by MUHD NURLUQMAN, TAN WEI XIN & DAVID LEE

SURROGATE
INDIAN
A look into India’s surrogacy industry
the

THE INDIAN SURROGATE — A LOOK INTO INDIA’S SURROGACY INDUSTRY by MUHD NURLUQMAN, TAN WEI XIN & DAVID LEE
With Special Thanks
hedwig alfred
Shyam tekwani
deepa Suryanarayanan
Nikon singapore

&

Wee kim wee

school of
communication
and information,
nanyang technological
university, singapore
 First Word M
AKE no mistakes about it, India is not the place to migrate
to if you are a stickler for cleanliness, efficiency and
straightforwardness.
Yet, for what it is worth, their indomitable spirit and ability to
get on with life in the face of adversity border on the inspirational.
The 26/11 Mumbai attacks was as astounding in the extent
of the massacre – at least 173 killed and 308 injured – as it was
resounding in the indictment of the city’s inability to fight terror.
Then again, in India, when you can’t fight, you cope. So just like
the 2003 and 2006 Mumbai train blasts and a slew of other attacks,
Mumbai was up and running again in a matter of days.
It was a good thing too, for we would not have been able to
complete our fieldwork about surrogate mothers in India.
Of course we were on tenterhooks flying into a terror-stricken
state so quickly after such a large-scale assault. However, and this is
not from the benefit of hindsight, we somehow felt safe enough to
make the trip. And so we went, much to the chagrin of our families
and friends.
Necessity is the mother of all inventions in India and it seems
the concept of surrogate mothers is a classic example of Indian
improvisation as well.
They are usually poor womenfolk who conceive on behalf of
another couple in return for a sum of money they would otherwise
take many more years to make. You must understand there are not
much career prospects for most of the uneducated women in India.
The cost of such procedures in India is also almost a quarter
of what clinics in America or Europe charge. Hence, India is fast
emerging as a popular destination for childless couples to seek help.
Advocates of surrogacy call it a win-win measure. Neutrals
feel it is controversial. Opponents wish the idea was never born at
all, deeming it exploitative — the childless couple may be held to
ransom, or the destitute surrogate mother may be underpaid.
Scratch the surface, and surrogate mothers will tell of how the
needs of two desperate women are met in such a transaction — the
barren gets a baby, the broke gets a bonus. And they all live happily
ever after.
Dig deeper and the surrogates begin to reveal the trauma and
turmoil they experience before plunging into what some of them
call the “last decent resort” to pay off debts, buy a house, or save for
their children’s education.
Even doctors in India are divided on this issue. There are those
like Dr Indira Hinduja who feel that adoption should be the way to
go for couples unable to conceive. However, most IVF doctors are
like Dr Nayna Patel, who recommends surrogacy with stringent
guidelines.
Then there are some who take it to another realm, such as Dr
Gautam Allahbadia, who offers surrogacy options to gay couples.
On a personal level, it was difficult to miss how some couples
long to have children. We would never understand what it is like to
go through 10 failed fertility treatments like Sue did.
In her own words, the well-to-do American lady of Korean
descent would never imagine herself in a rundown Indian clinic in
the middle of a sleepy and dusty rural village, wiping her tears as she
tells her story to rookie journalists. The physical and psychological
trauma must have been immense.
Mother Teresa could not have put it better: “Even the rich are
hungry for love, for being cared for, for being wanted, for having
someone to call their own.”
We think, even more so the poor. Hence, we present to you the
A new mother rests on a bed at the Akanksha Infertility Clinic in Kaival Hospital
story of the surrogate mothers in India, as well as tales from other
after giving birth a few hours earlier.
stakeholders in this burgeoning industry.
CONTENTS
An embryologist
injecting sperm
into an egg at the
page 6-9 Rotunda Fertility
Clinic in Mumbai.
CRADLE OF THE WORLD
An introduction to the surrogacy industry.
The fertilised
embryo will then be
transferred to the
surrogate.

page 12-17
THE FACE OF SURROGACY
An exploration into the lives of India’s surrogates.

page 20-23 24-31

page
INDIA’S MOTHER TO THE SURROGATE HOUSE
SURROGACY A photo-essay on the surrogate hostel in Nadiad,
home to Dr Patel’s surrogates for the months that
Dr Nayna Patel: The pioneer of they are pregnant.
commercialised surrogacy in India.

