10/03/2013 02:45 EDT | Updated 01/23/2014 06:58 EST

What India Can Teach Us About 'Renting Wombs'

For all the raised eyebrows about India's billion-dollar surrogacy industry, that system still seems preferable to our own. At least there, a woman who undergoes the substantial physical and mental rigours of a surrogate pregnancy is clearly and openly compensated for her efforts.

The National Post had an interesting piece yesterday about a controversial "baby factory" in India, where dozens upon dozens of poor Indian women live together in dormitories while serving as surrogates for paying clients from across the globe. Thanks to a new BBC documentary called House of Surrogates, we now know some of the details of this clinic, which is run by a glamourous and controversial doctor named Nayna Patel. In particular, we know the story of one the clinic's Canadian clients, identified as "Barbara," and her surrogate, identified as "Edan."

Barbara is a 54-year-old woman. She spent three decades of her life trying unsuccessfully to have a child. Eventually, she became a client of Dr. Patel's and, through the clinic, hired Edan to carry, deliver and breastfeed her baby boy. After spending several months in India, Barbara brought her infant son home to Canada, her dreams of motherhood fulfilled.

Edan's participation in the surrogacy was also motivated by motherly dreams, though of a different sort. Her hope was to take the $8,000 she received for serving as a surrogate and to use it to better her own children's lives by providing them with an education. For an impoverished family such as Edan's, it's a massive sum of money -- an amount they could almost certainly never have earned in other ways. (To give you an idea of the scale, we learn that one of the other surrogates featured in the documentary, Vasanti, is married to a man who makes $40 a month.)

So is this a win/win transaction?

Despite all the criticism of Dr. Patel and charges of exploitation and "baby selling," I think it is. What is the ultimate outcome? A healthy baby for a woman who's spent nearly her entire adult life yearning to be a mother? A chance for a desperately poor family to help their children transcend the daily struggle for survival? By all accounts, Dr. Patel's clinic is professional and hygienic. The complaints that emerge on the documentary from the women serving as surrogates are valid and understandable -- boredom, physical pregnancy discomforts, missing their own families while they spend 9 months in the dormitories. But the complaints don't suggest abuse or poor conditions. In some ways, what seems to be the hardest part for the surrogates is the emotional pain of letting go of the babies they have carried and, in many cases, nursed and cared for, for so long. But that pain is no different from what surrogates experience here in Canada, where surrogacy itself is legal, but paying for it is against the law.

Indeed, for all the scorn Dr. Patel receives for "renting wombs," and all the raised eyebrows about India's billion-dollar surrogacy industry, that system still seems preferable to our own. At least there, a woman who undergoes the substantial physical and mental rigours of a pregnancy is clearly and openly compensated for her efforts. Here, surrogates must either be exceptionally selfless human beings who want nothing in return for carrying another person's child for nine months (such people are rare), or they must be paid under the table for unknown amounts in deals that cannot be revealed or monitored. On the whole, the potential for injustice and exploitation rises when a pretence must be maintained that no financial transaction is taking place -- when bags of cash are being exchanged in dark hallways. A Canadian surrogate cannot protect herself with a legal contract outlining how or when she will be paid. She is also put in a position of having to lie to the fertility doctor, the very person on whom she's depending to safeguard her well-being during the delicate process of embryo implantation (and all the hormones and medications that go along with it). Is she being treated fairly? Paid enough? It would be a lot easier for us to know the answer if she could talk about it openly and identify others in the same boat with whom we could compare her experiences. And that would make it better for her as well.

I suppose one could reply that the answer is to crack down on paid surrogacy in Canada. To more aggressively enforce the prohibition. (Only one such prosecution has been launched in the nine years that Canada's assisted reproduction law has been in place.)

But these things are not easy to prove. Nor does it seem particularly constructive to further punish couples plagued by infertility, and the people trying to help them, with criminal charges. Why not instead take the best of what Dr. Patel offers -- the pairing up of women who both have something real to gain from each other -- and improve upon it?

Canada could legalize paying for surrogacy, but also provide sample contracts encapsulating protections for all parties. Offer information to would-be surrogates on their rights and to would-be parents on their legal options. Generally speaking, provide people information to make beneficial choices, without actually making the choices for them.

There are no fairy tales in real life, and I'm sure there have been many difficulties for both Barbara and Edan. But their circumstances being what they are, it's hard to imagine either one of them not feeling she is better off now than she was before her involvement with Dr. Patel's clinic. Why not offer the same opportunity to women in Canada as well?


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