Those who were staying at home generally planned to say that they were expecting their own child, and then that something had happened to the baby. Surrogates were convinced that they were not doing anything wrong but, according to them, society thought differently.
They explained that Indian people are quick to pass judgement but:. The majority of surrogates wanted greater awareness in society. This demand could explain why they welcomed our study, hoping that it would spread more information on surrogacy. The surrogates explained that people who condemn them for doing sinful, dirty work are only ignorant, and so are not entitled to judge them.
Two women explained that educated people understand and accept the process of surrogacy, but illiterate people think it is immoral S19, S Surrogacy is sealed by a contract between surrogates, intended parents and medical doctors. In our study, 23 surrogates had signed the surrogacy contract. Footnote 3 Eight surrogates had not read the agreement because it was in English , but they declared that it had been thoroughly explained to them.
Surrogates explained that they had to do everything the doctors asked them to do. This condition was sometimes written into the agreement. Surrogates did not choose the intended parents, and they made no demand to do so. Only one surrogate, Devna S28 explained that she was wondering how the intended parents would behave toward her as they belonged to a higher caste. Some surrogates declared that they were aware of hierarchical relationships.
However, no criticism was expressed regarding the organization of surrogacy. Despite difficulties, surrogates described their ongoing or past experience as a positive one. They felt they acquired new knowledge and competencies. Kasi S30 declared for instance that, through surrogacy, she developed some skills such as communication skills through the numerous appointments with medical doctors and agency managers.
This positive experience may also be linked with the medical care, unrelated to pregnancy, that some of them received, like Sushmita S03 who had eye surgery to correct a squint. On the other hand, however, their narratives simultaneously reveal a consciousness of their working conditions and social situation, and some empowerment and benefits of being surrogates.
In the remainder of the discussion, we describe how our findings can be seen as pivoting on four paradoxes, echoing the surrogacy controversies in feminist literature. Thirdly, another paradox concerns the emotional and bodily involvement of surrogates. Finally, we showed that surrogacy as it is experienced and described relates to specific gender norms in India. Our study findings validate some preconceptions and deconstruct others, revealing social and gender paradoxes in surrogacy practice in developing countries such as India.
The first paradox deals with the reasons why women commit to surrogacy. It is commonly assumed that in developing countries where surrogacy is commercial, only poor women in immediate need of money commit to it.
In our field study, most surrogates interviewed did not appear to be in desperate poverty. The median income of the surrogates interviewed was 10, INR [ euros] which was well above the Indian family median income INR per month, or around 80 euros Footnote 4 [ 44 ]. They clearly stated their financial motivation, but they saw the practice as a unique opportunity for upward social mobility and described better working conditions than their previous job.
A similar middle-class profile of surrogates has already been described in two other studies [ 15 , 36 ]. Overall, Indian surrogates appeared to be on an upwardly mobile social trajectory both in our study and in other research [ 45 ].
The financial motivation for surrogacy observed in our study is in line with all other studies in India, as well as with studies in Israel where it is also paid [ 25 ]. This is in contrast with some other countries. In the United Kingdom, surrogacy is unpaid [ 46 ]. In the United States, surrogates are paid but they rarely acknowledge financial considerations as their main motivator [ 34 , 47 ], and Heather Jacobson even showed that they find such an idea offensive [ 48 ].
Surrogates tended to describe surrogacy as a paid activity offering better conditions than their previous job. Some authors have observed that other employment may indeed be more harmful, dangerous and abusive, with a much lower income than surrogacy [ 4 , 23 , 50 , 51 ].
Facing the need for money and sometimes financial crisis and debts, women had to find strategies, not necessarily to survive but to live better. Surrogacy appears as an option to earn a large sum of money that would be impossible with any other work. They considered that using their reproductive body was a better alternative than other wage labor available for women in India. Surrogacy thus appears as a strategic and thoughtful choice to improve living conditions.
Our empirical data do not sustain the hypothesis that it is an economic non-choice for surrogates. Does it lead to better economic and daily life conditions? The second paradox concerns the moral condemnation of surrogacy. In India, a patrilineal society, married women are traditionally assigned to their husband, family and home and their body is supposed only to ensure lawful descent for the family [ 53 , 54 ]. The surrogates we interviewed rejected the stigma, valorizing their commitment and condemning the condemners.
Remunerated activities outside the home are socially perceived as degrading for women. People are not aware of new reproductive technologies and would therefore think that surrogates had to have a sexual relationship with a man other than their husband. Moral taint occurs when an occupation is regarded as somewhat sinful or of dubious virtue, which is the case of surrogacy.
When surrogates explained that people were not familiar with the process of in vitro fertilization, they placed themselves apart. They now knew that it was possible to have babies without sexual intercourse and they were aware of medical advances, which was not the case of their relatives.