page 32-33 page 34-35

A PACKAGED DELIVERY A COUPLE’S LAST RESORT
Surrogacy India, a Mumbai-based surrogacy startup, An insight into the thoughts of foreign childless
aims to give foreigners peace of mind, and of course, couples who have come to India to seek help.
a baby.

page 38-40 page 41 the

BABY MIRACLE
A Gujarati couple faces an uphill battle after
losing three children. Desperate, they turn to
surrogacy as the very last attempt to have a child
they can call their own.
COVERING BIRTH BEAT
Two journalists from India’s biggest newspapers,
The Times of India and Daily News Analysis,
speak out on the issues covering surrogacy as
news reporters.

page 44-45 page 36-37

SURROGACY in SINGAPORE
Surrogacy, both altruistic and commercial, is banned in
SURROGACY GOES GAY
How a Mumbai clinic is going against the norm by allowing
the bustling city-state. Can it be a solution for its infertile foreign same-sex couples to have their own babies through surrogacy.
couples who have exhausted every other option?
 01
CRADLE
OF THE
WORLD
Worth an estimated US$445
million (S$680 million),
commercial surrogacy is big
business in India where 75.6
percent of its population lives
on less than US$2 a day. Critics
argue that India’s womb-for-rent
industry amounts to exploitation,
while a new bill is in the works
to plug any loopholes in this
controversial transaction.
S a new house. My
EVEN months pregnant, Meena
is praying that this child will
eventually deliver her family
a better future. Stroking her swollen
belly, the 34-year-old is as excited as any
expecting mother, except the baby she is
carrying is not exactly hers.
When surrogate mother Meena gives
birth in Anand’s Akanksha Infertility
Clinic, the newborn will be passed on
to its biological parents – a childless
American couple.
Surrogacy refers to the process
in which a woman gets artificially
impregnated, and after delivery the baby
is returned to the commissioning parents.
In India, the surrogate mother gets paid
for her gestational services.
A successful delivery will make
Meena Rs250,000 (S$7,444) richer, an
page 06
01 A Gujarati woman coaxes her child, obtained through a surrogate, near Akanksha Infertility Clinic.
Surrogacy has given a new line of hope for many Indian and foreign childless couples.
02 A man takes a nap while his wife undergoes an interview to be a surrogate at Akanksha. Behind him are photos of
surrogate babies that the clinic has delivered in the last six years.
amount her odd-job labourer husband
Haresh would only be able to make in 10
years.
“With the money, I won’t have to
worry about rent. I can buy a new house.
My son will also have an education,”
Meena said in her native Gujarati. “And
I am also doing a good deed by providing
the childless couple a baby.”
The couple that hired her had made
their way down to the laid-back town from
San Francisco, California, close to a year
ago, to begin the surrogacy process.
Like them, many desperate couples
from Singapore to Switzerland, as well as
Indians living abroad, are flocking to India
with revived hopes of finally being able
to have a child of their own, drawn by the
attractive combination of highly-qualified
doctors, a flexible legal framework and low
costs.
Fulfilling a dream
John and Sue Lee, both 37-year-old
Korean-Americans, have been trying for a
baby for the last seven years to no avail.
Desperate after failing seven Intra-
Uterine Insemination (IUI) and three
In-Vitro Fertilisation (IVF) attempts, the
couple decided to turn to surrogacy as a
“
02
last resort after reading about encouraging
testimonies on Internet forums.
“We have already busted more than
US$100,000 (S$153,139) in the States
engaging top IVF experts with no results,”
John said. “Of course, it helps that it is
cheaper over here as we have already
With the money, I
depleted much of our savings trying to
fulfill our dream.
won’t have to worry
“I think this is a major pull factor for
most childless couples thinking about
about rent. I can buy
surrogacy.”
According to top surrogacy clinics in
Ahmedabad and Mumbai, the number of
surrogacy cases has soared over the last
son will also have an
five years.
While there are no firm statistics
education.”
recorded, doctors say, around 500 to 600
surrogate babies could be born throughout the recruitment of the surrogate, her
the world each year, with around 200 pregnancy, to the final delivery.
coming from India. This figure could be as low as a
India’s average surrogacy success rate quarter of what it would cost in the United
is 37.9 percent — for every 100 surrogacy States or Europe.
attempts, about 38 babies are born.
Currently, experts estimate the
industry to be worth US$445 million, with
Controversial
around 3,000 clinics across India offering Despite being hailed as a beacon
surrogacy services. of hope by many surrogate mothers
Intended parents are charged around and commissioning parents, surrogacy
US$20,000 for the entire surrogacy remains a controversial issue in India.
process – from initial consultation to In 2008, the media reported the case
page 07

