Outsourcing Babies

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Outsourcing babies!
Deccan Herald / Feb 16,2008

There is a growing demand for Indian surrogate babies from foreigners but there is a lack of a legal framework to deal with surrogacy, paving the way for unscrupulous middlemen who push uneducated and poor women into surrogate motherhood, says Neeta Lal

After years of trying and treatment, US-based couple Jason and Nancy are finally proud parents of a healthy baby girl. And their tiny bundle of joy, Tara, was delivered for them by Ashaben through a surrogacy arrangement at Kaival Hospital in Gujarat. An Israeli gay couple experienced similar joy when, at Mumbai‘s Hiranandani Hospital last September, they ‘fathered’ twins through a surrogacy programme.

Noted fertility expert Dr Indira Hinduja describes surrogacy as one of the well-accepted methods of assisted reproduction that benefits patients who can’t conceive or carry a pregnancy to term. Of late, there has been a growing demand for Indian surrogate babies from foreigners, infertile couples in India and even single mothers — making the country a preferred destination for such a service. As per the Indian Council for Medical Research (ICMR) estimates, due to the upward spiral in the number of surrogacy cases, the reproductive sector in India is expected to rake in a whopping US $ six billion this year.

“After IT services,” opines Dr Nisha Kathuria, a Delhi-based gynaecologist/obstetrician, “it’s now the turn of babies to be outsourced from India. In these times of globalisation and market-driven economies, there’s considerable demand for this service.”

Low medical costs

Indeed. And fuelling the demand is a slew of factors, including low medical costs and a competent workforce. According to Dr Anoop Gupta, Medical Director, Delhi IVF and Fertility Research Centre, the total cost of renting a womb in India works out to around US$10,000 as compared to about US$50,000 in the West. In the US, states the expert, surrogate mothers are typically paid US$15,000, while the agencies claim another US$30,000. In India, however, fertility clinics charge in the realm of US$2,000 to US$3,000 for the procedure, whereas a surrogate is paid anything between US$3,000 and US$6,000 — a fortune in a country where the average annual per capita income is US$500.

But, despite the demand, surrogacy has its share of critics in India due to the moral, legal and ethical debate that swirls around it. Opines lawyer/activist Preeti Katyar, “If surrogacy becomes an avenue by which women in richer countries choose poorer women in our country to bear their babies, then it is economic exploitation, a kind of biological colonisation.”

A factor that has contributed to the negative feeling is the lack of a definitive legal framework to deal with surrogacy and related issues. While commercial surrogacy is banned in many countries — including Italy, Australia, Spain and China — and permitted with restrictions in the US, France and Germany, the Indian government is yet to formulate any laws. In fact, the only guidelines, which regulate surrogacy — and the clinics that provide ART (Assisted Reproductive Techniques) — are the ones framed by the ICMR and the Ministry of Health and Family Welfare in 2005. But these, point out experts, are nebulous and patient and doctor-unfriendly. For instance, Section 3.10 of the ICMR guideline states, “No relative or person known to the couple may act as a surrogate.” This, experts believe, is ludicrous as it propels childless couples needlessly towards commercial surrogacy. In fact, in-vitro fertilisation (IVF) experts say that in 90 per cent of the surrogacy cases in India, the mother is related to the childless couple while only in five per cent cases, the surrogacy is altruistic and in the remaining five per cent, commercial. So, infertile couples are forced to think twice before going in for it due to the costs involved, which is unfortunate as India is home to 14 per cent of the world’s estimated 80 million infertile couples.

Legal ambiguity

Then there is ambiguity about a surrogate mother’s rights. Delhi-based lawyer Rita Row says, “The guidelines are skewed and thoughtless. There’s very little to protect the interests of the surrogate mothers.” The guidelines state that “a surrogate should be younger than 45 years” without mentioning the minimum age. So does that mean an 18-year-old, or someone even younger, can become a surrogate mother?

Also, what happens after the baby is born? “The biggest problem,” explains Dr Gupta, “arises after the baby’s birth. Foreigners are unable to get legal assistance when it comes to taking the child back home.” According to the ICMR guidelines, a child born through surrogacy “must be adopted by the genetic (biological) parents unless they can establish through genetic (DNA) fingerprinting that the child is theirs.” Ergo, the only option left open to them is to ‘adopt’ the baby — which is a very lengthy and cumbersome process in India.

Dangerous

The regulations don’t provide legal protection to Indian parents, either. The only legal recognition of the child’s parentage is the birth certificate, and it’s only the birth mother’s name that can be used for this purpose. Consequently, if the birth mother decides not to hand over the baby after birth, there’s nothing the intending parents or the doctor can do about it.

Unsurprisingly, with such ambiguous regulations in place, surrogacy in India has become a dangerous playing field for unscrupulous middlemen who entice and push uneducated and poor women into surrogate motherhood. This practice also encourages the misuse of a surrogate child for terrorism, prostitution or unethical genetic engineering research.

