~ 198 ~
“Neither flesh of my flesh, nor bone of my bone, but still, miraculously my own.”
es, this is the magic of Outsourcing Motherhood but can we call it magic in true
sense. It is a debate of our head and heart. ‘Outsourcing’ and that too
‘Motherhood’! Doesn’t it impinge you? Former one is a buzz in business and the later, in
our hearts. And to give it a respectable name we combine both the buzzes and call it
“Surrogacy”.
The practice of renting a womb and getting a child is similar to Outsourcing Pregnancy.
Despite the legal, moral and social complexities that shroud Surrogacy, there is nothing
stopping people from exploring the possibility of becoming a parent. Women who may
choose to ‘Rent’ their womb for a Surrogate Pregnancy are slowly shaking off their
inhibition and fear of social ostracism to bring joy to childless couples. Under this chapter
the researcher has discussed the Social Scenario of Surrogacy in India especially in
Gujarat, Maharashtra, Rajasthan and Madhya Pradesh, from its inception till the present
time. The chapter further unveils the reasons for the growth of the Multi –Million
Surrogacy industry in India.
INDIAN SCENARIO
Over the past few years, India has seen an explosion of fertility services that promise a
cure for the allegedly increasing rates of infertility. Assisted Reproductive Technologies
(ARTs),1 a group of technologies that assist in conception or in the carrying of pregnancy
to term, have proliferated unchecked, becoming a veritable ‘Fertility industry’.
___________________________________________
1 Assisted Reproductive Technologies (ARTs) are a group of technologies that assist conception and pregnancy. These technologies are designed to increase the number of eggs and/or sperm, or to fertilize them, resulting in the improved ‘probability’ of conception/pregnancy that is not otherwise possible. The technologies used for assisting reproduction range from simple or ‘low-tech’ methods such as intrauterine insemination (IUI) to ‘high-tech’ methods such as in vitro fertilization (IVF) in all its variations. Although surrogacy is an arrangement, it has been included in ARTs.
Y
~ 199 ~
This industry is an integral part of the country’s expanding medical market and medical
tourism industry. Within this, surrogacy, particularly Commercial Surrogacy, the practice
of gestating a child for another couple or for an individual through the use of ARTs and in
return for remuneration, has drawn much attention and raised several ethical concerns. In
the absence of any kind of Regulatory or Monitoring mechanism for the ART industry in
India including a national registry, it is difficult to arrive at the exact statistics pertaining to
the existing Surrogacy industry. However, the sharp rise in the number of Surrogacy
arrangements based on media reports and anecdotal evidence is a significant indicator for
estimating the scale and spread of the Commercial Surrogacy market. An exponential
growth in the industry is evident from the comparative figures over the years that was
estimated it to be an industry worth more than USD 400 million till 2008.2
But, still it’s not clear how big the Indian Surrogacy market officially is, how many
Surrogate Children are birthed each year or how many ART clinics there are. Birthing a
Market, A Study on Commercial Surrogacy (2012) by Delhi-based Sama - a resource
group for women and health – was supported by the United Nations Population
Fund India; it quotes figures from the National Commission for Women to peg the
number of clinics in India offering Surrogacy services at about 3000. There has, however,
been no confirmation from the Government on these figures.
At present, the volume of this trade is estimated to be around $ 5000 million and the
numbers of cases of Surrogacy are increasing rapidly.3 On the other hand, the
Confederation of Indian Industry (CII) figures identify Surrogacy as a 2.3 billion dollar
industry annually. The CII study estimated that 10,000 foreign couples visit India for
reproductive services. It’s not just foreign couples alone but the demand for Surrogates
from Indian couples is also growing.
____________________________________________ 2 Warner, J.,Outsourced Wombs, New York Times, 3 Jan., (2008). and Kohli. N., Moms Market, Hindustan Times, 3 Jan., (2011)
3 http://www.mightylaws.in\outsourcing-motherhood may 2012.htm
~ 200 ~
Estimates by Doctors indicate that up to 40 per cent of their clients are foreign
couples/Indians living abroad, implying that a significant proportion of clients are resident
Indians. As the researcher pointed before that the exact extent of this practice in India is
not known, but inquiries have revealed that this practice has doubled in the last few years.
There is a growing demand for fair-skinned, educated young women to become Surrogate
Mothers for foreign couples. Often, couples have to wait for as long as eight months to a
year for their turn. Normally women from small towns are selected for outsourcing
pregnancy.4 In places like Anand, Surat, Jamnagar, Bhopal, Indore, a large number of
couples from both within India and abroad travel to fulfill their desire for a child. Several
American, Russian and British women are duly registered with the Akankshya Clinic of
Anand and the Bhopal Test Tube Baby Centre for the procedure.
Leading fertility expert Dr Firuza R Parikh, Director - Department of Assisted
Reproduction and Genetics at the Jaslok Hospital and Research Centre in Mumbai, points
out that Indian IVF Clinics have good results, which create huge potential for expansion
“India can
become a very
big Hub for
Surrogacy if
the ART bill
gets tabled in
Parliament and
if international
and Indian
clients have
clarity on the
issue.’’ She
adds that
transparency of all processes and having a law rather than a bill, would help all concerned.
__________________________________________________
4 Surrogate mothers: Outsourcing pregnancy in India‘ article by Joseph Gothia, 26th June 2008, link: http://india.merinews.com/cat Full.jsp?articleID= 136421
~ 201 ~
As we emerge as a hub for surrogacy, there may be further refinements in the ART bill, but
delays are not helping, ’’ adds Parikh.5 She estimates that around 2500 to 4000 Surrogacy
cycles per year are performed in India. One successful cycle of Surrogacy in India can cost
anywhere between Rs 11-20 lakh (between 25-35,000 USD). In smaller cities, it can be
cheaper.
According to the National Commission for Women (NCW), there were about 3,0006
clinics in early of last decade which has now crossed over two lakh across India offering
Fertility treatment and out of them many are providing Surrogacy services to couples from
North America, Australia, Europe, and the other continents. These figures reflect the status
of India as the most favored destination for Commercial Surrogacy. This comes as a boon
to childless couples all round the world. At the same time it raises serious ethical and legal
concerns and mirrors the plight of the poor in an underdeveloped country, who are willing
to sell something as sacrosanct as their Women’s Motherhood.
Conservative to Progressive Approach
“In India, it is estimated that approximately 15 to 20 per cent couples suffer from
infertility, “says Dr Anoop Kumar Gupta, Medical Director and Infertility Specialist
of the Delhi In-Vitro Fertilization (IVF) Center.” The figure is on the increase due to
increased urbanization, pollution, stress, a competitive work environment and a fast-paced
lifestyle,” he adds. Various surveys reveal that the figure of childless couples is increasing
at an alarming rate unanimously in all the countries. For the treatment of fertility various
Artificial Reproduction Techniques are developed and Surrogacy is the latest out of them.
Surrogacy is a complex and challenging topic that is plagued with controversies for the
past several decades. There are many legal, social and ethical aspects of a pregnancy
involving a Surrogate Mother.
___________________________________________
5 http://indiatogether.org/what-surrogate-parenting-entails-in-india-laws
6 Kannan, S., Regulators Eye India’s Surrogacy Sector, 2009, BBC World News, 18 March.
~ 202 ~
There have been some famous cases which garnered public attention and have given rise to
endless debates in favor of as well as against the procedure. India created history by being
the first country to legalize Commercial Surrogacy in 2002. Internationally, India has
become the preferred destination for couples desiring pregnancy through Surrogacy
although it is difficult to estimate the prevalence of Surrogacy in India. Today Surrogacy is
a booming business in India which leaves behind the traditional values and ethics.
Surrogacy is prevalent from ancient era but with the march of time the conservative
outlook towards Surrogacy has changed into a progressive outlook.
Mythological Surrogate Mothers are well known in India. Yashoda played mother to
Krishna, although Devki and Vasudeva were Biological Parents. Likewise, in Indian
mythology Gandhari made Dhritarashtra the proud father of 100 children, although he had
no biological relationship to them.7 No doubt, Surrogacy was prevalent in earlier time even
but it was not having a social acceptance.
With the lapse of time and progress of society the old concept of Surrogacy has totally
capsized. The primordial urge to have a biological child of one’s own flesh, blood DNA,
aided with technology and the purchasing power of money, and coupled with the Indian
entrepreneurial spirit, has generated the ‘Reproductive Tourism Industry’, estimated at
Indian rupees 25,000 crores (US$5000 million) today.
In 1984 the world saw the first successful birth through Gestational Surrogacy. Ten years
later, in Chennai, this happened for the first time in India. Three years after that, in 1997,
an Indian acted as a gestational carrier, and got paid for it, in order to obtain ‘medical
treatment for her paralyzed husband. But India’s Surrogacy boom began in January 2004
with a grandmother delivering her daughter’s twins. The success flashed over the world,
literally spawning a virtual industry in the State of Gujarat in India.
__________________________________________________ 7 Anil Malhotra & Ranjit Malhotra, All aboard for the fertility express, Commonwealth Law Bulletin, 38:1, 31-41, (2012) DOI: 10.1080/03050718.2012.646733 http://dx.doi.org/10.1080/03050718.2012.646733
~ 203 ~
In the past couple of years, the number of births through Surrogacy doubled with estimates
ranging from 200 up to 350 in 2008 alone. Today, while Iceland has the first openly Gay
woman politician as its Prime Minister, India boasts of being the first country intending to
legalize Commercial Surrogacy, in 2002, to legitimize both Intra and Inter-country
Surrogacy, which is rampant.
The term Surrogacy which was till last decade heard once in a blue
moon is now no more an unheard term in India. It has not only marked
its inception in metros but has with very swift pace moved towards the
small cities like Badwani, Indore etc. The outlook of masses towards
Surrogacy has undergone a vital change in last decade. This progressive
change towards Surrogacy can be witnessed from the mushroom growth
of fertility clinics dealing in Surrogacy in small cities as well as from the
numerous advertisements published in Newspapers for hiring a
Surrogate by the intended parents from time to time.
In the Indian context, the following factors have created a conducive environment for the
expansion of the industry: lack of regulation; comparatively lower costs in relation to many
developed countries for instance, Canada, the United Kingdom (UK), and the United States
of America (USA);
shorter waiting time;
the possibility of
close monitoring of
Surrogates by CI
(Commissioning
Parents); availability
of a large pool of
women willing to be
Surrogates, and
infrastructure and medical expertise comparable to international standards.
~ 204 ~
The motivations of women’s in India to enter into Commercial Surrogacy arrangements
stem from the emergent conditions of survival or deprivation. Their choices and
engagement in this and other options of work are also steeped in their perception of their
roles and responsibilities towards their children and families. Contrary to the more popular
discourse of altruism of giving the gift of motherhood to an infertile woman, the idea of a
good and responsible mother for their children and responsibility towards their families is
what seems to be gearing women into not just considering but also, often, convincing their
husbands into agreeing for them to enter such arrangements.
Some Surrogates have also chosen Surrogacy over other available work options, for
instance, domestic work or other kinds of work that are too arduous and have long working
hours, or have stated a preference for remaining at home and earning money. Their choices
are thus a reflection also of the constraints of the larger context of work availability or
unavailability and of the factors that influence the employability of women from a
particular class and that hence structure their lives.
These processes of constituting new subjectivities are seen to take place in the context of
the growing popularity of Surrogacy as an option for working-class women, and of the
scale achieved by the industry in a short span of time. The nature of labour in developing
countries like India in an international regime of globalization and liberalization has made
the flourishing of this industry possible.
As briefly addressed before, India is rapidly becoming the most popular country for
‘Fertility Tourists’, which is due to a number of interrelated factors which includes;
relatively low-cost medical services, the easy availability of Surrogate wombs, an abundant
choice of donors with similar racial attributes, and the lack of any law to regulate these
practices is attracting both Foreigners and Non-Resident Indians (NRIs) to sperm banks
and Surrogate mothers in India.
