Surrogacy in India has rapidly become part of the landscape of international reproductive tourism. Reproductive or procreative tourism is part of the growing travel circuits of infertile couples – from the developed and developing world to economies with affordable infertility care such as India, Thailand, Mexico, and Brazil. Reproductive tourism also includes circuits of egg donors travelling across the world to donate their biogenetic matter for fertility procedures.
The demand for Caucasian eggs from Caucasian women is part of a parallel “industry” that facilitates cryopreserved eggs/ovum to be transported across continents, as well as promotes reproductive tourism for egg donors on paid holidays to donate their bio matter.
The commercial gestational surrogacy arrangement, since 2013, has suffered from lower “footfalls” of foreign couples due to a directive from the Ministry of Home Affairs, Government of India, which restricts access to everyone but foreign heterosexual couples, married for two years and unable to conceive. This meant that foreign gay couples cannot contract a surrogacy arrangement in India, leading to reduced transnational traffic.
But ways of circumventing such a directive also emerged when news reports suggested that after the devastating Nepal earthquake in 2014, the Israeli government airlifted Israeli gay couples stranded with their newborns – born from Indian surrogates – but ignored the surrogates. The Nepalese government’s ambiguous stand banned domestic surrogacy arrangements, but allowed “externally” contracted arrangements to be fulfilled on its soil. This effectively helped Indian IVF clinics to facilitate surrogacy arrangements between Indian surrogates and foreign gay couples in Nepal, while meeting the demands of the Indian directive.
In India, commercial surrogacy, too, occupies this complicated terrain of reproductive tourism.
The transnational character of the arrangement is because infertile couples and individuals – gay and heterosexual – from across the world are attracted to come to India, largely due to cheap treatment options and the availability of even cheaper surrogacy services from Indian gestates. The surrogacy industry has also benefited from the way the arrangement has been marketed across the world – through IVF agents and doctors. In the documentary Made in India (2010) by Vaishali Sinha and Rebecca Haimowitz, a transnational agency run by an Indian and based in the USA liaisons with clinics and couples to contract a surrogacy arrangement in India.
Commercial surrogacy in India operates through spaces of transnational ties that include local networks of IVF clinics, surrogacy agents, and surrogates. When trying to understand the transnational political economy of surrogacy in India, we notice an important focus on what Bharadwaj and Glasner call “liminal third spaces” in their book on stem cell research in India.
These “liminal third spaces” emerge in the conflicted and multiple engagements that the local governments, cultures, practices, and people undertake in relation to the global and the transnational. In the exchange of bodies and genetic material across borders and boundaries, liminal third spaces become important sites of conflict and critique to existing norms and rules. IVF clinics, intended parents, and commercial surrogates operate in these liminal third spaces that form important networks to facilitate a commercial surrogacy arrangement.
IVF and ARTs are both universal and localised. Unable to sustain universalised Western notions and engagements with IVF in ethnographic encounters in other parts of the globe, ARTs become subject to localised manifestations. Hence, ARTs take on “mutating” characteristics, as Inhorn and Birenbaum-Carmeli mention, which differentiate between cultural experiences of IVF/ARTs.
A culture thus emerges around IVF and its use, thriving on aggressive marketing and advertising, which positions this technology as the only solution to replicate and recreate when faced with the failures of biology, manifest in the form of infertility.
Infertility has been popularly represented as a “lifestyle disease”, impacting only a few who belong to the middle and upper-middle classes. Lifestyle choices such as late marriage, stress, and an inhospitable urban environment impact fertility. Stories of an infertility “epidemic” amongst the educated urban middle class made it a disease that had to be countered fast.
Thus, infertility and its treatment are constructed and marketed to a largely urban clientele, disregarding patients and requirements in the semi-urban and rural sectors. As per a 2010 newspaper report by Durgesh Nandan Jha, the IVF wing of a government hospital in Delhi was “ailing” due to very few embryologists and even lesser equipment. This “apathy” on the part of the state emerges from its health policy which places the responsibility of a burgeoning population on the shoulders of its poor and economically weak masses.
According to Sunita Reddy and Imrana Qadeer, IVF and transnational commercial surrogacy are essential parts of the burgeoning new medical tourism industry in India.
This industry caters to most major health services, including organ transplantation, intensive surgeries, and intensive care. Within this industry, the IVF culture occupies an important place in the procreative/reproductive tourism industry, which is now being spearheaded by the “surrogacy industry”. The moniker “industry” was first mentioned in a document by the Law Commission of India (2009) on regulating commercial surrogacy.
Within the notion of an “industry” is the overwhelming fear of exploitation that dogs research on commercial surrogacy. For scholars such as Rayna Rapp and Arlie Hochschild, commercial surrogacy is exploitative, and yet, it occupies the conflicted terrain of reproductive choice and agency. Anthropological work emerging from India provides a more nuanced reading of commercial surrogacy and surrogates.
For instance, Vora speaks of the kind of marketability that the IVF clinics depend upon to attract foreign clientele, necessarily involved in extracting the maximum amount of “labour” from Indian surrogates, even as they are positioned as needy and, therefore, requiring intervention through involvement in commercial surrogacy. Pande calls this “a gift for global sisters”, wherein foreigners are told they are doing a philanthropic good deed by supporting Indian surrogates.
In 2015, a controversial advertisement by the Japanese advertising and marketing agency Dentsu – on surrogacy in India – showcased the Indian surrogate in an exoticised rural setting, seeking to escape impoverishment by participating in a gestational surrogacy arrangement for a Japanese couple. The advertisement ends with the surrogate looking at an image of the baby on the couple’s phone, as she never gets to see it post delivery. In a commentary on the advertisement, Sarojini et al speak of how motherhood is projected through a transnational marketing of supply and demand for children.
Excerpted with permission from Surrogacy, Anindita Majumdar, Oxford University Press.