of Baby Manji, a child born to an Indian
surrogate hired by a Japanese couple
through Dr Nayna Patel’s Akanksha
Infertility Clinic.
Manji’s parents, father Ikufumi
Yamada, 46, and ex-wife Yuki, 42,
divorced shortly before birth, resulting in
the baby getting caught in a legal tussle for
months as Indian law prohibits single men
to adopt.
Neither Yuki nor the surrogate
mother wanted to take custody of whom
Indian newspaper The Times of India
dubbed as the country’s “first surrogate
orphan”.
Baby Manji was finally allowed to leave
the country only after the Supreme Court
granted custody to Emiko Yamada, the
child’s 75-year-old grandmother.
Hence, this unique case also set a
precedent in Indian courts deeming
commercial surrogacy to be legal.
Shaken Up
However, the surrogacy industry
could still be shaken up by the upcoming
Assisted Reproductive Technology
(Regulation) Bill & Rules, which doctors
hope would be passed at the next
parliamentary session.
The main highlight of the new
regulation, according to experts, is the
page 08
assurance it offers to all the stakeholders
of surrogacy.
It states that a surrogate baby will be
recognised as the legitimate child of the
commissioning couple even if they divorce
or become separated, with the child’s birth
certificate carrying both genetic parents’
names.
The draft Bill also makes it
compulsory for foreigners seeking
surrogacy services in India to provide
documentary proof that they would be
able to bring the baby back to their home
country.
Another key clause rules that intended
parents seeking surrogacy through
assisted reproductive technology (such
as IVF), and the surrogate mother, “shall
enter into a surrogacy agreement which
shall be legally enforceable”.
Once the law is enacted in
parliament, a committee of experts, Non-
Governmental Organisations (NGOs) and
fertility clinicians will also have the right
to inspect and regulate clinics that offer
surrogacy, said Dr Ajesh Desai, director
of Gujarat’s State Institute of Health and
Family Welfare.
Dr Gautam Allahbadia, a member of
the drafting committee, said: “All the grey
zones in infertility treatment will become
black and white.”
On the surrogate’s end, the Bill also
proposes that all of her expenses shall “be
borne by the couple or individual seeking
surrogacy”.
It adds: “The surrogate mother may
also receive monetary compensation from
the couple or individual, as the case may
be, for agreeing to act as such surrogate.”
Underpaid?
There is currently no standard amount
that surrogate mothers receive as payment
for renting out their wombs. This has led
01
01 and the surrogate mother renouncing her
G K Mawani and his wife
Rama celebrate their son
Jay’s birthday in Surat,
Gujarat. Jay was born
through a surrogate from
Dr Bavishi’s clinic in
Ahmedabad.
02 to dispel any doubts as to whether her
A surrogate mother carries
her child near Akanksha.
to debate about whether the surrogates’
interest is adequately looked after.
In some instances, surrogate mothers
receive payouts as low as Rs25,000,
according to the National Commission for
Women, an NGO based in New Delhi.
Mumbai-based journalist Deepa
Suryanarayanan said: “We are concerned.
Does the surrogate mother in India, a
woman who usually receives little or no
education, really know what is stated in the
forms before signing them?
“Having lived in poverty all her
life, would she know whether she is
underpaid?”
A quick survey of the surrogate
mothers’ “rates” in Akanksha’s wards
is telling. A Brahmin surrogate will get
Rs300,000, while a lower-caste woman
can only look forward to about half that
amount.
Dr Patel remains tight-lipped about
“
Most people think
very badly of
surrogacy. They
think it means to
sleep with other
men. So I don’t tell
my relatives and
friends.”
the exact terms of her clinic’s consent
forms – which intended parents and
surrogates say are largely about payment
right to the baby.
But Dr Patel claims they are translated
into the surrogate mother’s native
language and explained what each clause
means before she puts pen to paper.
The 49-year-old doctor was also quick
surrogates will hand over the babies when
they are due.
“Many surrogate mothers regard
it not as ‘handing over’ the baby, but as
‘giving back’ the baby, as the child was
never theirs to keep,” she explained.
Meena echoed Dr Patel’s views: “I
don’t think I will have any harsh feelings
about returning the baby to their true
parents. I might feel sad, but I know the
baby does not belong to me. I will move on
and be happy again because both parties
will benefit.”
Nothing dishonourable
While Meena’s husband understands
that “there is nothing dishonourable in
surrogacy”, there are many in the
conservative Indian society that still
regard the practice as taboo.
She said: “Most people think very
badly of surrogacy. They think it means
to sleep with other men. So I don’t tell my
relatives and friends.
“It took Madame (Dr Patel) time
to explain to Haresh what exactly is
surrogacy. But he has been with me all
this while, following the procedure, and he
