Surrogacy in India

One more reason to work with medical tourism agencies which have partnership with IVF clinics in countries with favorable laws.

India’s Rent-a-Womb Industry Faces New Restrictions

By HILLARY BRENHOUSE Hillary Brenhouse – Sat Jun 5, 6:50 pm ET

Since the day they were delivered more than two years ago, twin toddlers Nikolas and Leonard Balaz have been stateless and stranded in India. Their parents are German nationals, but the woman to whom the babies were born is a twentysomething Indian surrogate from Gujarat. The boys were refused German passports because the country does not recognize surrogacy as a legitimate means of parenthood. And India doesn’t typically confer citizenship on surrogate-born children conceived by foreigners. Last week Germany relented, turning over travel visas, and the entire Balaz family is finally going home – though only after a long legal battle that took them deep into the convoluted world of inter-country adoption.

“We can only wish them good luck,” India’s Supreme Court told local media. But it also reiterated the urgent need for legislation to regulate one of India’s fastest-growing industries. Hundreds of foreign tourists spill into the country every year to hire women to incubate their children. India has become the world capital of outsourced pregnancies, whereby surrogates are implanted with foreign embryos and paid to carry the resultant babies to term. In 2002 the country legalized commercial surrogacy in an effort to promote medical tourism, a sector the Confederation of Indian Industry predicts will generate $2.3 billion annually by 2012. Indian surrogate mothers are readily available and cheap. Unlike most countries in which surrogacy is lawful – and bucking the norm in heavily bureaucratic India – the procedure can take place without reams of government red tape. (Read ‘India’s Medical Emergency.’)

That may soon change. A draft bill to direct assisted reproductive technology (ART) is likely to be introduced this year in Parliament. The new legislation will beef up surrogacy guidelines authored by the Indian Council of Medical Research (ICMR) that have often gone unheeded by the few hundred Indian fertility clinics accustomed to writing their own rules. Among them is the Akanksha Infertility Clinic in the town of Anand, in the western state of Gujarat, where the Balazs found themselves. “We are lost when there are no laws,” says Akanksha medical director Dr. Nayna Patel, who has become the face of the industry abroad since being spotlighted on the Oprah Winfrey Show in 2007. “But the people drafting the bill have to remember to take care of the clinics, too.”

Patel chooses among the women who appear at the clinic, at least three a day, hoping to hire out their wombs. She pairs the surrogates with infertile couples, catering to an increasingly international clientele base – from 13 foreign couples in 2006 to 85 in 2009. And she oversees the negotiations between them. The entire process costs customers around $23,000 – less than one-fifth of the going rate in the U.S. – of which the surrogate mother usually receives about $7,500 in installments. Patel implants the women with embryos, using specimens from sperm or egg donors if necessary. Once pregnant, the surrogates are housed onsite until delivery, in a dormitory that was once a local tax office, so that they can be supervised. But under the new legislation, Patel will be permitted to supervise nothing but surgery. (Read ‘Can One Pill Tame the Illness No One Wants to Talk About?.’)

The new proposed government bill bans in-vitro fertilization (IVF) clinics from brokering surrogacy transactions. It also calls for the establishment of an “ART bank” that will be responsible for locating surrogate mothers, as well as reproductive donors. Fertility clinics will only come into contact with surrogates on the operating table. “We need to create a safe distance between the clinic and the surrogate to avoid unethical practices,” says Dr. R.S. Sharma, deputy director general of the ICMR and member-secretary of the bill’s drafting committee. “IVF clinics should only be concerning themselves with science.”

It’s a suggestion that has caused a stir in the medical community. Dr. Patel insists that she will not accept a surrogate sent to Akanksha unless she herself is permitted to perform medical and background checks. She maintains that ART banks will not have enough experience to determine whether a woman is fit for surrogacy, let alone to replicate the personal bonds she cultivates with her surrogates. “The trust they have with me is what makes the whole thing secure and safe,” she says. “And at the end, when they want to buy a house or a piece of land for farming, we get them the best deal. With this bill, we will not know what they are going to do with such a big amount of money.”

Indeed, surrogate mothers are likely to enjoy an unprecedented autonomy. They’ll have more freedom in negotiating their fee and receive mandatory health insurance from the couple or single employing them. Firm legal standards will ensure that medical professionals only be permitted to implant three embryos in a woman’s uterus per attempt. (The American Society for Reproductive Medicine advises doctors to implant just one; until recently, Dr. Patel routinely used five at a time, aborting anything more than two fetuses.) The legislation will only allow a woman to act as a surrogate up to five times, less if she has her own children, and will impose a 35-year age limit. That way, ladies motivated by desperation won’t be able to put themselves at risk.

