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Her.meneutics is edited by associate editor Katelyn Beaty and online editor Sarah Pulliam Bailey.

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October 21, 2010

Outsourcing Baby-Making in India

The disturbing realities of reproductive tourism as a global growth sector.

Ellen Painter Dollar

It’s a typical story in our global economy: Citizens of wealthy nations hire Indians to provide goods and services that cost less than the same goods or services domestically produced. But in the case of “reproductive tourism,” the Indian laborers are surrogate mothers who literally labor on behalf of foreign couples. They are paid to 'host' babies who are later carried home to the U.S., Britain, Israel, Australia, and other developed nations.

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One expert recently referred to reproductive tourism as a “global growth sector,” with India leading the trend. (Reproductive tourism is not limited to India. British women regularly travel to U.S. fertility clinics to access a larger pool of donated eggs, and Indian-style surrogacy programs are springing up in Guatemala.) Fertility clinics in India market their services by offering foreign clients travel services so they can sightsee while in India for an IVF cycle or retrieving their baby. The clinics also recruit surrogates, usually poor Indian mothers; help clients obtain donor eggs and sperm; perform in vitro fertilization (IVF); house, feed, and provide medical care to surrogates during their pregnancies; and deliver babies.

Advocates for this business claim that everyone wins. Childless couples get the babies they long for, and surrogates receive income for better housing and education for their own children. But it’s not that simple. Indian surrogates must live in special housing while they are pregnant. They are well-fed and taken care of, but what does it say about whose families are more valuable when Indian mothers are away from their own children for months while they gestate babies for wealthier foreigners? According to a recent Slate article, many of the women cannot read their surrogacy contracts. Those from higher castes are paid more than those from lower castes, and surrogates are paid only if they deliver a living child.

Two scenes from the HBO documentary Google Baby illustrate the injustice and heartbreak in the fertility tourism boom. In one scene, an Indian woman who recently gave birth to a baby for a foreign couple sits by her husband as he talks about the difference their surrogate payment has made, allowing them to buy a house and other comforts. He says he expects his wife will serve as a surrogate again. He says that, although women’s brains are generally inferior to men’s, his wife made a good decision. The wife, who admitted in an earlier scene that handing the baby over right after birth was very painful, listens in silence.

In another scene, an Indian woman is on the operating table, giving birth via C-section. She says she can feel the doctor cutting, and it becomes clear that her anesthesia is not working. The anesthesiologist puts something into her IV line and soon, she is lying still, sedated. One doctor standing by her head pushes hard on her belly over and over, as if he is kneading a stubborn loaf of bread. Another doctor pulls the baby out. Immediately after delivering the baby, the doctor answers a phone call while a staff person wraps the baby and takes her away. The baby’s intended parents will not arrive in India to pick her up for several days, so in the meantime, the staffer will care for the infant.

The surrogate lies on a stretcher, her eyes dazed and vacant as her husband holds her hand and strokes her hair. A baby was just born, an event that usually brings people together. But all of the parties involved are essentially alone, disconnected from each other and from the central event of the baby’s birth: The doctor takes a phone call, the surrogate woozily recovers from sedation, the intended parents make travel plans, and the baby is whisked away.

In researching reproductive ethics, I come across those who scoff at the possibility of “designer babies” in which children are manufactured to meet cultural expectations. Many insist that such fears are overblown, because the public would never accept such violations of human dignity. Certainly most fertility patients set out to build a loving family, not exploit poor women or manufacture a child to their specifications.

But as reproductive technology grows in scope and capability, it raises significant moral questions that deserve our attention (as I wrote about IVF two weeks ago). Fertility tourism might be one area of reproductive ethics where conservative Christians, who traditionally focus on the sanctity of human life, and liberal Christians, who traditionally focus on human rights, particularly for women, can speak out together for justice and compassion. We don't have to project some dystopian future to witness instances in which human dignity — the dignity of Indian mothers serving as surrogates and the babies they deliver — is violated by clinics, entrepreneurs, and aspiring parents who are turning procreation into a fee-for-service market.