~ 205 ~
Now let’s us discuss these reasons for the growth of the proliferating Multi-million
Surrogacy industry in India in lucid and elaborated manner.
Low Cost Surrogacy Easy Availability of Pool of Willing Surrogates Abundant Choice of Donors Lack of Regulatory Laws Expertise Medical Services Supportive Machinery
Low Cost Surrogacy
Surrogacy in India is a hot topic right now. Intended parents are interested in the low costs
of International Surrogacy, and many are considering Surrogate Pregnancy in India. There
are many many success stories on Surrogate babies born in India.
Hundreds of happy parents have brought their children home without the least bit of
difficulty, while being able to afford Surrogacy, something they may not have been able to
do in their own Country. For those seeking a Gestational Surrogate Pregnancy, who will be
using their own eggs, the number one incentive to Surrogacy in India is the price.
It would be silly to imply that there was any other major reason for choosing to go through
International Surrogacy or Surrogate Parenthood in India. The reason that Intended
Parents go to India is 100% because of the cost, quoted at $20,000-30,000 of the entire
Surrogacy process. On the contrary, it is estimated that in the United States, the payment
for hiring a Surrogate Mother ranges between US$15,000 and $30,000, the whole
procedure can cost $45,000 to $60,000 plus.8
______________________________________________________________
8 http://www.delhi-ivf.com/india_surrogacy.html
~ 206 ~
The fees for the rest of the process including fertility clinics; lawyers; medical fees; and
agencies and/or egg donors, if they're used, generally cost more than the fee going to the
Surrogate. Gestational Surrogacy costs more than Traditional Surrogacy, since more
complicated medical procedures are required. Surrogates who carry a baby for a family
member i.e., sister or daughter usually do so for expenses only.
Here it is docile to mention the argument of Qadeer who argues that there is no way to put
a value on a human baby but arbitrarily, and asserts that therefore this value has to be the
same everywhere in the world, including in the third world where poor women who
become Surrogates provide cheap labor. She compares the situation in India with the
situation in the United States, where hiring a Surrogate is many times more expensive and
where she is better provided for in terms of medical expenses, health insurance including
for her family, expenses for maternity care and clothing, and the hiring of an independent
lawyer.
She compares Surrogacy with Human-Organ Donation to demonstrate that, unlike the
former, the latter has been restricted to a non-commercial transaction by the state.
According to her, this “distinction between human body parts donated and those rented,
and the equating of goods and living beings in Commercial Surrogacy” is irrational.9 This
logic obscures the difference between the product of social human labor, such as any
consumable commodity, and the product of women’s procreative labor, a baby.
Hence, India is foremost in Surrogacy because of the low cost treatment and availability of
women opting to be Surrogate for childless couples. According to the 228th report of the
Law Commission of India, “NEED FOR LEGISLATION TO REGULATE ASSISTED
REPRODUCTIVE TECHNOLOGY CLINICS AS WELL AS RIGHTS AND
OBLIGATIONS OF PARTIES TO A SURROGACY” the usual fee for Surrogacy in
India is $25,000 to $30,000 which is almost one third to what it would cost in USA. 10
___________________________________________________________
9 Supra note 38, Chapter III, at 102
10 http://lawcommissionofindia.nic.in/reports/report228.pdf
~ 207 ~
Moreover laws in US and UK do not allow the Surrogate woman to charge the childless
couple; whereas in India there are no laws preventing a Surrogate woman in accepting
compensation for renting her womb. A Childless couple offer Rs.3,00,000 to Rs.4,00, 000
or more and sometimes even funds for education to the children of Surrogate woman and
still save thousands of dollar as compared to their own country. Thus, the entire process of
Surrogacy in India is very cost effective and this is the prime factor behind the flourishing
Indian Surrogacy industry.
Easy availability of pool of willing Surrogates
There are several reasons why a couple from the developed world might want to travel to
India for Surrogacy. UK law dictates that Surrogacy must be altruistic, which has led to a
severe shortage of women willing to be Surrogates. The amount of money legally payable
to Surrogates to cover expenses tops out at around £10 000—nowhere near enough of a
financial incentive. Not only that, Surrogacy agreements is not enforceable in the UK. This
means that after months of searching for the right Surrogate and waiting for the baby to be
born, the prospective parents might be left bereft of their baby. This can happen in the
USA too.
In India, meanwhile, these problems are almost non-existent. For one thing, the Surrogacy
agreement is legally binding. Cultural and Financial factors also mean that Surrogate
Mothers rarely want to keep the baby. The taboo around Surrogacy means that most
women keep their pregnancy largely a secret. Indian Surrogates are often struggling to
provide for the family they already have; they can't afford not to get paid. Fertility Doctor
Kaushal Kadam, at the Corion Fertility Clinic in Mumbai, says that if anything,
Surrogates ask her “you are sure they are going to take the baby, right? I can't afford to
raise three children”.11
_________________________________________________________
11 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961933-3/fulltext
~ 208 ~
Indian Surrogates earn between $5000 and $7000—an enormous sum for women would
normally only earn about $300 a year. The women's financial desperation has led some
ethicists and women's rights groups to feel that Surrogates are being exploited. Yet it is
precisely because the women have so few alternatives to earn money that some doctors feel
they cannot take a moral high ground. “I really don't see any exploitation”, says Kadam.
“It's a mutually beneficial situation where the couple is getting their baby and the
Surrogate is getting benefited in the end.”
In this scenario, Commercial Surrogacy is often portrayed as a win-win situation. It is seen
to give ‘Desperate and Infertile’ parents the child they want, and to provide poor Surrogate
women the money they need. In the face of this growing globalization of capital and
shrinking local avenues for jobs and resources, women from marginalized communities
and regions find themselves more impoverished, powerless and vulnerable. For these
women, access to work and occupations has decreased over time, while new markets have
opened up for both their sexual and reproductive labor. Commercial Surrogacy for the
domestic and international markets is one such avenue and it is gaining ground in many
urban and semi-urban areas in India today and a huge pool of women from such areas are
eager to act as Surrogates.
The women who engage in Surrogacy are usually poor. They agree to conceive on behalf
of another couple in return for a sum of money that would otherwise take many years to
make. It is important to understand that these women generally do not have many career
prospects as they are predominately uneducated, often engaged in casual work, sometimes
migrants in search of better job opportunities and living in slum areas with inadequate
housing facilities. They come from lower middle class backgrounds, are married, and are
in need of quick money in order to, among other purposes, maintain their families, buy a
house or pay for the children‘s higher education or to settle up a business for her
unemployed, drunkard husband. The need for money is often felt so deeply that childless
couples often negotiate a better price as a result of the competition.
~ 209 ~
There is a growing demand for fair-skinned, educated young women to become Surrogate
mothers for foreign couples. Nevertheless, reasons for foreigners coming to India in search
of Surrogate mothers vary, but the easy availability of women acting as Surrogates in
abundance is another very important factor responsible for attracting international clients.
Women from lower socio-economic backgrounds readily agree to become a Surrogate
mother in India in return for payment, as hiring a surrogate in the western countries12 is not
only difficult, but, the treatment is also immensely costly.
Abundant Choice of Donors [
India is fast becoming the hub for IVF and Surrogacy as the country’s market value is
expected to touch INR 14.2 Billion and register a CAGR of 14 percent approximately over
the next five years. India has witnessed an unprecedented and unregulated growth of
IVF/Infertility/Assisted Reproduction Technology (ART) clinics and hospitals. With the
estimated number of around 3,000 fertility clinics across the country and new clinics being
added every day, India has occupied a place of prominence on the world IVF map.
The present boom, witnessed by the IVF segment, is a result of various factors. The easy
availability of Surrogate Mother, Gamete Donors and Low-cost Infertility Treatments have
made India a favoured destination for Reproductive Medical Tourism or better known as
Fertility Tourism.13 During the fertility treatment the Prospective parents need to honestly
look for a reasonable Donor. The donor can be known, such as the Prospective Mother's
Husband or a friend. He might be an anonymous or "willing to be known" donor to a
sperm bank.
__________________________________________________
12 Shuriah Niazi, Surrogacy Boom, October 14, 2007, by arrangement with WFS, Source: http://www.boloji.com/wfs6/wfs1027.htm
13 Elets News Network (ENN), India’s baby making business: The Growth Story, August 2014, available at http://ehealth.eletsonline. com/2014/08/indias-baby-making-business-growth-story/
~ 210 ~
Many Prospective Parents work with sperm banks because the donors generally cannot
seek legal parental rights, such as visitation. Others are comfortable with, for example, a
donor who plays an uncle-like role in the child's life. Whatever boundaries the parents and
the law draw, however much or little contact he has with the child, the donor will be a
lifelong presence within any AI-created family. Even when happy about their upbringings,
most AI-conceived people are curious about their Biological Fathers. And therefore the
selection of donor is a crucial part in Surrogacy.
The would-be parents from the Indian Diaspora in the US, UK and Canada, and Foreigners
from Malaysia, the United Arab Emirates (UAE), Afghanistan, Indonesia, Uzbekistan,
Pakistan and Nepal are descending on sperm banks and In-Vitro Fertilization (IVF)
Centre’s in India looking for the South Asian genetic traits of perfect sperm donors.14
There is an abundant choice of donors with similar racial attributes available in India. This
is another very important factor contributing to the Surrogacy industry of India.
Lack of Regulatory laws
India has surreptitiously become the booming centre of a fertility market with its
‘Reproductive Tourism’ industry. Assisted Reproductive Technology (ART), as it is
clinically known, has been in vogue in India since 1978. The ‘Rent a Womb’ industry in
India is witnessing a boom, with infertility affecting one in every six couples.
Commercial Surrogacy, of which Gujarat is a known hub, was legalised in India in
2002. In India, while the exact numbers are not recorded, guess estimates put the number
of children born to Surrogates at 25,000, with 50 per cent of the clients coming from the
West. _______________________________________________
14 Anil Malhotra & Ranjit Malhotra, All aboard for the fertility express, Commonwealth Law Bulletin, 38:1, 31-41, (2012) DOI:
10.1080/03050718.2012.646733 http://dx.doi.org/10.1080/03050718.2012.646733
~ 211 ~
Accepting that India is fast being recognized as an “Attractive Option” for Commercial
Surrogacy centre, human rights activists maintain that while Commercial Surrogacy in
itself is welcome “Where persons unable to have children are aided by willing Surrogates
to have their biological children, problem comes in due to the exploitative nature of the
business and lack of regulation in the industry”.
If we talk about the Surrogacy laws in other nations, in Canada, Surrogate Mothers are not
allowed to accept payment but unfortunately this has driven the practice underground.
In Japan, it is the woman who delivers the baby, and not the woman who provides the
eggs, who is considered the Baby’s Mother in a Surrogate birth. In Australia not all states
have laws on Surrogacy but the ones that do are Queensland, where Surrogacy is illegal,
Tasmania where it is an offence to make or receive payment for Surrogacy and contracts
are not legally binding, and in South Australia and Victoria where Surrogacy contracts are
illegal. In South Africa, paying Surrogate mothers is illegal.15 Thus in maximum
countries Surrogacy is considered to be illegal and therefore many infertile couples from
west turn towards India for Surrogacy as in India it has been legalize in 2002 by
Supreme Court but still it is much unregulated.
India has become a Paradise of Surrogacy, but, the fact remains that it is still unlegislated
and largely unregulated, despite being judicially recognized. This is one of the reasons of
so many foreigners coming to India for Surrogacy. In India, the IVF market is largely
monopolized by small niche players and sole-practitioners, as the loose regulatory
environment is promoting constant mushrooming of such players. The IVF industry in
India is completely unregulated. Anyone can open an infertility or Assisted Reproductive
Technology (ART) clinic and start performing procedures the same day, as there is a lack
of centralized regulatory body with complete visibility over the whole market.
