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Reproduction dilemma

Neeta Lal (Spotlight) / 5 August 2012

WANTED: A fair, good-looking, educated, healthy lady, preferably a Brahmin of 20-30 years of age in Chennai with a good background for egg donation.”

If this ad – which mimics the millions of matrimonial ads that flood Indian newspapers—in a women’s magazine, doesn’t amplify the crass commercialisation that drives the country’s $500-million fertility industry, then perhaps the following recent episodes will.

In May, Premila Vaghela, 30 – who had agreed to become a surrogate mother for an American couple to supplement her family income—died in the eighth month of a surrogate pregnancy. The desperately poor mother of two underwent a routine check-up at an IVF (in vitro fertilisation) clinic in Ahmedabad (Gujarat) following which she suffered a convulsion, collapsed and died.

Sushma Pandey, barely 17 years old, reportedly died due to procedures related to egg harvesting conducted on her by a clinic in Mumbai. Two years after her death, the Bombay high court last week pulled up the police for not prosecuting the clinic for its blatant violation of the age requirement for women donors set out by the rules of the Indian Council of Medical Research.  

Neither Sushma nor Premila are with us today to tell us about the exact circumstances that drove them into these murky commercial dealings. But their untimely deaths do raise chilling questions about the use and abuse of assisted reproductive technologies by the fertility industry.

Both cases, while now reduced to being cold statistics in the annals of medical history, underscore the glaring deficit of laws governing the industry. Dubbed as the “surrogacy capital of the world”, India’s fertility industry (growing at seven per cent annually), is poised to become a whopping US$2.3 billion enterprise by 2015, according to the Confederation of Indian Industry.

Indian physicians now oversee an estimated 2,000 surrogacy births a year for domestic and overseas couples. For thousands of childless couples from the West — including the US, the United Kingdom and Canada — faced with an inability to conceive and the legal and fiscal bottlenecks that involve surrogacy in their native countries, the low-cost surrogacy options in India are a boon.  Driving the demand for Indian surrogates amongst infertile couples in industrialised nations, are Indian’s unique advantages as a low-cost surrogacy destination, mushrooming ART clinics, the easy availability of poor surrogate mothers and of course, its pliant laws.

Most Indian IVF clinics have a strong Internet presence, which helps them lure overseas patients. The demand for Indian surrogate babies is growing at home too, as India hosts 14 per cent of the world’s estimated 80m infertile couples.

Due to the spiraling demand, the trade is dominated by unscrupulous middlemen who entice and push marginalised women into surrogate motherhood. There’s no protection against the misuse of a surrogate child for purposes of terrorism, prostitution or unethical genetic engineering research either. Ethical questions about leveraging a woman’s social and economic vulnerability to commercially exploit her womb as a commodity and make handsome profits are also of concern.

Such insouciance is especially unpardonable in a country which has a staggeringly high maternal death rate. In 2010, India accounted for 19 per cent of the estimated 287,000 women who died in pregnancy and childbirth, according to the United Nations. According to a 2011 survey by a city-based non-governmental organisation, Center for Health Education, Training and Nutrition Awareness, a childbearing mother dies every eight minutes in India.

The draft bill in India dealing with the use of ART has been in cold storage since 2008. The bill itself isn’t without its share of flaws. But it can help the stakeholders avoid some of the pitfalls of unregulated commercial surrogacy while acting as a deterrent for unconscionable business transactions. Had that been the case, both Premila and Sushma would have been amongst us today.

Neeta lal is a freelance journalist based in New Delhi



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