Inside India's international baby farm - Times Online May 9, 2010
Cradling her baby, Oliver, Alison, 31, happily strokes his head, holds his hands and feeds him from a bottle, like any proud new mother. But for the Australian primary-school teacher and her 35-year-old British husband, William, the birth of their son has followed a long and desperate medical struggle in which both had almost given up hope of having a child.
William and Alison live in London, but Oliver was born here, in Anand, Gujarat, in a clinic filled with barefoot women in flowing saris, in a remote rural community in India. It was an unusual entry into the world, but Olivers entire conception had been far from ordinary. The tiny boy, born five weeks prematurely, was conceived through an egg donor and in-vitro fertilisation; he was carried by an Indian surrogate mother whom his parents had met just two days before his birth.
Oliver was born to a woman from Anand, a small town at the forefront of Indias booming reproductive tourism market, where foreign couples flock for infertility treatments. The chaotic, dusty backwater, where rickshaws, cows and street vendors swirl around each other in the punishing midday sun, has earned the nickname the cradle of the world.
Since 2003, 167 surrogate mothers have successfully given birth to 216 babies at the Akanksha Infertility Clinic, run by Dr Nayana Patel and her husband, Hitesh.
Around 50 surrogates are pregnant currently, making Anand one of the biggest surrogacy hubs in Asia. For Alison, the clinic offered a last hope after IVF failed. I didnt have any eggs, she says, so my sister was my donor. We had five attempts at IVF three failures, a miscarriage and an ectopic pregnancy. We were told to give up.
Our doctor at the time suggested surrogacy, but I dismissed it, says William. We would need an egg donor and a surrogate mother, so I was resigned to a life without children although you never give up hope.
Alison first contacted Dr Patel, a glamorous woman in her late forties, in August 2008, and the couple flew from their London home to India in January last year to begin the first round of treatment. Although their arrival in the developing country was a culture shock, they say: The technology is really good, the expertise is first-class, and the customer service is excellent. They paid around £14,300 for the surrogacy package, of which between £4,250 and £4,900 would go to the surrogate mother. Volunteer surrogates receive £30 a month up to delivery, plus £390 at three and six months, and the whole amount at delivery, regardless of the outcome.
Usually, in the first stage of surrogacy, the wifes ovaries are stimulated to produce eggs through hormone treatment. After 9 to 11 days of hormone injections, the eggs are extracted and fertilised with the husbands sperm. Two days later, if all goes according to plan, some of the resulting embryos will be implanted in a surrogate mother. In Alisons case, the eggs were retrieved from an anonymous donor the couple were told only that she was 26, and were given a detailed report of her medical history. The donor would have received around £150-£250 for this uncomfortable procedure which can cause side effects similar to those of the menopause such as hot flushes and night sweats.
After the embryos are implanted, there is a two-week wait to find if any have resulted in a pregnancy. According to the UK Human Fertilisation and Embryology Authority, the live birth rate for IVF is just 20% per treatment cycle, so it was a disappointment, but not a total shock, when the first surrogate mother lost the baby at eight weeks. As embryos had already been created and frozen, Alison and William did not return to India for the next two attempts at implantation. Their successful surrogate mother was 35 and, according to clinic rules, was married, a mother herself with a good obstetric history. You get lots of updates, month to month, says Alison. There are the scans, and they do a baby shower for the surrogate mother in the seventh month. Its sort of like a blessing of safe passage.
When news came that Oliver would be premature, the couple rushed to be present for the birth. We all went together for a scan. It was exciting, says Alison. Meeting the surrogate mother for the first time was quite unnerving. Because we dont speak Gujarati, I think we spent most of the time smiling and nodding and trying to have a very basic conversation.
The birth was quick after Oliver lodged himself in a breach position and a caesarean was performed. The first time she held him, about three minutes later, Alison was terrified. He was having some breathing difficulties at the time. The paediatrician was here, rushed him to hospital, and I didnt get to hold him again for another two or three days because he was on oxygen and being tube-fed. So it felt strange. The first experience was very nerve-racking, but after that it was really nice to finally get to hold him.
