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The International Surrogacy Market

In Bangalore, where many women earn just $150 a month working in garment factories, surrogate mothers can make thousands of dollars by carrying others’ babies to term. But at what cost?
Bangalore, India. (Photo: Muhammad Mahdi Karim/Wikimedia Commons)

Bangalore, India. (Photo: Muhammad Mahdi Karim/Wikimedia Commons)

I’m sitting on the floor of Kavita’s one-room home with Chandra. Best friends, both women are receiving regular dosages of synthetic hormones to prepare them for a surrogacy pregnancy. They have never met the intended parents for whom they are contracted to birth a baby.

“The recipients pray to God that they may have a child,” Kavita says, speaking in Kannada, her native tongue. “We surrogate mothers, too, pray, but to give us strength to give up that baby we will never see again.”

“I know that through my suffering I have filled another home with a child,” Chandra says. “But what kind of people are these recipients? How can they face themselves and look that baby in the eye, knowing that they never allowed him to be held in the arms of the mother who gave birth to him?”

"We surrogate mothers, too, pray but to give us strength to give up that baby we will never see again."

Living in the southern Indian city of Bangalore, Kavita and Chandra are among the thousands of working-class women in India who have built surrogacy into a market endeavor that brings in an estimated $2.3 billion annually. Infertile couples and individuals within India and others from the United States, Australia, Britain, Germany, Spain, and Japan pay between $45,000 and $60,000 per baby (in the U. S., surrogacy costs can run as high as $80,000 to $100,000). These seekers of transnational reproductive services come to India for one of two reasons: Surrogacy is prohibitively expensive in their own countries, or laws ban commercial surrogacy where a woman is paid to carry to term an embryo prepared from sex cells that legally belong to the intended parents.

Though critics point out that adoption is always an option, legal statutes in various countries and discrimination have hindered many LGBT and older individuals’ access to parenting through adoption. For those who can afford the costs of surrogacy, then, the growth in commercial fertility services in countries such as India, Thailand, and now Mexico, is a gift when they had previously resigned themselves to a life of childlessness.

Few people can deny the joys that children can bring to their parents’ lives, and there is no question that access to infertility assistance is an essential element to an individual’s reproductive, and, by extension, human rights. Gay rights advocates in the global north also make the connection between basic human rights and gay parents’ rights to birth children and raise them in queer families. But the question arises: What of the child’s—and surrogate mother’s—rights?

Working-class women in India are not coerced into surrogacy. And various media sources, citing infertility agencies and intended parents, claim that Indian surrogate mothers can make as much as $8,000 per pregnancy, though the women I met in Bangalore in 2011 made $4,000. This can seem like a princely sum, especially when compared with the estimated $150 per month these women make in Bangalore’s numerous garment factories.

Yet women like Kavita and Chandra have mothers, fathers, siblings, cousins, and in-laws themselves burdened with unpaid medical bills, agricultural loans, and other failing economic endeavors that need to be financed. Children require adequate education. Rents on livable homes are expensive. The working poor are endemically short on cash, and the money Kavita and Chandra earn will disappear within a matter of months. Some women are back at the surrogacy agency, willing to vend their reproductive abilities all over again. This time, they hope, they can build a savings account for their children.

Infertility clinics in India routinely hire two surrogate mothers for each client they work with, and implant up to four embryos in each woman. The potential mothers then undergo fetal reduction procedures to achieve optimal birth outcomes, and intended parents return home with one to two children with each surrogacy agreement. While the surrogate mother no doubt consents to the contractual requirements of commercial pregnancy and labor, many women are unaware that they will almost always deliver through Cesarean surgery between weeks 36 and 38 of gestation. None of the 70 women I met received post-natal care from surrogacy agencies that hired them. And while they had been screened and counseled, many women mourned the loss of the children they will never see again.

The surrogate baby is almost always birthed per-term through Cesarean even though medical research shows pre-term infants have more difficulties feeding and are prone to hypoglycemia, jaundice, apnea, and respiratory distress. These infants can recover and thrive in loving homes, but like the countless adopted children who precede them, they may wonder about their origins. Who are the women who gave birth to them? Why did these women choose to give birth to them? Do these women have their own children? And, if so, where are these children? Because their parents do not keep in touch with their surrogate mothers the children are unable to locate the women who gave birth to them. Their origins are obscured.

Commercialization of pregnancy can meet the reproductive desires of those who can afford it, but at what cost? And who pays the price?