Mailorder Wombs: Outsourcing Birth to India

So much of America's economic activity takes place on faraway shores,
from call centers in Mumbai to sweatshops in Shanghai. Still, you'd
think that making a baby would be one job that's hard to offshore. But
today, for a fee, a woman in another country can serve as a "gestational surrogate," carrying a fertilized egg
to term and then delivering the baby straight to your door, halfway
around the world. We're not used to talking about that kind of labor as
an outsourced job. But farmed-out childbirth has become a full-fledged industry in India, turning the rural
poor into wombs for hire.

The practice has become increasingly common with new advancements in
in-vitro fertilization. The efficiency of the technology raises ethical, legal and cultural questions about the meaning of parentage.

Like Autotune and drone warfare, the transaction might feel
disturbingly mechanized: someone, an infertile couple, for example,
creates an embryo in a lab, ships it abroad for gestation in a
stranger's body, then takes possession again after birth. But in a
consensual financial arrangement, what's the big deal, really? There's
less (but still some) stigma surrounding child care
services, though that also involves contracting out the duties of
motherhood.

But maybe what makes the global surrogacy market so different is that the
service providers are women in poor countries who feel compelled to lease their bodies to care for
their own families.

In a parallel to the international adoption controversy, the potential
for coercion is pervasive: To what extent are impoverished surrogates
really free to negotiate their labor, especially if they are controlled
by a childbirth clinic that regularly processes "recruits" into a $445
million industry.

Nicole Bromfield at RH RealityCheck describes
the dynamics of the "recruitment" of rural Indian women:

In some of the Indian clinics, the surrogates are recruited
from rural villages, with most recruits being poor and illiterate.
Surrogacy recruits are brought to the clinics where they are required to
stay in the clinic's living quarters in a guarded dormitory-like
setting for the entire pregnancy. Supposedly this practice not only
allows the clinics to monitor the surrogates' activities and behaviors
during the pregnancy, but also is seen as protecting the surrogate from
ridicule by family members and neighbors; most Indian women acting as
surrogates keep it a secret because it is seen as dirty or immoral. What
is alarming about the recruiting process is that it is notably similar
to the recruitment process used by human traffickers to coerce rural
women into sex work in cities. Also similar to other trafficking
situations, the women have to sign documents (often in English) that
they cannot read and then are kept "under lock and key" until the
obligations set forth in the contract are fulfilled. Most surrogacy
contracts prohibit sexual contact between surrogates and their husbands
and surrogates are generally allowed only minimal contact with their
partners in any case.

This regulation of the bodies of surrogate women (typically young,
impoverished, and of color) challenges common assumptions about
individual rights in the global labor market. Even outside the ethical
debate on surrogacy itself, there's a clear need for government
oversight to ensure that both the women, and the babies they are
commissioned to bring into the world, are protected from abuse.

Noting that some families have faced legal disputes over the
citizenship of global-surrogate babies, Bromfield writes, "it is
imperative that global standards be developed and the USA, European, and
other nations take an active role in setting requirements. This can be
done under rights of citizenship and immigration."

As with most global trades, it all comes down to price: Bromfield
reports, "Surrogacy costs about $12,000 to $20,000 per birth in India,
whereas in the U.S., it is upwards of $70,000 to $100,000." A rural
Indian woman may earn roughly $5,000 to $7,000 from the surrogate
pregnancy, far more than a regular low-paying job. But the easy flow of money across borders underscores
another ethical quagmire. The same pattern emerges in global migration:
wealth crosses national boundaries and products flow back the other way,
but the movement of workers and families is brutally restricted. For
better or worse, transnational surrogacy challenges us to reconcile
human relations with commercial transactions in the global marketplace.