The surrogate mother visited Oliver while he was in the intensive-care unit, and nursed him with her own breast milk. You seem to develop a way of communicating, says Alison, adding that the moment of the final handover went more easily than expected. I think she knew the reason why we were doing this, and she was prepared for the fact that he was coming home with us. Shed come and say hello and hold him for a little while, but she did seem to keep a little distance. I think she needed to do that to help herself, because it could be really hard to carry the baby for eight or nine months and then say goodbye. Alison and William promised to stay in touch with her. Wed like to send a Christmas card and photos to show her how he is growing up, and if we came back here we would like to meet up with her.
The story of how the surrogacy industry has boomed in Anand, also known as Indias milk capital, began in 2003 when Dr Patel arranged for surrogacy by a 44-year-old local woman, who wanted to lend her womb to her childless UK-based daughter. When the woman gave birth to test-tube twins her own genetic grandchildren it made headline news. Patel began to receive requests for surrogacy from India and abroad, and scores of local women signed up.
The 50 pregnant women at the clinic are mainly of lower caste and from impoverished nearby villages. The pay they can hope to receive following a birth is equivalent to over 10 years salary for rural Indians. At face value, the deal seems like a win-win situation. Childless couples receive a longed-for baby, while poverty-stricken women can finally buy a home or afford a good education for their own children, raising their status in Indias paternalistic rural communities. But is it really an equitable relationship, or an example of westerners exploiting the worlds poorest women by paying a fraction of the price that they would closer to home for what, at its most basic, is a womb for rent?
By some estimates, Indian surrogacy is already a £290m-a-year business. While the Akanksha clinic is transparent about treatments and charges, India has few laws to regulate surrogacy, which opens the door for unscrupulous agents to exploit both the surrogate mothers and desperate couples. If it is poverty that compels the women to put their bodies through the physical and emotional stress of pregnancy, how can this be fully their choice?
The ethics of hiring a poor woman to carry their child was something Alison and William thought through carefully. Its a difficult issue and everyone has to form their own opinion, says Alison. Obviously, the lady has to give up her life and body for nine months. Our surrogates children were much older, but I wouldnt have been 100% happy if shed had a three-year-old she had to leave behind.
If Id had a child by normal means, then I would probably think it was exploitation, says William. But I dont personally feel bad. These women are all adults and they know what theyre doing. The reason is mainly financial, and it gives them a chance to improve their lives. Are they being exploited? I dont think so. I do feel very sorry for the people here. Even the waiter in our hotel gets £200 a month, and you look at it and it just doesnt seem fair. Its the luck of the draw really, but can we solve the problems of the world?
It is hard, continues Alison, because obviously people who know us and our situation understand that this was our one opportunity, and we jumped at it. Whereas people who dont know the struggle weve been through might think, well, why have you done this?
They dont want to appear ungrateful, but some surrogate mothers admit that they would not take the risk if they had a choice. My husband took almost two months to convince me to do it, says Anandi, a 39-year-old about to give birth for an American couple. He said, Do it for your children. But I have very young children and I was worried about leaving them.
I will feel sad when I give away the child. I dont know if I will be allowed to have contact with it. My children want me to give the baby away; they dont want it at home. Nobody else knows about this. The village people would say bad things. Ive just said that Ive gone away for work, and I havent even told many of my relatives, only a few. They wouldnt understand.
Anandi had just moved from one of two confinement homes, where surrogate mothers live for the duration of their pregnancies. They may leave the gated premises only for hospital check-ups, and their husbands and children are allowed to visit on Sundays. This is to protect the baby, explains Hitesh Patel. If they stay at home, we dont know what theyre doing. They might be working. Are they eating a balanced diet and taking proper rest? The surrogates also enjoy staying at the homes, he maintains. For the women its like a paid holiday.
The laid-back atmosphere in both homes would appear to support his claim. They have very basic facilities, peeling walls and sparse furniture. The women sleep in single beds, three to a tightly packed room. There are small shrines for prayers and a TV for entertainment, although with only plastic chairs or the floor to sit on. Posters of Jesus, the Hindu god Ganesha and babies adorn the walls. This may sound far from luxurious, until you compare it with their own mud homes, many of which lack basic bathroom facilities. And while, at home, they wait hand and foot on their families, here they float around in colourful gowns, chatting, reading or sleeping, appearing content. Their confinement also provides them with an escape from the questioning glances of curious neighbours who would regard their growing bellies as shameful.