doesn’t mind now.”
Like Meena, many surrogate mothers
are recruited by word-of-mouth. Still, the
supply usually cannot keep up with the
demand, because practices like Akanksha
usually follow a stringent checklist before
matchmaking intended parents with a
surrogate mother.
Dr Patel said: “Say, a childless couple
comes through my door and the wife
wants a baby so bad, but she has a missing
uterus, how can I reject this couple?”
“But if a woman says she wants a
surrogate to help her carry a baby because
she doesn’t want the pregnancy to affect
her work or her figure, I won’t even
consider. There are more needful couples
to help.”
Same-sex
Dr Patel also added that, due to
personal convictions, she does not
entertain any same-sex couples requesting
for surrogacy.
However, the commercial, and by now
global, nature of surrogacy has ensured
that there are those who will welcome
these clients.
Based in Mumbai, Dr Allahbadia’s
02
Rotunda Fertility Clinic has handled the
surrogacy cases of 15 same-sex couples
(none from India) that he says form 10 to
20 percentof his clientele.
“Ethically, I don’t think there’s
anything wrong. Same-sex couples have
their rights to a child too. It is hard not to
be moved by their genuine desire to have a
child,” he said.
Legally, there is also nothing to stop
gay or lesbian couples from approaching
Dr Allahbadia to employ a surrogate’s
services in India.
However, if the draft bill is passed
without amendment, the long queues
that proceed directly to clinics such as
Akanksha or Rotunda could be a thing of
the past.
India’s new draft rules stipulate that
couples like John and Sue that require a
surrogate mother will have to approach
surrogacy agencies instead of going
straight to an infertility specialist.
While the proposed changes could
help to boost the surrogacy industry in
India by providing an explicit set of rules
and regulations, it may also spell the end
of Dr Patel’s booming business if she is
not allowed to keep her personal pool of
surrogate mothers anymore.
“The law is the law, I will not go
against it. A doctor will always put the
welfare of the patients as priority,” Dr
Patel said.
page 09
 SURROGACY
MAP OF THE WORLD
1
North America
- An estimated 25,000 surrogate
babies were born in the US from
1976 to 2007.
- A typical payment for a surrogate
ranges between US$20,000
(S$30,782) to US$25,000.
- States that allow but regulate
surrogacy: California, Arkansas,
Florida, Illinois, Nevada, New
Hampshire, Texas, Utah, and Virginia.
- Commercial surrogacy in Canada
has been illegal since 2004, although
altruistic surrogacy is allowed.
2 Western Europe
- Although surrogacy is legal in the UK, no commercial
arrangements are allowed and the surrogate mother can
only receive expenses – in thousands of pounds through
the Surrogacy Arrangement Act – for medical and
pregnancy related expenses.
- Most women become surrogate mothers for altruistic
reasons. Only married couples can participate in a
surrogacy agreement.
- Countries in the European Union that bans all forms of
surrogacy: Germany, Sweden, Norway and Italy.
page 10
3 South Asia
- When the Indian parliament passes
the Assisted Reproductive Technology
(Regulation) Bill & Rules, 2008, surrogate
mothers may receive money for carrying
the child and all their expenses are paid
during pregnancy.
- The surrogate mother is bound by law to
give up rights to the child, and the child’s
birth certificate will have the names of his/
her genetic parents.
- Single parents can also have a child
through a surrogate mother.
- All foreigners renting a womb in India
will require documentary proof from their
embassy that the child is accepted in the
country of his/her genetic parents.
7 Eastern Europe
- Russia and Ukraine are the only European
countries where surrogacy is fully legalised.
- Foreign couples are allowed to pursue surrogacy
arrangements in both countries.
5
3
4
Southeast Asia
- Unclear laws regulating assisted
reproductive services make Thailand,
Malaysia and Philippines the go-
to places for foreigners seeking
surrogacy services in this part of the
world.
- All forms of surrogacy are banned in
Singapore.
5 East Asia
- In Japan, there is no law to regulate surrogate births. Medical councils such
as The Japan Society of Obstetrics and Gynaecology as well as the Science
Council of Japan have called for surrogacy to be banned.
6 Oceania
- In 2008, it is reported that more than 100 Japanese couples have used - In Australia, the state of Queensland bans all
surrogates to have children in the United States. Meanwhile, a law to regulate forms of surrogacy.
surrogacy is being studied. - In other Australian states: Victoria, the
- Last year, media reported on a 61-year-old Japanese woman who became a Australian Capital Territory, Tasmania and
surrogate mother to her own grandchild – possibly the oldest surrogate mother South Australia commercial surrogacy is
in Japan. prohibited, except altruistic surrogacy.
- Gestational surrogacy is banned in China. - Commercialised surrogacy is banned in
New Zealand.
page 11