_____________________________________________
15 http://nitawriter.wordpress.com
~ 212 ~
Although the Indian Council of Medical Research (ICMR) reports 3,000 clinics
particularly dealing in Surrogacy around the country, certain market forecasters estimate
that there could be as many as 15,000 sole practitioners who focus on Surrogacy only.
Currently, the industry stick to guidelines set out by the ICMR that includes when, and by
whom IVF can be performed. The guidelines do not lay down any rules for the setting up
of ART clinics, Compensation to be paid to the Surrogates, no. of Embryos to be
implanted in the Surrogate etc. And this is the reason why infertile couples from across the
globe are turning to India.
In India Surrogacy is legalized but unregulated and therefore the medical practitioners are
involved into Mal Practices. It is observed that in maximum Surrogacy arrangements
Surrogates are considered as objects and attention is paid only to the desires of Intended
Parents. The Medical practitioners and even the guidelines of ICMR seem to support the
desirous couples. There is no Monitoring of the ART Clinics.
Clinics function in tight cliques, with unrelated centre’s like Dental Clinics sometimes
assisting Fertility Clinics. Although there are no fixed rules related to the amount of
compensation for the Surrogate Mother, it is arbitrarily decided by the clinics. Often the
woman who delivers the baby is paid very less for it. Though the couple who wants to
have a baby through Surrogate mothers pays anything between Rs.2 lakh and Rs.5 lakh to
agents, the woman Dr who delivers the baby gets only Rs.75, 000 to Rs. 1 lakh.
“No fixed compensation structure, no laws that cater to the health and number of births
that a surrogate can support and usually incomplete advertisements of the services by
medical establishments work against the interest of the women involved in the case”.16
_________________________________________________ 16 B. S. Perappadan, Clamour grows for stringent regulation of surrogacy, THE HINDU, (New Delhi edn., August 25, 2014 ) available at http://www.thehindu.com/news/cities/Delhi/clamour-grows-for-stringent-regulation-of-surrogacy/article6348956.ece
Dr. Ranjana Kumari, Director, the Centre for Social Research says:
~ 213 ~
Fertility experts are also concerned that ICMR guidelines, which say that Surrogates can
be implanted with a maximum of three embryos, are being flouted. Fertility Doctor
Kaushal Kadam, at the Corion Fertility Clinic in Mumbai, says that she knows of some
Indian clinics that implant Surrogates with more than they should, one clinic reportedly
with five or six embryos. Kadam's assertion was borne out in numerous conversations that
the researcher had with fertility experts in India. Gillian Lockwood, medical director of
the Midland Fertility Services, West Midlands, UK, which deals with Surrogacy, is
shocked that doctors would implant such “Dangerously high numbers of Embryos”. For
Surrogate mothers, she says, “there is already an increased risk due to the immune
mismatch, which can lead to conditions like pre-eclampsia or gestational diabetes”.17
Implanting so many embryos increases the risk of multiple births, which have substantial
health risks. Even a twin pregnancy strains organs such as the liver, kidneys, and thyroid.
Multiple births can mean babies are born prematurely, which leaves them at a higher risk
for health problems later on in life. Ironically, Prospective Parents might view implanting
high numbers of embryos as a good thing. For “many couples, if they see this is their only
chance for a family, adopt a sort of buy one, get one free approach. Given that it doesn't
cost any more to have a Surrogate Mother have twins for you, they can sometimes see it as
a weird economy of scale.
Bobby Bains, who with his wife Nikki, has now had two children through Surrogates in
India, revealed that Surrogacy in India worked out so much cheaper precisely because
clinics implant more than the two embryos that is standard in the UK. In one of their
Surrogacy attempts in 2007, their potential Surrogate was implanted with six embryos.
Thus, the lack of regulation in the process of Surrogacy in India is being capitalized by the
Medical practitioners for earning huge profits by supporting the Intended parents
especially from west as in their countries either Surrogacy is banned or is under strict
monitoring of the Government.
_____________________________________________________ 17 Supra note 11
~ 214 ~
Expertise Medical Services
Surrogacy and ART offer solutions to infertility. The existing demand for these services
distorts priorities in the organization of health-care services as pressure is built to set up hi-
tech reproductive techniques within open markets and public sector service infrastructure
without building the basic facilities that help to prevent the infertility. The poor have to
either sell their assets to access the facilities or use the opportunity to earn by selling their
own reproductive potential the women that are pushed into this process carry the maximum
risks to their health. Over the past 10 years or so, our country has seen a mushrooming of
fertility clinics. This has inspired the medical tourism, where Surrogacy has important
place in its list of attraction as couples from abroad come seeking easy access to Surrogate
mothers. According to private providers, first world comforts and quality is available at
these Indian Institutions at the third world prices.
A 2012 study by the Confederation of Indian Industry estimated that nearly 10,000 foreign
couples visit India yearly for reproductive services and nearly 30% are either single or
homosexual.18 The relatively low cost involved an average Surrogacy package costs almost
50% less as compared to other countries, easy availability of a large pool of Surrogates,
good medical infrastructure with more than 2 lakh IVF clinics and legal freedom which
does not restrict single, gay or unmarried couples from availing this form of ART, has
taken India to spiraling heights in the field of International Surrogacy. These factors have
pushed the Surrogacy beyond its legitimate place. The technology which has evolved to
give the joy of parenthood to infertile couples has now become a business leaving behind
the traditional values and ethics. In India, IVF treatment is available at an affordable cost
which is nearly one-quarter of the cost in developed nations. Fertility clinics in countries
like UK, Israel, Australia, France, Spain, and Denmark are finding it more and more
difficult to fulfill the demand for donor eggs and hence turning to India. Furthermore, India
is also home to some of the finest International IVF Centres and top-notch IVF Doctors. ________________________________________________
18 Krishnan V. India’s draft surrogacy bill bars homosexuals, live-in couples. http://www.livemint.com Politics /ZsS2zs7Kvq Hlk4FCgu W0EN/Draft-surrogacy-Bill-bars-homosexuals-livein-couples.html (Last accessed August 26, 2013)
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Most of the major global IVF stakeholders have recognized the size of this opportunity,
and some have already entered the market. For instance, a renowned UK IVF operator,
Bourn Hall has established its two clinics in Gurgaon and Kochi. Despite this monumental
growth and expansion, the IVF sector is not without a catch. There are glitches, pitfalls and
dilemmas which can prove to be deleterious for its growth in the long run.
But while such circumstantial ambiguities persist, on the medical side, with internationally
trained Indian doctors, state-of-the-art facilities, high end diagnostics, thoroughly screened
Surrogates and qualified staff, the multi-million dollar Indian Surrogacy industry could
well turn out to be the largest in the world. Young doctors studied from top medical
colleges are providing their services in Surrogacy Clinics. The Indian Fertility Clinics are
running without any regulation and are not even following the ICMR guidelines properly
as there is no monitoring authority at National and State level. Because of lack of
regulation the medical experts are supporting the intended parents in return of huge profits.
Hence, the world class Medical amenities and Hi- tech Medical Infrastructure with
Expert Medical Practitioners and Services available in India are another very prominent
factors augmenting fertility tourism in India.
Supportive Machinery
With the globalization of trade in services, and the rise in Medical Tourism, India has
emerged as an attractive destination for medical services, and more recently, reproductive
services. As corporatized health care pushes Medical Tourism, the Indian state is also
extending its support to this burgeoning sector. For the last few years, India’s ‘Fertility
Industry’ has experienced rapid expansion, with the country emerging as one of the leading
Global Destinations for ‘Fertility Tourism’ or ‘Reproductive Tourism’ today.
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In India, Assisted Reproductive Technologies (ARTs), including for Surrogacy, have
achieved the proportions of an industry. Multiple Factors drive the demand for Surrogacy
in India. Out of them one such factor is the Supportive Machinery for Surrogacy available
in India.
Commercial Surrogacy for the domestic and international markets is the new avenue and it
is gaining ground in many urban and semi-urban areas in India today at an alarming rate.
Many ART clinics in India have tied up with foreign hospitals and agencies to solicit
‘clients’ globally in a bid to expand their clientele. These are included in the Medical
Tourism Services that are supported and incentivized under international agreements such
as the General Agreement on Trade in Services (GATS) under the World Trade
Organization (WTO).
The industry functions through actors and collaborators at various levels, in an
environment characterized by lack of binding standards or regulations, where these
multiple stakeholders stand to profit enormously. ART clinics are not the only players in
the business of promoting ‘Reproductive Tourism’ in India. Other players include a wide
array of organizations catering to clientele both at the national and international levels.
These range from ART consultants, medical tour operators, surrogacy agents, the
~ 217 ~
hospitality industry, and tourism departments to other organizations specializing in the
promotion of medical tourism. The Indian Government promotes medical tourism by
offering incentives such as low interest rates for loans provided for establishing hospitals
and subsidized rates for buying drugs, importing equipment, and buying land for clinics. In
addition, the General Agreement in Trade in Services (GATS) includes trade in medical
services, thus enabling private hospitals treating foreign patients to receive financial
incentives; these incentives include the ability to raise capital at low interest rates and the
eligibility for importing medical equipment at low rates of duty.
As Qadeer and Reddy assert, Medical tourism is an industry that thrives on cheap air
fares, Internet and communication channels in developing countries, and hi-tech super-
specialty medical services for people who can afford it, whether foreign or national
medical tourists. It also effectively deploys and markets Indian exotica, and packages
health care along with other traditional therapies and treatment methods.
To create demand, ART providers argue that with infertility being ‘Rampant and rising
steadily’ in today’s world, ARTs have become the ‘need of the hour’. They cite higher
rates of infections and ensuing complications, particularly in the absence of adequate
Gynaecological and Obstetric services, as factors that contribute to the high levels of
infertility in India. Providers thus claim that they are merely responding to the demand of
women ‘desperate’ to become mothers. There is an increasing medicalization and
pathologization of the condition of infertility, with the industry pushing for early medical
intervention.
The medical practice is motivated most by the need to keep up the ‘Success Rate’ and to
ensure the satisfaction of the Commissioning Parents, wherein the rights of the Surrogates
do not feature as a concern. Various studies revealed that several decisions taken in the
course of the treatment” such as those of opting for IVF in all cases, transferring multiple
embryos, performing foetal reduction, deciding on the time of delivery and preference for
~ 218 ~
caesarean sections, denying Surrogates to breast feed, are motivated by the concern for
ensuring conception and relinquishment on the terms of the Commissioning Parents. The
fact that these decisions translate often into unnecessary invasive procedures, can result in
lasting effects on the body has no bearing. Of equal significance is the fact that while such
decisions are supported by the Commissioning Parents’ intent as well as payments for the
“treatment”, Surrogates may find themselves left to their own selves and resources when it
comes to facing and dealing with health consequences post-pregnancy.
Privileging the financial interests over considerations of Surrogates’ health, while evading
any scrutiny by grounding all decisions in being “Medically indicated”, poses a great
challenge to ethics of medical practice, where “treatment” for one party, infertile couples
can come at the expense of health and participation of the Surrogate, who lacks the
privileged status of the client. The process lacks any transparency and the use of
technology, and the rationale for it, is seen to take into account the wishes of the
Commissioning Parents. Such skewed priorities and decisions in provisioning healthcare
are not surprising when the channel is that of profit-run, private enterprises that are more
concerned with the satisfaction of their ‘Consumers’ and stand completely unaccountable.
The Commercial Surrogacy arrangement is located in health care settings characterized
largely by private profit-oriented centres and hospitals offering services for infertility,
including Surrogacy. In this scenario, the Commissioning Parents have the power to set the
terms of the Surrogacy arrangement; their position as ‘Paying Customers’ for the services
accessed is accepted as legitimate and thus privileged. This creates a perception of the
Surrogate as merely an appendage to the Commissioning Parents. This is further amplified
by the class differences that characterize the arrangements, with Surrogates being able to
enter the spaces of these facilities by virtue of being Surrogates, spaces that are otherwise
inaccessible to and unaffordable for them. The health care extended to them is conditional
on their role as Surrogates and on the health of the children to be born through Surrogacy.