Pushpa, a 33-year-old mother of three, is five months pregnant with her second surrogate baby. Her first, a girl called Sivi destined for an Indian couple from Benares, paid for an outdoor latrine and plastering of her familys two-room village hut. The two surrogacies will pay for the education of her children. The eldest, Hirem, 15, wants to be an IT software engineer, and her middle daughter, Hina, 13, wants to be a teacher professions that will pull both children out of a generations-long cycle of poverty.
Im very proud that my three children are studying well. I want them to become whatever they want to be, says Pushpa.
Her 47-year-old husband, Francis, who initially talked her into the idea, is equally proud of his wife. I earn 100 rupees [£1.46] a day in a local factory. My wife is now earning much better than me, he says with a wide smile.
Pushpa, however, is still dealing with the consequences of her sacrifice. She gave her first surrogate daughter away in December 2008 after a caesarean birth and longs to see her. Her husband, who was present at the handover, recalls Pushpas tears, and how the babys tiny hand clutched her blouse.
I was nursing her in the hospital for 10 days and the couple visited her every day, Pushpa says. They call every 15 days. If the baby is crying or laughing, then they put the telephone next to her so that I can hear. I have the same love for the child in Benares that I have for my own children. I feel like crying when I hear the childs voice it makes me feel bad. But I would never tell them that I want to meet the child, as she is theirs. I gave her away and I wont force them.
Pushpa is clearly missing her own children. Although they can visit her every Sunday, the eldest two are caught up in revising for exams. Hina is now in charge of the household and must take care of the cooking and chores.
Sumita, aged 32, is in the sixth month of her first surrogacy, and she too is nervous about handing the baby over. As she speaks, her five-year-old daughter, Janisha, clings to her hand and her gown. Janisha has become more withdrawn and has lost weight since her mother left the family home.
I decided to do this for the education of my children, Sumita explains. I am currently spending 500 rupees [£7.32] a month to send them to a government school, but I want to send them to a private school. It costs 1,000-1,500 rupees a month for a good Christian school. I met the couple and it felt good. They were from Mumbai and were nice to me. They told me they would allow me to talk to the child and would keep in touch. I am very happy about that.
The rest of the article in the link below.
Inside India's international baby farm - Times Online
Cradling her baby, Oliver, Alison, 31, happily strokes his head, holds his hands and feeds him from a bottle, like any proud new mother. But for the Australian primary-school teacher and her 35-year-old British husband, William, the birth of their son has followed a long and desperate medical struggle in which both had almost given up hope of having a child.
William and Alison live in London, but Oliver was born here, in Anand, Gujarat, in a clinic filled with barefoot women in flowing saris, in a remote rural community in India. It was an unusual entry into the world, but Olivers entire conception had been far from ordinary. The tiny boy, born five weeks prematurely, was conceived through an egg donor and in-vitro fertilisation; he was carried by an Indian surrogate mother whom his parents had met just two days before his birth.
Oliver was born to a woman from Anand, a small town at the forefront of Indias booming reproductive tourism market, where foreign couples flock for infertility treatments. The chaotic, dusty backwater, where rickshaws, cows and street vendors swirl around each other in the punishing midday sun, has earned the nickname the cradle of the world.
Since 2003, 167 surrogate mothers have successfully given birth to 216 babies at the Akanksha Infertility Clinic, run by Dr Nayana Patel and her husband, Hitesh.
Around 50 surrogates are pregnant currently, making Anand one of the biggest surrogacy hubs in Asia. For Alison, the clinic offered a last hope after IVF failed. I didnt have any eggs, she says, so my sister was my donor. We had five attempts at IVF three failures, a miscarriage and an ectopic pregnancy. We were told to give up.
Our doctor at the time suggested surrogacy, but I dismissed it, says William. We would need an egg donor and a surrogate mother, so I was resigned to a life without children although you never give up hope.
Alison first contacted Dr Patel, a glamorous woman in her late forties, in August 2008, and the couple flew from their London home to India in January last year to begin the first round of treatment. Although their arrival in the developing country was a culture shock, they say: The technology is really good, the expertise is first-class, and the customer service is excellent. They paid around £14,300 for the surrogacy package, of which between £4,250 and £4,900 would go to the surrogate mother. Volunteer surrogates receive £30 a month up to delivery, plus £390 at three and six months, and the whole amount at delivery, regardless of the outcome.
