Wow! A friend of mine just sent me the link to this article!
Customer
service, tech support…these days we outsource everything to India. So
why not pregnancy? Here is a report on the growing number of Indian
women willing to carry an American child.
By Abigail Haworth
ferociously hot outside the Akanksha Infertility Clinic, a scuffed
concrete building in the small Indian city of Anand. Crammed into a
single patch of shade by the gate, a stray cow and a family of beggars
— caked so uniformly in dung-colored dust they resemble clay models —
wait out the noontime heat. Inside, the lobby is jammed with barefoot
female patients in circus-bright saris. Nurses in white Indian tunics
scuttle among them, hollering out names and brandishing medical files.
The air smells faintly of sweat and damp cement. On the walls, blurry
photos of babies and newspaper clippings celebrate the clinic’s raison
d’être: "The Cradle of the World" declares one headline.
In this case, the metaphor is also literal. The Akanksha clinic is at
the forefront of India’s booming trade in so-called reproductive
tourism — foreigners coming to the country for infertility treatments
such as in vitro fertilization. The clinic’s main draw, however, is its
success using local women to have foreigners’ babies. Surrogacy costs
about $12,000 in India, including all medical expenses and the
surrogate’s fee. In the U.S., the same procedure can cost up to
$70,000.
HT: Abigail Haworth
As
she sits in the empty doctor’s office, a young Indian man wearing a red
T-shirt and stonewashed jeans enters the room. Without a word, he
proceeds to stick a needle in Ordenes’s arm and fill a syringe with her
blood. She looks up at him quizzically — she has no idea who he is.
After he leaves, she examines the livid red dot left behind on her skin
for a second, then shrugs. "So anyway, the years disappeared, and now,
as you can see, here I am in India."
The temperature at 9 a.m. the following morning is pushing a
brain-melting 107 degrees. Najima Vohra, immaculately dressed in an
electric-blue tunic-and-pants set, arrives at the clinic an hour early
for her meeting with Ordenes so they can bond a bit more before the
procedure begins. It’s not the most intimate venue, but Vohra is
uncomfortable being seen anywhere else — like most women here, she
plans to keep her surrogacy a secret. Vohra is slim, and her long hair
is tied back with a plain rubber band. "I couldn’t wait to get here,"
she says through a translator, sitting in a plastic chair in the lobby.
"I’ve been so excited since Dr. Patel chose me to be a surrogate that I
haven’t been able to sleep."
Vohra says she’s not ashamed of being a surrogate, but most locals are
very traditional and don’t understand. "They think it’s dirty — that
immoral acts take place to get pregnant," she whispers, explaining
their disbelief that she could conceive a child without having sex.
"They’d shun my family if they knew." Vohra comes from a village 20
miles outside Anand, but she has temporarily moved to the town with her
husband and two children, a 12-year-old daughter and a 7-year-old son,
to hide what she is doing. "We told our neighbors we were coming here
for work, which is not strictly a lie."
Vohra has no job but helps her husband in his scrap-metal business, for
which they earn 50 to 60 rupees ($1.20 to $1.45) a day. If her
pregnancy is successful, the $5500 she receives will, as she puts it,
"give my children a future."
Growing up, Vohra worked in the wheat fields; she had little education.
After her parents married her off at 16, she moved with her husband
into a one-room mud house that erodes every year during the monsoon
season. She plans to divide her surrogacy windfall three ways: buying a
brick house, investing in her husband’s business, and paying for her
children’s education. "My daughter wants to be a teacher," she says.
"I’ll do anything to give her that opportunity.
"I’m
fit and strong, and I’ve already given birth twice," she continues,
scoffing at the idea of being nervous. And yes, she’s mentally prepared
to hand over the baby. "It won’t even have the same skin color as me,
so it won’t be hard to think of it as Jessica’s." The clinic stipulates
that all surrogates must already be mothers so they understand what’s
involved physically and will be less likely to become emotionally
attached to the babies they bear.
