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Another job being outsourced to India: surrogate pregnancy

The women in Anand are pioneers in the growing field, having given birth to about 40 babies for infertile couples worldwide.

January 06, 2008|Sam Dolnick | Associated Press

ANAND, INDIA — Every night in this quiet western Indian city, 15 pregnant women prepare for sleep in the spacious house they share, ascending the stairs in a procession of ballooned bellies, to bedrooms that become a landscape of soft hills.

A team of maids, cooks and doctors looks after the women, whose pregnancies would be unusual anywhere else but are common here. The young mothers of Anand, a place famous for its dairy industry, are pregnant with the children of infertile couples from around the world.

The small clinic at Kaival Hospital matches infertile couples with local women, cares for them during pregnancy and delivery, and counsels them afterward. Anand's surrogate mothers, pioneers in the growing field of outsourced pregnancies, have given birth to about 40 babies.

More than 50 women in this city are now pregnant with the children of couples from the U.S., Taiwan, Britain and beyond. The women earn more than many would make in 15 years. But the program raises a host of uncomfortable questions that touch on morals and modern science, exploitation and globalization.

Dr. Nayna Patel, the woman behind Anand's baby boom, defends her work as meaningful for everyone involved.

"There is this one woman who desperately needs a baby and cannot have her own child without the help of a surrogate. And at the other end there is this woman who badly wants to help her [own] family," Patel said. "If this female wants to help the other one . . . why not allow that?"

Experts say commercial surrogacy -- or what some call "wombs for rent" -- is growing in India. Doctors work with surrogates in virtually every major city. The women are impregnated in-vitro with the egg and sperm of couples unable to conceive on their own.

Commercial surrogacy has been legal in India since 2002, as it is in many other countries, including the United States. But in India it is becoming a viable industry rather than a rare treatment. Experts say it could take off for the same reasons outsourcing in other industries has been successful: a wide labor pool working for low wages.

Critics say couples are exploiting poor women in India -- which has an alarming maternal death rate -- by hiring them at cut-rate prices to undergo the hardship and risks of labor.

"It raises the factor of baby farms in developing countries," said Dr. John Lantos of the Center for Practical Bioethics in Kansas City, Mo. "It comes down to questions of voluntariness and risk."

Patel's surrogates are aware of the risks because they've watched others go through them. Many of the mothers know one another, or are even related. Three sisters have all borne strangers' children, and their sister-in-law is pregnant with a second surrogate baby. Nearly half the babies have been born to foreign couples; the rest to Indians.

Ritu Sodhi, a Los Angeles furniture importer who was born in India, spent $200,000 trying to get pregnant through in-vitro fertilization, and was considering spending $80,000 to hire a surrogate in the United States.

Then, on the Internet, Sodhi found Patel's clinic.

After spending about $20,000 -- more than most couples because it took the surrogate mother several cycles to conceive -- Sodhi and her husband are home with their 4-month-old baby, Neel. They plan to return to Anand for a second child.

"Even if it cost $1 million, the joy that they had delivered to me is so much more than any money that I have given them," she said.

Patel's center is believed to be unique in offering one-stop service. Other clinics may request that the couple bring in their own surrogate. But in Anand the couple just provides the egg and sperm; the clinic does the rest.

Young women are flocking to the clinic to sign up for the list.

Suman Dodia, 26, said she would buy a house with the $4,500 she received from the British couple whose child she was carrying. It would have taken her 15 years to earn that on her maid's monthly salary of $25.

Dodia's own three children were delivered at home; she said she never visited a doctor.

"I'm being more careful now than I was with my own pregnancy," she said.

Patel says she accepts only couples with serious fertility issues, such as survivors of uterine cancer. The surrogate mothers have to be between 18 and 45, have at least one child of their own, and be healthy.

A rotating cast of surrogate mothers lives together in a home rented by the clinic. They receive their children and husbands as visitors during the day, when they're not busy with English or computer classes.

"They feel like my family," said Rubina Mandul, 32, the surrogate house's den mother.

Mandul, who has two sons of her own, gave birth to a child for an American couple in February. She said she missed the baby, but stayed in touch with the parents over the Internet. A photo of the couple and the child hangs above the sofa.

"They need a baby more than me," she said.

The surrogate mothers and the parents sign a contract that promises the couple will cover all medical expenses in addition to the woman's payment, and the surrogate will hand over the baby. The couples fly to Anand for in-vitro fertilization and again for the birth. Most end up paying the clinic less than $10,000 for the entire process, including fertilization, the fee to the mother and medical expenses.

Counseling is a major part of the process and Patel tells the women to think of the pregnancy as "someone's child comes to stay at your place for nine months."

"The fetus is theirs, so I'm not sad to give it back," said Kailas Gheewala, 25, who plans to save the $6,250 she's earning for her two daughters' education. "The child will go to the U.S. and lead a better life and I'll be happy."

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