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Is surrogacy a legitimate way out of poverty?

Women
India
Poverty
Children
Newborn babies

Moneymakers: commercial surrogacy is big business across the world. © ZUMA Press, Inc./Alamy

Nayna

Reproductive infertility has always put unwanted pressure on couples, causing them much anxiety. The poor also have a dream to live a happy life without the burden of poverty.

Becoming a surrogate empowers women with a sense of worth and authority. Surrogates could actually help liberate women. Domestic labour should be paid, so when reproduction and pregnancy becomes a job, we will look at the value of female labour in a new light.

YES: Nayna Patel is the medical director at Akanksha IVF Clinic, Anand, Gujarat, India. More than 825 surrogate babies have been born at her clinic. Her work has been featured on the Oprah Winfrey Show and on the BBC. She runs the Anand Surrogate Trust for the benefit of the surrogates and their families.

This would elevate women’s status in a patriarchal capitalist society. They have the right to fulfil their dreams – not by doing anything wrong or immoral – but by giving the greatest gift, which is creating a family.

Only a hungry person understands the value of a piece of bread. How helpless does a woman feel when she wants to feed her children and can do nothing about it? Is it illegitimate to buy a house, educate children, start a small business and live a happy life by being a surrogate and helping an infertile couple?

Are we justified in refusing to enrol a surrogate, leaving her to live a life of struggle, pulling out the rug from under her? No, because the surrogate gets the blessings of the couple and financial support; the couple gets the baby – a win-win situation for all. Surrogacy allows a woman to help another woman.

In order to perpetuate survival on this planet, nature has given us two most powerful instincts, the instinct of self-preservation and the instinct of reproduction. So, if a woman wants to get rid of her poverty by doing the noblest deed, I firmly reiterate, surrogacy is a legitimate way of doing it.

Mohan

Let me make it very clear that I am talking about commercial surrogacy. The idea of ‘gifting’ life to a childless couple elides the fact that this is a global industry, said to be worth $3 billion in the US alone.

An estimate by a business newspaper suggests that as an integral part of the growing medical tourism industry, the fertility industry is said to have brought in additional revenue of $1–2 billion to India in 2012.

NO: Mohan Rao is a medical doctor, specializing in public health. He is a professor at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India. His published works include From Population Control to Reproductive Health: Malthusian Arithmetic and, as editor, The Unheard Scream: Reproductive Health and Women’s Lives in India.

According to another estimate by a senior official in the Indian Council of Medical Research (ICMR), the figures are even higher.

What we need to talk about is imperial bio-politics: capital, labour and entrenched inequalities that are at the heart of this global industry.

It is therefore disingenuous to talk about commercial surrogacy at the level of the individual surrogate. She is the last link in a chain of actors, all of whom are making large amounts of money from her reproductive labour.

Involved in this network are promoters, third-party administrators, travel agents, the hospitality industry, surrogate hostel admin­istrators and, of course, the doctors. Frequently, NGOs are used to source surrogates.

It is risible to talk about how this ‘empowers’ the surrogate. Most empirical research on surrogates shows us that they see themselves as reproductive slaves. They are stigmatized, and many of them are unable to return to their former homes, although they tell themselves they are not prostitutes.

Nayna

Any arrangement or procedure – be it medical or otherwise – has a chain of people earning from it. So why sideline surrogacy?

Becoming a surrogate empowers women with a sense of worth and authority. Surrogates could actually help liberate women – Nayna

The fact remains that there are couples who cannot have babies without surrogacy (even when they have tried adoption) and there are women who want to have a better life for themselves and their families. If by doing this noble deed, a woman can achieve that, who are we to judge?

As for the surrogates, you cannot go by the studies but have to meet them personally and share their experiences. I can quote innumerable surrogates whose lives have been changed by this.

Most of our surrogates have been able to use the money to support their children into higher education, buy a house for their family, start a small business, and pay off debts. They never see themselves as reproductive slaves!

It is society which looks upon them in that way. ‘Reproductive Slaves’ – please, before saying this, at least spend a day in their lives and experience what they are going through.