Of course, it’s impossible for Vohra to know how she will feel after
she gives birth — this is the wild card, the reason custody battles
sometimes ensue in the U.S. All surrogates at the clinic sign a
contract agreeing to hand over the baby — which reassures prospective
parents, but also supports arguments that the women, many of whom are
illiterate, are being taken advantage of. (In the U.S., only a handful
of states regard presigned contracts as legally binding. In others, a
surrogate has a small window of time after birth to stake her claim to
parental rights.)
Vohra sits in silence for a while and examines her cracked fingernails.
"If I do feel sad after the birth, I won’t show it," she says
eventually. "I can understand how much Jessica wants this baby." In
India, she explains, infertility is considered a curse.
Ordenes arrives at exactly 10 a.m., having hired her own car and driver
to help navigate the belligerent scrum of auto rickshaws, rusting
buses, and camel carts in downtown Anand. She walks over and hugs
Vohra, ignoring the custom that discourages lower-caste Indian women
from interacting with those outside their group. Vohra smiles.
Ordenes has brought her own interpreter, a female student from the
local college recommended by the clinic, since Vohra doesn’t speak
English. However, when they find an empty ward upstairs and sit on the
beds to talk, the women struggle for words. It’s as though they both
realize the gap between their lives is so vast, there’s simply no
sensible place to begin.
Ordenes feels her way with some questions about Vohra’s kids, then
fills her in on her latest ovum count — a topic that consumes foreign
patients while they’re here, since their sole contribution to the
pregnancy is healthy eggs. (Surrogates’ own eggs are never used.)
Ordenes has produced six eggs so far, but two need extra time to
mature. She takes Vohra’s hand and squeezes it and promises to look
after her during the pregnancy. "You’re my angel, you’re my angel," she
coos and hugs her again. Then Ordenes gets out her camera to take
photos to send to her husband.
Patel’s
office is a gloomy, narrow room with a computer at one end and an
ultrasound machine behind a fraying living-room curtain at the other.
Her enormous desk sits in the center, piled high with papers. The room
is constantly packed with nurses, patients, and anyone else who cares
to wander in — nobody ever knocks before entering.
Making her rounds of the upstairs ward, where pregnant surrogates have
been admitted for monitoring, Patel says the business has taken off
beyond anything she imagined. She has about 150 foreign couples on her
waiting list, and every week three new women apply to be surrogates.
She works 14-hour days and insists she’s only involved in surrogacy
because there’s a genuine need. "I accept patients who have an
established infertility problem," she says. "I’ve had some women ask to
do surrogacy because they don’t want to give up work for a pregnancy,
but I turned them down flat."
All the same, Patel admits there are dangers if the surrogacy business
continues to grow in India. "There is little regulation by the Indian
Medical Council, the body that oversees such practices," she says.
"Rules need to be tighter to ensure women are not exploited."
As a guest speaker at many international infertility conferences, Patel
isn’t fazed by the foreigners who beat a path to her door — including
clients from Taiwan, Japan, the U.S., Europe, and Australia. But she
refuses to treat gay couples, revealing her deeply conservative
cultural roots. "I get e-mails from gays and lesbians," she says, "some
of them very well written — but I don’t feel right about helping them."
The people she does feel good about helping are the local women — the
surrogates — so long as they’re not being coerced by their husbands or
in-laws eager for a paycheck. "I must be certain it’s a woman’s own
decision," she explains. "If there’s any sign of tension or
unwillingness, I spot it straightaway." Patel also helps to ensure each
woman keeps control over her fee. "For example, if she wants to buy a
house, we’ll hold her money for her until she’s ready. Or if she wants
to put it in an account for her children, we’ll go with her to the bank
to set up the account in her name." The money gives many women their
first taste of empowerment.
