iSCi Kyoto 2012/09/01

Cross-border Commercial Surrogacy in India and Its Cultural Background

Mizuho Matsuo, Ph.D.  Niigata  University  for  Interna1onal  and  Informa1on  Studies

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Introduction

What is the nature of cross-border reproductive tourism in Asia? What is Japan’s involvement?

What is the nature of commercial surrogacy in India?

What are the cultural issues and background? 2  

Cross-border Reproductive Tourism in Asia

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Surrogacy Trends in India

　1986 First Indian IVF baby born in Mumbai

　2004 India’s first successful commercial surrogacy

　2005 National guidelines established for approval/

supervision/regulation of clinics

　2008 The Baby Manji case → Baby rendered

stateless

　2010 Submission of draft ART regulation bill (The Assisted Reproductive Technologies Regulation Bill

2010）

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Commercial Surrogacy in India

Approx. 1000 IVF clinics nationwide A $600 million market

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Features of the ART Regulation Bill of 2010

•  Commercial surrogacy approved •  Restrictions placed on number of times one woman can act

as surrogate and on qualifications of surrogate candidates •  Intended parents listed as “legitimate parents” on birth

certificate (babies born by surrogacy treated as intended parents’ legitimate children)

•  If the intended parents reside overseas, surrogacy is permitted only in cases where in their home country surrogacy is legal and the child is recognized as their biological offspring.

•  Intended single and homosexual parents are also eligible to apply for surrogacy.

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Surrogacy Type I: Organized Surrogacy 3

Small regional city with population of less than 100,000

Anand, Gujarat

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Number of Deliveries by Surrogacy

Number    of  deliveries  

Number    of  babies  

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The Cost of Surrogacy

25,700 USD 7500～9000 USD (plus US $50/month)

Hospital 　  

　　　　　　

Party 　  

　　　　　　

Surrogate 　  

　　　　　　

expenses for IVF compensation expenses for delivery insurance

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Procedures for Clients  

・ Contact the hospital beforehand via e-mail

・ Stay in Anand for 15-20 days before embryo transfer

・ In most cases, clients meet the surrogate two or three

times during her pregnancy.

・ Receive monthly reports during pregnancy

・ Visit Anand a few days before the due date

・ Take the baby home 3 days to 2 months after its

birth. 10  

  Mr. W is in his late 40s; he has lived in Canada for 22 yrs. and owns a company.

  Mr. W had a baby girl by surrogacy as a single parent. He traveled to India in December, 2010, donated sperm, purchased eggs, and hired a surrogate. A baby girl was born in August, 2011.

“The doctor had already selected eggs and a surrogate. I didn’t have any choice about them. Before I came to the clinic, I imagined that I would choose an egg donor and a surrogate from a database or a photo album, but that wasn’t the case. The doctor was the designer of my baby.”

The Case of Mr. W (a Non-Resident Indian Originally from Mumbai)

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 “When I first came to the clinic, I was abruptly introduced to a

surrogate. When I had a consultation at the office, a woman

was sitting behind me. Then I was told, ‘she is the surrogate.’ I

was so surprised. I could hardly say anything to her. I was told

that I could see her about three days later, so I arranged for

an interpreter. But I could not see her again. My husband

went back to Japan on that day, so he met her only once. 　　

The Case of Ms. Y (Japanese, in Her 30s)

⇒There are not many chances to meet surrogates. 12  

Profiles of Surrogates

Surrogate Experiences  as  surrogate

Remarks

Ms. B 41 years old; Christian

First two times for Americans; last one time for Japanese

Worked for 15 years as a nurse at Hospital A. Husband has been a chauffeur for a medical doctor for 13 years.

Ms. C 28 years old; Hindu from Nepal.

Two times for Japanese

Worked as a caretaker for babies at a hospital for 3 years. Sister also has experience as a surrogate.

Ms. D 32 years old; Christian

Pregnant at time of interview in first-time surrogacy for NRI (Non-Resident Indians) living in the US.

Sister-in-law and two friends have also been surrogates. Sister-in-law is working in the dining room of “Surrogate House” 13  

“Mothers’House”Where Surrogates Live

When the survey was conducted, a total of 80 women (62

surrogates less than 9 months’ pregnant and 18 surrogates

9 months’ pregnant) were living at Mothers’ House.

They were served three meals a day and provided with

medical care and health checkups.

Family visitors were allowed on Sunday afternoons.

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Hindus, Christians, and Muslims are living

together at the Mothers’ House; they come from

“untouchable” to low and middle castes. Statues

of Hindu gods and Jesus are found on the same

altar, and women of different religions share the

same room for extended periods.

⇒ A very unusual living environment for India  

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Surrogacy Type II: Unorganized Surrogacy 4

Mumbai, Maharashtra

The biggest city in India, with a population of 16

million.

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Village for “Untouchables” in Area A Commercial Surrogacy and Egg Trade by Village Women

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Medication/Injection at a Caretaker’s House

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•  A key woman called a “caretaker” lives in the village

• 　 The caretaker searches for surrogates and egg donors

•  She acts as an intermediary for clinics, agents, and

surrogates

•  She provides daily medication/injections and information

•  Compensation for surrogates is about Rs. 150,000-200,000

•  Compensation for egg donors is about Rs. 20,000-30,000

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Agent

surrogates  

Agent

caretaker caretaker

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  Many clinics exist ⇒ Caretakers negotiate with

clinics to seek better conditions.

  There is no backup from doctors.

  There is no care or guarantee of surrogates’ health.

  Clients have direct contact with surrogates; foreign

clients have greater demands than for organized

surrogacy.

  No statistical data; the details are unknown.

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Conclusion 5 Under organized surrogacy, surrogates temporarily

share a common living space at “Mothers’ House.”

It is a very unique living environment that might

help bridge caste/religious/class barriers in Indian

society.  

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•  Under unorganized surrogacy, networks rooted in the

existing community (i.e., villages of “untouchables”)

serve to connect surrogate mothers.

⇒ This may make it possible to obtain more

beneficial conditions for surrogate mothers in Mumbai.

•  Meanwhile, the possibility of exploitation by doctors

and clients is increasing. 26