In such setups, the administration and providers are left completely unsupervised and
~ 219 ~
unaccountable for situations when decisions are taken at the expense of the health of the
Surrogate. The inferior status of Surrogates in the Surrogacy arrangement is evident from
the process of information transaction, which is largely under the control of
Commissioning Parents, Hospitals, and agents. Access to, and flow of, information and
participation in the decision-making process are predicated on the hierarchies of
knowledge, expertise and class that structure the Surrogacy arrangement.
The contract and the process of ‘Counseling’ are tools designed to serve the interests of the
Commissioning parents, the Hospitals and the Surrogacy industry. In current practice, the
contract does not embody the interests and conditions of the arrangements and are not set
by all ‘parties’ equally. It is merely an affidavit signed by the Surrogate agreeing to hand
over the child after birth and to relinquish all rights over the child. Nor are all the ‘parties’
obligated equally through this contract, resulting in an extremely biased contractual
agreement. ‘COUNSELING’, too, is practiced as an informal interaction between
Surrogates and Doctors/Agents. It is aimed at building a particular perspective among
Surrogates that is designed to ‘Convince’ them initially of the benevolence of becoming
Surrogates, and thereafter of the need to relinquish the child.
The practice is also seen to reflect compliance with, and the strengthening of, the
prevailing social hierarchies by catering to the demand for specific oocytes, to the demand
for specific kinds of women as Surrogates based on caste, religion, or class identity, and to
the demand for practices of selecting embryos on the basis of sex or against disability. In
nutshell, in India the Surrogacy industry and especially the infertile couples are supported
by numerous actors such as Surrogacy Clinics, Surrogacy Hostels, Agents, Surrogacy
Centers, top class Medical Practitioners, various Hospitals, Legal Practitioners, Medical
Tour Operators, Indian Tourism Department etc. This is again one of the major reason of
the growing Surrogacy industry in India as it is very easy and convenient for infertile
couples to come down to India and have their own Genetic Child with the help of the
available Support System.
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Scenario in Special Reference to Few Indian States
Infertility is a problem faced by couples worldwide.19 In the United States an estimated 6.1
million women between the ages of fifteen and forty-four have an impaired ability to
conceive children;20 in Australia, an estimated 1 in 6 couples between the ages of twenty
and fifty suffer from infertility;21 in Canada an estimated 600,000 people are dealing with
infertility;22 and these rates could double in the decade to come.23 Partly because of these
staggering statistics relating to infertility, the field of assisted reproduction-which includes
egg donation, intrauterine fertilization, In-Vitro insemination, embryo screening, and
surrogacy24 has grown astoundingly in the past three decades. Of these Assisted
Reproductive Techniques, Surrogacy is arguably the most controversial.
The concept of Surrogacy in India is not new. Commercial Surrogacy or "Womb for rent,"
is a growing business in India. In India, English speaking environment and cheaper
services attract the willing clients. Future projections of Surrogacy practice range from
opportunity to exploitation - from rural women in India uplifted out of poverty to a
futuristic nightmare of developing country baby farm.
_____________________________________________________
19 Marcia c. Inhorn, Local Babies, Global Science: Gender, Religion And In-Vitro Fertilzation In Egypt, (2003) ("Infertility is a global health issue that affects millions of people worldwide."). 20 Joyce c. abma et al., Health statistics, fertility, family planning, and women's health: NEW DATA FROM THE 1995 NATIONAL SURVEY OF FAMILY GROWTH 7 (1997) (noting that in 1995, 6.1 million women of reproductive age had "impaired fecundity," meaning "difficult or impossible to get pregnant or carry a baby to term"). 21 Hearing Before the Standing Comm. on Health and Ageing, H.R., Commonwealth of Australia 6 (July 6, 2005) (statement of Professor Michael Chapman, Chairman, IVF Directors Group) 22 The Infertility Awareness Association ofCanada, http://www.iaac.ca/en/home (last visited Mar. 5, 2009). 23 See Alex Barnum, Forlnfertile Couples, It's California or Bust: State Has Become Major Destination for Making Babies, S.F. CHRON., Aug. 15, 2005, at Al (noting estimates that infertility in industrialized European nations could double in the next decade). 24 John A. Robertson, Commerce andRegulation in the AssistedReproduction Industry, 85 TEx. L. REV. 665, 665 (2007) (book review); Jami L. Zehr, Student Article, Using Gestational Surrogacy and Pre-Implantation Genetic Diagnosis: Are Intended Parents Now Manufacturing the Idyllic Infant?, 20 LOY. CONSUMER L. REV. 294, 296 (2008); see CHARLES P. KINDREGAN, JR. & MAUREEN McBRIEN, ASSISTED REPRODUCTIVE TECHNOLOGY: A LAWYER'S GUIDE TO EMERGING LAW AND SCIENCE 8-10 (2006) (listing examples of uses of assisted reproduction technology).
~ 221 ~
In case of Surrogacy in India, it is hard to tell that whether these women are exercising
their own personal rights or whether they are forced to become Surrogate Mothers due to
their mother-in-law's or husband's desire to fulfill material and financial needs.25
Opponents of Surrogacy argue that the practice is equivalent to prostitution and by virtue
of that similarity; it should be disallowed on moral grounds. Surrogacy contracts are
dehumanizing and alienating since they deny the legitimacy of the Surrogate's perspective
on her pregnancy. Surrogate mother tries to avoid developing a special bond with the child
in her and views the pregnancy as merely a way to earn the much-needed money. The
payment for bodily services dehumanizes the Surrogate mother and exploits her
reproductive organs and capability for personal gains of the wealthy.
Commercialization of Surrogacy in India has created several social conflicts. Given the
extreme vulnerability, one-third of the Indian women due to poverty, exclusion from and
marginalization in labor and job markets, patriarchal social and family structures and low
educational levels, the financial gain through Surrogacy become a key push factor. Since
most Surrogate mothers are not from well-off sections and the motive primarily is
monetary so they are easily exploited by the agents working for Commissioning Parents.
Secrecy and anonymity creates a negative environment that affects human relations within
and outside families. In General this is the status of Surrogacy in India. Now let us discuss
the Social Scenario of Surrogacy in reference to some particular states which are as
following:
Gujarat Maharashtra Rajasthan Madhya Pradesh
_______________________________________________
25 Surrogate Motherhood in India, available at http://web.stanford.edu/group/womenscourage/Surrogacy/
GUJARAT
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For almost all Indians, the family is the most important social unit. Till as recently as a
couple of years ago, infertility was a glaring phenomenon that proved to be a shattering
experience for many couples. In the Indian family milieu, mothers-in law and intrusive
relatives would cast aspersions and make sly innuendoes on couples for not being able to
have kids in the first few years of marriage. Irrespective of their socio-economic status and
the caste or community they belong to, infertile couples are outcaste and discriminated
against.
However, with the Advancement of Science and Technology, a lot of things have changed
for the better. Right from changing our old mindsets to motivating us to explore newer,
more successful ways to live our life, technology has made things possible which weren’t
so before. The wonder of IVF is one such example which has come as a boon to millions
of couples who face the scourge of infertility like a thorn in the flesh.26 Over the last two
decades, there has been an exponential growth of infertility clinics around the world. The
concept of IVF has gained popularity at a swift pace in India over the last decade.
____________________________________________________________
26 India’s baby making business: The Growth Story, ehealth – The enterprise of Healthcare, August 9, 2014
http://ehealth.eletsonline. com /2014/08/indias-baby-
making-business-growth-story/
Currently, India’s
fertility market is
witnessing double-
digit growth which
is driven by proliferating infertility rates amongst married couples and availability
of competitive treatment procedures.IVF, Intrauterine Insemination (IUI) or Artificial
Insemination by husband or donor sperm, egg freezing, Intra cytoplasmic sperm injection
(ICSI), donor egg treatment, donor embryo treatment, endoscopic diagnosis as well as
~ 223 ~
surrogacy is all practiced widely in India with new techniques being evolved and
developed on a par with international standards. Sperm donation is a recent development
in Indian fertility market. It requires a kind of a medical expertise that is being expanded
and spread throughout.
Today, India stands at the forefront of reproductive medicine and Gujarat is touted as a
MECCA for all the IVF treatments. The presence of many IVF clinics and high
availability of Surrogates in Gujarat has ensured that Surrogacy has picked up majorly in
Gujarat, especially in Anand, which has earned the reputation of a ‘Baby Farm’.27
Anand, a small district in Gujarat, is home to India's first milk co-operative Amul
movement empowering scores of women, but since 2007 it is scripting a very different
story. Now it is considered to be the country’s Surrogacy capital. Anand is a city of about
100,000 people in the western Indian state of Gujarat. A curious fact about the
demographics of the state of Gujarat is that a large percentage of Guajarati’s have settled in
different parts of the world. Of the 20 million Indians spread across the globe, 6 million are
from the state of Gujarat, meaning that nearly 30 percent of the total Non-Resident Indian
(NRI) population is from this one state.28 Non-Resident Guajarati’s (NRGs) coming to
India for personal and medical visits are making Gujarat one of the most popular sites for
medical tourism in India.
________________________________________________
27 Lakshmi Ajay, Gujarat, a hub of rent-a- womb industry in India , The Indian Express, Nation, February 13, 2014, New Delhi available at http://indianexpress.com/article/india/india-others/gujarat-a-hub-of-rent-a-womb-industry-in-india/ 28 Pande A., Commercial Surrogacy in India: Manufacturing a Perfect Mother-Worker, : Journal of Women in Culture and Society 2010, vol. 35, no. 4 Available at http://www.iss.nl/fileadmin/ASSETS/iss/Guests/Adoption___surrogacy /Publications/Amrita _Pande _Pub.pdf
The majority of medical tourists are cardiac patients, but an increasing number of patients
are coming for joint replacement, plastic surgery, and now in vitro fertilization and
Surrogacy. Dr Nayana Patel is considered to be the Founder of Surrogacy industry in India
and especially Gujarat where she runs her infertility clinic named as “AKANKSHA
CLINIC”. Akanksha infertility and IVF clinic at “KAIVAL HOSPITAL ” in Anand has
~ 224 ~
come in existence to give a helping hand with modern techniques to many infertile
couples. The center is well established and has in recent years achieved some of the best
result. The center is now recognized internationally for its IVF and Surrogacy services. Dr.
Nayna Patel, Medical director of this centre has passed her MBBS and MD with five
gold medals. She has attended the scientific programme and IVF workshops at National
University, Singapore in 1996, and has been to IVF centers in USA, South Korea, UK etc.
She has received extensive training for all these techniques.29
Dr. Nayna Patel with her contracted Surrogates
Dr. Nayna Patel says, "Human beings have two main instincts; the instinct of self-
protection and the instinct to reproduce." And she should know – she has carved out a
career matching infertile couples with women willing to "Rent their Wombs". Beginning
with a couple of Surrogacy’s a year in 2003, Patel's Akanksha clinic in the West Indian
state of Gujarat now delivers about 250 Surrogate babies a year. ________________________________________________ 29 http://ivf-surrogate.com/
For now, however, it's business as usual at the Akanksha clinic. The researcher observed
that When Patel arrives at her clinic, the lobby is full of women. Some wear brightly
coloured saris; are in western dress. They are either desperately seeking a baby or hoping
to lift themselves out of poverty and offer their own children a better life. At the clinic of
~ 225 ~
Nayna Patel, perhaps India’s best-known “Surrogate Doctor” who delivered Anand town’s
first Surrogate baby, more women’s are signing up to be Surrogates, with even nurses and
teachers lining up, as their husbands lose their jobs.” The women who come here usually
want the money to buy a home, pay off loans, or for their childrens’ college education,”
said Patel in her small clinic, the walls of which are covered with clippings and pictures of
Patel with babies and parents.
