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Transnational Commercial Surrogacy in India: Gifts for Global Sisters?

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Transnational Commercial Surrogacy in India: Gifts for Global Sisters? Reproductive BioMedicine Online (2011) 23, 618-625 www.8ciencedirect.com www.rbmonline.com FÍ SFVTFR SYMPOSIUM: CROSS-BORDER REPRODUCTIVE CARE ARTICLE Transnational commercial surrogacy in India: gifts for global sisters? Amrita Pande Department of Sociolo3y, University of Cape Town, South Africa E-mail address: amrita,pande(5uct.ac.za. Amrita Pande Is a lecturer In the Sociology department at University of Cape Town. Her research primarily focuses on globalization, gendered bodies and gendered work spaces, new reproductive technologies and new forms of social movements. She Is currently writing a monograph based on her multi-year ethnographic study of surrogacy clinics In India. She Is also Involved as a performer and educator 1n a theatre production. Made in India, based on her work on surrogacy. Her other ongoing projects Include research and advocacy work on the sponsorship {kafala) system of migration and Its effects on the lived experiences of migrant domestic workers In Lebanon. Abstract In this ethnography of transnational commercial surrogacy In a small clinic In India, the narratives of two sets of women Involved In this new form of reproductive travel - the transnational clients and the surrogates themselves - are evaluated. How do these women negotiate the culturally anomalous nature of transnational surrogacy within the unusual setting of India? It Is demon- strated that while both sets of women downplay the economic aspect of surrogacy by drawing on predictable cultural tools like 'gift', 'sisterhood' and 'mission', they use these tools In completely unexpected ways. Previous ethnographies of surrogacy In other parts of the world have revealed that women Involved In surrogacy use these narratives to downplay the contractual nature of their relationship with each other. Ironically, when used In the context of transnational surrogacy 1n India, these narratives further high- light and often reify the Inequalities based on class, race and nationality between the clients and suppliers of reproductive tourism In India. (#' <C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. KEYWORDS: gift-glving, India, Inequalities, narratives, reproductive travel, transnational commercial surrogacy Introduction classified Into three areas: (1) the legal and other works that debate the ethics or morality of this practice (Anderson, In recent years much has been written on 'reproductive 1990; Andrews, 1987; Brennan and Noggle, 1997; Ragone, travel' - people travelling across borders and even across 1994; Raymond, 1993); (11) feminist literature that views continents for assisted reproductive technologies such as surrogacy as the ultimate form of medicalization, commod- IVF, amniocentesis and commercial surrogacy. Commercial ification and technological colonization of the female body surrogacy Is a fairly new phenomenon In the global south (Corea, 1986; Dworkin, 1978; Neuhaus, 1988; Raymond, but has been a topic of heated debates In Euro-America 1993; Rothman, 2000); and (111) more recent scholarship that since the 1980s. Scholarship on surrogacy can be broadly focuses on the Impact of surrogacy on the cultural meanings 1472-6483/S - see front matter © 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. do1:10.1016/J.rbmo.2011.07.007 Transnational commercial surrogacy in India: gifts for global sisters? 619 of motherhood and kinship (Markens, 2007; Roberts and gacy. Because of the moral and ethical ambiguity surround- Franklin, 2006; Thompson, 2005). The predominant focus ing surrogacy, many countries, including China, the Czech on ethics and exploitation is not surprising given the anom- Republic, Denmark, France, Germany, Italy, Mexico, Saudi alous nature of contractual surrogacy, where, by construct- Arabia, Spain, Sweden, Switzerland, Taiwan, Turkey and ing families through the market place, 1t disrupts the some US states ban surrogacy altogether. Some countries assumed dichotomy between private and public, between have Imposed partial bans, for instance Australia (Victoria), production and reproduction. Brazil, Hong Kong, Hungary, Israel, South Africa and the UK. Surprisingly little, however, has been written on how the Amongst the latter group of countries, Canada, Greece, women Involved In the actual process of surrogacy negotiate South Africa, Israel and the UK permit gestational surro- these disruptions. This is partly because of the relative pau- gacy, subject to regulations. Then there are other countries city of ethnographic material on surrogacy. The only com- with no regulations at all: Belgium, Finland and India prehensive ethnographies of surrogacy are Helena (Teman, 