India's 'Rent-a-Womb' Industry Draws Criticism

Dr. Nayna Patel, center, surrounded by surrogates at her clinic. Photo: SWNSNews of a controversial surrogacy center’s expansion in India — where impoverished women have been hired out to birth more than 500 babies for Westerners — has reignited a debate on the ethics of what some have called a "rent-a-womb" practice. But the clinic’s director, Dr. Nayana Patel, is defending what’s become a $1 billion-a-year industry in the country.

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“These woman are doing a job. It’s a physical job. They are paid for that job,” Patel noted in the BBC documentary “House of Surrogates,” which aired on Tuesday in the U.K. and provided a look inside Patel’s Akanksha Infertility Clinic. “These women know there is no gain without pain. I definitely see myself as a feminist. Surrogacy is one woman helping another.”

To those who say the practice exploits women, Patel told Yahoo Shine in an email, "It is very easy to criticize, but it is very difficult to face the reality. If the critics can give the surrogate what she dreams and change her life and give the childless couple their baby, one can stop surrogacy."

Patel, who has run the clinic in rural Gujarat for nearly a decade, is currently building a new, state-of-the-art surrogacy hospital that will contain residences for the surrogate mothers, apartments for the visiting Westerners, delivery rooms, an IVF department, and even restaurants and a gift shop. It will be just another one of India's 150 known fertility clinics, about 60 percent of which offer commercial surrogacy, according to a recent in-depth story on the subject in the San Francisco Chronicle.

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At Akanksha, the gestational surrogates — who carry babies created from foreign embryos not containing their own eggs — receive approximately $8,000 from Patel for their services ($10,000 for twins), which is a large sum for women whose husbands earn about $40 a month. In exchange, according to the BBC, they must agree to live in a surrogate dormitory and remain celibate throughout the pregnancy — and, in some cases, look after and breastfeed the newborn for up to eight weeks while its new parents deal with complex paperwork in India before taking their baby back home.

“This is a white baby being born to an Indian-nation lady, so the attachment is almost nil,” Patel noted in a 2010 interview. Scientists, though, have asserted for years that women can begin bonding with their babies while they're still in the womb, and many women report feeling a connection immediately after conception. In the film, two-time surrogate Edan talks about how difficult it will be to say goodbye to the boy she birthed.

“I have spent a lot more time with this one, so to give him away is more upsetting. No one can understand. Only we know how much pain we go through,” Edan explains. “Maybe not my life, but my children’s lives will be better. Won’t they?”

Patel, in the documentary, admits, “I have faced criticism. I am facing it and I will be facing it, because this, according to many, is a controversial subject.” She adds, “There are a lot of allegations that this is just a business, this is just baby-selling, a baby-making factory, and all these phrases used to hurt. I feel that each and every person in this society is using one or the other person.”

Adrienne Arieff, owner of a public relations firm in San Francisco, had twins, now 4 1/2, through a surrogate at Akanksha and wrote a memoir about her experience, “The Sacred Thread: A True Story of Becoming a Mother and Finding a Family—Half a World Away,” in 2012. In a CNN interview following her book’s publication, she explained that, after three miscarriages, she and her husband looked into Indian surrogacy because she had spent time in the country and felt a connection, and because Patel had “impeccable credentials.” On Wednesday, she told Yahoo Shine that, while "I definitely have issues with surrogacy in general," she had an "incredible" experience. 

"I was superengaged—I moved to India for the pregnancy—and I treated her the way I would treat any family member," Arieff said about her relationship with the surrogate mother, whose side she was at during the birth of her twins. "I care about her tremendously." She also owed her positive experience to having worked with Patel. "I feel like she's pretty amazing, and that she's doing this for a lot of the right reasons," she said.

Though Arieff has faced criticism since writing her book and has been called "elitist" and "privileged" by those who haven't approved, she said she's OK with that. "I'm not going to change anybody's mind. It's like religion — you are either pro or against," she said.

Another woman who worked with Patel — identified only as Barbara, 54, from Canada, in the BBC documentary — tried to get pregnant for 30 years before hiring a surrogate at Patel’s clinic. “Infertility is a medical problem," she said. “If people born with bad eyesight get corrective eyeglasses, and diabetics get insulin, why can’t we get medical treatment for our problem?”

Some ethicists, though, remain critical of the industry. “I don’t think any of us has a right to be a parent,” Marilyn Crawshaw, a sociologist and assisted reproduction expert told the Telegraph recently. “There are people who say this is a win-win situation, and you can find Indian women who have acted as surrogates who say they have earned more money in nine months than they would in 10 years. But these women wouldn’t be doing this if poverty wasn’t a driver.” 

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