"Make Me a Baby As Fast As You Can" India International Surrogacy

Reproductive tourism or reproductive trafficking, it has many names. Rally can call it a lot of things too, but that would violate our own terms of service. .

From Make Me a Baby As Fast As You Can [Slate 1/9/12 by Douglas Pet]:

“The booming business in international surrogacy, whereby Westerners have begun hiring poor women in developing countries to carry their babies, has been the subject of plenty of media buzzing over the past few years. Much of the coverage regards the practice as a win-win for surrogates and those who hire them; couples receive the baby they have always wanted while surrogates from impoverished areas overseas earn more in one gestation than they would in many years of ordinary work.”

“But make no mistake: This is first and foremost a business. And the product this business sells—third-party pregnancy—is now being offered with all sorts of customizable options, guarantees, and legal protections for clients (aka would-be parents). See for example the December 2010 Wall Street Journal article “Assembling the Global Baby,” which focused on high-profile PlanetHospital, a Los Angeles-based medical tourism company that has become one of many one-stop-shops for overseas surrogacy and that is going to great lengths to woo customers. “We take care of all aspects of the process, like a concierge service,” company founder Rudy Rupak told the Journal.

The Journal article didn’t go into much detail about how surrogates’ rights might figure into this “concierge service.” But interviews with those running the operation, information that was available on PlanetHospital’s website until it was redesigned last year, and an information packet called “Results Driven Surrogacy” that the company distributes to prospective clients, begin to fill in the picture. The version of the packet that PlanetHospital sent me in July assures clients that each surrogate is “well looked after.” Surrogates spend “the entire duration of the pregnancy at the clinic or a guest house controlled by the clinic” where their habits, medications, and diets are carefully regimented and monitored. PlanetHospital promises clients that when surrogates have a history of smoking, “we make sure they do not suddenly get a craving for it during pregnancy.”

Like most other surrogacy clinics and brokers, PlanetHospital accepts only surrogates who already have children of their own. While the usual reasoning for this sort of requirement is that having children proves a woman can safely carry a pregnancy to term, PlanetHospital’s literature notes that the policy also ensures that she does “not bond with your baby.”

“India Bundle” Package

” In addition, PlanetHospital offers customers a novel means of accelerating their bid for a family: The option of having embryos implanted into two surrogates at the same time. The selling points of this package (which was previously marketed under the name “India Bundle”): Implantation in two surrogates at a time increases the chance of immediate impregnation and decreases the waiting time for a baby. As the company’s website used to explain:

PlanetHospital innovated the idea of routinely performing IVF on two surrogates simultaneously thus increasing the odds of pregnancy by more than 60%. The notion of hiring two surrogates in the US and doing IVF on both surrogates would be financially prohibitive, PlanetHospital has negotiated rates with a highly reputable clinic in India that not only provide couples with two surrogates, but also four attempts.

Of course, this approach could also leave a couple with multiple babies, possibly gestating in multiple women. Until recently, if both surrogates became pregnant—or if either surrogate became pregnant with twins—clients could opt to have the extra pregnancy aborted or twins reduced to a singleton, depending on how many babies the clients wanted or decided they could afford. As PlanetHospital’s website used to explain, “The simple answer to that is it is up to you to decide what you wish to do, you can choose to have all the children (which will cost slightly more of course…) or you can request an embryo reduction.” Founder Rudy Rupak told me via email that the company no longer allows clients to elect either reductions or abortions under the advice of its lawyers, who worry that it could open up some “nasty debates” as Indian authorities discuss the possibility of surrogacy regulation. “If a client wants both surrogates then they have to accept it if both are pregnant,” he wrote.”

The ONLY reason this is not offered anymore is to AVOID REGULATION. Have we as a society hit rock-bottom yet?

Pricing

“According to the pricing information PlanetHospital provided me, the company’s cheapest package for a single surrogate pregnancy is $28,000. To use two surrogates simultaneously, clients pay an initial $15,500, plus $19,600 for each surrogate that gets pregnant and delivers a baby. (And if one or more surrogate ends up carrying twins, clients pay a surcharge of at least $6,000 per twin.)