It all began with a Grandmother Surrogate for a UK couple in 2004 that pitched Anand and
Patel into the spotlight. Following their lead, locals and foreigners began to flock to Patel’s
clinic, drawn by the lower costs, relaxed attitude toward Surrogates and lack of legislation.
Dr. Patel, was featured on a special show on Oprah Winfrey 7 years ago, raised her voice
in defence.
“My argument is: the Surrogate is not killing anyone, not committing an illegal
or immoral act. And if a Surrogate’s child is able to get an education, if one
family is able to buy a home — and help a needy couple in the process, where is
the harm?”30
A Surrogate is generally paid about Rs250, 000-400,000 ($4,000-$8,000), a huge sum of
money in a country where many live on less than $2 a day. Many women, who come from
different areas, have found employment in the In-Vitro Fertilisation (IVF) clinic in Kaival
Hospital run by Dr Nayna Ben Patel. To them she was like a Godmother and the Mother of
Surrogacy in India.
________________________________________ 30 Chandran R., Poverty makes surrogates of women in Gujarat , Live Mint, Apr 24,2009 , available at http://www.livemint.com /Politics /F7XhxvREB6TKZo3ybQiISJ/Poverty-makes-surrogates-of-women-in-Gujarat.html
Dr. Nayna says that "I would like to help them all throughout my life and the way we are
trying to build up this support group for the surrogates and build up a fund for the
surrogates."31 Couples from western countries come to Dr Patel’s Clinic with a hope of
~ 226 ~
having their own Child. Looking into the concern of the Intended parents she has
established a Surrogate House for 24*7 monitoring the Surrogates.
Raju bai's is a familiar story in the "Surrogate House" where she lives with 39 other
pregnant women. Owned by Patel, the house is located 10 minutes away from the clinic.
With two to three iron-framed beds in each room, the house has the look of a hospital
ward. The Surrogates, clad in loose, colourful gowns, are sitting, lying, stretching,
watching TV or chatting with each other. In one room, hangs a picture of a crawling
toddler with the words: "The time to be happy is now." The majority of the women are
second-time Surrogates and will have caesarean sections. "We have to cut our stomachs for
money," says Anjuman Pathan, a blunt, 30-year-old. "It's not a bad thing, is it?"32
Life at the Surrogate House creates a sense of sisterhood. The women enjoy the rest and
care they may not have had during their own pregnancies but are confined to the house for
the whole pregnancy. Their families can visit on Sundays but the Surrogates only leave the
premises for medical check-ups or if there is a family emergency.Thus, its docile here to
say that initially Doctors with western education, top-notch facilities and lower prices had
already made India an attractive destination for procedures ranging from bypass surgery to
liposuction. And now, Lax Legislation and an entrepreneurial streak in Gujarat have helped
make Anand a last stop for many childless couples at home and abroad. In this bustling
town known for India’s best-known brand of butter, Patel has delivered more than 600
Surrogate babies, 40% for Indians living abroad and 20% for foreigners.
________________________________________________ 31 Bhardwaj R., India preferred destination for surrogacy due to low cost, but practice remains unregulated, CNN-IBN, Oct 18, 2014 available at http://ibnlive.in.com/news/india-preferred-destination-for-surrogacy-due-to-low-cost-but-practice-remains-unregulated /506888-3-238.html 32 Inside India's surrogacy industry , December 06, 2011 Available at http://www.theguardian.com /world /2011 /dec /06 /surrogate-mothers-india
Apart from Akanksha Clinic, Gujarat is now a hub of hundreds of other IVF Clinics.
Out of them one such Clinic is Hope Maternity Clinic. At Hope Maternity Clinic in
Anand, it was observed that the proportion of international clients was the clear indication
of the success of medical tourism. Hope Maternity Clinic is very unremarkable looking: it
~ 227 ~
is one clinic among the many mushrooming medical stores and hospitals lined up one after
the other on a street in the center of the city.
Dr. Usha Khanderia, Medical Director of the Center, specializes in infertility and
assisted reproductive technologies. She had her first successful case of Surrogacy in 2004
when a woman gave birth to her own Grandchildren on behalf of her UK- based daughter.
For her second case, Khanderia convinced an employee at her clinic to be a Surrogate.
Since then she has matched over 100 Surrogates with couples from India and from places
as diverse as the United States, Taiwan, South Korea, South Africa, the United Kingdom,
and Spain.33 In nutshell, in Gujarat Surrogacy has turned to be a booming business.
Infertile Couples from abroad come to Gujarat with a hope of having their own Genetic
child and therefore there is a mushroom growth of IVF Clinics in Gujarat particularly in
Anand, Surat, Ahmedabad etc. Following is the list of few very popular clinics of
Gujarat.34,35
IVF CLINICS IN GUJARAT
Akanksha Infertility Clinic 91-2692-253789
Dr Nayana Patel,
Kaival Hospital, Station Road
Anand, Gujarat, 388001.
Email: [email protected]
Web: www.ivfcharotar.com [
_________________________________________ 33 Supra note 28 34 IVF Centres in Ahmedabad, In Vitro Fertilization Treatment, India Justdial http://www.justdial.com/Ahmedabad/ivf-centres, 35 Clinic locator, http://www.fertilityjourney.in/locator/clinic.asp?C=99152420668499421296&search Type=&page=&do Search=True &State=Gujarat
Motherhood Women And Child (91)-79-30492250
Surgen Arcade, First Floor, Sola, Ahmedabad - 380063,
Above Axis Bank, Near Science City
Estd. in 2012
~ 228 ~
Nautam Nursing Home (91)-79-30247826
Rasala Marg, Ellis Bridge, Ahmedabad - 380006,
Near Mithakali Six Roads
Estd. in 1976
Boon IVF Center (91)-79-30925070
2, Sumangalam Society, Drive In Road, Ahmedabad - 380052,
Near HDFC Bank, Opposite Drive In Cinema
Estd. in 2013
Pratham Ivf & Urology Clinic
(91)-79-30925164
131, 132,135, 136, First Floor, Advait Complex,
Vastrapur, Ahmedabad - 380015, Near Sandesh Press
Estd. in 2003
Dev Art IVF and Shachi Women
(91)-79-30495687
First Floor, Kaveri Complex, Subhash Bridge, Ahmedabad - 380027,
Opposite RTO Office, Subhash Bridge Circle
Estd. in 1992
Sarvamangal IVF and Womens
(91)-79-30247946
301 & 303, 3rd Floor, Jyoti Complex, 132 Feet T Ring Road, Satellite, Ahmedabad - 380015,
Beside Dr Parekh Hospital
Estd. in 1996
Nova Pulse Ivf Clinic Pvt Ltd
(91)-79-30234767
108, Swastik Society, H L Commerce College Six Road, Navrangpura, Ahmedabad - 380009,
Behind St Xaviers Ladies Hostel And Sams Pizza
Estd. in 2000
Wings Womens Hospital
~ 229 ~
(91)-79-30931756
2, Sumangalam Society, Thaltej, Ahmedabad - 380054,
Opposite Drive In Cinema , Near HDFC Bank
Estd. in 2006
Jani Nursing Home
(91)-79-30932477
7 A , Urmikunj Society, Navrangpura, Ahmedabad - 380009,
Nr St Xavier's College Corner, B/H Bank Of Baroda
Estd. in 1982
Vani Ivf Centre And Hospital
(91)-79-30492214
Vani Hospital, 32 Asmita Society, Maninagar, Ahmedabad - 380008,
Near Kashivishwanath Temple, Maninagar East
Estd. in 1994
Tulip Womens Hospital
(91)-79-30247371
Kalatirth Complex, Satellite, Ahmedabad - 380015,
Above HDFC Bank, Near Prernatirth Derasar, Jodhpur
Estd. in 2001
Vijaya Maternity And Surgical Hospital
(91)-79-30922375
Second Floor, Chanakya Plaza, New C G Road-Chandkheda, Ahmedabad - 382424,
Opposite Swagat 1 Bunglows/ICICI Bank
Estd. in 2007
Reshambai Fertility Hospital
(91)-79-30234768
Swastik Complex, First Floor, Shahibaug, Ahmedabad - 380004,
Opposite Rajasthan Hospital
Estd. in 1996
Lifeline Multispeciality Hospital
(91)-79-30925752
Shayona Tilak, New S G Road, Chandlodiya, Ahmedabad - 380061,
~ 230 ~
Near Vandemataram Arcade
Estd. in 2013
Rosemaarry Womens Hospital
(91)-79-33014099
29 & 30, B Block, Mansi Complex, Premchand Nagar Road, Vastrapur, Ahmedabad - 380015,
Opposite Satellite Tower
Estd. in 1994
Sushrusha Navneet Memorial
(91)-79-30817141
Sushrusha Hospital, Navrangpura, Ahmedabad - 380009,
In a Lane Opposite Navrangpura Telephone Exchange Building Near Sardar Patel Seva Samaj Hall
Estd. in 1991
Shashwat Ivf Center Pvt Ltd
(91)-79-30236020
Second Floor, Nilkanth Palace, Prahladnagar Road, Satellite, Ahmedabad - 380015,
Opposite Seema Hall
Estd. in 1997
Sunflower Womens Hospital
(91)-79-30492423
132 Feet Ring Road, Memnagar, Ahmedabad - 380052,
Near Manav Mandir, Opposite Helmet Circle
Estd. in 2004
Palash Hospital
(91)-79-30247913
14 C P Nagar Society Part 1, Bhuyangdev, Ahmedabad - 380052,
Bhuyangdev Cross Road
Estd. in 2010
Mayflower Womens Hospital
(91)-79-30817167
Mayflower House, 132 Feet Ring Road Drive In Road, Memnagar, Ahmedabad - 380052,
Opposite Traffic Police Halmet, Near Manavmandir
Estd. in 2003
~ 231 ~
Anand Surgical Hospital Pvt Ltd
(91)-79-22815100, (91)-9727395266
Memco Cross Road, Memco, Ahmedabad - 380025,
Near Ioc Petrol Pump
Estd. in 2014
Bavishi Fertility Institute
(91)-79-30234809
Dr Himanshu Bavishi, Dr.Falguni Bavishi,
Paldi Cross Road, Paldi, Ahmedabad - 380007,
Near Gajrawala Flat Next To Adani CNG Station Opposite Municipal Garden
Email: [email protected]
Web: www.ivfclinic.com
Nagoris Institute For infertility
(91)-79-26401090, 26402090
Opp Krupa Petrol Pump, Ellis Bridge, Ahmedabad - 380006,
Nr Parimal Garden
Estd. in N/A
Poojan Maternity And Fertility...
(91)-79-22818183, (91)-8460810362
202, 2nd Floor, Shruhad Complex, Devi Multiplex Road, Naroda, Ahmedabad - 382330,
Opposite Anil Showroom, Naroda Doctor House, Narayan Nagar Bus Stand
Estd. in N/A
SHASHWAT IVF CENTRE PVT LTD
(91)-79-26931919, 26930007
2nd Floor, Nilkanth Palace, Prahalad Nagar Road, Satellite, Ahmedabad - 380015,
Opp Seema hall
Estd. in 1996
21st Century Hospital & Test Tube Baby Centre
91-261-2490190
Dr Purnima Nadkarni, Dr.Pooja Nadkarni Singh,
51/B,Dawer Plaza,Near SaveraHotel,Station road Surat, Gujarat, 395003.
Email: [email protected]
Web: www.nadkarnigroup.com
~ 232 ~
Me & Mummy Hospital & IVF Centre
91-261-2471111 / 0261- 2479731-32-33
Dr Praful Doshi,
3rd Floor, Jainidhi Complex, Opp Bahumali Building, Nanpura Surat, Gujarat, 395001.
Email: [email protected]
Web: www.meandmummyindia.com
Pulse Women's Hospital, Melbourne IVF Gujarat
91-79-26422626
Dr Manish Banker, Dr.Pravin Patel,
108, Swastik Society, Bh St Xavier's Ladies Hostel, Navrangpura , Ahmedabad, Gujarat, 380009.
