Where do babies come from?
In our increasingly
interconnected world, the answer to that question is growing more complicated. American
couple hoping to become parents using an egg donated in London, a surrogate in
India and a delivery planned in Nepal. Some couples have gone south of the
border to find surrogates. But in an industry where the clients are desperate,
the surrogates are poor and the profits for the middlemen agencies are huge,
there can be heart-wrenching results.
And it’s not just U.S.
couples entering the brave new world of reproductive tourism. Would-be parents
from China and Europe are also coming to American shores for fertility
treatments and to find surrogates who will give birth to American citizens.
Surrogacy is now a
multi-billion dollar global industry, but there are only a handful of countries
where it’s explicitly legal to hire a woman to bear your child. Here’s a guide
to some of the international surrogacy hotspots, and how they’re handling the
outsourced baby boom.
Russia
Russia is “a sort of
reproductive paradise,” according to the Russian law firm specializing in
surrogacy. The country has one of the most liberal surrogacy laws in the world,
as well as some of the cheapest rates. Procedures cost, on average, between
$15,000 to $30,000. In 2012, surrogate mothers in Russia reportedly gave birth
to around 1,000 children, although there was no data on how many of those were
for foreign couples.
Then, last fall, the tide
shifted. Russian pop diva Alla Pugacheva, 65, and her husband had twins through
a surrogate, rattling conservative corners of the country. A Russian Orthodox
Church official decried surrogacy as a “mutiny against God” and “very happy
fascism with a contract,” reported one Russian newspaper. Elena Mizulina, the
architect of the nation’s infamous gay propaganda law declared that surrogacy
was “threatening not only Russia, but humanity as a whole with extinction,”
likening the practice to nuclear weapons.
As part of a conservative
surge in the country, Russian parliamentarians drafted a bill in April that
would ban commercial surrogacy entirely, and restrict its use to married
people. The bill excludes gay couples, as same-sex marriage isn’t recognized in
Russia.
Ukraine
Ukraine is one of the newest
Meccas of international baby-making. For foreign couples, the price tag
reportedly ranges from $30,000 to $45,000, less than half what it costs in the
U.S. Only written consent is required, and Americans and Europeans don't even
need a visa.
As long as parents are
infertile, legally married and straight, the laws in the post-Soviet nation are
stacked to protect the rights of the intended parents. Couples can select their
baby’s gender and scoop up the birth certificate of their surrogate-born kid,
almost as soon as he or she takes a first breath, essentially extinguishing the
rights of the surrogate mother entirely.
India (and Nepal)
Three Indian surrogates,
implanted with the embryos of wealthy Westerners, live together in one room in
a Mumbai ghetto, rented by the clinic. In a nation with 1.2 billion people,
plentiful English speakers, abundant hospitals and widespread poverty, it's
little wonder that India has become a surrogacy destination for many
Westerners.
Commercial surrogacy has
been legal here since 2002, getting its start largely thanks to infertile
couples of Indian origin in the U.S., U.K. and Middle East. Even factoring in
costly plane rides, seeking help at one of India's more than 1,000 fertility
centers can be a relative bargain. India's surrogacy prices of $18,000 to
$30,000 are roughly one-third of the cost in America. Sudhir Ajja, who co-founded Mumbai clinic
Surrogacy India, told ABC News that nearly all of his clients are from overseas
– many coming from the U.S., Australia and Sweden. The exact size of India's
industry is unclear, with estimates ranging from $450 million to $3 billion a
year.
But India's big business of
renting wombs has raised thorny ethical concerns. Many surrogates come from
crushing poverty, but stand to earn $5,000 to $7,000 in nine months – a huge
sum for women who would otherwise bring in well under $1,000 annually. Some
surrogates, however, are lured into contracts they don’t understand or are
cheated by shady middlemen. Others are confined to sometimes crowded shelters
near the fertility clinics, where their personal freedoms -like family visits -
are restricted.
Some clinics have introduced
more out-patient care models for surrogates, and there have been attempts to
monitor and regulate the growing industry. A bill to reduce exploitative
practices has gone unsigned for more than four years, but in that time, one
major regulation has taken effect. In 2012, India’s Home Ministry decreed that
foreigners seeking a surrogate must be a man and a woman, pushing same-sex
couples and would-be single parents to look elsewhere for help. But some Westerners
have gotten around the rule by hiring Indian or Nepalese women to get in vitro
fertilization in India, only to deliver the babies in Nepal.
Thailand
India's new surrogacy
regulations have been a boon for the industry in Thailand, where surrogacy
agencies have since reported a higher number of international clients. Among
this influx of clients are American same-sex couples, flocking to the country
for bargain deals.
Thailand doesn't have
restrictions on same-sex couples. In fact, there aren't any laws in the country
regulating surrogacy at all, which has raised concerns about the exploitation
of surrogates.
In 2011, Thai authorities
shut down the Bangkok operations of Babe 101, an international surrogacy
agency, accusing its staff of human trafficking by luring some surrogate
mothers to the country with promises of unrelated jobs. The incident
highlighted how the country's lack of regulations resulted in complicated legal
questions around rights to children in surrogacy cases.
The country's parliament is
now considering legislation that would offer protections, but could also
prohibit commercial surrogacy arranged through a third party. If this
legislation comes to fruition, it would complicate surrogacy for lesbian
couples and transgender clients, while raising new questions about legal
guardianship for gay couples.
Despite these looming
changes, the country remains a popular destination for international surrogacy,
particularly among Australians.
United States
Elton John and his partner
David Furnish with their son Zachary Jackson Levon Furnish-John, who was born
through a surrogate mother in California, in October 2011. In the United
States, surrogacy is a two-way street. While Americans head all over the world
to hire surrogates for a fraction of the cost at home, the U.S. also plays host
to thousands of reproductive tourists. All forms of surrogacy are banned in
countries such as Germany, Sweden, Italy and Norway. Others like Australia,
Greece, Denmark and the Netherlands have outlawed commercial surrogacy. In a
way, America's patchwork of state laws about surrogacy make it a microcosm of
the rest of the world.
With its network of sperm
banks, fertility clinics and laws favoring would-be parents, California is the
capital of commercial surrogacy in the U.S., attracting the likes of Elton John
and his partner. According to a 2012 Berkeley Journal of International Law
study, a U.S. surrogacy arrangement can cost anywhere from $80,000 to $120,000.
Of that, the surrogate receives between $14,000 to $18,000.
Some states that permit
surrogacy require intended parents to be married, which excludes single people
and many same-sex couples.
A 2013 American Society for
Reproductive Medicine study estimated that one in 20 surrogacy deliveries in
the U.S. are to foreigners. On the other hand, the "incidence of U.S.
patients traveling abroad for care is estimated to be far lower than the rate
of patients coming into the United States." To put that in context, there
were only an estimated 1,400 births via surrogacy in the U.S. in 2010.
For people who live in
countries such as China, where surrogacy in banned, there are some added
bonuses to hiring an American surrogate or participating in so-called birth
tourism. The child can get a U.S. passport, which can lead to citizenship for
the parents down the road.
((http://america.aljazeera.com/))