They felt that by becoming surrogates they were becoming part of a modern and knowledgeable society, exactly as was observed with institutionalized delivery and use of modern contraception [ 58 ]. Surrogates developed strategies to combat the stigma attached to surrogacy, to overcome its negative representation and to valorize their activity. A third paradox appears regarding the maternal bond. As noted in the introduction, some scholars, especially essentialist feminists, point out that there is an inevitable attachment of pregnant women to the fetus.
The surrogates described a clear affective but detached attitude to the future child, and defined surrogacy as a physical activity more than an emotional one. We observed no kind of maternal bond, which is consistent with other findings in India [ 44 ] and observations in other countries such as Canada, the US and the United Kingdom [ 24 ].
The bond with the future child that surrogates bear was nevertheless described as an affective bond. It appears more as a nanny bond [ 25 ]. They drew a parallel between nannies and surrogates, explaining that both are women whose work involves psychological and bodily intimacy. The surrogates we interviewed approached surrogacy as a physical job. Teman showed that Israeli surrogates separated their body from their self and bonded better with the intended mother than with the child they were bearing, through a relationship described as fusional.
Surrogacy is often described in the literature as reinforcing gender inequalities. Indeed, we observed that women become surrogates in order to respond to gender constraints as mothers and wives.
However, paradoxically, by becoming surrogates they go against gender norms through which women are assigned to one man the husband , one family family-in-law , and are not encouraged to have wage-paid employment. Indian women are assigned to maternity, children and the household [ 13 , 54 ]. Surrogacy was perceived by the women we met as a new way to generate income, without creating suspicions or threatening the reputation of the family as the surrogacy was kept secret and thus to take care of their family.
Surrogacy stems simultaneously from gender constraints and from the will to go beyond gender constraints. Through our interviews with surrogates, intended parents and medical doctors, we confirm the lack of autonomy, liberty and decision-making power of surrogates regarding pregnancy, delivery and the entire process, as has been observed in other studies conducted in India [ 60 ] but unlike findings in other countries the UK, Israel, the USA.
In their narratives, surrogates did not complain of lack of autonomy. We cannot rule out that this absence of complaints was biased by the conditions of interview, since a person from the clinic or agency was often present and since the clinics may have selected surrogates who were considered as having had a trouble-free experience and no specific complaints. However, similar observations were made in other studies such as that of Rudrappa, who interviewed surrogates in surrogacy homes where the presence of cameras in the dormitory was not perceived by the women as disturbing or violating intimacy [ 15 ].
Surrogates are constantly under supervision, exactly as they are in their everyday life. Thus, lack of autonomy does not seem to be specifically related to surrogacy, but to Indian society in general. This domination and submissiveness are reinforced by the fact that surrogates belong to a lower class than medical doctors and intended parents, in a society that is traditionally strongly hierarchical and unequal, where power and autonomy depend on social class and economic resources [ 63 ].
This medical power and domination are not specific to surrogacy: in India, as elsewhere, medical power is generally exercised over economically disadvantaged and socially marginalized people [ 64 ], including in maternity and gynecology services [ 65 ]. Medical doctors and intended parents tend to counteract the image of exploitation. For them, surrogacy is a win-win situation: childless couples go back home with a child while surrogates earn a large sum of money.
Intended parents stated that they had chosen the clinic that offered the best ethical and medical conditions in order to avoid possible exploitation [ 67 ].
In this context, however, and as far as it can be judged based on our interviews, surrogates were not forced to enter into the surrogacy process.
We had the impression that they did not want to portray themselves as submissive women, nor as vulnerable women and victims. They described themselves as women taking control of their destiny, taking the few options available to fulfil their responsibilities as spouses and mothers. These women have deconstructed the usual image of Indian surrogates as vulnerable and exploited women. Empirical data make it possible to go beyond the theoretical field.
As in other developing countries where commercial surrogacy is flourishing, India has a significant reserve of reproductive workers because of gender norms and gender inequality that generate unfavorable conditions for women [ 41 ]. Surrogacy may be a way to improve the living conditions of the family and children. The economic, social and political context, especially the gender norms, of a given society may lead to possible paradoxical situations, including for women themselves.
It is commonly assumed that women in developing countries are vulnerable, and that they are forced to commit to sex work or outsourced reproductive labor because of economic and gender constraints [ 17 , 20 , 68 ]. The social and especially the gender paradoxes that we have analyzed here with transnational and commercial surrogacy echo the social paradoxes of globalization related to migration, sex work and care activities [ 70 , 71 ].
Globalization has created new social and economic opportunities for women, but at the same time it has strengthened global and local gender inequalities. For example, Robin Cavagnoud has explored families of Bolivian women who had migrated alone for economic reasons and worked in care activities.
Likewise, the family remains organized around a female and maternal figure such as the grandmother and not around the father who did not migrate [ 72 ]. Care activities, such as childcare, and domestic work or sex work are generally performed by economically disadvantaged local women or immigrant women.
