Riding the surrogacy roller-coaster

In December 2012, our in vitro fertilization (IVF) path in the US ended following several years of trying with no success. My wife and I still wanted to have a child. We had already been thinking of surrogacy in India as the next step if IVF did not work and headed there to begin the process. We chose India for more than one reason — it was the least expensive country to do surrogacy in at the time, I had been working a lot in South Asia and felt comfortable in the country from a cultural perspective and we had good friends there.

So it was that I went to Mumbai, late December of 2012. We had extensively researched various surrogacy clinics and read a lot about the experience we could expect. There were a few horror stories, but we chose to ignore those and focus on the positives. We zeroed in on a company called Surrogacy India. Though it had not been around as long as some of the others, it came with good referrals. We spoke to the doctors, who seemed well regarded and who we liked. I didn't visit any other clinics in Mumbai. It was a short visit. We paid a few thousand dollars as deposit to the clinic, left the samples and flew back.

About two months later, in February 2013, a surrogate was ready and the process started. The first round worked and the Surrogate became pregnant. Sadly, the pregnancy ended at 10 weeks. We were familiar with these heartaches during our IVF process. It was sad, but we moved on to the next round. That round did not work either, nor did the one after that. Finally, the surrogate became pregnant in June 2013 – round four. It was an emotional time for the family. My brother had tragically passed away earlier that month and our whole family saw the news of a pregnancy as a very good omen. We Skyped several times with our surrogate over the following months and become very emotionally involved with her and the process. We were ecstatic. After years of trying, the pregnancy passed the first trimester and then the second trimester with no issues.

It appeared as though this one was finally, indeed going to happen. The baby was due in March 2014. I began preparations to come to India and got medical visas accordingly. In mid-January, when the surrogate was seven months pregnant, she was unable to Skype with us because she felt unwell. After an anxious few days, we found she had contracted Hepatitis E, a waterborne disease, and was life-threateningly sick. Her liver was failing and she needed a transplant. We pushed the hospital, Lilavati, and the doctors to look for a liver. Medical experts described it as a rare situation and said there was no procedure in place in an eventuality such as this one. Subsequently, we started getting demands from the hospital for large payments. We were apparently responsible for all the expenses of the surrogate, even in case of complications.

Our top priority — the same as that of Surrogacy India and Lilavati Hospital — was the life of the surrogate. But the money was huge — $10,000 plus to begin with. I could see this figure reaching a zone that we could have had no hope of paying off. We stalled on payments to buy time to figure out where we could find the money from to pay for a new liver for the surrogate. According to Surrogacy India, this was something that had never been done before for a surrogate. Over the next week or so, we sweated it out as the surrogate's condition worsened, then got better and then took a turn for the worse again. Finally, we got the dreaded phone call. The baby, a boy, had died. We were devastated. The mother had been bleeding due to the liver complications. Doctors did not want to do a Caesarian and the baby was allowed to die. Though we had lost our baby, we were incredibly relieved that the surrogate made a full recovery. Our main focus then shifted to how and why this occurred. Many details remain unknown to us since we were not present in Mumbai. Our friends in the city took on the job of investigating, going to the hospital for details and visiting our surrogate, whose name I will not divulge for her sake.

We were very upset to find that she had contracted Hepatitis E while at home. We had been categorically told she would not be going home. It's only later that we learned that all surrogates are allowed to go home whenever they like.

At this point, we believe Surrogacy India's negligence led to the death of our baby. At the very least, surrogacy clinics in India should not claim (and most of them do) that the surrogates live full time in the clinics. We were told by Surrogacy India after our baby died that surrogates can go home any time they want to by law. Of course, this makes sense in a free country, but they should not be making claims to the contrary. No part of our $40,000 was refunded to us.

After a month of mourning, we got on an airplane and went to India and visited the grave site of our dead son. Newborns are buried in India. We also met with Surrogacy India as we needed them to sign off on our medical visa paperwork even to be allowed to leave the country. At the time, I did not know if I was going to get stuck with the massive hospital bill. In the end, they paid that, and I was free to go and start over again.

Our desire for a baby remained. We were heartbroken after what had happened in Mumbai and, when it came to choosing our second clinic, we headed to Delhi. We spent a couple of weeks in the city and looked at several clinics. Most of these were better known in the international surrogacy circuit. But here too, I met a guy whose claims that his baby was born with no genetic link to either him or his partner, prevented him from getting the family out of the country. He lived in India for a year before he was finally allowed by the US Embassy to adopt the baby and take her home.

Eventually, I chose a clinic called Delhi-IVF. They were a very busy clinic, catering mainly to middle class Indians — unlike most of the glitzy big surrogacy clinics that focus on advertising to westerners. We were spent — emotionally, financially and physically — after our experience in Mumbai, and I knew we had one roll of the dice left and it would be the end, whatever the outcome. I signed a "guaranteed baby" (as absurd as that sounds) agreement and put down a $10,000 deposit. The clinic would keep trying until it worked, they said. Another $10,000 would be due with each trimester of the pregnancy.

The process with Delhi-IVF was not smooth either. We found the communication minimal and not very specific. The doctor always told us not to worry. Relations dipped. There even came a time when I was not on speaking terms with the doctor. We often wondered if we had made a mistake. Then — incredibly — on December 28, 2014, our boys were born. We were stunned, and strangely, not happy or excited at all after five years of trying to have a child. All that changed when we arrived in India and met them for the first time. It has been wonderful since then. Surrogacy, ultimately, in a way, is selling child-hopeful couples their ultimate dream. When it succeeds, all the hardships disappear. But when it doesn't succeed — and I fully understand that side too — there is a gnawing, horrible emptiness that nothing can fill.

Surrogacy in India is a gamble. If it works, you hit the jackpot. It is better than surrogacy in most other countries because there are no complications for the parents (e.g. birth certificate, passport, etc). If it doesn't work, there is no legal recourse since we are foreigners. Even obtaining information is an uphill task. Surrogacy needs to be tightly regulated and standardised in India to ensure that neither clients nor surrogates are taken advantage of.

Vineeta K, assistant manager operations at Surrogacy India, responded with regards to Bussian's case. Vineeta pointed out that the liver transplant was "only a suggestion, but no liver transplantation took place". She said that the couple had signed a contract, which expressly stated that the surrogate would be admitted to a clinic only if required. At other times, the surrogate would be free to live in her own house. "To assume that the surrogate mother got infected due to her poor home conditions will be incorrect, as none of her family members were infected," said Vineeta in an email response.

Vineeta noted that the Bussians were aware of all the costs, including the responsibility to bear expenses related to the surrogate's complications, and that these had been explained in the contract too. "The patient was aware, paid up sincerely all fees till second trimester of pregnancy," said Vineeta.

Pointing out that "Peter has agreed and appreciated on multiple occasions that the information provided to him was professionally handled and in the best way", Vineeta said, "We believe that the surrogate is our responsibility and we did (and will always do) everything possible to keep our surrogate healthy. In this case, to ensure their health, we provided best care, and the costs escalated ($19,000) at the Fortis Hospital."