Published by CIAMS
First part of the article (recommended) was about the situation of commercial surrogacy and its transition to altruism in India. A summary of the follow-up study of Sheela Saravanan about the serious violations of human rights and medical ethics that continues to take place in India. In the second part, Researcher Sheela Saravanan responds to our interview about her latest investigation: Surrogacy in India: Bioethics, Human Rights and Agency. A deep and extensive analysis from a perspective of bioethics and human rights published through The European Observatory for Non-Discrimination and Fundamental Rights (E.O.N.D.F.R.) in France, and on the current situation of surrogacy in India and its impact in the world.
Saravanan, is a professor in the Department of Anthropology at the University of Heidelberg, Germany. She has two masters in geography and development. Doctorate in public health, she has specialized in reproductive health and childbirth practices in India. Her post-doctoral work in German universities, focused on maternal and child health, selective abortions, reproductive technologies and surrogacy. Author of «A transnational feminist view of surrogacy biomarkets in India».
Her approach has always been based on reproductive justice and transnational feminism. In addition to a great speaker, who has exhibited on numerous occasions her work at the United Nations and other important conferences, she is an independent researcher on violence against women in Asia and Europe, as well as on reproductive health. Her book, «A Transnational Feminist View of Surrogacy Biomarkets in India,» is the result of an extensive field research, a document made of many interviews with women that reveals the terrible conditions in which «surrogate» mothers are monitored at throughout her pregnancy, in addition to the business of eggs donor and embryos market.
SS: The law that puts an end to commercial surrogacy in India is a very much needed and a welcome move. The Draft Assisted Reproductive Technology (ART) Bill 2005 had been sitting idle for 14 years without any further progress. During this period surrogacy was neither a legal nor illegal status and this situation was leading to a spread of trafficking of women and children, exploitation of women, abandonment of children and extreme forms of commodification of women and children. There have also been deaths of surrogate mothers and egg donors in clinics that remain unreported. People were using surrogacy and IVF procedure rampantly for sex selective abortions.
The latest follow-up study that I conducted in February 2019 on the emotional, physical and financial impact on surrogate mothers revealed that poor women had to go through surrogacy at least twice before they can come out of poverty. Two surrogacy means multiple IVF trials and the extreme hormone treatment and over-medicalisation takes a huge toll on women`s physical health. Moreover, the several separations from children has an adverse effect on their emotional well-being.
TD: What did the study reveal?
SS: My study revealed that when surrogacy was legal in India, several illegal, inhuman and unethical surrogacy practices were rampant. Some serious violations of human rights are taking place; women are detained in surrogate homes against their wishes, their body and integrity is violated, illegal sex selective abortions are being performed, none of them are given a copy of their contract, the manner in which the children have been relinquished is crude and without the consent of the surrogate mothers; eventually all surrogate mothers are forcefully alienated from the babies born. Almost all the 45 surrogate mothers I spoke to, perceived surrogacy as a form of slavery.
There are some obvious flaws in the Surrogacy Bill that excludes certain sections of the population. But from a broader perspective, the Bill will save the women from the adverse physical and emotional impacts of surrogacy. The Bill doesn’t specify against surrogate homes, how many embryos should be transferred into a surrogate mother’s womb, hence it is still doesn’t protect the exploitation of women in some ways.
TD: Will the 3,000 clinics close?
SS: The fertility clinics will not close down but they will not be able to do commercial surrogacy. They will be involved in all other kinds of fertility treatments such as egg donation, pre-implantation genetic diagnosis, .
Is there an illegal practice problem?
Opponents say prohibition of commercial surrogacy could push the business underground, but it is widely known that black markets thrive more in places where there is an ongoing booming legal body markets. When surrogacy was legal in India, young girls were reported to have been kidnapped from remote areas of India (North–East, Jharkhand, and Chhattisgarh) and transported to metropolitan areas and forrced into surrogacy practices. Children were abandoned. Now at least if a woman is being forced into surrogacy, she can approach the court.
The popular clinic in Anand was sending messaging and calling all the surrogate mothers telling them that this is their last chance to recruit into surrogacy as the new law may be implemented soon. Hence the clinic will not be able to practice surrogacy to the extent that they have been doing so far.
The interest among women in Anand for surrogacy has also reduced drastically because they feel it is exploitative and they also think it is sinful and act of selling children and hence they felt that the money they earned through surrogacy didn’t remain in their hands.
TD: What has prostitution to do with surrogacy?
SS: I will compare this market to the prostitution market. It is well known that Prostitution is legal in India and according to the Indian law, pimps and forced prostitution is illegal. But exploitation and trafﬁcking is only increasing under this legalised framework. According to the National Crime Record Bureau, India, almost 20,000 women and children were victims of human trafﬁcking in 2016, a rise of nearly 25% from the previous year (ToI 2017). A study conducted in
From my follow-up study in Anand, I got to understand that the practice cannot continue to the extent it was previously. There may be attempts of illegal practice but doctors will have to do in the risk of imprisonment and fine so it will reduce drastically.
TD: Today in India women are 61 percent of live liver donors and 74 percent of living kidney donors. Is there the risk that exploitation or subjection of women is hidden even behind these solidarity practices (in a patriarchal society as India is)
SS: A recent study conducted by Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), reveals that 86% of kidney donors in India are women and only 14% are men. These markets raise ethical questions the bioavailable are usually the vulnerable sections of the society (poor and women). These concerns are evident not only in organ donation but also in gamete donation, trafficking and prostitution. There are several patriarch nuances to this pattern. According to Prof. Gupta, SGPGIMS, the patriarchy evident in kidney donation patterns is; Men being earning members, they hesitate in donating kidney. Men also have the liberty to remarry while women don’t. The study also revealed that, women were major donors in traditional joint families.
Given that the commercial GPA has been banned in India since 2015 for foreign couples, where is the demand being directed?
As Nepal, India, Thailand, Mexico and Cambodia limited or proposed a prohibition on commercial surrogacy, the practice has moved to Laos, Malaysia, Kenya, Nigeria, Ghana, South Africa, Argentina and Guatemala. This pattern of globally moving markets that is based on exploitative capitalisation and the control over human reproductive biomaterial by the rich using global inequalities and vulnerabilities is a form of re-colonisation of women’s bodies and labour. The ethical concern of this development and movement of biomarkets, is that certain bodies (usually poor women) become more bioavailable within the existing global or national structural inequalities.
I want to deeply thank Sheela Saravanan for her kindness in answering all these questions, but above all for her struggle for a fairer world for women and girls. As she states:
«The purpose of reproductive justice is to reduce inequalities and not use the vulnerabilities of some in favor of the reproductive freedom of another. It is not just reproductive injustice, it is an inhuman way of having children.»
“No seré una mujer libre mientras siga habiendo mujeres sometidas”