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International Commercial Surrogacy in India: Exploitation, Poverty, Alternatives and Survival

05/10/2013 19:30 BST | Updated 05/10/2013 19:30 BST

The thriving Indian international surrogacy business is much in debate at the moment. Couples from all over the world, usually from developed nations in which surrogacy is illegal as it is seen as demeaning, pay an Indian clinic to organise to have their baby gestated and carried inside an Indian surrogate, who then gives birth to the baby to be taken away by the couple. The surrogate, always a woman from a very poor background, receives a fee.

Kishwar Desai's recent novel Origins Of Love highlighted this issue in the form of a crime thriller. It portrayed how corruption, greed, mismanagement and exploitation work hand in hand to ruin people's lives. This week, BBC Four broadcast a documentary on the same subject, made by Matt Rudge. Called House of Surrogates, the programme demonstrated skilfully the complexities behind the obvious issue of exploitation.

As mere observers from the West, we can criticise many things which go on in developing countries. Like child labour, commercial surrogacy and international surrogacy tourism are naturally unacceptable in the context of developed economies. But before we pass judgment and carry our banners to outlaw such atrocities, we need to understand what part they play in the lives of the people we are trying to save. As the programme made clear, there is no doubt that the business of surrogacy encourages rich people - sometimes in India but mostly from other countries - to use poor women's wombs to have children. There is also no doubt that the money the rich clinic owners earn in the process allows them to live in extravagant comfort while the poor women struggle to use their earnings to take just one step up from their pitiful existence. But as we all know (and as Dr Nayna Patel, the woman who runs a surrogacy clinic, said quite rightly in the documentary), poor people, especially poor women, are exploited in countries such as India in any case. Let us consider some typical scenarios for a poor woman in a poor country:

  • Spend all day at home in extreme poverty, have numerous children, work all day to look after them, get beaten up by the husband when he comes home in the evening, often drunk. Repeat the same routine the next day, with no chance of a way out.
  • Work as a domestic maid, running from household to household, from 8 a.m. till 7 p.m. Then go home and do all of the above. The husband either works and spends the money on drink, or does not work at all. While the mother is busy earning money to feed the mouths of her children, the older girl child looks after her siblings.
  • Work on building sites or farms as a casual labourer carrying loads and get a pittance for it. The long term reward: a fast ageing, fast deteriorating body with long term health consequences.
  • Sell the body to feed the children, get ostracised by society and die from disease and ill health.

There are many other equally pathetic scenarios I could mention. But more importantly, the final outcome for poor women is the same. They give their labour to put food in front of their families with no hope of any changes in their circumstances. What's more, the vicious cycle goes on for the next generation: the girls repeat the lifestyles of their mothers while the boys follow their fathers.

Poor people in India - both men and women - sell other bits of their bodies also, such as their kidneys or their blood (sometimes even infected blood). They take part in medical experiments for money. The payment for such sacrifices is very low and so those people come back to do the same again if possible. And, at the end of the day, it still does not change their lives or the lives of their children. Women in India, as no doubt worldwide, are strong and often ambitious for their children. I have spoken with many domestic workers in India whose lives have not changed despite the growth of the country, but whose outlook and aspirations have. They are not happy with their lot and they want more. As the country grows and taboos fall apart, though slowly, they learn to demand more. They work all day if necessary so they can send their children to school, so they can leave their husbands if necessary, so they can make their one-room living shacks more permanent. They are determined to give their children a better life than they had, at all cost. But domestic or other low-paid work gives them very little scope for doing this without running themselves into the ground in the process and yet the benefits, at the end of the day, are minimal.

What Rudge's documentary showed is that when done with some degree of integrity, commercial surrogacy might give the women something back, with which they can change their lives permanently. It is inarguable that the women are forced to take such drastic action by their circumstances, by their husbands, by rich businesses, by society. No one can argue against the fact that it breaks their hearts when the babies are separated from them, that they cringe in disgust when the paying foreign parents with no respect for the country they are buying their product from or its customs hug them patronisingly when they take the babies away, that the money they are paid is little compared to what the clinics earn. But what it also does is give impoverished women some autonomy. The money they get does not sound much when quoted in pounds or dollars but it goes a long way in India, given the conversion rate and the low cost of living there. It allows women to plan the future of their families the way they see fit. It puts money into their own hands. They do not need us to take this choice out of their hands with no offer of an alternative. What they need is for us to help them to make their chosen action work for their benefit. In the face of widespread exploitation by the rich, we need to support the women who have limited choices due to their lives' harsh realities; to help them to get out of the cycle of generations of poverty, to add a better alternative to the list of scenarios presented above. In the programme, we saw the sisterly solidarity among the women, their eagerness to utilise the facilities provided within the infrastructure built around the surrogacy business, the collective support and encouragement given by the women to each other to help the victims of domestic violence to leave their abusers.

We have two options. We can sit comfortably in our armchairs and tell these women to reject the option of surrogacy because it is exploitation. Or we can help them to get organised against the businesses which exploit them without offering adequate benefits and empower them to assert their rights. This way maybe their daughters will not have to choose the same path for survival.