2010). Apart from the recent spurt of surrogacy Ragone's (1994) study of six surrogacy agencies In the USA 1n India, commercial surrogacy Is most prevalent In the state and more recently Elly Teman's (2010) work on surrogacy of California and 1n Israel, where surrogacy Is tightly con- In Israel. With the exception of Teman's work In Israel, trolled by the state and restricted to Jewish citizens. The where surrogacy is tightly controlled by the state and Indian structure 1s closer to the liberal market model of sur- restricted to Jewish citizens, this entire literature Is about rogacy In California, where surrogacy births are primarily surrogacy In the Euro-American context. This Is not alto- managed by private, commercial agencies that screen, gether surprising, since commercial surrogacy 1s a very match and regulate agreements according to their own cri- recent phenomenon outside of Euro-America, and India 1s teria. The clinics 1n India operate not only without state the first country In the global south to have a flourishing Interference but they often benefit from the governmental industry In both national and transnational surrogacy. support for 'medical tourism', a particular form of travel In this paper the ethnographic work on surrogacy Is for medical reasons. extended by examining a cHnic 1n India, where the anoma- In the past few decades, medical tourism has been gain- lous nature of surrogacy becomes even more pronounced Ing momentum 1n India. It 1s a sector that the Confederation because of Its large transnational clientele and the fact that of Indian Industry predicts will generate US$2.3 bilUon annu- surrogacy Is flourishing Informally, In a legal vacuum. Spe- ally by 2012 (Brenhouse, 2010). While several countries In cifically, this paper asks: How do two sets of women Latin America and Asia, Including India, Cuba, Jordan, involved 1n surrogacy - the transnational clients and the Malaysia, Singapore and Thailand, actively promote medical surrogates themselves - negotiate the culturally anomalous tourism, India Is considered one of the world leaders, sec- nature of surrogacy within the unusual setting of India? The ond only to Thailand. There are several factors working In setting Is unusual partly because there are vast economic favour of India as a destination for such travel - cheap and cultural differences between the buyers and sellers of costs, large numbers of well-qualified and English-speaking surrogacy 1n India. Additionally, there are no laws regulating doctors with degrees and training from prestigious medical the surrogate-client relationship. As a consequence, schools In India and abroad, well-equipped private clinics (national and International) clients are able to take advan- and a large overseas population of Indian origin who often tage of the client-friendly policies of private clinics and hos- combine cheaper treatment with a family visit. Medical pitals, where doctors are willing to offer options and travel 1s, In fact, a campaign, conducted with full govern- services that are banned or heavily regulated In other parts ment support. In 2004, the government launched an Interna- of the world (Pande, 2009a, 2010a; Rimm, 2009). tional advertising campaign and declared that treatment of Previous ethnographies of surrogacy 1n other parts of the foreign patients Is legally an export and deemed eligible for world have revealed that women Involved In surrogacy use all fiscal Incentives extended to export earnings. The major- narratives such as 'g1ft-g1v1ng', 'sisterhood' and 'mission' ity of medical travellers to India are cardiac patients but an to downplay the contractual nature of their relationship Increasing number of patients are coming for joint replace- with each other (Ragone, 1994; Teman, 2010). The present ment, plastic surgery and eye treatment. Reproductive paper demonstrates that while the surrogate In India and tourism, cross-border reproductive care (CBRC), Is the the Intended mother also use the narratives of 'gift', 'sis- latest addition to this ever-growing list of services. terhood' and 'mission', they use these In completely unex- Although there have been significant advancements In pected ways. The gift-giving surrogate of Euro-American reproductive technologies since the birth of the first IVF contexts. Ironically, transforms Into a needy gift receiver baby In India In 1978 (Kumar, 2004), the rapid growth of 1n the clinic In India. When used In the context of transna- reproductive travel In India 1s only partly due to technolog- tional surrogacy In India, these narratives further highlight ical Improvement. In order to attract couples from other and often reify the Inequalities based on class, race and countries, clinics market assisted reproduction treatments nationality between the clients and suppliers of reproduc- through both print
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