01
Hansha works 14-hour shifts as a nurse at the Akanksha Infertility Clinic in Anand, Gujarat. She received Rs250,000
after successfully delivering a surrogate child to an American couple — an amount 83 times her monthly salary.
THE
FACE
OF
SURROGACY
For most lower-middle
class women in India,
surrogacy presents a
unique opportunity to
break free of poverty,
though not without
its repercussions –
the surrogates are
often ostracised and
misunderstood as being
“easy”. But these
women are unfazed
by all the surrounding
controversy as they are
driven to earn a better
living for their families.
E
ARNING a meagre Rs3,000
(S$89) per month as a nurse,
Hansha struggles to make ends
meet. After spending half of her earnings
on rent for her squalid one-room flat that
is equipped with neither electricity nor
gas, she barely has enough cash to keep
her 16-year-old son in school.
She worries constantly for her
husband — a truck driver — who earns
Rs5,000 per trip transporting goods
on long haul journeys through India’s
treacherous highways. Every time
Hansha’s husband leaves, she said, it
seems like he is saying his last goodbye.
page 12
Hansha also has to provide for her
15-year-old little sister and ailing father
who lost his leg in a railway accident. They
currently live in a makeshift tent along a
stretch of train tracks in the dusty town
of Nadiad, some 22 kilometres away from
Hansha’s flat in Anand.
“It’s very hard,” Hansha, 39, said in
her native Gujarati. “I have to take care of
my family and work also.”
Hansha works 14 hours a day, seven
days a week, taking the height and weight
of patients, measuring blood pressure and
giving injections at Anand’s Akanksha
Infertility Clinic.
It was through her work at the clinic
that she learned of the financial rewards in
being a surrogate.
Hansha became a surrogate mother in
December 2007 and delivered twins — a
boy and a girl — for a couple from the
United States. Her services earned her
Rs250,000 — almost seven years worth of
her monthly income.
For many lower-middle class women
in India, surrogacy represents an unique
opportunity to escape the sinkhole of
low wages and debt. Through surrogacy,
women like Hansha can earn decades
worth of savings in a mere nine months.
“This is the fastest route to money,”
said Hansha.
Now, Hansha lives in a spartan three-
room apartment with gas stoves and
fluorescent ceiling lights, without having
to worry about the rent. She has even paid
off all her debts.
Being able to own, rather than rent, a
house is very important in India because it
protects you from being held to ransom by
unreasonable landlords, Hansha said.
Caste discrepancy
To purchase her own apartment,
33-year-old Deepa has also become a
surrogate mother. In 2007, she rented out
her womb to an Indian couple from the
United States and delivered a healthy baby
boy.
However, the single mother was paid
a higher fee as she was born into a higher
Hindu caste (Brahmin), compared to
Hansha. This is a common discrepancy in
one of the most rigid class-bound societies
in the world.
Many intended parents, especially
those of Indian descent, would choose
candidates based on their caste, said
page 13