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Posted by Katelyn Beaty on October 21, 2010 8:00 AM

Comments

Not a great movie (as in not well done) - this article is conjuring up images of the movie "The Island" starring Ewan McGregor and that is really not a good thing. I think I'm going to be sick.

Posted By: Leslie | October 21, 2010 10:03 AM

It's terrifying that babies have become an "industry" and a "market." They become products--objects--in that moment, just as that mother lying on the table. Something is wrong!

Posted By: LivewithFlair | October 21, 2010 11:19 AM

As the President would say "make no mistake, and let us be absolutely clear on this" "reproductive tourism", Baby "outsourcing", "host" mothers, and surrogacy "programs" all speak of one thing, the commodification of life.

For too many people, including many of what was once known as the "gentle" sex, human life is now something to be bought, sold and bartered much as slaves were a century or more ago. Once women went shopping for merchandise, now they travel to collect "made to order" babies.

The fact that one female is willing to pay another to carry a baby to term for her and under some of the conditions highlighted in the article, is clear evidence that the western world is no longer a civilization, since it has lost all sense of what is decent and moral.

However it was bound to happen. Roe v Wade opened Pandora's Box and allowed the death angel bwho slaughter the innocent to escape. All life has been cheap ever since. Thirty seven years later we have a tranquilized society, too desensitized by mass killings to feel any sorrow for "rent-a-womb" suurogates or their off-spring.

Posted By: Steve Skeete | October 21, 2010 9:10 PM

I wonder why we automatically move to villify this subject? The description of the c-section birth is much like the c-section I experienced. Nothing seemly or monstrous about it. Lots of people go into surgery with less than general anesthesia and experience pain when the pain-killer hasn't yet taken effect. All this shows is that we humans can be absolute masters of yanking around someone else's emotions.

Across the hall from me is a wonderful young woman. She loves children and has dedicated much of her life to working to help them. She spends her days teaching kids how to get along, manage their anger and be productive members of society. She would give anything to have a child of her own, but two debilitating chronic illnesses means before she was 25, she had to grieve the loss of potential motherhood. If she ever achieves the resources to hire a surrogate so she can have a baby of her own, it's not about finding the perfect child. It's not going to be about buying or selling. It's just going to be about finding a way in our modern world to do something she couldn't otherwise do: have a child to love.

Posted By: Tami M | October 22, 2010 8:54 AM

I have to disagree, Tami. What she could not otherwise have is a child *who is her direct biological descendant* to love. When did adoption cease to be an option? Or even foster care? If one is looking for a child to love, opportunities exist. It is that we want a particular kind of child to love, on our terms, that is the difference. I'm not trying to dismiss the pain those who struggle with infertility face; as a single mother, dealing with her own chronic debilitating medical condition, who has raised her son from toddlerhood to near adulthood alone after having been divorced years ago against my wishes, I know I haven't had the pain of wanting desperately to have my own child and not being able to. But I do know what it's like to have broken dreams and unresolved heartbreak. More importantly, I know that real parental love is about the child, not the parent, and can't help but be concerned by the extent of the economic and human costs we feel to be justified in our quest to love on our terms.

Posted By: SarahG | October 22, 2010 10:42 AM

There is certainly a lot of exploitation going on here, but it's at all sorts of different levels. There is the exploitation of a rich/educated culture exploiting a poor/uneducated culture and the exploitation of women being coerced by their husbands to make money. It is notable that these types of exploitation touch other areas of Western life that we rarely talk about. (For example, Americans rarely think about what it takes for us to have the most inexpensive products possible in our stores. Also, everyone thinks adoption is great, but international and domestic adoptions can involve these types of exploitation as well.)

I think a separate question is whether or not gestational (or traditional) surrogacy is always and definitively exploitative. Is it never a wonderful thing that a woman carries a child for a woman who can not, even if there is reasonable compensation involved? I would think it would depend on the people involved, their motives, and their relationships with one another.