They never think of themselves as prostitutes. They are seen as ‘prostitutes’ by society and so-called ‘well wishers’, who use such terms. Their families support them. They are welcome back home. The surrogates are empowered.

Mohan

You attempt to obfuscate issues. It is not necessary for any medical procedure to be paid for. It is in your world that money-chasing is disguised as ‘donation’ or ‘gift’ or ‘altruism’ in order to mask a deeply exploitative practice. No-one here is talking of altruistic surrogacy, but commercial surrogacy.

The fact remains that commercial surrogacy is taking place largely in poor countries, with a large population of poor women, willing to be exploited within a system of entrenched structural coercion.

The idea of ‘gifting’ life to a childless couple elides the fact that this is a global industry, said to be worth $3 billion in the US. – Mohan

This is a facet of neoliberal global dystopia, which makes money out of the bodies of poor people, sometimes in clinical trials, sometimes in surrogacy. It is by recognizing this aspect of the global bio-economy that governments have stepped in to ban trade in body parts, such as kidneys.

Doctors who prescribe surrogacy strengthen patriarchy. What it represents is the genetic worship of the ‘male line which has to be carried on’. Instead of questioning and undermining the heterosexual normative family, what surrogacy does is entrench it.

Black feminists [in the US] – the experiences of slavery and the exploitation of their repro­duction still vivid in their histories – have challenged the discourse of ‘choice’ and ‘empowerment’ in their quest for reproductive justice. They understand what reproductive slavery is.

It is true that a state’s failure to provide for education and health often forces women with few options to take recourse to surrogacy, but that should not justify it.

Nayna

With all due respect, the greatest number of surrogacies are happening in the US, one of the richest countries in the world – the so-called superpower – and with couples coming from Europe, Britain and Japan. Nobody says that’s exploitation.

Also, surrogacy is not a one-day procedure which a woman can be forced into. Surrogacy can only take place if a woman does it voluntarily.

What is exploitation? A woman becoming a surrogate and from that money buying a house, educating her children, helping her husband start a small business? Or allowing a woman to stay poor, letting the husband commit suicide and her children give up their studies due to financial crisis?

If a state fails, should the woman also fail and never empower herself?

Surrogacy gives the surrogate her due respect in her family, makes her a more confident female and empowered woman – this in itself is less patriarchal. There is no question of male line! You need to be in this age and understand the process of surrogacy. It is ridiculous to compare it to reproductive slavery.

There is no organ removed, like kidney transplants – so there is no comparison there, either. You could compare it with donating blood. A woman can be a surrogate not just once, but up to three times (according to Indian Council of Medical Research guidelines).

Even in Indian mythology and the Bible – there is mention of surrogacy.

So rather than be critical, understand and accept this procedure as a legitimate way out of poverty and salute these surrogates!

Mohan

You deliberately, and misleadingly, place the responsibility of poverty on the individual. There are a billion people going hungry in the world. Is surrogacy the answer?

Are you not aware that self-directed violence is frequently a response to structural violence? Far from empowering a woman, it represents loss of choice, loss of autonomy, loss of control. It is an expression of lack of opportunities; not of ‘empowerment’.

There are so many cases of women in India being forced into surrogacy by their families. There are also reports of women being trafficked for surrogacy. This therefore feeds into and feeds off the rampant misogyny in India.

Again, you deliberately, and repeatedly, confound altruistic and commercial surrogacy. There was no global reproductive labour industry at the time of the Bible, exploiting women’s bodies, mining them.

Do you support the surrogate creation of a saviour baby? What are the long-term health impacts of surrogacy?

Also, we must question how ‘voluntary’ is the decision of the surrogate to enter into an exploitative relationship. Libertarian feminists valorize choice, seduced by the idea of a contract. How free is the labour contract? Surrogacy is a tribute to the un-free character of wage labour.

That surrogacy happens in the world’s richest nation is not surprising. Capitalism, patriarchy and race come together there in worship of the dollar.

‘Not an angel, not a whore’ is the plaintive cry of the surrogate. What she is, is a woman whose reproductive labour is exploited at the altar of patriarchy.