Deepa. “They do not mind paying a bigger
price for a higher-caste surrogate. It is a
religious thing also,” she said.
Carrying a baby for nine months was
not easy, Deepa recalled. Besides enduring
labour pangs, she also had to hide her
swollen belly from friends and relatives.
In an intensely patriarchal society, social
stigma is a risk that all surrogates carry
despite the high dividends.
“They think very badly of this thing so
I don’t want to tell,” Deepa said. “Because
of financial reasons, people do this.
Otherwise no one does this.”
Changing attitudes
Director of Anand’s Akanksha
Infertility Clinic, Dr Nayna Patel has
seen her fair share of people who are
uneducated about surrogacy. “I have a
surrogate’s father-in-law and his son
who think that IVF is immoral and the
surrogate has to sleep with someone else,”
she said.
However, as Dr Patel observes,
attitudes have changed and society has
started accepting surrogacy. “Now men
are coming to me and saying, ‘my wife
wants to be a surrogate too’.”
Dr Patel, whom many fertility experts
credit for bringing India’s reproductive
industry to worldwide prominence,
oversaw the rise in Gujarati women renting
out their wombs over the past six years.
“In 2003, I could not find one
surrogate. In 2005, I had just 18. But in
2008, I have 175 surrogates with me,” said
Dr Patel.
Initially, doctors placed advertisements
on newspapers to recruit surrogates.
As news of this get-rich-quick scheme
spread, most of the applicants either
came forth offering their services or were
introduced by others, Dr Patel said. Locals
who recommended healthy and financially
needy women to the clinic were given a
token sum in return.
No laws
However, critics of surrogacy lament
the lack of legislation in place to regulate
the sudden rise in surrogates.
Many describe the guidelines
discharged by the Indian Council of
Medical Research (ICMR), which governs
commercial surrogacy, as being full of
loopholes that may lead to exploitative
practices as it is implemented without
audits by the clinics themselves.
Council member of the Federation
of Obstetricians and Gynaecologists
Society of India, Dr H D Pai expressed his
concerns that surrogacy is giving India
bad press: “What is being projected is
that India is a lawless market — people
are getting exploited and foreigners are
coming here to hire wombs.”
“They should regulate it and fix the
amounts so there will be no exploitation,”
said Dr Pai.
But Mumbai-based lawyer Amit
Karkhanis, an expert in medical law, said
all these fears are unfounded as surrogacy
can only be good for India. “We follow the
ICMR guidelines very strictly,” he said.
“A 30-year-old woman who is in need
of money can sell her body and sell her
sex. But it is better that she becomes a
surrogate mother. It is a decent and noble
way of earning money, plus you make
some poor people happy.”
Many have also lambasted India for
allowing the outsourcing of wombs for
cheap. In the United States, surrogate
mothers receive between US$15,000
(S$22,921) and US$45,000, compared to
their Indian counterparts who get about
US$6,800 on average.
But Dr Nayna Patel passionately
rebuffs these allegations.
“America is a popular place for
Europeans to find surrogates. Why don’t
you say that Americans are exploiting
surrogacy,” Dr Patel said. “So I say
anything that is done by a rich country like
America is good, but anything being done
by India is not good?”
“I’m not bothered because my
conscience is clear and my surrogates
know what I am doing,” said Dr Patel.
Written contract
According to Karkhanis, most
surrogate mothers are bound by contract
to return the newborn to its intended
parents within weeks after delivery.
However, there have been documented
cases in American courts of surrogates
who refused to hand over the babies to the
commissioning couple, citing emotional
attachment.
She said: “When I had to give up the
baby, I was heartbroken and I cried.
“
“But I told myself that the baby is not
mine,” she said.
Such incidents do not occur in Anand,
said Dr Patel, because she only accepts
women, like Hansha and Deepa, who
already have children of their own. What is being
Also, surrogates have to go through
intensive medical checkups to ensure that projected is that
they are physically and mentally fit.
Most importantly, said Dr Patel, India is a lawless
consent from the surrogates’ husbands
and parents take top priority. market — people
As a last measure against fraud, the
contract also ensures that the fees are are getting exploited
paid in instalments, said Dr Patel, to deter
surrogate mothers from abortion. and foreigners are
For wombs-for-rent like Hansha and
Deepa, they are happy that they saw coming here to hire
through their pregnancies so that they get
their money. wombs.”
“I am happy, I get benefit and people
at the other end get benefit also,” Hansha
said. offering surrogacy over the past five years.
Founder of Mumbai-based fertility
Urban Surrogates service provider Surrogacy India, Dr
Sudhir Ajja said that the industry is
Some 450 kilometres south of Anand, opening its doors wider because the
the bustling financial hub of Mumbai has detailed laws are about to be cleared
seen a sharp rise in the number of clinics through the Indian parliament.

