CSR recently released a report entitled ‘Surrogacy Motherhood: Ethical or Commercial’ based on a study conducted in Gujarat. The report provides an insight into the rise of surrogacy in India, and the emergence of India as a popular destination for couples seeking surrogate mothers. According to Ms Manasi Mishra, head of research at CSR and the lead author of the report, ‘Cheap medical facilities, advanced reproductive technological know-how, coupled with poor socio-economic conditions, and a lack of regulatory laws in India, combines to make India an attractive option’. The report states that there is a growing demand for fair-skinned, educated young women to become surrogate mothers for foreign couples. Average cost of surrogacy is around $10,000-30,000 which includes the remuneration of the surrogate mothers, IVF costs, foods and consumables, legal and doctors’ fees, delivery cost and antenatal care. For international medical tourists the cost seems extremely reasonable which instigates more number of couples to seek such treatments here in India. The report goes on to state the importance of passing the Artificial Reproductive Technology (2010) Bill soon, so that clear laws are in place, which will clarify the Indian government’s stand on surrogacy, and will prevent exploitation of women in the name of surrogacy. It talks about the need to provide adequate health care facilities to the surrogate mother, and providing the baby with all amenities, irrespective of the nationalities of the biological parents. The legislation should also cover the rights and duties of the commissioning parents, thus covering all three concerned parties within its ambit. The report provides a snapshot of the growing phenomenon of surrogacy in India, and asserts the need for the passage of the ART Bill soon, so as to prevent exploitation of Indian women in the name of surrogacy, along with protecting the child.

1. Centre for Social Research
An Institution for the Women and Girls
of India since 1983

2. Surrogate Motherhood-
Ethical or Commercial
CENTRE FOR SOCIAL RESEARCH NATIONAL COMMISSION FOR WOMEN

3. Background
 Due to physiological conditions certain women are unable to give
birth to their offspring. The urge of motherhood leads them to
seek alternative solutions like Artificial Reproductive Technology
(ART), In-Vitro Fertilization (IVF), Intra-Uterine Injections (IUI)
etc.
 A surrogate mother - hired to bear a child that she turns over at
birth to her employer. The word ‘surrogate’ means substitute.
 India - popular destination for surrogacy arrangements for rich
westerners - cheap medical facilities + advanced technological
know-how.

4. Government’s initiatives
 2005 – Introduction and implementation of National Guidelines for
Accreditation, Supervision and Regulation of Assisted
Reproductive Technology (ART) Clinic in India, by the
ICMR, MoHFW, Government of India.
 June 25, 2008 – Meeting-cum-workshop called by the
MoWCD, Government of India.
 December 2010- Introduction of Draft ART Bill
 However, till date there is no such laws to protect the rights and
interests of the surrogate mother, the child or the commissioning
parents.

5. Justification of the study
 Not much research done so far in India on surrogacy
 Ethical, philosophical and social questions related to the issue of
transaction of money involved which gives the matter of surrogacy
a commercial and business angle with no legal provision yet
 Apart from NRIs, couples from abroad e.g.
USA, Russia, UK, Sweden, Israel and Australia
 Since the surrogate mother mostly comes from the low-income
background, the need to protect her interest vis-a-vis the
clinics/Infertility physicians is apparent

6. Justification of the study (Contd)
 The rights of the child is almost never considered. Early handover
of the child hampers breastfeeding; also, transferring the duties of
parenthood
 The supposed benefit of surrogacy is wrapped under a facade
which claims that the entire procedure is based upon eqal exchange
– which is not the case in reality
 The larger questions remain unanswered until a rigorous research is
done:
• Is it legal to become surrogate mother in India?
• Will the child born to an Indian mother be a citizen of this
country?
• What happens if the surrogate mother changes her mind and
refuses to hand over the baby or blackmails for custody?
• Who will take the responsibility of the child if the
commissioning parents refuse to take the former due to
abnormalities?