Email: [email protected], [email protected]
Web: www.pulse-hospital.com
Sunflower Women's Hospital 079-27410080 / 27410090
Dr Raman Patel / Dr.R.G.Patel, Dr.R.G.Patel,
Near Manavmandir, Opp Traffic Police Helmet Cross,
Drive In Road, Memnagar Ahmedabad, Gujarat, 380052.
Email: [email protected]
Web: www.sunflowerhospital.in
MAHARASHTRA
It is now 11 years since Commercial Surrogacy was legalized in the country, mainly to
promote health tourism, but Surrogate Motherhood is yet to gain due recognition. In fact,
Surrogate Mothers are an exploited lot. A study by the Centre for Social Research (CSR)
has found that the women who agree to be Surrogate Mothers get only one or two per cent
of the total money a couple spends to have a child in this manner. The rest of the money is
pocketed by owners of fertility clinics, doctors, nursing homes and middlemen. In fact, the
condition of the Surrogate Mother is worse than that of a slave.
~ 233 ~
She not only has to carry the fertilized egg in her womb for nearly 10 months but is also
kept aloof from her own family. She is often admitted to a secluded place where she has to
eat food and medicines prescribed by doctors, not for her own nourishment but for the
growth of the child in her womb. Logically, she should be the one who must benefit the
most. Surrogacy is no more a small business. The Confederation of Indian Industry has
pegged the volume of such business at `13,800 Crore. Yet, it is almost unregulated leading
to exploitation of women in India and especially in the State of Maharashtra. These are the
views expressed in an article published in The News Indian Express. 36
India is fast turning into a Surrogacy hub for couples desperate to have children. But there
is a flip side - the possibility of exploitation. CNN-IBN takes a look at both sides of what's
being called the fertility industry. "I have big dreams for my children. I want my son to
become an engineer and my daughter to be a doctor," said Kaushal, who is a Surrogate
Mother.37 To realise those dreams, 29-year-old Kaushal, a Mother of two, decided to
become a Surrogate.
_____________________________________________
36 “Eliminate exploitation of surrogate mothers “ The New Indian Express ,2013, 20th July http://www.newindianexpress. com/editorials/Eliminate-exploitation-of-surrogate-mothers/2013/07/20/article1691946.ece
37 India a surrogacy hub despite the flip side, IBN live, 2012, Jun 12 http://ibnlive.in.com/news/india-a-surrogacy-hub-despite-the-flip-side/265568-17.html
The motivation was purely financial. Living in Mumbai on a Rs 150 income for a family of
four, she knows she will be compensated well for carrying someone else's baby to term.
Surrogates are paid between Rs 2 to 4 lakh and for the infertile couple waiting, the gift is
priceless. This is again a story from, Mubai which is leading in Fertility clinics in the State
of Maharashtra.
According to Hrishikesh Pai, a Mumbai-based In-Vitro Fertilization Specialist and
Vice-President of the Indian Society for Assisted Reproduction, India had about 350
facilities that offer Surrogacy as a part of a broader array of infertility-treatment services,
triple the number in 2005. In the year, 2008 Dr. Pai says, about 1,000 pregnancy attempts
~ 234 ~
using Surrogates were made at these clinics. Next year, the figure jumped to 1,500, with
about a third of those made on behalf of parents from outside India who hired Surrogates.38
Rudy Rupak, President of Planet Hospital, a California-based Medical-Tourism
company, says that in the first eight months of 2009 he sent 600 couples or single parents
overseas for Surrogacy, nearly three times the number in 2008 and up from just 33 in 2007.
All of the clients in 2009 went to India except seven who chose Panama. Most were from
the U.S.; the rest came from Europe, the Middle East and Asia, mostly Japan, Vietnam,
Singapore and Taiwan.
No official agency keeps track of the number of would-be parents who travel to India for
Surrogacy. But the proliferation of clinics around the country providing such services gives
some idea of the rising demand for Surrogates: women who bear children on behalf of
other people, often in return for money, a practice that is legal in India.
____________________________________________________
38 Margot Cohen ,“Hiring A Surrogate in India WSJ” 2009, Oct.9, available at http://www.wsj.com/articles /SB10001424 0527 4870425200 45744 59003279407832
Mr. Rupak says that because of growing demand from his clients for eggs from Caucasian
women, he's started to fly donors to India from the former Soviet republic of Georgia,
where he has connections with clinics. The first woman arrived last month. A Planet
Hospital package that includes an Indian egg donor costs $32,500, excluding transportation
and hotel expenses for the intended parent or parents to travel to India. A package with
eggs from a Georgian donor costs an extra $5,000.
Another city of Maharashtra, which is in nascent stage of Surrogacy is Pune. A woman and
Child Specialty Hospital ONP Tulip has launched the city’s first Surrogacy centre in the
year 2013. The hospital that is well known in the field of IVF and high risk obstetrics will
~ 235 ~
offer guidance and medical, legal and administrative support for the entire Surrogacy
process, Dr. Amita Phadnis, Director, ONP Tulip, said.
“We screen the potential Surrogate woman to ensure that she is medically and
psychologically fit to go through the pregnancy. Our selection criteria are strict
and the potential Surrogate woman has to undergo a lot of medical fitness tests,
before her selection is approved. Most important, she should voluntarily make a
decision of Surrogacy”.39
Looking at these stories, it’s very apparent that Surrogacy is increasing at an alarming rate
in Maharashta and especially in Mubai, Pune, Nagpur etc. And therefore for the first time
in India, the Maharashtra Medical Council (MMC) has decided to formulate rules and
regulations on Surrogacy and has formed a committee for the same. The step was taken
after the Mumbai Police Commissioner wrote a complaint letter to the MMC alleging
malpractice on part of city's three leading infertility experts, who are from the Surrogacy
sector.
__________________________________________
39 Kshirsagar A., Pune gets first surrogacy centre 2013, Jan 10 http://www.thehindubusinessline.com/news/pune gets-first-surrogacy-
centre/article4294357.ece
The three Clinics are Bandra's Rotunda Fertility Clinic, Andheri's Corion Fertility
Clinic, and the Surrogacy clinic at the Lilavati Hospital in Bandra. The committee
constituted by MMC comprises Gynaecologist Dr Sanjay Gupte from Pune and Senior
Gynaecologist Dr Bipin Pandit of Mumbai. MMC is a statutory body that has the power
to suspend a Doctor's license if s/he is found guilty of malpractice. Currently, the
Surrogacy treatment is unchecked, unsupervised and not regularized. According to sources,
there are around 70-80 IVF Centre’s in Mumbai and 200 in the state, with the numbers
rising over the past few months. The cost of the treatment runs into lakhs.40
~ 236 ~
The letter, which was written to MMC last month, requested the body to look into the
Doctors' alleged malpractices. The issue was discussed in a meeting of the ethical
committee on Saturday. In the absence of any clear regulations on Surrogacy, committee
members felt the need to introduce the same to keep a watch on it. MMC member Dr
Shivkumar Utture said, "We discussed the letter and how the surrogacy sector is
unregulated. We will investigate the allegations in the letter, but, in the meantime, we have
formed a committee, which will formulate rules and regulations for Surrogacy that will be
applicable for Maharashtra."41
Keeping a watch on Surrogacy has been a long-pending demand of health activists. There
have been cases wherein the Surrogate mother was exploited by doctors for money. Dr.
Satish Pawar, Director of Health Services in Maharashtra, said, "There are many
things in Surrogacy that need to be looked into. Exploitation of the Surrogate Mother is the
biggest problem. The state too has its own committee looking into the Surrogacy Rules and
regulations."42
______________________________________
40 Santosh Andhale and Somita Pal, Maharashtra Medical Council forms panel to regularise surrogacy, 2014, 6th April http://www. dnaindia.com/india/report-maharashtra-medical-council-forms-panel-to-regularise-surrogacy-1975602
41 Id.
42 Id.
The Indian Council of Medical Research, drafted the Assisted Reproductive Technology
(Regulation) Bill and Rules in 2008, then revised draft in 2010 and now in 2013, but it's
unfortunate that the proposed law is still pending in Parliament. Presently, the Surrogacy
sector in India is said to be around Rs 900 Crore, which, according to industry experts, is
growing at 20% every year. Each birth costs as much as Rs 12 lakh, out of which the
Surrogate Mother gets only Rs 3.5-4 lakh, apart from Rs 5,000 a month for her food and
nutrition supplements.
~ 237 ~
Indian Medical Association Secretary Dr Jayesh Lele said, "The state health department
had appointed an eight-member expert committee to formulate rules and regulation on IVF
treatment six months ago. After our meeting, we filed a report and submitted it to the
Government. For such kind of treatment, there need to be rules in place."
In nutshell, whatever be the ethics of promoting Commercial Surrogacy, there is no doubt
that its turnover is likely to grow as same-sex marriage is increasingly becoming legal in
the West. It is, therefore, high time that a suitable law is enacted in this regard. A bill,
introduced in the Maharashtra legislature about two years ago to deal with issues related to
Surrogacy, is yet to be passed. Maharashtra has stolen a march over other states in
exploiting the potential of the New Reproductive Technique, though states like Kerala are
not far behind. At the Centre, a draft Assisted Reproductive Techniques Bill, framed in
2008, revised in 2010 and then in 2013 has been pending in Parliament. The Centre should
come up with a model law to deal with all Surrogacy related issues.
Following is the list of few IVF Clinics43 working with the
“Motto - Making happy families out of couples” and claims that treating
infertility is not an occupation for us, but it is our passion and we do it with
compassion. _____________________________________________________ 43 See http://www.hiranandanihospital.org/content/ivf-clinic.html, http://ivfinindia.in/, http://www.startlocal.in/fitness/infertilityivf services/maharashtra/ http://www.icmr.nic.in/icmrnews/art/List%20of%20Enrolled%20ART%20Clinis-5%203%202013.pdf
IVF CLINICS IN MAHARASHTRA
Rotunda Clinic: Mumbai
91-022-26405000
672, Kalpak-Gulistan, Perry Cross Road, Near Otters Club, Bandra West,
Mumbai, Maharashtra, 400050
Rotunda Fertility Clinic and Keyhole Surgery Centre
91-022-26390044
~ 238 ~
Shastri Nagar, X-13, Garden View, 7-10, Near Lokhandwala Circle, Andheri West,
Mumbai, Maharashtra, 400050
Rotunda-The Center for Human Reproduction 91 22 2655 2000
Website : http://www.iwannagetpregnant.com
Mail: [email protected]
Corian Fertility Clinic,
91-22-26395588/5599
2nd Floor, Trans Avenue, Lokhandwala Road,
Near Versova Telephone Exchange,
Andheri (West), Mubai – 400053, India
Kamala Polyclinic & Nursing Home Dr. Jatin Pankaj Shah
66-C, Motiwala Building, 1st Floor, Gowalia Tank, Mumbai-400026, Maharashtra.
Email: [email protected] ; [email protected]
Website: www.drjatinshah.com
Surrogate India 91-098-20281854
Mumbai, Maharashtra, 400014
Dept. of Assisted Reproduction & Genetics Dr. Firuza Rajesh Parikh
Jaslok Hospital & Research Centre, 15 Dr. G. Deshmukh Marg, Mumbai-400026, Maharashtra.
Email: [email protected] ; [email protected]
Website: www.ivfclinicindia.com
Gynaecworld Assisted Fertility Unit Dr. Duru Shah
Gynaecworld, 1st Floor, Kwality House, Above Chinese Room, Kemp’s Corner,
Mumbai- 400026, Maharashtra.
Email: [email protected]
Website: www.gynaecworld.com ; www.ivfclinicindia.in
~ 239 ~
Malpani Infertility Clinic Pvt. Ltd. Dr Aniruddha Malpani
Jamuna Sagar, Shahid Bhagat Singh Road, Colaba, Mumbai-400005, Maharashtra.
