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Assisted Reproduction

Surrogacy In India A Form Of Neocolonialism?

That is the argument being made by Venkatesan Vemb:

What makes India a preferred destination for commercial surrogacy?

The Indian state has gone out of its way to create a medical tourism market in India, which of course is wider than reproductive tourism. It’s replicating the success of the ‘call centre’ model, where the country’s labour force is outsourced to external companies. Call centre outsourcing has worked well from a government point of view. The medical tourism model that the Indian government facilitates is also a kind of labour outsourcing. The success of the reproductive tourism industry has been enabled by the government, which sees this as an economic development model.

The second reason, of course, is that India competes on price very consciously in the gestational surrogacy space.

Are gestational surrogacy regulations in India more lax than elsewhere?

Currently, there isn’t a law that governs assisted reproductive technology in India. There’s draft regulation that hasn’t been passed, and a set of voluntary guidelines framed by the ICMR in 2005, which is not enforceable. So, India doesn’t regulate it at all. Other countries, too, don’t regulate the area very well: in the US, for instance, there are multiple state-by-state regulations. There are other countries that have little by way of regulation of this area. These tend to be the countries that attract commercial surrogacy.

From a bioethics perspective, what are the concerns arising from gestational surrogacy?

There are various ways to do commercial surrogacy; some are more harmful than others.If you have no regulation, as is the case in India, a surrogate woman faces a situation where not much is known of how much medical care she’ll get, whether it’s good quality medical care, whether she gets any follow-up care if there are any problems, whether she will have her liberty constrained and so on. The civil rights and health of women who come forward for this type of work are in some degree of danger. Clinics say they’ve taken steps to ensure they provide good care. But given that there’s no oversight, it’s potentially dangerous.
Commercial surrogacy is also fundamentally exploitative. But some of the exploitative features can be minimised with proper care and regulation.

How significant is the fact that a surrogate mother makes no genetic contribution, and therefore the baby looks more like the parents than the surrogate?

The whole point of opting for gestational surrogacy is to have a baby who has the same ethnic characteristics as yourself. What happens in gestational surrogacy is that the surrogates are often of a different ethnic group than the intending parents. In the US, for instance, African-American or Latino women are surrogates for white couples.

There’s a racial aspect to it, but I don’t think it’s a racist conspiracy. It’s driven by a secondary phenomenon whereby the earning capacity of someone is shaped by a much older history of racial administration and equality of relations. There is a strong aspect of colonial relations involved here: you could say it’s a neo-colonial phenomenon, rather than a racial phenomenon.

Are you saying commercial surrogacy is a form of neo-colonialism?

Yes, I am, and it is! There’s a parallel phenomenon going on where international pharmaceutical companies are using Indian subjects for clinical trials. The Indian state is facilitating the marketing of its own population’s diseases (in the case of clinical trials) and reproductive capacities (in the case of surrogacy) to overseas purchasers. So, yes, it is a kind neo-colonialism and the Indian state is involved quite actively in it.

In the history of colonial relations, the natural wealth of a colonised country was exported to the colonising country. This could be raw materials, food, spices, textiles and indigenous wealth and labour capacity. The system operated in the interests of the colonising country, not the colonised country. There’s something similar going on with commercial surrogacy.

You also bring a feminist perspective to the debate. Doesn’t feminist theory view commercial surrogacy as a form of economic productivity?

There’s a lot of internal discussion from different kinds of feminists about how to view this. I certainly think it’s a type of economic activity. But it’s a problematic type of work, and in some cases, problems arise because it’s not recognised as work and the protections that come with labour regulations are not present. Having said that, even if it were regulated, I don’t think it would fix everything.

A surrogate mother exchanges the gestation of a child for money: this makes the most fundamental human connection between the mother and the child into a commercial transaction.

The feminist argument is quite similar: commercial surrogacy exploits a woman’sneed for money, by asking her to do something that is fundamentally harmful. I’m not entirely convinced by that argument, which is why I think it’s possible to see it in less absolute terms.

Discussion

One comment for “Surrogacy In India A Form Of Neocolonialism?”

  • Jon

    The issue of gestational surrogacy in India and the surrounding controversy is also very much symbolic of internal Indian social politics. The sad irony is this: the intelligentsia, radical feminists, nationalists, and religious fanatics are very against this practice as they feel it exploits poor Indian women, the proverbial smoking gun of many political causes. If you want to get people’s attention, imply that a woman has been exploited, whether that is true or not. I tend to believe though that their protests are more of a pretext for broader geo-political grievances than concern for low-caste Indian women who are using the free market to improve the lives of themselves and their family. So is the reaction these groups have sincere, or ethnocentrism more than anything else, with perhaps a smidgeon of egocentrism. The fact is the surrogates are thoroughly-screened both physically and mentally, as are their husbands who must consent to this before they can enroll with any clinic. The aftercare is very good and there have not been any reported incidents of surrogates suffering serious medical issues as a result of clinic negligence given the thousands of live births that have occurred.
    The surrogates are well compensated and the money they receive is life-altering. They finally have the funds to buy a house, educate their children and lift them to the next rung of the economic ladder. The transformation for some has been well-documented and it is akin to winning a lottery. It is one thing for the Indian elites to scream bloody murder, but they should also invest some of their energy in achieving economic justice for all members of Indian society and eliminating all vestiges of the caste system, which is a life-long death sentence and life of suffering for those born into the lower castes. Social and economic mobility is almost unheard of in India unless you “break the mold” so to speak. I applaud these women and their supporting husbands and family for wanting something better for themselves that their economy can’t give them, ever. Most studies of Indian surrogates have also shown that they would do it again if they had the opportunity given the impact this had on their lives. That speaks for itself.
    Interestingly, in the US where most surrogates also come from the lowest rungs of the economic ladder, it’s unheard of for Americans to stigmatize these women as being exploited. In fact, the attitude in America is “it’s her body, she can do whatever she wants with it”. Why do we feel it’s any different with Indian surrogates. Their choice is of free will and rooted in economics, just like their American counterparts. We may not approve of the choices people make given our own moral values; but there is no denying that the marriage of globalization and the internet will probably yield many more social conundrums like this going forward. We have to keep an open mind. Humanity is evolving; perhaps too fast for some people to accept.

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