7. Objectives of the study
 To conduct a situational analysis of surrogacy in the three study
areas and the issues involved
 To examine the existing social and health protection rights
ensured to surrogate mother
 To analyze the rights of the child in surrogacy arrangements so far
 To study the rights and issues pertaining to commissioning
parents
 To suggests policy recommendations for protection of rights of all
the parties involved through legal provisions

8. Project coverage
 Project areas:
Surat
Anand Jamnagar
Surrogacy
 Universe of the study - surrogate mothers, their
families, commissioning parents, the clinic , agents and other
stakeholders like community members, owners/care takers of
shelter homes/guest houses
 Sample size – 100 surrogate mothers and 50 commissioning
parents

9. Project Methodology
Methodology: Exploratory research
 Tools – 2 sets of structured questionnaires for surrogate mothers
and commissioning parents and one semi-structured
questionnaire for clinics/doctors. The questionnaire were field-
tested in Delhi
 Focused Group Discussions (FGDs) were conducted with
surrogate mothers, stakeholders and community members

10. Surrogacy

11. Surrogacy

12. Surrogacy

13. Surrogacy

14. Surrogacy

15. Surrogacy

16. Main Concerns and Findings
 Ethical issues - It seems not to be ethical for someone to create a human
life with the intention of relinquishing it.
 Rights of the surrogate mother are not protected and regulated by law
in India it is easy to exploit her and hence, seems to be a matter of grave
concern.
 The child can be harmed if the commissioning couple is not fit parents.
 The surrogate mothers are illiterate, economically vulnerable and
desire for some money.
 Agents approach women for surrogacy (97.2% in Surat and 100% in
Jamnagar) and to get in touch with the concerned clinic.
 None of the surrogate mothers hold a copy of the surrogacy agreement.
 The contract does not mention any insurance or emergency needs that
the surrogate mother may require during pregnancy or after
relinquishing the baby.
 If the Commissioning parents do not wish to continue with the
pregnancy due to deformities in the baby or sex preference, the baby is
aborted without any say of the surrogate mother.

17. (Contd)
 The amount of money given to the surrogate mother is not fixed
and is usually decided arbitrarily by the clinic or the doctor.
 Relationship between the surrogate mother and the CP remain
harmonious in the beginning of surrogacy arrangement, but from a
distance. However, the relationship takes a downturn as the
pregnancy period advances to its completion.
 Most of the surrogate mothers stay in the shelter homes (98.3% in
Anand) during the pregnancy period.
 Reasons for the CP to go for surrogacy are long term illness like
diabetes, dysfunctional sexual organ, complications in previous
pregnancy, repeated failed fertility treatment, etc. .
 The contract is signed between the surrogate mother and the
commissioning parents, the clinics always attempt to escape from
any legal hassle.
 The surrogate mother is unknown to the CP and it is decided in the
clinic which surrogate mother should match the particular CP.
 When to relinquish the baby- by CP & Doctor/Clinics

18. Major Recommendations
 There should be right-based legal provision for the surrogate mothers.
 There should be legislation on surrogacy arrangement involving all
the three parties
 Payments to surrogate mothers to be regulated
 In case surrogate mother gives birth to twins she should be paid
double amount or at least 75% of the price for the second child.
 To maintain and monitor the anonymity of the surrogate mothers.
 The surrogate mother should not undergo more than 3 IVF trials
 The surrogate mother should be provided by the copy of the contract
 There should be an interpreter (other than doctor) for the
communication linkage between the surrogate and CP.
 Provision of intensive care and medical check-ups of their
reproductive organs during the 3 months after pregnancy.
 Health Insurance for both the surrogate mother and the child is
essential to ensure a healthy life.
 Regulations would enable the government to ensure that the clinics
charge fair prices.

19. Thank You
Dr. Ranjana Kumari, Director CSR
Dr. Manasi Mishra, Head of Research
Centre for Social Research
2, Nelson Mandela Marg
Vasant Kunj, New Delhi - 110070
Phone: +91 (0)11 26899998, +91 (0)11 26125583
Fax: +91 (0)11 26137823