ANAND, Gujarat // For one British couple living in Abu Dhabi and exploring options for treatment to have a child, turning to a surrogacy clinic in a small, dusty town in India seemed an uncomfortable proposition at first.
The couple, speaking on condition of anonymity, had heard about the clinic in Anand in Gujarat state from acquaintances in Dubai, also expatriates, who used the services at the clinic and returned to the UAE with a baby, which was carried and given birth to by an Indian surrogate mother.
The Abu Dhabi couple had almost lost hope of having a baby that was genetically theirs after a botched IVF procedure at a London clinic in 2008 left the woman unable to carry a child. She and her husband decided to fly to India to take a look.
“Initially we came and we started turning back,” the woman, a 37-year-old management consultant, explains. “It’s a bit of a shock. The standards of medical hygiene are very different when you come over here. Then I bumped into an American couple who said it actually works. We met some of the surrogates, who were planning to buy houses, start businesses with the money they were getting, and we felt reassured that they weren’t being exploited.”
The couple went ahead and this month, on Friday the 13th, a surrogate from a small village near Anand gave birth to a baby girl.
The child is one of more than 680 babies that have been born at the clinic to surrogate mothers – mostly from poor villages – over the past nine years. Fees now start from US$30,000, a fraction of the price that the same service would cost in the West. The Akanksha Infertility Clinic, which has attracted worldwide media attention, is at the centre of India’s commercial surrogacy industry.
The controversial sector, often dubbed “rent a womb”, has been criticised for offering “baby farms”, and compared with India’s outsourcing industry has an estimated annual value of $2.3 billion, according to the Confederation of Indian Industry.
Commercial surrogacy was legalised in the country in 2002. It is unregulated, however, although guidelines from the Indian Council of Medical Research offers some direction. In many countries, including the United Kingdom and Australia, commercial surrogacy is illegal.
Surrogacy is also not allowed in the UAE, and this has provided as opportunity for India to capitalise on surrogacy as a growing area of its booming medical tourism industry.
“I think India should take advantage of this,” says Dr Nayna Patel, the medical director of the Akanksha centre. “In India, the medical skill is so well recognised all over the world. Indian doctors are famous all over the world. Now, when India is coming up as a medical tourism hub, surrogacy should be promoted.” Dr Patel says that the clinic attracts significant interest from couples in the UAE, including non-resident Indians.
“Even people in Saudi Arabia are showing interest, but we don’t know what the legal procedure is. We’re receiving a lot of inquiries from the Middle East.”
The vast majority of surrogacy cases at the clinic are performed for foreigners and non-resident Indians.
“There are so many reasons why couples prefer India,” Dr Patel says. “Definitely one is affordability. But the second is they trust the medical technology and the skill and they’re happy with the Indian doctors.”
India’s widespread poverty means that the money given to the surrogates can have a life-changing impact. The fee paid to the surrogate is about $8,000 in Anand. Whereas when the clinic first started offering surrogacy, it was a challenge to find the surrogate mothers, word of mouth has spread around and there is now no shortage of eager participants.
As its surrogacy business has grown, Akanksha is investing in a modern facility for 300 million rupees (Dh17.6m) on the outskirts of Anand, which is expected to be completed in about a year. But Dr Patel insists that she doesn’t want to grow the service to the extent where she cannot be personally involved in all of the cases.
“When [the couples] see how the money is going to help the whole family come up, the education of small children, building a house, then they feel it is the right time and place to do surrogacy,” says Dr Patel. “The economy of Anand benefits, from the hotels, the airlines, the rickshaw drivers.”
Not every clinic in India is concerned about caring for the welfare of the surrogates, however. Some are more focused on generating business.
“There were also some clinics we contacted in North India and we felt like they were being really commercial and they were pushing us and pushing us,” according to the couple from Abu Dhabi.
In Mumbai, down a small lane in an old building in south Mumbai, Dr Jatin Shah runs the Mumbai Infertility Clinic and IVF Center, which oversaw the surrogate birth of the Bollywood actor Shah Rukh Khan’s baby son recently.
Dr Shah is doing about 10 surrogate cases a month. “It’s very slow growth,” he says, although he acknowledges the publicity surrounding Shah Rukh Khan’s child could encourage more Indians to look at surrogacy as an option. But the clinic currently caters only to Indian couples. He explains that he would look at doing surrogacy for foreign couples only when a surrogacy law is in place.
“I want the law to be very clear because I don’t want to spoil our name,” Dr Shah says. “There is no official legal regulation.”
There is a draft Assisted Reproductive Technologies Bill that has been drawn up in New Delhi, but it is unclear when a law will be passed.
Dr Patel refutes claims that commercial surrogacy is unethical or exploitative, if managed correctly.
“It’s very, very subjective,” says Dr Patel. “What I feel is that every human being is born with two basic instincts. One is to survive and the other is to reproduce. Here what happens is the surrogate is trying to survive and the couple is trying to reproduce.
“When they come together to help each other they are solving each other’s problems. These critics who claim to be very ethical should go and stay in the life of a surrogate for a day. If she’s not getting one square meal, if she wants to educate her children, if she wants to see her family living in a house of their own, what’s wrong?
“Do you want the surrogate to live this life of poverty and misery or do you want her to change her life? What is more ethical, I would say?”
Sonya Christian, 30, is one of the surrogates in Anand, living in a house near the clinic along with other surrogate mothers.
She is eight months’ pregnant with a child she is carrying for a couple from Singapore. She has two sons of her own, aged 8 and 10. The Akanksha clinic demands that the surrogates have to have their own children to qualify.
Ms Christian was a surrogate in 2011 for the clinic. Her husband lost his hand in an factory accident six years ago and the family has depended on insurance payments of 1,200 rupees (Dh70) a month plus meagre income from odd jobs for their livelihood.
With the funds from the surrogacy, they plan to build a house, Ms Christian explains.
Purnima Rawal, 36, is also in the eighth month of carrying a child, for an Indian couple.
She normally earns just 4,000 rupees a months working as a housemaid and separated from her husband 12 years ago.
“I have a son in class 12 and I want to use the money for him to go for higher education,” Ms Rawal says. She was also a surrogate in 2011 and used that money to move from a makeshift home with a tin roof to a house she had built.
Another surrogate, Sharda Solanki, 32, says that she plans to give the money to her husband so that he can start his own business.
The surrogate of the Abu Dhabi couple (see main story) says she is moving her family to a new house, while her husband is going to use some of the money to set up a diamond business.