Usually, in the first stage of surrogacy, the wifes ovaries are stimulated to produce eggs through hormone treatment. After 9 to 11 days of hormone injections, the eggs are extracted and fertilised with the husbands sperm. Two days later, if all goes according to plan, some of the resulting embryos will be implanted in a surrogate mother. In Alisons case, the eggs were retrieved from an anonymous donor the couple were told only that she was 26, and were given a detailed report of her medical history. The donor would have received around £150-£250 for this uncomfortable procedure which can cause side effects similar to those of the menopause such as hot flushes and night sweats.
After the embryos are implanted, there is a two-week wait to find if any have resulted in a pregnancy. According to the UK Human Fertilisation and Embryology Authority, the live birth rate for IVF is just 20% per treatment cycle, so it was a disappointment, but not a total shock, when the first surrogate mother lost the baby at eight weeks. As embryos had already been created and frozen, Alison and William did not return to India for the next two attempts at implantation. Their successful surrogate mother was 35 and, according to clinic rules, was married, a mother herself with a good obstetric history. You get lots of updates, month to month, says Alison. There are the scans, and they do a baby shower for the surrogate mother in the seventh month. Its sort of like a blessing of safe passage.
When news came that Oliver would be premature, the couple rushed to be present for the birth. We all went together for a scan. It was exciting, says Alison. Meeting the surrogate mother for the first time was quite unnerving. Because we dont speak Gujarati, I think we spent most of the time smiling and nodding and trying to have a very basic conversation.
The birth was quick after Oliver lodged himself in a breach position and a caesarean was performed. The first time she held him, about three minutes later, Alison was terrified. He was having some breathing difficulties at the time. The paediatrician was here, rushed him to hospital, and I didnt get to hold him again for another two or three days because he was on oxygen and being tube-fed. So it felt strange. The first experience was very nerve-racking, but after that it was really nice to finally get to hold him.
The surrogate mother visited Oliver while he was in the intensive-care unit, and nursed him with her own breast milk. You seem to develop a way of communicating, says Alison, adding that the moment of the final handover went more easily than expected. I think she knew the reason why we were doing this, and she was prepared for the fact that he was coming home with us. Shed come and say hello and hold him for a little while, but she did seem to keep a little distance. I think she needed to do that to help herself, because it could be really hard to carry the baby for eight or nine months and then say goodbye. Alison and William promised to stay in touch with her. Wed like to send a Christmas card and photos to show her how he is growing up, and if we came back here we would like to meet up with her.
The story of how the surrogacy industry has boomed in Anand, also known as Indias milk capital, began in 2003 when Dr Patel arranged for surrogacy by a 44-year-old local woman, who wanted to lend her womb to her childless UK-based daughter. When the woman gave birth to test-tube twins her own genetic grandchildren it made headline news. Patel began to receive requests for surrogacy from India and abroad, and scores of local women signed up.
The 50 pregnant women at the clinic are mainly of lower caste and from impoverished nearby villages. The pay they can hope to receive following a birth is equivalent to over 10 years salary for rural Indians. At face value, the deal seems like a win-win situation. Childless couples receive a longed-for baby, while poverty-stricken women can finally buy a home or afford a good education for their own children, raising their status in Indias paternalistic rural communities. But is it really an equitable relationship, or an example of westerners exploiting the worlds poorest women by paying a fraction of the price that they would closer to home for what, at its most basic, is a womb for rent?
By some estimates, Indian surrogacy is already a £290m-a-year business. While the Akanksha clinic is transparent about treatments and charges, India has few laws to regulate surrogacy, which opens the door for unscrupulous agents to exploit both the surrogate mothers and desperate couples. If it is poverty that compels the women to put their bodies through the physical and emotional stress of pregnancy, how can this be fully their choice?
The ethics of hiring a poor woman to carry their child was something Alison and William thought through carefully. Its a difficult issue and everyone has to form their own opinion, says Alison. Obviously, the lady has to give up her life and body for nine months. Our surrogates children were much older, but I wouldnt have been 100% happy if shed had a three-year-old she had to leave behind.