In a push to avoid cases similar to the Balaz family debacle, the bill will also make things more challenging for foreign customers. The new legislation will require that the international couple’s home country guarantee the unborn infant citizenship before a surrogacy can even get off the ground. Such a stipulation will certainly not go over with Germany. “In fact, I’m not sure if any country will be ready to pledge citizenship before birth,” says Amit Karkhanis, a prominent Mumbai surrogacy lawyer. Countries accepting of surrogate-born children typically rely on DNA tests done post-delivery to determine the parentage of the baby.

Same-sex couples – a growing number of whom are relying on Indian surrogates – may not even make it as far as a plea for a government pledge. Just last year, Delhi’s High Court overturned a section of the penal code outlawing “carnal intercourse against the order of nature,” and the status of gays and lesbians in the country remains unclear. “Tomorrow, if the government outlaws gay relations,” says Sharma of the bill’s drafting committee, “then we will not allow gay couples to hire surrogates. The law of the land will be followed so far as this issue is concerned.”

When Australian partners Trevor Elwell and Peter West visited the country nearly two years ago, only one clinic was open to providing them surrogacy services. Now, with their surrogate-born twin girls a year old and their third baby incubating in Mumbai, Elwell estimates that a half-dozen Indian IVF clinics cater to homosexual couples. The men have found it uncomplicated to use Indian egg donors. They’ve made the switch to a facility where their new surrogate knows they are gay, and is comfortable with it. And they attained Australian citizenship for their children in a process that took no more than a few weeks. For them, as for most who flock to India hoping for a baby, informal surrogacy guidelines have been a blessing. “If the bill does complicate things, people will go to another country,” Elwell says. “There will always be somewhere this can be done. This is just the beginning.”

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2 Responses

  1. What are the chances that a USA couple can buy a baby from clinic/surrogate mother and get the baby into the US without legal battles?

    If I understand correctly, a woman or couples might be able to get up to two babies on a case-by-case basis. Also a person/couple could potentially qualify if the person/people are between 50 & 55 years old.

    If a couple wants a baby do they need to be married? and, if they do, for how long?

    Might a woman qualify if she’s taken meds for anxiety/depression but has been very mentally healthy for several years? She’s never hurt anyone or herself.

    I didn’t comprehend totally the laws that are potentially changing.

    Could thorough paperwork re: all these terms/potential problems and law changes be sent to the USA woman/couple? Paperwork that a lawyer could advise us on?

    Thanks, in advance, for answering my questions knowledgably.

    • Mary, we will be delighted to answer your questions. However, before I answer your questions, I wanted to make it clear that our company does not work with IVF clinics in India. Neither do we work with surrogacy agencies in India. I am sure there are some good clinics and great fertility doctors in India. However, we don’t send our clients to India, because there are great fertility clinics closer to the U.S. Why send US clients to India, when you can get the same thing closer. With that in mind, let me share information about our surrogacy programs.

      >What are the chances that a USA couple can buy a baby from clinic/surrogate mother and get the baby into the US without legal battles?
      Your chances of bringing the baby into the US are 99.99%. Just today one of our prospective clients asked me the same question. I told him that clients using our IVF clinics in conjunction with the surrogacy program have not had any issues with brining the babies back to the United States. Can it happen? Perhaps. However, until now, there hasn’t been any problem.

      Mary, please also keep in mind that surrogacy programs are typically a staged process. That is, the adopting parents pay for the surrogacy in installments, as we move through the process. If you send us your email address, we’ll gladly share more detailed information with you. Moreover, you may also choose to use an escrow management account agency (http://www.themedvacation.com/blog-escrow-account-management-surrogacy?wp).

      If I understand correctly, a woman or couples might be able to get up to two babies on a case-by-case basis. Also a person/couple could potentially qualify if the person/people are between 50 & 55 years old.
      The clinics that we work with will be able to help couples in the range you mention. You will be able to request to have twins. There will be an additional delivery fee for twins though. Some clinics we work with require that the couple is married. In that case you will have to provide a marriage certificate. One clinic we work with does not require couples to be officially married.

      Might a woman qualify if she’s taken meds for anxiety/depression but has been very mentally healthy for several years? She’s never hurt anyone or herself.
      This should not be an issue. However, the clinics evaluate couples on case by case basis.

      I didn’t comprehend totally the laws that are potentially changing.
      Again, these laws apply to the clinics and surrogacy agencies in India. They do not pertain to MedVacation and its IVF/Surrogacy partners. If you are interested, we’ll be happy to email you more information on laws and regulations governing surrogacy for our IVF clinics. Email us at info@theMedVacation.com.

      Could thorough paperwork re: all these terms/potential problems and law changes be sent to the USA woman/couple? Paperwork that a lawyer could advise us on?
      Depending on the clinic you choose to work with, the clinic will assist you with all the paperwork or do this paperwork for you. You have some choices. We do have legal form that we can share with you. Alternatively, our clinic’s attorneys will do all the paperwork on your behalf.

      I hope this is helpful, Mary! Don’t hesitate to contact us, if you have any other questions.

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