Email: [email protected]
Website: www.drmalpani.com
Narvekar Infertility and Endoscopy Clinic Dr. Ajanta Narvekar
Patel Chambers, 2nd Floor, Opp. Opera House Theatre, Next to French Bridge,
Mumbai- 400026, Maharashtra.
Email: [email protected] ; [email protected]
Website: www.drnarvekar.com
Nirmiti Fertility & IVF Dr. S. Krishnakumar
1st Floor, Parasmani Building, Near Naupada Police Station, M.G. Road,
Shahu Market Thane(W), Mumbai-400602, Maharashtra.
Email: [email protected]
Website: www.nirmitifertility.com
Shreyas Infertility & IVF Centre Dr. Shreyas Padgaonkar
Aparna Hospital, J. Nehru Road, Mumbai-400080, Maharashtra.
Email: [email protected] ; [email protected]
Shruti Nursing Home, Centre for Human Reproduction Dr. Hitesh Parikh
19-A, Pali Road, Opp. HSBC Bank, Bandra (West), Mumbai–400050, Maharashtra.
Email: [email protected]
Website: www.latestinivf.com
Southern Cross Fertility Centre Dr. Faram Erach lrani
United Western Apartments, Ground Floor, Veer Savarkar Marg, Prabhadevi,
Mumbai- 400025, Maharashtra.
Email: [email protected]
Website: www.southerncrossfertility.com
Tomar IVF Centre
~ 240 ~
Dr. Sushma Gajendra Tomar
Tomar Nursing Home, Prabhu Appt., Opp. Union Bank of India, Ulhasnagar-421001, Maharashtra.
Email: [email protected]
Website: www.tomarnursinghome.com
Deogiri Nursing Home-Endoscopy & Test Tube Baby Center Dr. Pandit Palaskar
1, Bhanudasnagar, Jawahar Colony Road, Behind Akashwani & Big Bazaar,
Aurangabad- 431005, Maharashtra.
Email: [email protected]
Website: www.panditpalaskar.com
Patankar Fertility Solutions Pvt. Ltd. Dr. Amit Patankar
Patankar Fertility Solutions Pvt. Ltd., 500/B/1, Parvati, Opp. Sarasbaug, Pune-411009, Maharashtra.
Email: [email protected] ; [email protected]
Website: www.patankarhospital.com
Genesis Fertility, IVF & ICSI Centre, Pune Dr. Leena Patankar
Genesis, Fertility IVF & ICSI Centre, 986/A/1, Shukrawarpeth, Opp. Saras Baug,
Pune, 411002, Maharashtra.
Email: [email protected] ; [email protected]
Website: www.patankarhospital.com
Bloom Fertility Centre Lilavati Hospital 91-098-23561231
Bandra (w.) Mumbai, Maharashtra, India 400050
Merck Specialities Pvt Ltd 91-022-66609000
Shiv Sagar Estate A, Dr Annie Besant Road, Worli, Mumbai, Maharashtra, 400018
Morpheus IVF 91-022-42030900
606, 6th Floor, Dev Plaza, Opp Shoppers Stop, Andheri W, Mumbai, Maharashtra, 400058
Shri Chaitanya Fertility Clinic 91-025-12860742
Royal Status, Sir Balchandra Marg, Behind Mid Town Pritam Hotel, Kohinoor Road,
Lokmanya Tilak Colony, Dadar East, Mumbai, Maharashtra, 400014
~ 241 ~
Shivani Scientific Industries Pvt Ltd
91-022-28961768
26A, Raju Industrial Estate, Penkar Pada Road, Nr Dahisar Checknaka, Mira, Mumbai, Maharashtra,
Dr Nandita Palshetkar Clinic
91-093-23312315
Mumbai, Maharashtra, 400050
Ayyub Khan Clinic 91-094-22522603
66, Ganesh, Peth, Firoz, Chambers, Floor 4, Pune, Maharashtra, 411002
Dr A K Pawar Institute
91-025-32596797
Charuhas, Nr Gaikwad Classes, Nashik, Maharashtra, 422001
Wardhman Hospital Malegoan Road, Nandgoan, Maharashtra
Dr L H Hiranandani Hospital 91 22 25763333 / 25763300. Fax : +91 22 2576 3344 / 3311
Hill Side Avenue, Hiranandani Gardens, Powai, Mumbai (400 076)
Email : [email protected]
http://www.startlocal.in/fitness/infertilityivfservices/maharashtra/
Ankur Fertility Centre
A, 01, First Floor, Imperial Mahal, Above HDFC Bank, Khodadad Circle, Dadar T.T., Mumbai 400 014.
RAJASTHAN Surrogacy is growing as an industry in the state as many childless couples from abroad are
coming Rajasthan with hopes of getting a child through Surrogate Mother. Women from
~ 242 ~
different walks of life have played the role of Surrogate Mother for mostly childless Indian
couples living in Gulf, South-East, UK and other countries.
Rajasthan is yet another Indian state, in the booming business of Outsourcing Motherhood.
Though, if we compare it to Gujarat and Maharashtra it is far behind in Surrogacy. But the
growth in ART Clinics in Rajasthan reveals that it is on the way to become another
paradise of infertile couples soon.
Medical director of a Jaipur-based Fertility Centre, Kailash Garg said: "Our clients
are from various countries. There are some medical disorders which can prevent a woman
from conceiving a baby.” Unlike Mumbai and Gujarat in Rajasthan the stigma attached to
Surrogacy is disastrous. Neither party wishes to disclose their Identity. The women acting
as Surrogate do not reveal their identity as there are apprehensions that sometimes they
may be expelled from their caste, if others come to know that she is a Surrogate Mother.
The Doctors and the Clients keep the identity of the woman secret. Says Dr. Garg, "The
clients select the woman for Surrogacy from a decent family background. The woman
should be healthy. She should not have health related problems like HIV, Hepatitis or any
mental illness. We are doing it following all the legal guidelines of the Indian Council of
Medical Research. We do not arrange the Surrogate Mother. It is the couple's job. Our job
is clinical only." 44
Moreover, a private fertility centre in Udaipur is also providing facilities for Surrogacy.
Centre's Doctor Kshitiz Murdia said, "Our clients are from India as well as from abroad.
In a month, we give clinical services to at least five couples." Surrogacy industry is
growing in Rajasthan but in very secretive manner. As the populace of Rajasthan is
Conservative so the parties involved in it maintains the confidentiality. In Abu Road,
which is close to the Gujarat border, a woman working as a housemaid earlier is now
completely into the business. This is fourth time she is conceiving a baby as a Surrogate
~ 243 ~
Mother. A Member of Society for All Round Development (SARD), Sirohi Brijmohan
Sharma said: "The woman is now conceiving the baby of a couple living abroad." The
doctors follow the common In-Vitro Fertilization (IVF), a process for using sperm to
fertilize egg outside the body.
In last few years it is being observed that there is mushroom growth of ART Clinics in
Rajasthan. Out of them few are enrolled under National Registry of ART Clinics and
Banks in India, Indian Council of Medical Research, New Delhi45 and rest are running
on their sweet will. The industry is totally unchecked and unregulated. Following is the list
of few IVF Clinics running in Rajasthan.46
____________________________________________ 44 Syed Intishab Ali, “Spurt in women opting to become surrogate mothers” 2013,Apr 22, available at http://timesofindia.indiatimes .com/city/jaipur/Spurt-in-women-opting-to-become-surrogate-mothers/articleshow/19669561.cms 45 For detail list of ART Clinics enrolled under National Registry of ART clinics and Banks in India Visit http://www.icmr.nic.in/icmrnews/art/List%20of%20Enrolled%20ART%20Clinis-5%203%202013.pdf
46 See http://www.icmr.nic.in/icmrnews/art/List%20of%20Enrolled%20AR%20Clinis-5%203%202013.pdf , http://www.justdial .com/ Kota-rajasthan/Infertility-Clinics/ct-10265454, http://www.whatclinic.com/fertility/india/rajasthan
IVF CLINICS IN RAJASTHAN
Indira Infertility Clinic and Research Centre 9, Govindpura Colony , Opp. M.B. College Ground, Near Subhash Nagar, Udaipur, 31
Neelkanth Fertility and woman care Hospital
91-294-6530105
10-11, Doctors Lane, Near RSEB Office,
Behind Celebration Mall, Bhuwana, Udaipur.313001 (Raj.) INDIA
New Enquiries: +91-96363-28777, +91-91662-58999
Existing/Old Patients: +91-97846-00614
International Fertility & Healthcare Center Dr. Vibha Kailash Garg
International Fertility and Healthcare Center, Dr. Garg Tower, *Near Reserve Bank of India,
456, Swai Ram Singh Road, Jaipur-302004, Rajasthan.
~ 244 ~
Email: [email protected]
Website: www.fertilitytreatmentindia.com
Shivani Fertility & IVF Centre Dr. Neelam Bapna
Saket Hospital, Sector-10, Meera Marg, Mansarovar, Jaipur-302020, Rajasthan.
Email: [email protected]
Website: www.jaipurivf.com
Aanchal Fertility & Mother Care Hospital Dr. C.P. Dadhich
Near Pareek College Turn, Behind Zanana Hospital, Jhotwara Road, Chandpole Bazar,
Jaipur-302016, Rajasthan.
Email: [email protected] ; [email protected]
[email protected] ; [email protected]
Website: www.aanchalcare.com
Bhandari Hospital and Research Centre Dr. Rekha Bhandari
138-A, Vasundhra Colony, Gopalpura Bypass, Tonk Road, Jaipur-302018, Rajasthan.
Email: [email protected]
Website: www.bhandarihospital.net
Agrawal Neuro Psychiatry Centre
(91)-744-2431217, (91)-9829035071 Main Road, Jawahar Nagar, Kota, Rajasthan
Laser Urology Clinic Dr. Rajesh Jain
(91)-9829878123, 9829279123
Sheela chaudhary road, Talwandi, Kota, Rajasthan
Vivan Hospital For Sexual Health (91)-141-4653324
Queens Road, Vaishali Nagar, Jaipur
~ 245 ~
Sukh Sagar Hospital & Health Centre
(91)-9928413132, 9314501515
No-1, Vishwakarma Industrial Area, Jaipur
Pribbgom Test Tube Baby Centre and Infertility Hospital (91)-9414017364, 7597588800
Scheme No. 1, Alwar Ho, Alwar
Dr Anish Gupta
(91)-744-2364737, (91)-9351656848
Kota-8 , Kota , Rajasthan
Swastik Clinic & Infertility Clinic (91)-9667320198
Main Road, Dcm Road, Kota, Rajasthan
Baheti Hospital & Centre for Reproductive Healthcare Dr. Vinod Kumar Baheti
14, Usha Colony, Malviya Nagar Main Road, Jaipur-302017, Rajasthan.
Email: [email protected]
Website: www.baheti-ivf.com
Vasundhara Hospital & Fertility Research Centre Dr. Sanjay Makwana
11/11, Nandanwan, Chopasni, Housing Board, Jodhpur-342001, Rajasthan.
Email: [email protected] ;
Website: www.vasundharafertility.com
Shri Nidaan Hospital & Hope Fertility Centre Dr. Deepak Chauhan
27, Vidhyut Nagar-A, Ajmer Road, Jaipur-302021, Rajasthan.
