Tuesday, April 20, 2010

Motherhood Redefined?

Are all alternative arrangements to human limitation justified?

Traditionally, a mother may be defined as a female who is the biological parent, related through marriage to a biological father, or through a contract of adoption. However, procreative options have multiplied over the years to include a surrogate as a third party in the usual two-party parenthood equation.

A surrogate mother is defined in The Columbia Encyclopedia, Sixth Edition, as “a woman who agrees, usually by contract and for a fee, to bear a child for a couple who are childless because the wife is infertile or physically incapable of carrying a developing fetus.” The resulting offspring may be a biological offspring of one or both parents. The book, “Children of Choice: Freedom and the New Reproductive Technologies” authored by John A. Robertson, calls this arrangement, “Reproductive Collaboration”.

In recent years, India has placed itself on top of the reproductive outsourcing industry owing, mainly, to medical expertise, low costs and a relaxed legal atmosphere. The surrogacy industry in India is considered to be at a value of $445 million/year, by some estimates. Commercial surrogacy was legalized in India in 2002. In the absence of a proper legal framework, the surrogates sign a contract handing over all rights to prospective parents according to the guidelines issued by the Indian Council of Medical Research. Since the name on the birth certificate is that of the biological parents, the process of taking the baby out of the country is also carried out with relative ease. Contrarily, pre-signed contracts hold no legal standing in many US states wherein the surrogate is required to sign over her rights at the time of delivery. If she chooses to assert her claim, however, she has a window period after birth to file that in.

Multiple reasons push couples towards this option, like repeated miscarriages and IVF failures, a hysterectomy or a diseased/damaged uterus etc. However, Dr. Nayna Patel who runs the popular Anand Clinic in Gujrat, India, has admitted to having received requests by women who have none of the medical reasons to go for surrogacy, "I've had some women ask to do surrogacy because they don't want to give up work for a pregnancy, but I turned them down flat." To want to use poor women from developing countries as human incubators to produce their off springs, while not compromising their work, health and physical attractiveness raises some serious ethical questions that further complicate the issue.

When fertility clinics match prospective surrogates with infertile couples, elaborate screening and counseling is done to ensure a harmonious transaction. Indian women, belonging to a largely conservative society, are believed to maintain a generally healthy lifestyle devoid of alcohol and drug abuse, though various poverty-related environmental factors affect their health in other ways not always taken into consideration. The chosen surrogates are usually below the ages of 40 and are married women with at least one live birth to show for credible reproductive capacity.

In the absence of an effective social services network or support system, the surrogates are left to deal with the trauma of delivery and separation all by themselves. However, fertility experts like Dr. Patel insist that "Many surrogate mothers see this not as 'handing over' the baby, but as 'handing back' the baby, as the baby was never theirs to keep." To avoid stigma and condemnation from their conservative society, often these women keep their services secret from their relatives.

The cost factor remains one important reason for these couples to look to the Indian industry. Anuj Chopra wrote in April, 2003 in the Christian Science Monitor about a couple from London who found a surrogate mother in India, paying her $9,720 for a service which would have cost them three times more in UK. The cost for surrogacy in the US comes to around $75,000 as compared to an average of $25,000 in India, including the complete costs of travel and treatment. The surrogate receives approximately $6,000 to $7,000, which is a small fortune by local standards. Many surrogates have disclosed using the money for buying property or paying for their children’s education. Some have even used it to get expensive medical treatment for family members otherwise beyond their grasp.

Opinion on the moral, ethical and legal issues surrounding surrogacy vary considerably worldwide. Surrogacy was outlawed in 1991 in France by the highest court and it was declared that, "The human body is not lent out, is not rented out, and is not sold." In Australia it is illegal to pay a surrogate mother apart from her medical expenses. In Germany, sperm and egg donation are not allowed, based on the idea that every child has a right to know and be raised by their own parents. In some other countries like Sweden and Spain efforts to legalize surrogacy have received wide condemnation, while some other western countries evaluate surrogacy requests on a case-to-case basis through independently formed Ethics Committees.

The Oprah Winfrey Show aired an episode titled, ‘Wombs for Hire’ on October 09, 2007 anchored by Lisa Ling of ABC and The National Geographic. It received some strong criticism for calling the desire of commissioning couples from richer nations to find surrogates from poor countries as a case of “women helping women”, rather than exploitation of the surrogates’ economic desperation. When Lisa asked the commissioning mother in question about her views on this, she tearfully responded with, “Sangita and I give each other a life that neither of us could achieve on our own.” Literally speaking, that might be true but the program has been criticized by viewers for not addressing more critical moral and legal questions regarding the rights of the surrogate in case of complications, rights of a baby born with genetic abnormalities, DNA testing to ensure paternity, or issue of the donor’s unused egg disposal and the like.

Another moral dilemma rises when surrogacy is likened with prostitution as it involves the appropriation of women’s bodies for money. While some call it empowerment of poor women, others insist it is nothing but degradation and exploitation. Merits of adoption have long been propagated as the real solution to the problem of childless couples, yet the desire for becoming a biological parent remains.

Commercial surrogacy is a complicated issue and opinion is deeply divided on its various implications for individual and society at large. It will take a long time yet before we can make the choices of individuals consistent with values of their societies in a rapidly evolving world. The use of services such as commercial surrogacy requires regulation and clearly defined framework to prevent misuse and injustice to all concerned.

SouthAsia July, 09

1 comment:

Thank you for sharing your views.