Of those amounts, PlanetHospital’s Indian surrogates are paid between $7,500 and $9,000. By comparison, the cost of a single surrogate pregnancy in the United States can run up to $100,000 including medical expenses, of which about $20,000 goes to the surrogate. Rupak emphasized the extent to which Indian surrogates stood to benefit from the arrangement. “While some people might scream exploitation,” he wrote to me in an email, “bear in mind that the per capita average income of a typical [Indian] surrogate would be $600/annum. She is thus making close to 12x her annual salary by being a surrogate.”

It is worth looking beyond economic comparisons, however, to see how such transactions may compromise surrogates’ choices. For example, if one of PlanetHospital’s Indian surrogates wants to abort her own pregnancy, she is out of luck. The company’s vice president of corporate affairs and business development, Geoff Moss, recently told me:“If they feel like terminating the pregnancy, they can’t do that; there is a legal contract.” He also suggested that surrogates would not want to take that step even if it were available to them: “They have children at home,” he said, “so they understand how important it is for these people to be parents.”seems unlikely that PlanetHospital’s prohibition on surrogate-elected abortions would fly in the United States. George Annas, chair of the department of Health Law, Bioethics & Human Rights at Boston University’s School of Public Health, told me via email that he believes “there is no way a competent adult woman could prospectively waive her constitutional right to terminate (or not) a pregnancy (or selectively reduce one) that would be upheld by a U.S. court.” It would appear, then, that Western surrogacy brokers benefit by looking across borders not just because it allows them to locate cheap “labor” but also because some arrangements may face less legal scrutiny than they would in the United States. Moss confirmed that legal differences between the two countries make India an attractive location for surrogacy. “In the United States, in many cases, there will be surrogates all of a sudden saying that they want to keep the baby,” he said, “In India it’s all contractual.”

Forced C-Sections

“The surrogates’ lack of control over the course of their pregnancies continues through delivery day. According to PlanetHospital’s information packet, “All the surrogates will deliver the child through cesarean birth.” Moss explained one reason for this policy: “Because we can time it that way for the intended parents to be there for the birth. That way if the baby is going to be born on Dec. 10, the parents can make their travel arrangements, fly to India, and be there to receive the baby when it’s born.” The information packet adds another reason: C-sections are “much safer for the child and the surrogate.” Rupak told me that while surrogates can refuse the operation and delivery naturally, PlanetHospital had been advised by independent obstetricians that routine Cesarean delivery was the safest choice. Women’s health experts and advocates would likely disagree, as many believe C-sections to be riskier to both mother and baby in the absence of other complications. The procedure also makes vaginal birth more hazardous in subsequent pregnancies and could therefore endanger the lives of low-income surrogates who may not have access to hospital care for future deliveries.”

About those negative reviews….

“PlanetHospital’s information packet ends with a note cautioning prospective clients not to make too much of any negative reviews of the company that they might find on the Internet. “[S]urrogacy is a very emotional matter,” the packet explains. “This is not a matter of buying a car, this is a life you are asking us to help you create.” But while we can probably all agree that ordering up a child is nothing like buying a car, PlanetHospital goes on to draw an equally unlikely parallel between its business and that of a well-known purveyor of mail-order shoes. “Like Zappos,” the note concludes, “we too want to ‘deliver happiness’ and maintaining our integrity is the most important part of that mission.”

Not mentioned in the article is the documented trouble with obtaining visas for the newborns.

The author does not seem to be aware that there are regulations underway for international surrogacy. We are not holding our breaths on any positive impact of that since the international adoption regulations sure don’t prevent corruption and trafficking. We covered the Hague Conference on international surrogacy here.

We discussed the booming surrogacy market in India last June here.

REFORM Puzzle Piece

Rally calls it like she sees it. You can disagree, but this is unmasked baby selling.