Achieving
that financial freedom is hard work. In one of the wards, Sofia Vohra
(no relation to Najima), 35, is lying in a room with three beds, an
ancient ceiling fan, and wall paint that has bubbled in the heat like a
nasty rash. She is about to give birth for the sixth time, to a baby
she’s carrying for a couple living in the U.S. She has five children of
her own, a husband who’s a lazy drunk, and a job crushing glass that’s
used in making (of all things) fortified kite string, for which she
earns $25 a month. She became a surrogate for no other reason than to
pay for her two daughters’ dowries, an illegal — but still widely
practiced — Indian marriage ritual.
"I’ll be glad when this is over," she says, as Patel places a
stethoscope on her ballooning brown stomach. "It’s exhausting being
pregnant again." Then, in case her complaints are misunderstood, she
quickly adds, "This is not exploitation. Crushing glass for 15 hours a
day is exploitation. The baby’s parents have given me a chance to make
good marriages for my daughters. That’s a big weight off my mind."
It’s lunchtime on Thursday, and the clinic’s surrogate mothers crowd
into a small room where the staff is throwing a party. Among them is
30-year-old Rubina Mondal, a former bank clerk with long, straight
black hair, dressed in a red sari fringed with gold. In February, she
gave birth to a healthy boy for a couple from California.
Mondal heard about Patel’s clinic on a TV show, and traveled to Anand
from her home in the eastern city of Kolkata. Her reason was purely
economic: Her 8-year-old son, Raj, has a hole in his heart, and working
as a surrogate was the only likely solution to covering his expensive
medical care. Patel matched Mondal with Karen, a 33-year-old who works
for a mortgage lending company in Los Angeles.
Karen and her husband, Thomas, wanted children, but she had been
diagnosed with a uterine tumor at age 16 and knew someone else would
eventually have to carry the baby. Mondal conceived on the first try.
Over the next eight months, Karen called every week from the States to
hear news of her growing child. On top of the surrogacy fee, Karen paid
for a spacious two-bedroom apartment in Anand for Mondal’s family,
hired a cleaner, and sent care packages containing cotton pajamas and
panties for Mondal and toys for her two sons.
Five
weeks before the baby was due, Karen flew to India and moved in with
Mondal so they could go through the final weeks together. "Karen became
like my sister," says Mondal. Patel delivered the baby boy, Brady, at
the clinic.
Like Ordenes, Karen had tried to find a surrogate in the States. "Some
of the women were nice, but we just didn’t click," she explains. As a
Buddhist, Karen thought she’d have an affinity with India’s shared
beliefs in fate and karma. She also connected with the warmth of Mondal
and the clinic. "The people were honest and real," Karen says.
She bristles at those who suggest that she chose India because it was
hassle-free. "Some people made it out like we went grocery shopping and
came back with a baby," she says. "But being in India was tough — the
heat, the mosquitoes, worrying about Rubina and the baby’s health. You
have to want a baby real bad to deal with this kind of arrangement."
Karen e-mails Mondal photos of Brady every week, and she plans to bring
her to the U.S. for her son’s first birthday next year. "I want Brady
to have a relationship with the woman who carried him for me," she
says. Meanwhile, she has embarked on a second surrogacy. Najima Vohra’s
sister, Razia, is 10 weeks pregnant with a sibling for Brady.
Karen’s story gives hope to Ordenes. Ten days after her arrival, she
learns that the latest ultrasound has revealed eight healthy eggs —
good news, seeing as more eggs mean a greater chance of producing
viable embryos to implant in Vohra. Still, the odds are iffy: For a
younger couple, the chances of a surrogate conceiving are 30 to 40
percent, but that drops to 15 to 20 percent for someone Ordenes’s age.
As excited as she is about the prospect of Vohra’s pregnancy, Ordenes
isn’t sure she can stick around for the embryo transfer — Patel has
scheduled it for the following week. "I really want to stay to be with
Najima," she says, "but I need to get home because I’ve arranged to
have my basement renovated." She quickly realizes how that sounds and
adds a qualifier. "Well, you know, good workmen are very hard to find.
And the renovations are for the baby."
