Coming on the heels of the new Bill which bans commercial baby-bearing or surrogacy is an uncompromising investigation into the serious health hazards of assisted reproduction, the murky market for genetic materials to create designer babies and the ruthless exploitation of women. Packed with alarming data from global studies and interviews with leading practitioners, surrogate mothers, couples undergoing in vitro fertilization (IVF), fixers and donors, Politics of the Womb, is a seminal work by writer-activist Pinki Virani... and it hasn't come a day too soon.
Any country which allows its women citizens to turn into renters of uteri and vendors of ova is guaranteeing the commodification of the girl child.Pinki Virani
"Any country which allows its women citizens to turn into renters of uteri and vendors of ova is guaranteeing the commodification of the girl child," states Virani, "policymakers have begun to see this, and more and more countries are moving towards altruistic egg and sperm donation apart from calling a halt to commercial surrogacy." The reader will be shocked as she painstakingly elaborates the real health risks to mother and child, the traumas accompanying some dodgy procedures and the ugly underbelly of the fertility business.
High failure rate
Start with the fact that professional bodies in Europe and America agree the global failure rate for IVF is between 70-80%... and this increases dramatically if the mother is older than 35. Apart from the obvious physical and psychological trauma to the parents of repeated implants, there is the ethical question of the "high death rate for embryonic and foetal human beings". Given that clinics routinely implant two embryos for every attempted pregnancy cycle and it can take between 3-6 cycles to conceive, the ethical issues are serious but there is no regulation of this human debris.
A US government report of 2012 found only 36% of cycles produced a clinical pregnancy with 21% resulting in a live birth. In the unregulated Indian market some clinics manipulate the woman with hormones that appear to confirm a pregnancy, and then say she miscarried when there was no pregnancy to begin with. Others deliberately retain the best embryos for later cycles, forcing the mother to go through unnecessary trauma from failed implants. Clearly, it's a business and like all businesses, the big bucks come from overseas customers who trawl the Indian market for poor women who rent their wombs or young girls who sell their eggs. Now we have a law against this, but the perennial challenge of implementing it remains.
"There is so much money to be made," says Virani, "that pimps have set up official shop with business cards and some only an e-address to facilitate intercity, inter-state, national, international procurement of eggs and uteri...they guarantee they will make available uteri for dying-to-be parents to commission as surrogates and eggs to be stuffed into them, and sweet sweet (sic) stories can then be narrated to friends and family about mail order babies as they are cooed to the surrogate's belly over video calls."
Here's a chilling example of an international surrogacy gone wrong, which, unfortunately, is not as uncommon as we would wish. "In 2005 a Canadian couple -- Canada permits only altruistic surrogacy -- paid for the creation of twins in India through purchased eggs and a rented uterus. The DNA test showed the boy from the twins was not genetically related to the father, the sperm supplier. The fertility clinic had implanted an unrelated embryo in the surrogate. The couple were parents in their fifties. And that's another cruelty -- at least for foreign babies from India -- giving the poor things parents who are half a century older than them; just born and already bonded labour as juvenile care-givers."
[Selling eggs is easier]... than renting out their vulvae as call girls; more discreet, taking comparatively much less time than renting out their uterus...Pinki Virani
Those who are lucky enough to have children through IVF or surrogacy may discover it's a mixed blessing as studies show conclusively there is a higher incidence of major birth defects. One US study showed up to 6% of infants had a higher than average rate of mental, neural, physical and developmental problems. IVF babies have an increased risk of developing cerebral palsy, autism, mental retardation, especially if the couple is past their reproductive prime which is often the case. The mother doesn't escape the long-term effects of being pumped full of hormones and chemicals either as her risks of developing cancers of the ovaries and breasts increases significantly.
The "andaa dhandaa"
Perhaps more shocking was the revelation that it is not only poor women who trade their eggs and uterus to have a better life. College students and professionals are also selling their eggs to make easy money. "Easier at any rate than renting out their vulvae as call girls; more discreet, taking comparatively much less time than renting out their uterus as surrogates," says Virani who mentions a hair stylist who is donating her eggs to finance a vacation. Egg freezing is a corporate perk in companies like Apple and Microsoft and it is medically supported when the patient is going in for cancer treatment. Diana Hayden had a baby this way and others push the boundary of possibilities like the 60-year-old British woman who wants to have her dead daughters eggs implanted to produce her own grandchild. She won the case and added a whole new meaning to family relationships.
Says a Delhi-based policewoman, "All these women are told your eggs are going to make a baby but it does not work like that. These doctors are also doing andaa dhandaa, like mega agents. They are buying from women, selling somewhere else and taking a commission." The market for human eggs is huge because India also has a stem cell treatment industry and "is considered an important site of the global tissue economy," says Virani.
[P]imps have set up official shop with business cards and some only an e-address to facilitate intercity, inter-state, national, international procurement of eggs and uteri...Pinki Virani
On 14 October, 2015, the Supreme Court expressed serious concern that India was leading in surrogacy tourism and strongly advised against commercial surrogacy. The backlash was immediate, with doctors asking why they should be punished for the bad apples. Similarly, not all surrogate parents are above board. There are paedophiles, human traffickers and other devious exploiters of children who have entered the surrogacy market as cases from Thailand and elsewhere show.
Critics of the new surrogacy bill say it discriminates against same sex couples and unmarried ones but India has finally woken up to the horrors of commercial baby-bearing in an unregulated industry. If you have the stomach to read this book, beware the strident language which might not appeal to all readers.
Politics of the Womb is published by Penguin Random House India