Email: [email protected] ; [email protected]
Website: www.nidaanhopefertility.com
~ 246 ~
MADHYA PRADESH
Madhya Pradesh is witnessing a rise in Surrogacy as childless couples from India and
abroad is thronging the state in search of women who are ready to rent their wombs for a
price. The trend has consequently led to the increase in the number of women who are
willing to become Surrogate Mothers to fulfill their financial needs. "Surrogacy is thriving
in Madhya Pradesh. People are now economically and mentally strong and willing to
sidestep traditional beliefs to have children through this method," Infertility Expert Dr
Dinesh Jain told.47
___________________________________________________________
47 Surrogacy on rise in Madhya Pradesh: expert, THE INDIAN EXPRESS, 2010, September 12, available on http://timesofindia.indiatimes.com/india /Surrogacy-on-rise-in-Madhya-Pradesh-expert/articleshow/6540915.cms
Smaller cities in India, such as Bhopal and Indore in Madhya Pradesh, are frequented by
childless couples from other parts of India and even abroad. Unable to bear children for
various reasons, such couples travel to these cities with hope. Bhopal and Indore have
certainly gained popularity as a result of an increasing number of women agreeing to
Surrogacy, carrying another couple's embryo to full term, the many specialized Assisted
Reproductive Technology (ART) clinics, and the comparatively affordable treatment.
Surrogacy has been a common phenomenon in urban India for the past few years. But most
of the prospective mothers would earlier solicit clients only through families, relatives and
Indian agencies. But in Indore the trend has become global. Indore, Madhya Pradesh’s
Commercial Centre, has become a hub for Surrogacy as childless couples, including Non
Resident Indians (NRIs), from all over the world are flocking here, health officials have
said.48 According to them, In-Vitro Fertilization (IVF) centre’s in the state charge Rs 4
lakh or more from a needy couple for Surrogacy.
The primary reason behind the flourishing Surrogacy industry in Indore is Indore’s
emergence as a premier destination in the country for infertility treatment.
~ 247 ~
[
“Indore is among the leading centre’s of such treatment in India. The first
clinic in the city was opened way back in 1976, when even the procedure
was alien to most of the practitioners,”
Dr Dhiraj Gada, President of All India Association of Infertility Doctors.
“The early start gave a boost to the treatment in the city and it grew with the increasing
number of experts and facilities”, said Dr Asha Baxi, who is running Disha Fertility
Centre in the city since year 1998.
_________________________________________ 48 Id.
Not only the early start but the availability of a wide range of facilities coupled with cheap
rates has added to the number of patients visiting the city. Patients from over the country
and even abroad are visiting the city to avail the treatments. “I treat around 8-10 non
residential Indians every year,” added Bakxi.49
Undoubtedly, Indore in Madhya Pradesh is emerging as a centre of Surrogacy on the
global network. Another very big reason of growth of Surrogacy in Indore is Internet.
Surrogacy in Indore has gone global with the Internet. The internet has seen a sudden spurt
of advertisements offering wombs for hire in Indore. Not only are Surrogate Mothers
placing ads on their own on the net, the web is full also of sites that promise to help
childless couples rent a womb in Indore.
For instance, a website hosted out of India, “surrogacyfinder.com”,offers the services of
city women Anjali, 24, Shashakti, 28, Sarika, 28, and Pratibha, 37, as Surrogate mothers
to couples all across the world.50 Individual ads are posted mainly on websites that accept
free ads. Women who want to let out their services leave their name, age and contact
~ 248 ~
details on these sites for couples. In all the cases, rates are negotiated only after a personal
meeting or through a trusted intermediary.
Surrogacy Cases are increasing at an alarming rate in Indore and Bhopal. A Bhopal
residents Rajesh Shrivastava, 41, and his wife, Usha, 37, who were unable to conceive
after 12 years of marriage, they decided to go in for ART, this includes techniques such as
In-Vitro Fertilization and Surrogacy. The couple visited the ART centre run by Dr Dinesh
and Dr Shefali Jain in Indore.
____________________________________________
49 DNA , Indore surrogacy ads impregnate world wide web, 2011, Aug 29 http://daily.bhaskar.com/news/MP-IND-indore-surrogacy-ads-impregnate-world-wide-web-2386982.html 50 Id.
"Usha had suffered six miscarriages in 12 years. Initially, the idea of a Surrogate did not
appeal to them. But they agreed when one of their relatives came forward," reveals Dr
Shefali Jain.51 This was two years ago. Now, Rajesh and Usha are proud parents of twin
daughters. The treatment cost the couple just Rs 150,000 (US$1=Rs 39.90). In Indore, one
of the Intended parents on the condition of not revealing their name disclosed that they
gave an ad in the newspaper for the requirement of a Surrogate Mother. Indore which has a
population of 30, 00,000, many women responded to the advertisement seeking Surrogate
Mothers, placed in a leading Hindi daily. Within 24 hours of the advertisement having
appeared, a dozen women had evinced an interest. Surprisingly, none enquired anything
about the couple. Money was the overriding concern.
Generally, Women who are willing to undergo the procedure come from lower middle
class backgrounds, are married, and are in need of money. So much so that, often, childless
couples negotiate a better price as a result of the competition. I personally visited the Clinic
of Shefali Jain in Indore. I was stun seeing the negotiations between the Surrogate and the
Intended parents. Shweta Khanna, 35, from Indore was willing to be a Surrogate mother.
Initially, she asked for Rs 100,000. However, when another woman offered to do the same
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for Rs 75,000, Shweta had to settle for Rs 50,000. "I have been a Surrogate Mother before.
This time I'll have no problem... my husband is also agreeable," she says.52 Most women
insist on anonymity for fear of social stigma.
There are more than a dozen clinics having renowned experts offering their services in
Indore. President of All India Association of Infertility Doctors, Dr Dhiraj Gada who
is also credited with having the first infertility clinic in the city in the year 1976 said, “The
affable nature of the people is also making the city a hub of infertility treatment.” Since a
lot of people come to the city for treatment, there is a huge demand for Surrogate Mothers.
________________________________________________________________ 51 Shuriah Niazi , Surrogacy Boom, 2007, Oct 14 , available at www.boloji.com/index.cfm?md=Content&sd=Articles&ArticleID=3056
52 Id.
DNA responded to an ad by a woman called Aarti Patel, 24, whose local contact was a
resident of Rajwada, Indore.53 The contact said his ‘sister-in-law’ is currently in Gujarat.
But she would come to Indore if the couple wanted to negotiate a deal with her. Patel said
his relative, mother of a child, is in dire need of money. When asked about the charges he
did not comment. But amidst all the doubts and societal taboos, the number of childless
couples wishing to have a child through this technique is on the rise. It is estimated that in
Indore, which has 11 very renowned and popular ART Centre’s, around 200 childless
couples have been treated over a period of three years.
In Madhya Pradesh, apart from Indore few other cities are even earning laurels in the field
of Surrogacy including Bhopal and Jabalpur. Apart from the domestic rush, a large
number of couples from abroad also travel to Bhopal and Jabalpur to fulfill their desire for
a child. Several American, Russian and British women are duly registered with the Bhopal
Test Tube Baby Centre for the procedure. Often, couples have to wait for as long as eight
months to a year for their turn.
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Another reason is the financial cost of Surrogacy which is 5-6 times lower in India than
European countries. Besides, it is difficult to get a Surrogate Mother in those countries
following stringent laws in vogue there. Hence it is very clear from the above discussion
that surrogacy is growing in Madhya Pradesh for varied reasons at an augmenting rate and
especially in Indore and Bhopal. Following is the list of few very popular IVF Clinics in
Madhya Pradesh.55
IVF CLINICS IN MADHYA PRADESH
BASER GYNECOLOGY and IVF Centre
9/2, Manorama Gunj, Street No.5 Indore 452001
Their reasons for coming to India are varied. For some, the treatment is far too expensive
in their own country; for others, their National laws do not permit Surrogacy. Recently, a
37-year-old Russian came to Bhopal as the expense for Surrogacy is prohibitive in her
country - between Rs 15, 00,000 and 20, 00,000 - as compared to the Rs 200,000 cost in
Bhopal.
Dr Randhir Singh, Director, Bhopal Test Tube Baby Centre, elaborates, "Women
source information about the availability of Surrogate Mothers in Bhopal over the Internet
and then contact us. In foreign countries, Surrogate Mothers are not easy to find.
Therefore, they are interested in India.”54
___________________________________________
53 Supra note, 49
54 Supra note 51
According to Senior Advocate Kirti Gupta, "At present, it is not difficult to have a baby
through Surrogacy in India because there is no law to control or regulate it. The technique
is cheap, when compared to other countries, and Surrogate Mothers here charge
comparatively less for the services."
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IDEAL FERTILITY : ICSI / IVF & Genetic Center Dr D 'Pankar Banerji ( MS, OBGY)
Consulting Gynecologist and Fertility Specialist
IDEAL FERTILITY : IVF and Genetic Center
1st Floor, Deshbandhu Complex, Naudra Bridge,
Jabalpur, MP INDIA – 482001
Telephone :- + 91- 761 -2627711, 4046361
Mobile :- 91 - 0 – 9826166952
Mail :- [email protected]
_________________________________________________
55 List of Enrolled Assisted Reproductive Technology (ART) Clinics under National Registry of ART Clinics and Banks in India, Indian Council of Medical Research, See http://www.icmr.nic.in/icmrnews/art/List%20of%20Enrolled%20ART%20Clinis-5%203%202013.pdfhttp://www.morpheusivf.com/fertility-centers/indore-fertility-center
Asian Institute of Infertility Management & Dr. Shefali Jain Test Tube Baby Centre
Dr. Shefali D Jain
10/E, HIG Main Raod, Near Christian Eminent School, LIG Circle, A. B. Road,
Indore-452001, Madhya Pradesh.
Email: [email protected] ; [email protected]
Website: www.aiimivfindore.com
Morpheus Sridhar International IVF Center Dr. Jayashree Sridhar
48, Annapurna Road, Near Annapurna Temple, Indore -452001
O7314094149
Disha Fertility & Surgical Centre Dr. Asha A. Baxi
E-30, Saket Nagar (Extension), Indore-452001, Madhya Pradesh.
Email: [email protected]
Website: www.dishafertility.com
Bhopal Test-Tube-Baby Centre & Aman Hospital Dr. P. C. Jindal
E-1/13-A Arera Colony, Bhopal-462016, Madhya Pradesh.
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Email: [email protected]
Website: www.ivfgo.com
Dr. D'Pankar Banerji's Fertility Clinic 1st Floor,Deshbandhu complex, 482001
Naudra Bridge, Jabalpur, Madhya Pradesh, India
Tel. 0761 2627711
Dr. Ashwini Trikha,Dr. Mala Tiwari Jaganath Chambers, Padav, Gwalior
Madhya Pradesh, India 474002
917512376655
Indore Fertility Clinic First Floor C.H.L Hospitals,
L.I.G Square,Indore – 452008, M.P, India
Call us at: 0731-6621357-62
Write to us at: [email protected]
Akash Hospital, Indore Surrogacy centre, Plastic Surgeons
Bicholi Mardana Main Road, Opposite Agrawal Public School,
Indore - 452001
Akash Hospital, Pragati Vihar Surrogacy Centre, Gynecologists & Obstetricians
Main Raod, Bicholi Road, Pragati Vihar,
Indore - 452014
In nutshell, Surrogacy in India is spreading like a fire in a Jungle and especially in Gujarat,
Maharashtra, Rajasthan and Madhya Pradesh. The ART industry, of which Surrogacy is a
part, is estimated to run in several thousand crores in the country. Even as an increasing
number of childless couples from overseas come to India, legal experts express their
reservations. Many foresee hurdles after the child is born and caution that Surrogacy
should be carefully considered.
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In India Surrogacy is ungoverned by any laws. In the year 2009, Law Commission Report
has stressed the need to regulate ART clinics. Advocate Piyush Jain, who handles
Surrogacy-related cases, said a proper law should be in put in place to deal with issues
arising out of this Assisted Reproductive Technology (ART). Though, Surrogacy is
adopted by many reputed Institutions as a practice and the field is gaining momentum both
economically and qualitatively in India but still it is unregulated. In this chapter the
researcher has thrown light on the Social Scenario of Surrogacy in India. Now let’s us
study the Legal Scenario of Surrogacy in India and the world in the next chapter.
CHAPTER V
LEGAL STAND OF SURROGACY IN INDIA & THE WORLD