Outsourcing pregnancies to India

Rising numbers of infertile couples from U.S. and Europe are coming to India to hire surrogate mothers.

By Henry Chu, LOS ANGELES TIMES, Saturday, April 22, 2006


ANAND, India — As temp jobs go, Saroj Mehli has landed what she feels is a pretty sweet deal. It's a nine-month gig, no special skills needed, and the only real labor comes at the end — when she gives birth.

If everything goes according to plan, Mehli, 32, will deliver a healthy baby early next year. But rather than join her other three children, the newborn will be handed over to a U.S. couple who are unable to bear a child on their own and are hiring Mehli to do it for them.
She'll be paid about $5,000 for acting as a surrogate mother, a bonanza that would take her more than six years to earn on her schoolteacher's salary. "I might renovate or add to the house, or spend it on my kids' education or my daughter's wedding," Mehli said.

Beyond the money, she added, there is the reward of bringing happiness to a childless couple from the United States, where such a service would cost them thousands of dollars more.

Driven by many of the same factors that have led Western businesses to outsource some of their operations to India in recent years, an increasing number of infertile couples from abroad are coming in search of women willing, in effect, to rent out their wombs.

Two of Mehli's sisters have already served as surrogates — one of them for foreigners — and so has a sister-in-law. Mehli finally decided to join in, with the enthusiastic consent of her husband, a barber, and the guidance of a local physician who has become a minor celebrity after arranging more than a dozen surrogacies in the past two years, for both Indian and non-Indian couples.

For some, the practice is a logical outgrowth of of supply and demand in a globalized marketplace.

"It's win-win," said S.K. Nanda, a former health secretary in Gujarat state. "It's a completely capitalistic enterprise. There is nothing unethical about it. If you launched it somewhere like West Bengal or Assam" — both poverty-stricken states — "you'd have a lot of takers."

Others are unsure of the moral implications, and worry about the exploitation of poor women and the risks in a land where 100,000 women die every year as a result of pregnancy and childbirth. Rich couples from the West paying Indian women for the use of their bodies, they say, is distasteful at best, unconscionable at worst.

"You're subjecting the life of that woman who will be a surrogate to some amount of risk," said C.P. Puri, director of the National Institute for Research in Reproductive Health in Mumbai. "That is where I personally feel it should not become a trade."

The Indian Council of Medical Research estimates that surrogacy could bloom into a nearly $6 billion-a-year industry in India.

In the vanguard of the nascent industry is the small city of Anand, where gynecologist Nayna Patel is presiding over a mini baby boom. But eight of her recent and imminent arrivals won't be adding to Anand's population of 100,000: Three of the infants are destined for the United States, two for Britain and three for other parts of India.

Anand now has about 20 women who have volunteered to be implanted with embryos at Patel's clinic. A few have already gone through the process once and are eager for a second try.

Prospective foreign clients hear of Patel through word of mouth or Web sites dealing with infertility issues. By the time they contact her, and spend the time, energy and money to get to India, they are usually desperate for children and often emotionally battered from long years of trying and failing.

Patel has set some criteria for those she'll help: only couples for whom the baby would be their first and where the wife is either infertile or can't physically carry her own child to term.

Her potential surrogates must be between ages 18 and 45, in good health and already mothers, for physical and psychological reasons — physical, so they know what awaits their bodies, and psychological, so they feel less troubled about giving up a new baby because they already have children at home. The egg that contributes to the embryo is never one of their own, coming instead from an anonymous donor or the intended mother, and usually fertilized in vitro.

Both parties sign a contract under which the intended parents pay for medical care and the surrogate renounces rights to the baby.

In Anand, volunteers are repeatedly reminded by Patel and her staff that the fetuses in their wombs aren't theirs. Patel said no problems have arisen yet with too strong a bond forming between surrogate and child.

She acknowledges that money is the primary reason women have lined up to be surrogates; without it, the list would be short, if not nonexistent. Payment usually ranges from about $2,800 to $5,600, a fortune in a country where annual per-capita income hovers around $500.

But Patel cites cultural components as well — an empathy with the childless in a society that views producing progeny as an almost sacred obligation, along with Hindu teachings about being rewarded for good deeds in the next life.

"Those couples who don't have kids long for them, and I can understand their feelings," said Smita Pandy, 27, who has two children of her own and was about to give birth on behalf of another Indian couple. "I'll be happy because they'll be blessed with a child."