SURROGACY 101 making the baby: 1 The couple who wishes to have a child, also called the intended
parents, through the surrogate undergo IVF.

The mother’s eggs and father’s sperms are retrieved and fertilised
Not everyone’s eligible -
A childless couple is only allowed to hire a Two types 2 in the lab. Embryos are then transferred into the uterus of
the surrogate.

surrogate if the woman:

of surrogacy
— has no uterus
— has had many miscarriages
— has failed many IVF attempts 1. GESTATIONAL
3 The surrogate is given progesterone tablets for 15 days to ready her
endometrium (uterus lining). She takes this for three months.

— has genital tuberculosis or fibroids - Sperms from dad

— has a cardiac problem
— has had a liver or kidney transplant
- Eggs from mum or
donor other than
And the baby goes to...
surrogate — The genetic parents’ name will appear on the birth certificate. The surrogate

Who can be a surrogate? 2. TRADITIONAL mother will not be able to stake her claim on the child unless she proves that
the agreements made between her and the intended parents (IPs) are invalid.
- Eggs are from the — There is no legislation on surrogacy so only the Indian Contract Act is applied
According to the Indian Council of Medical Research:
surrogate mother to surrogacy cases. However, only contracts that are against public policy are
— The surrogate should not be more than 45 years old
- Surrogate’s egg is then considered invalid.
— Should test negative for HIV and Hepatitis B and C
artificially inseminated — There is no national registry on surrogacy thus far. However, a new bill regulating
— No one can be a surrogate for more than three times
with sperms from intended surrogacy (to be passed in parliament in 2009) will ensure that records will have to be
— All clinics need to ensure that the women are fit to
parent or donor kept by clinics and audits will be carried out.
carry the pregnancy

page 14 page 15

“Surrogacy is becoming fully legalised
and the guidelines are very specific now.
Everybody is okay with doing it,” Dr Ajja
said. “Initially a lot of doctors are not
willing to get involved.”
With more clinics vying for customers,
surrogacy fees are set at a competitive rate
upwards of Rs200,000.
“This amount could buy me a small
house in Mumbai,” said Mangal, a
29-year-old widow, in her native Marathi.
Rent can reach up to Rs1,500 per
month and Mangal, a surrogate under Dr
Ajja’s charge, struggles each month to pay
her dues.
“A quarter of my salary goes towards
rent. If I have my own place to stay, things
will be so much easier,” said Mangal, who
earns Rs6,000 a month as a police officer.
“I have not told my employers because if
they knew, they would give me the sack.”
page 16
01
Together with Mangal, fellow
surrogates in Surrogacy India, Rehka,
27, and Rajeshri, 24, were introduced to
surrogacy by a local doctor.
“I was shocked when our local doctor
said that carrying another person’s child
in my stomach was possible without
sleeping with another man other than my
husband,” Rajeshri said in Marathi.
“I told my husband, and initially he
said no. But I was able to convince him
there is nothing immoral,” Rajeshri said.
“We won’t be able to earn this kind of
money in years.”
“My husband brings home Rs200 a
day as a painter,” housewife Rehka said.
“During the monsoon season, his income
is badly affected.”
“If I had a choice or other options
to make this kind of money morally, I
wouldn’t do surrogacy,” said Rehka.
02
from previous page
01 Deepa, a Brahmin, gets higher payment for her gestational services than women from lower castes.
02 (Left to right) Sharen, 16, with her mother Jyostaben, 40 and siblings Joyl, 14 and Robin, 17.
The money her mother earns as a surrogate will help Sharen realize her dream of becoming a teacher;
Joyl wants to be a doctor while Robin aspires to be an engineer.
03 (Left to right) Manju, 27, Mangal, 30, Rajeshri, 25 and Rekha, 28, are all expectant surrogate
mothers with Surrogacy India, a Mumbai-based fertility service provider. They are closely monitored for the
first 15 days of pregnancy and are unable to leave the clinic.
03
Back in Anand’s Akanksha Infertility
Clinic, Hansha readies a Taiwanese
woman’s forearm for an injection that
would help her ovulate.
She would gladly rent out her womb
one more time, Hansha says, despite
potential health risks and the prospect
of having to live with fresh scars from
another Caesarean section.
This time, she wants to buy a house for
her little sister and her disabled father and
move them out of their tent — a makeshift
house with a canvas roof supported by
walls built from granite bricks on one side,
and rotting wooden A-frames on the other.
“I would like to become a surrogate
mother again,” Hansha said. “If a good
couple is willing to pay good money, I am
ready to become a surrogate one more
time.”
Anisha — a former surrogate mother, has used about half the money she received as a surrogate to
buy this auto-rickshaw for her husband.
14

