby (56.7% in Anand, 88.9% in Surat and 100% in Jamnagar). Since the rights of the surrogate mother are not protected and regulated by law in India it is easy to exploit her and hence, seems to be a matter of grave concern.