Womb for Rent
The exploitative industry of cross-border surrogacy in India
Cassandra Teulon, Staff Writer
March 12, 2023
Credit: DALL-E
Cross-border surrogacy in the Global South preys on the wombs of low-income, racialized women.
Since the legalization of commercial surrogacy in 2002, India has become a hotspot for aspiring parents. In India alone, this cross-border industry generates $2.3 billion annually, according to the Thomson Reuters Foundation.
The Indian surrogacy industry has minimal legal regulation, making it a haven for expectant parents wanting cheaper surrogacy services while avoiding the bureaucratic red tape of the North American industry. This has attracted predominantly white families to India in search of surrogate mothers.
To meet demand, surrogacy clinics have opened across India. The clinics offer an all-inclusive surrogacy process that starts with finding potential surrogates for Western clients, organizing the required medical procedures, and finally providing care to the surrogates until the child is born. Business Insider estimates more than 25,000 children are born to Indian surrogates annually, with over half of these children exported to Western parents.
Dr. Reena Kukreja, an assistant professor of Global Development at Queen's University, spoke to The Observer about surrogacy in the Global South.
"[The cross-border surrogacy industry] is a gendered regime of consumption. Tourists are extracting a commodity from the bodies of racialized people in the Global South," Kukreja said.
With scarce welfare services and limited employment options for women in India, surrogacy is an attractive way to make money. The compensation for surrogate mothers is higher than for other female occupations in India, such as textile workers or domestic helpers. Surrogacy clinics give women room and board throughout pregnancy, but living conditions are typically unsafe and unsanitary.
According to Kukreja, surrogacy is a last resort for women struggling to sustain their families financially.
In 2015, the Indian government banned the outsourcing of reproductive labor, making cross-border commercial surrogacy illegal due to concerning patterns of children being abandoned throughout the pregnancy. “Altruistic” surrogacy – supposedly motivated by goodwill rather than financial gain – remained legal.
Before the change in legislation, aspiring parents would cover the physical and psychological expenses associated with the surrogate's pregnancy and pay an additional wage to the surrogate. The new "altruistic" policy prohibits surrogates from earning more than the matched value of pre-and post-natal medical expenses.
"Altruistic" surrogacy isn't actually altruistic – it's exploitative. The practice drastically reduces the income the surrogate receives, as they are now only paid for the formally billable costs of medical appointments and insurance expenses.
Paying any extra wage to the surrogate, on top of matched medical expenses, is illegal. This means the women are still paid, but paid less – just the surplus from formally billable costs of medical appointments and insurance expenses.
Despite the drastic wage reduction, it is still enough to motivate many women to continue being surrogates.
For example, under altruistic surrogacy, aspiring parents pay approximately $19,000, while the Indian surrogate mother makes around $6,000. North American surrogate wages average around $35,000 for a full-term pregnancy.
In Canada, the Assisted Human Reproduction Act requires expectant parents to pay surrogates the value of all direct or indirect pregnancy-related expenses. This includes the costs of medical or legal appointments, snow removal, and grass-cutting throughout the pregnancy. The Indian government doesn't have similar legislation that outlines compensation for non-medical pregnancy-related expenses.
Through this deceptive framing of 'altruism,' medical tourism exploits the systemic disadvantage faced by women living in extreme poverty. Surrogates are still selling their reproductive labor for income – but for less pay.
"Why is it that countries in the Global South emerge as destinations for reproductive tourists? We are all shopping for bargains," Kukreja said.
Instead, surrogacy clinics continue to profit off the fees paid by expectant parents, as none of the payments outside of the mandatory medical costs can legally be given to the surrogate mother.
"The expectant parents are still consumers [when using Indian surrogacy services], but now the surrogate is not being paid adequately for their uterine labor," Kukreja said.
Radical feminists argue against banning commercial surrogacy, claiming it infringes on financial autonomy. By legally preventing women from profiting off their body's reproductive labor, it suggests women cannot weigh the hazards of surrogacy against the economic benefit.
Kukreja disagrees with these radical definitions of autonomy, saying the decision to be a surrogate is a "notion of imagined choice" for women desperate for employment.
Neoliberal reform in India has continually stripped back spending on welfare programs, making it even harder for poor women to be financially stable. As most surrogates in the Global South participate out of desperation, it is not a completely autonomous choice.
"This form of 'altruistic' surrogacy is based on gender norms of motherhood and sacrifice. This is what we expect fertile women to do," said Kukreja.
Although cross-border surrogacy was made illegal, it is still prevalent in Thailand, Colombia, and Ukraine. Cross-border surrogacy deepens structural inequalities along axes of class and gender.
When the search for discounted surrogacy services goes international, the bodies of racialized, poor women in the Global South are priced lower than potential North American surrogates.
An outright surrogacy ban would leave potential surrogates without employment opportunities and protective governmental mechanisms. Instead, Kukreja proposed a more transparent, international regulation ensuring all potential surrogates receive a fair wage, regardless of their location.
The well-being of women must be prioritized over the profit margins enjoyed by surrogacy clinics across the Global South. Global organizations must address the economic conditions that drive poor women to surrogacy out of desperation. Enhancing social welfare services and expanding labor markets to provide safer, more equitable forms of secure employment is essential.