the
SURROGATE
HOUSE
S
OME 40 kilometres away from
Akanksha Infertility Clinic is the
city of Nadiad, a rural college
township where temperatures in
the summer could reach a scorching 45
degrees. Famous for the Dharmasingh
Desai Institute of Technology and the
Ayurvedic College, Nadiad attracts
migrants from all over India. But the
hot and dusty town has been attracting
a different crowd in the past few years:
fertility tourists from all over the world
have been coming to Nadiad to pay a
visit to a new landmark — the surrogate
house.
Camouflaged amongst other dull
two-storey buildings like itself, the
surrogate house lies along a dusty main
road near the Western railway track that
links Ahmedabad to Mumbai. But the
surrogate house, as most people in the
area and Anand fondly call it, is not even
a house. It is a rented second-storey flat
with four rooms and a kitchen. It has
electricity and constant water supply;
proper metal-framed sliding windows
and curtains; and two squat toilets
instead of just buckets .
A television set sits alone in the
living room, with only a wall clock on an
adjacent wall for company. A small white
ceramic sink juts out awkwardly by the
page 24
side of the living room wall. There are no
tables in the entire house. Only plastic
chairs dot the concrete floor, which is
covered simply by plastic flooring printed
with abstract patterns.
The rooms are sparse. Everything
seems to be hidden behind built-in
cupboards, with neatly arranged metal-
framed beds aligned beside them.
It is the occupants, however, that
bring this rented flat to life. For they
are no ordinary tenants — 16 pregnant
surrogates live together in this flat and for
nine months they call this flat their home.
Rented by Dr Patel, the surrogate
house is an essential part of her surrogacy
services. To the pragmatic doctor, the
house gives her peace of mind: the flat is
near a hospital and there is a caretaker
who monitors the surrogates round the
clock. Food and housework is taken care
of. The only catch is that they will not be
able to live with their families during the
course of their pregnancy. The children
and husband can visit though, but only
during the day.
The surrogate house is a community
with all the surrogates feeding off
each other for support through their
pregnancies and the caretaker, 42-year-old
Niermala Oedra, is tasked to ensure that
they keep their chins up during their stay
at the house.
“I treat the surrogate mothers as my
daughters and I always ask those around
to take care of them in my absence,” said
Oedra.
“I feel sad whenever one of my
daughters leave the surrogate house after
delivery. We would get together and cry for
the one who leaves the house.”
Failure isn’t really an option for the
surrogates — they simply have too much
riding on the child growing inside them:
paying off debts, education funds, auto-
rickshaws or a new house.
For the surrogate house is not just a
temporary hostel for surrogate mothers, it
is a transition to a whole new life.
page 25
01 02 05

06

03 04
07 08

09

01 Lata, 33, sits on her bed at
the Nadiad surrogate house. Nearly
eight months pregnant, she said she
had no problems settling into her
temporary home.
02 Children are a common sight at
the surrogate house. Husbands and
children are not allowed to live at the
house due to space constraints but
they may visit during the day.
page 30
03/04 Everyday meals are
prepared by a cook that has been
specially hired for the surrogates but
the women often pitch in themselves,
whipping up their favourite dishes.
05 The surrogates congregate to
pray in front of an altar where framed
images of Sikh gurus, Hindu gods
and Jesus Christ lean against the
back of the wall on the floor.
06 There are a total of four rooms
at the surrogate house, which can
accommodate around 20 women.
The entire house is sparsely
decorated, and all the surrogates
sleep on metal-framed single beds.
One of the surrogates said that she
did not know how beds felt like until
she came to the surrogate house.
07 Mariaben, 34, in deep prayer.
With her baby due in a week, she
worries about the delivery but is
confident that Dr Nayna Patel would
be able to deliver the twin babies
she is carrying successfully to its
intended parents — a childless
South Indian couple.
10
08 An intended parent checks 10 The surrogates wave goodbye to
up on her surrogate. Some intended the intended parents who are making
parents decide to make the trip to their way back to Anand after their
Nadiad to visit the surrogates before short visit to the surrogate house.
making the final decision to pursue
surrogacy.
09 Surrogates are normally
expected to hand over the newborn to
its parents immediately after delivery
but many end up taking care of the
baby a couple of weeks after giving
birth.
page 31