What’s Wrong With A Surrogacy Market?

So, there’s yet another ban taking shape in India, this time on surrogacy for non-Indians within the country.

After being the choicest market for outsourcing business processes, medical transcription, and customer helplines, India is the hottest destination for ‘outsourcing pregnancies’. Or to put it less crudely, providing surrogate services to childless couples from richer nations. Even as I write the word ‘services’ next to surrogacy, I can picture the frown on the faces of the more conservative sections at the thought of equating pregnancy and childbirth with a business.

But there is no denying that surrogacy is a million dollar industry – a report by the Confederation of Indian Industry puts the industry’s worth at $2.3 billion.

Thanks to cheap airfare, developed medical infrastructure and affordable lodging, couples from around the world prefer to rent wombs in India. It doesn’t hurt that the laws around surrogacy in India are not as strict as they are, say, in the United Kingdom.  There, surrogacy is allowed where the surrogate mother is not paid, or only paid for reasonable expenses. Paying the mother a fee (known as commercial surrogacy) is prohibited.

Commercial surrogacy is legal in some American states, and, in fact, the United States might have been the preferred destination for surrogacies had it not been for the high costs associated with it. Thailand and Nepal used to be preferred destinations, but both countries have now banned it.

Thailand went for the ban after a case where a couple refused to adopt a baby with Down’s syndrome born to a surrogate mother. India seems to have followed in their footsteps with the recent announcement by the Supreme Court following a public interest litigation over the industry ‘exploiting women by foreigners’.

There are no estimates of the numbers of women who might be employed in this industry, either as surrogates or as support staff. But it is clear that an amount of $5,000-6,000 per surrogacy has attracted poor women in India. A regular low-skilled job would pay them the same amount in six to eight years.  So the customers are happy, and seemingly, so are the providers and doctors.

The problem stems from the morality and health stance taken up by policymakers and feminists. India is looking to introduce legislation that would set limits to one surrogacy per mother, an age limit for becoming a surrogate and bar all foreign nationals and unmarried Indians from the option of getting surrogacy services in India. The moralists call the policy exploitative of a woman’s body and the severing of the bond between the mother and the child as against normal motherhood.

What strikes me odd is the double standards.  On the one hand, there are shrill outcries over the reduction of a woman’s body to a womb; on the other hand, there is relatively less outrage over millions flocking to brothels every day to reduce a woman’s body to a vagina. Morally, renting out one’s womb can be termed an ultimate act of kindness towards the new parents.  On the other hand, prostitution is more impersonal, has lot more health-related dangers than surrogacy does, and there is criminality associated with it.

If one looks at the incentive mechanism or attempt an economic reasoning of surrogacy, it is easier to see why surrogate mothers would receive the best care in a market.

The entire exercise is geared towards producing healthy babies, and couples who use this service tend to watch over mothers as much as they would have if they were themselves expecting a child. Thus, the risk aspect that lobbyists have harped on is lot less than perceived. Prostitution, on the other hand, is a high supply market with little incentive to keep the woman healthy or safe.

What should be regulated in the surrogacy market is perhaps the forfeiture of money, if any happens in the case of a miscarriage. Or limiting the number of times a woman may become a surrogate, with respect to the number of children she already has or plans to have than any random number.

Women in the stories that I came across while researching for this issue, actually financed their children’s education or bought homes with the money earned.

This should come as a cheer to the feminists and moralists who worry about the effect of this on the surrogate’s own children, ignoring the fact that in the absence of this, she may have turned towards a profession that would have been harder on her children.

Of course, we as a society should create conditions where women don’t have to resort to either surrogacy or prostitution to earn a living. But it will take decades for a developing country to reach such economic, social and political conditions. Even developing technologies that make the need for surrogacy obsolete would take probably twice as many years. What we need are rational policies that do not pass judgments from a moral high ground, ignoring ground realities.

Next time we think derogatively of ‘surrogacy tourism,’ let’s pause for a moment and think – would we rather live in a world as we do now with thriving ‘sex tourism’?