But such commitment gives them more economic resources as well as greater autonomy and decision-making power as women, mothers and wives. However, in doing so, they face class and sex domination, moral resistance and stigmatization [ 68 , 74 , 75 ]. Interestingly, they seem to be exacerbated when these activities directly deal with the body of poor women, as is the case of surrogacy. Audio recordings of the surrogates interviewed and their transcription in English are not publicly available to protect the privacy and anonymity of the Indian surrogates.
Table 1 presents characteristics of the 33 surrogates interviewed, each one being identified by a pseudo fake first name given by the authors. The raw data are available upon reasonable request from the corresponding authors after having obtained the relevant legal and ethical authorizations.
The one surrogate Neela, S31 who declared that money was not the first motivation explained that she wanted to be a surrogate because she lost the baby at the first surrogacy attempt and also because she had realized the suffering of infertility a friend of hers had committed suicide because of infertility. Intended parents were mainly Indians in the Chennai agency and mainly internationals in the other clinics or agencies of the study. For transnational contracts, the surrogates we interviewed were aware that the intended parents were foreigners but they did not systematically know their nationality.
Crozier GK. Too blunt a tool: a case for subsuming analyses of exploitation in transnational gestational surrogacy under a justice or human rights framework. Am J Bioeth.
Measuring reproductive tourism through an analysis of Indian ART clinic websites. Int J Gen Med. Kirby J. Increasingly, surrogates function as gestational carriers, carrying a pregnancy to delivery after having been implanted with an embryo. In the United States there is no national regulation of surrogacy and its fifty states constitute a patchwork quilt of policies and laws, ranging from outright bans to no regulation.
The lack of national laws or regulation of surrogacy in the United States is cast against a backdrop of rising usage. Industry experts estimate that the actual number is much higher since many surrogate births go unreported. In surrogacy, the rights of the child are almost never considered. In addition, the child has no right to information about any siblings he or she may have in the latter instance. Feature stories. Vision of the mandate Reflections on the mandate Children born of surrogacy arrangements Sale and sexual exploitation in the context of sports Illegal adoptions.
ICTs and sexual exploitation of children. Surrogate FAQs. Surrogate Requirements. What are the Qualifications to Be a Surrogate Mother? Surrogate Health Requirements. Pregnancy Requirements for Surrogates. Surrogate Age Requirements. What are the Age Requirements for Surrogacy? What is the Surrogate Mother Age Limit? Can I Be a Teen Surrogate? What You Should Know. Can You Be a Surrogate in Your 20s?
Can a Year-Old Be a Surrogate? Surrogate Compensation. Highest-Paying Surrogacy Agencies. How Experience Plays a Role in Compensation. Gestational Surrogate Compensation. Traditional Surrogate Compensation. Surrogate Maternity Leave and Compensation. Surrogate Compensation and Taxes. Surrogacy Compensation FAQs. How to Find Intended Parents. How to Find Intended Parents with or without an Agency.
Being a Surrogate for International Intended Parents. Getting to Know the Intended Parents. People Involved in Your Surrogacy. How to Explain Surrogacy to Your Children. Why Work with a Surrogacy Agency? Pregnancy and Health. List of Medications Involved in Surrogacy. Intended Parents. The Surrogacy Process. What are the Requirements of Surrogacy?
How Much Does Surrogacy Cost? What are the Options of Financing a Surrogacy? Surrogacy vs. Adoption — Which is Right for Our Family? Intended Parents FAQs.
How to Find a Surrogate Mother. Available Surrogacy Situations from Around the Country. How are Surrogate Mothers Screened? How to Create an Intended Parent Profile. Getting to Know the Surrogate. Why We Use Certain Terminology. Find a Surrogate as a Gay Couple. International Surrogacy.
International vs. The 4 Risks of International Surrogacy. Why You Should Choose the U. Overcoming Infertility. Tips for Coping with Infertility. What is Infertility Counseling? Infertility Options for Family-Building. Raising a Child Born from Surrogacy. Tips for Intended Parents to Prepare for Parenthood.
Breastfeeding and Surrogacy. Surrogacy Laws and Legal Information. The Legal Surrogacy Process. Understanding Surrogacy Contracts. Establishing Parentage in Surrogacy. Surrogacy Laws By State. About Surrogacy. Surrogacy Surrogacy Definition.
Surrogacy Meaning. History of Surrogacy. Is the Baby Related to the Surrogate? Benefits of Surrogacy for Everyone Involved. Surrogacy News. Surrogacy FAQs. Types of Surrogacy. What is Gestational Surrogacy? What is Traditional Surrogacy? What is Commercial Surrogacy? What is Altruistic Surrogacy? What is International Surrogacy? Can Single Parents Pursue Surrogacy? Surrogacy Professionals. Questions to Ask a Surrogacy Agency. By State.
Surrogacy in Alabama. Alabama Surrogacy Laws.
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