India can take a few pointers from the US, which has strict regulations in place — the law there mandates that surrogate agreements be meticulously drawn out to delineate the responsibilities of intending parents as well as the surrogate. “But in India,” says Dr Kathuria, “surrogacy has a high potential for abuse as the monetary stakes are high.” Admits Dr Raman Prakash, a Mumbai-based psychologist who also counsels commissioning parents and surrogate mothers, “When anything is influenced by economics, there’s invariably a dark side to it.”

No awareness

Experts believe that the basic problem is that people are not well informed about surrogacy and its related issues. For example, a surrogate’s health is not given due priority. Fertility doctors are allowed to implant up to six embryos in a donor’s womb — in other countries it’s limited to three — which creates the risk of multiple pregnancies and can lead to severe complications, stillbirth or even the surrogate’s death.

In many cases, the surrogacy option is used even when it is not necessary. “Sometimes patients have had repeated IVF failures or recurrent miscarriages,” says Dr Kathuria. “Usually, a simple egg donation is enough rather than a more complicated surrogacy option.”

Doctors agree that a mass awareness campaign is key to making the treatment more accessible to all. Many sensitive, surrogacy-related issues too, need to be tackled. As Dr Asha Jaipuria, a social activist and NGO worker puts it, “Who ensures that the woman’s unused eggs or embryos are not harvested/stored and then sold to couples who want fair-skinned children? Or to couples who don’t have viable eggs/sperms?”

Moreover, some questions need urgent answers, such as: what happens if the surrogate dies during childbirth, is there due compensation for her motherless children in that case; and what about the postpartum psychological and emotional support for poor women surrogates?

There’s also the issue of money. As the treatment is expensive, there should be a regular audit to oversee the funds distribution to the surrogates. It’s time the government seriously considers enacting a law to regulate surrogacy and related IVF/ART technologies in India to protect and guide couples going in for such an option. Without a foolproof legal framework, patients will invariably be misled and the surrogates exploited.

Women’s Feature Service

Foreign adoption gets simpler

New Delhi, Oct. 14: The government has prepared new adoption rules that will spare prospective foreign parents harassment and delays of over a year in adopting Indian children.

Indians who want to adopt may, however, have to wait even longer than they do at present.

Foreigners will no longer need clearance from the state governments’ adoption coordination agency, a process which officials and activists said often takes over a year.

“State government clearance takes over a year in most cases and is the main reason for the harassment and delays that prospective foreign parents face,” said a senior official of the Central Adoption Resource Agency (Cara).

Cara, the country’s apex adoption body, is likely to declare the new guidelines “anytime now”, sources said.

Under the new rules, the government will be responsible for identifying the agency in India that can offer a child for adoption. Now, foreigners have to first apply to their governments, which have to find and get in touch with adoption agencies in India on their own. This process, Cara officials said, delays the entire adoption procedure, increasing the trauma of the child as well.

“Once a child knows about the adoption, it is in his or her best interests to be handed over to the parents. Both sides need to know each other better,” the official said.

Indian parents may, however, have to wait longer before they can start a family with their adopted child as all applications will now be scrutinised by the Centre.

The existing rules allow Indians to approach agencies directly, increasing the possibility of trafficking and other crimes against children under the garb of adoption, officials said. Now, parents will have to first register with a “state adoption agency” recognised by Cara.

Trained social workers of the state agency will file a “home study” after visiting the home of the prospective parents and interacting with them. The report will be made available to Cara. The state agency will identify an adoption home that matches the child’s needs with what the parents want.

MISSING CHILDREN
THE BUSINESS OF ADOPTION, TEHELKA JULY 7
Sanjay Dubey finds that instead of restoring lost children to their parents, the capital’s adoption homes are selling them Four-year-old Mohit is lucky. A distant relative, who wanted to settle a score with his parents Prem Sagar and Arti, kidnapped Mohit on May 10 and abandoned him at the Old Delhi railway station. Fortunately, he was rescued and sent to the Delhi Council for Child Welfare, a private adoption agency better known by its other name, Palna.
A frantic Sagar traced his boy to Palna and reached there on the morning of May 11. The officials there were extremely uncooperative. The parents were not allowed to meet their son. “After hours of waiting and pleading, Mohit was finally shown only to my wife and that too from a distance of some 10-15 yards,” says Sagar.
As the weekend fell over the next two days, Palna officials flatly told the parents that they could take Mohit home only on Monday, three days later. “They again refused to entertain us on Monday. We then had to go to the juvenile court, which directed us to the Child Welfare Committee (CWC) in Kingsway Camp,” Sagar told Tehelka.
The government has established CWCs all over the country for the welfare of children who need care and protection. CWC’s are vested with judicial powers and on CWC’s orders and the intervention of some good Samaritans, Mohit was finally restored to his family on May14.
In Mohit’s case Palna disregarded two cardinal rules spelled out in the Juvenile Justice Act (JJA).
»It is mandatory for the police or Childline (a centralised number for missing kids 1098) or any voluntary organisation to produce a missing child before a CWC.
»Every effort should be made to restore the child to his or her biological parents.
Over 34,000 children have gone missing in Delhi in the last 20 years (as per National Crime Records Bureau (NCRB) data). Most of them aren’t as fortunate as Mohit. In last three years alone, 6,687 children in Delhi have been declared untraceable by the Crime Branch’s Missing Persons Squad. A senior Department of Social Welfare (DSW) official lays the blame for this on voluntary adoption agencies. “They are fated to live either an orphan’s or an adopted child’s life, all thanks to various voluntary organisations,” he says.
Mohit’s is just one instance of how rules under the Juvenile Justice Act (JJA) and Central Adoption Resource Agency (CARA) guidelines to help missing, abandoned and runaway children are routinely ignored. Instead of providing them a ray of hope, adoption agencies only add to their misery.