If Id had a child by normal means, then I would probably think it was exploitation, says William. But I dont personally feel bad. These women are all adults and they know what theyre doing. The reason is mainly financial, and it gives them a chance to improve their lives. Are they being exploited? I dont think so. I do feel very sorry for the people here. Even the waiter in our hotel gets £200 a month, and you look at it and it just doesnt seem fair. Its the luck of the draw really, but can we solve the problems of the world?
It is hard, continues Alison, because obviously people who know us and our situation understand that this was our one opportunity, and we jumped at it. Whereas people who dont know the struggle weve been through might think, well, why have you done this?
They dont want to appear ungrateful, but some surrogate mothers admit that they would not take the risk if they had a choice. My husband took almost two months to convince me to do it, says Anandi, a 39-year-old about to give birth for an American couple. He said, Do it for your children. But I have very young children and I was worried about leaving them.
I will feel sad when I give away the child. I dont know if I will be allowed to have contact with it. My children want me to give the baby away; they dont want it at home. Nobody else knows about this. The village people would say bad things. Ive just said that Ive gone away for work, and I havent even told many of my relatives, only a few. They wouldnt understand.
Anandi had just moved from one of two confinement homes, where surrogate mothers live for the duration of their pregnancies. They may leave the gated premises only for hospital check-ups, and their husbands and children are allowed to visit on Sundays. This is to protect the baby, explains Hitesh Patel. If they stay at home, we dont know what theyre doing. They might be working. Are they eating a balanced diet and taking proper rest? The surrogates also enjoy staying at the homes, he maintains. For the women its like a paid holiday.
The laid-back atmosphere in both homes would appear to support his claim. They have very basic facilities, peeling walls and sparse furniture. The women sleep in single beds, three to a tightly packed room. There are small shrines for prayers and a TV for entertainment, although with only plastic chairs or the floor to sit on. Posters of Jesus, the Hindu god Ganesha and babies adorn the walls. This may sound far from luxurious, until you compare it with their own mud homes, many of which lack basic bathroom facilities. And while, at home, they wait hand and foot on their families, here they float around in colourful gowns, chatting, reading or sleeping, appearing content. Their confinement also provides them with an escape from the questioning glances of curious neighbours who would regard their growing bellies as shameful.
Pushpa, a 33-year-old mother of three, is five months pregnant with her second surrogate baby. Her first, a girl called Sivi destined for an Indian couple from Benares, paid for an outdoor latrine and plastering of her familys two-room village hut. The two surrogacies will pay for the education of her children. The eldest, Hirem, 15, wants to be an IT software engineer, and her middle daughter, Hina, 13, wants to be a teacher professions that will pull both children out of a generations-long cycle of poverty.
Im very proud that my three children are studying well. I want them to become whatever they want to be, says Pushpa.
Her 47-year-old husband, Francis, who initially talked her into the idea, is equally proud of his wife. I earn 100 rupees [£1.46] a day in a local factory. My wife is now earning much better than me, he says with a wide smile.
Pushpa, however, is still dealing with the consequences of her sacrifice. She gave her first surrogate daughter away in December 2008 after a caesarean birth and longs to see her. Her husband, who was present at the handover, recalls Pushpas tears, and how the babys tiny hand clutched her blouse.
I was nursing her in the hospital for 10 days and the couple visited her every day, Pushpa says. They call every 15 days. If the baby is crying or laughing, then they put the telephone next to her so that I can hear. I have the same love for the child in Benares that I have for my own children. I feel like crying when I hear the childs voice it makes me feel bad. But I would never tell them that I want to meet the child, as she is theirs. I gave her away and I wont force them.
Pushpa is clearly missing her own children. Although they can visit her every Sunday, the eldest two are caught up in revising for exams. Hina is now in charge of the household and must take care of the cooking and chores.
Sumita, aged 32, is in the sixth month of her first surrogacy, and she too is nervous about handing the baby over. As she speaks, her five-year-old daughter, Janisha, clings to her hand and her gown. Janisha has become more withdrawn and has lost weight since her mother left the family home.
I decided to do this for the education of my children, Sumita explains. I am currently spending 500 rupees [£7.32] a month to send them to a government school, but I want to send them to a private school. It costs 1,000-1,500 rupees a month for a good Christian school. I met the couple and it felt good. They were from Mumbai and were nice to me. They told me they would allow me to talk to the child and would keep in touch. I am very happy about that.
The rest of the article in the link below.
Inside India's international baby farm - Times Online
