‘Rent-a-womb trend is a form of neo-colonialism’

If you have no regulation, as is the case in India, a surrogate woman faces a situation where not much is known of how much medical care she’ll get, whether it’s good quality medical care, whether she gets any follow-up care if there are any problems, whether she will have her liberty constrained and so on. The civil rights and health of women who come forward for this type of work are in some degree of danger.

Commercial surrogacy — the rent-a-womb industry in India, where surrogate women bear children for foreigners for a fee — is flourishing, evidently under government patronage, but critics argue that the absence of regulation in India throws up a host of questions and concerns. “Commercial surrogacy is fundamentally exploitative, and is a manifestation of a neo-colonialist phenomenon in which the Indian state is actively involved,” explains Dr Catherine Waldby, Professorial Research Fellow at Sydney University’s School of Social Sciences. In an interview to DNA, Dr Waldby addresses the concerns from the perspectives of bioethics and feminist theory.

What makes India a preferred destination for commercial surrogacy?
The Indian state has gone out of its way to create a medical tourism market in India, which of course is wider than reproductive tourism. It’s replicating the success of the ‘call centre’ model, where the country’s labour force is outsourced to external companies. Call centre outsourcing has worked well from a government point of view. The medical tourism model that the Indian government facilitates is also a kind of labour outsourcing. The success of the reproductive tourism industry has been enabled by the government, which sees this as an economic development model.

The second reason, of course, is that India competes on price very consciously in the gestational surrogacy space.

Are gestational surrogacy regulations in India more lax than elsewhere?
Currently, there isn’t a law that governs assisted reproductive technology in India. There’s draft regulation that hasn’t been passed, and a set of voluntary guidelines framed by the ICMR in 2005, which is not enforceable. So, India doesn’t regulate it at all. Other countries, too, don’t regulate the area very well: in the US, for instance, there are multiple state-by-state regulations. There are other countries that have little by way of regulation of this area. These tend to be the countries that attract commercial surrogacy.

From a bioethics perspective, what are the concerns arising from gestational surrogacy?
There are various ways to do commercial surrogacy; some are more harmful than others.  If you have no regulation, as is the case in India, a surrogate woman faces a situation where not much is known of how much medical care she’ll get, whether it’s good quality medical care, whether she gets any follow-up care if there are any problems, whether she will have her liberty constrained and so on. The civil rights and health of women who come forward for this type of work are in some degree of danger. Clinics say they’ve taken steps to ensure they provide good care. But given that there’s no oversight, it’s potentially dangerous.
Commercial surrogacy is also fundamentally exploitative. But some of the exploitative features can be minimised with proper care and regulation.

How significant is the fact that a surrogate mother makes no genetic contribution, and therefore the baby looks more like the parents than the surrogate?
The whole point of opting for gestational surrogacy is to have a baby who has the same ethnic characteristics as yourself. What happens in gestational surrogacy is that the surrogates are often of a different ethnic group than the intending parents. In the US, for instance, African-American or Latino women are surrogates for white couples.

There’s a racial aspect to it, but I don’t think it’s a racist conspiracy. It’s driven by a secondary phenomenon whereby the earning capacity of someone is shaped by a much older history of racial administration and equality of relations. There is a strong aspect of colonial relations involved here: you could say it’s a neo-colonial phenomenon, rather than a racial phenomenon.

Are you saying commercial surrogacy is a form of neo-colonialism?
Yes, I am, and it is! There’s a parallel phenomenon going on where international pharmaceutical companies are using Indian subjects for clinical trials. The Indian state is facilitating the marketing of its own population’s diseases (in the case of clinical trials) and reproductive capacities (in the case of surrogacy) to overseas purchasers. So, yes, it is a kind neo-colonialism and the Indian state is involved quite actively in it. 

In the history of colonial relations, the natural wealth of a colonised country was exported to the colonising country. This could be raw materials, food, spices, textiles and indigenous wealth and labour capacity. The system operated in the interests of the colonising country, not the colonised country. There’s something similar going on with commercial surrogacy.

You also bring a feminist perspective to the debate. Doesn’t feminist theory view commercial surrogacy as a form of economic productivity?
There’s a lot of internal discussion from different kinds of feminists about how to view this. I certainly think it’s a type of economic activity. But it’s a problematic type of work, and in some cases, problems arise because it’s not recognised as work and the protections that come with labour regulations are not present. Having said that, even if it were regulated, I don’t think it would fix everything.

A surrogate mother exchanges the gestation of a child for money: this makes the most fundamental human connection between the mother and the child into a commercial transaction.

The feminist argument is quite similar: commercial surrogacy exploits a woman’s  need for money, by asking her to do something that is fundamentally harmful. I’m not entirely convinced by that argument, which is why I think it’s possible to see it in less absolute terms.

So, should commercial surrogacy be banned?
There aren’t really any good options. I don’t think banning it would work. It would only create a black market — and it might just happen anyway in even worse conditions. Perhaps good regulation is a safer way to go. International bodies such as the WHO and the ILO should become involved in developing some kind of an international system.