CHILD PLAY

34,000 children have been reported missing in Delhi in the last 20 years
6,687 children have been declared untraceable between 2004 and 2006
200 Indian couples are waitlisted on an average with each agency. Non-Indians are still preferred
Rs 10,000 is the maximum amount non-Indian couples can be charged for adopting a child
Rs 2,00,000 is the minimum amount non-Indians pay to adopt an Indian child
Rs 20,000 is the average amount paid by Indian couples to adopt a child. By law they should just pay for the expenses

Confidential reports on the functioning of adoption agencies issued by DSW and accessed by Tehelka reveal how Palna routinely flouts norms and rules. A 2005 DSW report states, “Childline and the police are unduly helping the agency [Palna] in procuring children for it in violation of statutory provisions.” It calls Palna’s style of functioning “whimsical, arbitrary and manipulated.”
The report also charges Palna with not presenting children before the CWC or the police. “Why did Palna receive them [the children] and keep them without producing them before the committee. The matter requires to be taken up with the Commissioner of Police,” it says.
The report also says that Palna charges an arbitrary amount of money from people who adopt children — both Indians and foreigners. “All this also reveals how the police and Childline are flouting the statutory and mandatory provisions of JJA, and putting the welfare and fate of innocent children at stake at the hands of such agency [Palna].”
Adoption agencies ignore the poor in the list of prospective parents since they can’t cough up enough moneyAt the time there were 10 placement agencies for orphans and abandoned or lost children in Delhi (eight of those continue to operate) and, according to the DSW’s confidential reports, their style of functioning is not very different from Palna’s. “Further investigation of these organisations revealed that they are not providing any social service to anyone,” says another report. “They are getting children through legal or illegal means and are selling them in the market. The foreigners give higher prices therefore they prefer to sell them to the foreigners.”
Clause 4.35 of CARA guidelines unambiguously states that an adoption agency must be run on a non-profit basis and it shouldn’t look to make money from adoption. Documents with Tehelka show that recognised adoption agencies such as the Church of North India, Welfare Home for Children and Palna, among others, charge about Rs 20,000 on an average from Indians, instead of just the amount to take care of expenses. The guidelines specify that foreigners can be charged a maximum of Rs 10,000 but they routinely have to pay lakhs of rupees.
Clearly, adoption is a lucrative business. This could explain why organisations don’t make any special efforts to restore children to their biological parents, and why children are not produced before the CWC.
The reports also point out that adoption agencies ignore prospective parents in the waiting list who are poor and unable to cough up a high sum of money. SC and CARA guidelines also specify that Indians have to be given preference over foreigners for adoption, but despite there being a long queue of hopeful Indian adoptive parents, adoption agencies do the opposite and prefer foreign nationals seeking to adopt children.
The JJA states that before putting up a child for adoption, the adoption agency must publish his particulars in at least four leading newspapers, of which two must be in regional languages. But “private adoption agencies … have resorted to just a farcical eyewash, by publishing their self proclaimed names and self estimated dates of birth without any photograph, that too only of a few children, in some less popular newspapers, off and on only.” The report says that the agencies do this, “to avoid finding their natural parents.” Commenting on this a CWC member asks, “How can parents recognise their offspring by such an absurd publication which does not even have the child’s correct name ?”
“Most private agencies seldom prepare child histories, in total disregard of the directives of the Supreme Court. Such history sheets could help in tracing the natural parents of a lot of children… These agencies have thus separated innumerous (sic) children from their natural homes… in their urge to mint money through adoptions.”
Had Mohit’s parents not reached Palna, says a senior DSW official, “he would have been in Palna for months without the required effort to trace his family. The agency then would have secured a release order — mandatory to give a child in adoption — from the CWC, finally to give him to a total stranger in return for a huge amount of money.”
This, sources say, is the fate of most children found alone in Delhi. But, what has happened to the reports prepared by some honest DSW officers? “There were all sorts of pulls and pressure on the then director of DSW, Jitendra Narayan, as these agencies are run by very powerful people. Narayan, was ultimately transferred and the new dispensation, after sitting on the matter for a whole year, did nothing more than giving a mild warning to all the organisations,” says a DSW official.
» Writer’s e-mail: sanjay@tehelka.com