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Babies Outsourced as Reproductive Tourism

Doctor hails 'reproductive tourism' as Indians make outsourced babies

Paul Peachey

ANAND, India --  After giving birth to healthy twins, Mrs A, a young Indian woman, handed them to a US-based couple knowing that she was unlikely to see them again. "Her parents never knew what she was doing," her mother-in-law confides. "She told them she had a baby boy but he passed away."

Mrs A, 27, is part of India's most prolific family of surrogate mothers, something that although not unlawful has to be kept a secret in this conservative country.

Two sisters and their sister-in-law, Mrs A - all mothers with their own children - gave birth to babies last year and passed them to childless couples. Another sister is waiting her turn.

In return for this "noble cause" they earn more than 100,000 rupees ($2,250) for each pregnancy, a comparatively huge sum since one of their working husbands earns about $5 a day. It will pay for their children's education and home renovations.

But it comes at a cost. For the sake of financial security, the life of India's new breed of professional surrogate mothers means lies, secrecy and often nine months hiding from disapproving eyes.

The births have caused a social shift in the small town of Anand in western Gujarat province. In the last two years, six women in the town, population 150,000, and surrounding villages have acted as surrogates, three of them for US-based Indian couples.

Two women are pregnant and seven more have been recruited, yet all are desperate to remain anonymous since fellow villagers might assume "immoral" acts have taken place.

Many women in India are sterilized after having children, but willingness to help other couples and the money that it can bring them is changing the attitudes of some.

"My first professional surrogate's husband had lots of problems. They had huge debts then she heard this and said: 'I don't mind doing it'," says Dr. Nayana Patel, who runs the Akanksha infertility clinic and is mentor and protector of the women. "They had re-mortgaged their house but she got it back."

She says that the program is for the "upliftment" of Indian women and says that the country can become a center of "reproductive tourism".

India's health industry is already slated to be worth $2.3 billion by 2012 by performing cheap surgery for foreigners.

Patel says that she has not received any complaints about the practise but has had many e-mails from the United States and Britain, including white couples, lured by the prospect of a surrogate child for some $5,000 compared with some $40,000 in the United States.

Overseas-based Indians are comforted since the surrogate mother has the same cultural background and has few rights to the child once it is born, according to Patel.

Industry guidelines brought out last year to regulate the work of the country's 250 or so IVF clinics estimated that up to 19 million couples in India were likely to be infertile. Hardly any of the clinics are involved in surrogacy work. But with booming India creating new middle-class couples able to pay for fertility treatment, the demand for surrogates is also increasing.

A high-profile case of a woman who gave birth to her own grandchildren on behalf of her UK-based daughter in 2004 was responsible for making this tobacco-growing area the surrogate center of India.

There is no law here now on surrogacy but national guidelines from 2005 are expected to be enshrined in legislation in the next few months, according to the Indian Council of Medical Research (ICMR).

In addition to expenses, the guidelines state the "surrogate mother would also be entitled to a monetary compensation from the couple" to be decided during talks between the two parties. But Dr. R.S. Sharma, deputy director general of the ICMR, said that debate continued over how much surrogate mothers could receive.

Hearing of the potential to earn relatively large sums has seen the odd inquiry from local women turn into daily visits from hard-pressed mothers.

There are childless couples to provide the demand. Patel says that she has heard from a couple in the northern city of Lucknow who have been searching for 16 years for a professional surrogate, and gets regular referrals from doctors in the western economic city of Mumbai.

"The problem is that people are operating in a legal vacuum," says Dr. Aniruddha Malpani, director of the Malpani Infertility Clinic. "Even if there was legal protection, if there was a legal dispute the child would be about 10 years old before it gets resolved," he says, referring to the slow pace of Indian courts.

Any reservations from Mrs A's family were swept away by the conviction of her ebullient mother-in-law, a former assistant in a hospital gynecological unit.

"This is the one occupation that gives you one lakh [100,000] rupees," she says. "A husband at a factory getting 1,000 rupees a month won't pay for household items and education for the children."

Eggs are fertilized before they are implanted in the women. Patel says that she will not allow women to use their own eggs, in case they became too emotionally attached to the babies.

"I cried a lot while I gave away the baby," says one of the sisters, Mrs. B, 26, who gave birth to a baby girl for an American couple three months ago. "I told the couple, I've preserved her for nine months, I have delivered her safely. Now please take care of her and I hope she'll take care of you when she's older."

Mrs B, married with a son and a daughter of her own says that she plans to do it again. But she knows that there are many who will not approve.

"For nine months she will be totally cut off in another world," says her mother. "She won't leave the house. When the doctor calls her for consultation she will come here but the family won't come to the house. I have taken responsibility for this."

Two other women also told of their struggles to keep their pregnancies secret but said that they were proud of what they had done.

"We are not publicly coming out because of the social stigma," a woman who is heavily pregnant with a baby due next month said as her four-year-old son cuddled up to her. "We are trying to hide ourselves away from the society in the same way that the people who are going to take them away want to keep a low profile. But we're happy because this is a noble cause."