Posted By: PLM | October 26, 2010 9:51 PM

Tami, your friend who can not give birth, she has a thousand different ways to "have a child to love" that doesn't include paying tens of thousands of dollars that could be put to better use and compelling some other woman to have it for you so it's her genetic progeny. I challenge anyone to come up with a reason for gestational surrogacy besides the desire to have a child who is one's own genetic progeny.

If being a parent is really about giving of oneself, the last thing on the list of criteria is whether they're genetically yours.

Posted By: Ken Crawford | November 4, 2010 1:03 PM

How much is the fee? How much does the surrogate mother get? How much does the owner profit per birth?

Some think energy companies make to much in profit (usually less than 10%) for providing a product that isn't morally nebulous.

How much profit is appropriate for this business? 10%? 20%? 50%?

Posted By: not too late | November 4, 2010 4:56 PM

There are adoption tax credits for U.S. taxpayers that decide to adopt a child.

Posted By: CPA Tampa | January 20, 2011 7:44 PM

India’s BPO industry has evolved and matured to present higher-end services that require judgment-based analysis and domain expertise, rather than function-specific, rules-based performance parameters alone. As service providers strive to offer end-to-end services, we see BPO falling into different segments. At one end of the spectrum is the traditional rules-based transactional outsourcing; while at the other end is judgment-based transaction processing and full-service business process outsourcing.
India has won its spurs as the world’s outsourcing destination of choice. Currently the country has a commanding share of the global outsourcing market.

India is undoubtedly the most favored IT/BPO destination of the world. This raises the question why most of the big MNCs are interested in outsourcing their operations to BPOs in India. The answer is very simple- India is home to large and skilled human resources. India has inherent strengths, which have made it a major success as an outsourcing destination. India produces the largest number of graduates in the world. The name of India has become synonymous with that of BPOs and IT industry hence the name BPO India.

Besides being technically sound, the work force is proficient in English and work at lower wages in comparison to other developed countries of the world. India also has a distinct advantage of being in a different time zone that gives it flexibility in working hours. All these factors make the Indian BPOs more efficient and cost effective. In order to meet the growing international demand for lucrative, customer-interaction centers, many organizations worldwide are looking to BPO India.

A subset of outsourcing, Business Process Outsourcing (BPO) involves contracting the operations and responsibilities through a third party service provider. From the last couple of years, the BPO industry has evolved as the most substantial sector in the Indian market. India has emerged as the most favored location for all Bpo services across the globe. This has accelerated the Indian economy to the heights, progressively boosting the statistics depicting the growth in the years to come and it has been however forecasted that by 2020, more than 80% of the world of business process outsourcing services will be served by the Indian companies. Marked as the best place to attain superior quality services globally, the BPO industry is strengthening its foundation in India.

http://phykon.com/

Posted By: bradwilliam | February 8, 2011 11:21 AM

to those of you who don't see why this is appalling; think of the potential for human traffickers. think of ALL the children around the world & here in the US waiting to be adopted. then think of creating new babies & taking women from their families & their own children to do so....ah, now it makes sense...making "families" is hurting families that already exist and has the potential to add yet another reason for traffickers to take women.
for those of you quoting scripture, jesus said to care for the orphans, so maybe instead of getting a designer baby, you can take infertility in a context of your own faith & think what God would want you to do; spend thousands on a new baby, or adopt one who needs care?

Posted By: s | March 22, 2011 4:08 AM

As I read this, I couldn't help but wonder how long it will be before it surfaces that somewhere, some clinic has been harvesting eggs and gametes and then using gestational surrogates to create children that the biological parents never knew about, or consented to... Children who will be marketed and trafficked for various purposes. When we divorce our sexuality and behaviors from the process of creating children, Pandora's box can be (and has been) opened.

Posted By: M.K. | August 22, 2011 5:23 PM

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