Surrogacy outsourcing to India ....
This week Judith Warner wrote her column on Outsourced Wombs, generating over 150 comments. Mine, however, was not published, even after I submitted it twice. So I decided to blog it.

I was interested in the variety of responses to the idea of presumably infertile American women contracting with Indian women to be gestational carriers (no genetic connection). Folks raised issues of exploitation, the free market, empowerment and entitlement. Strong opinions and feelings characterized most postings. As a sociologist studying reproductive practices, experiences and meanings, I am fascinated by the discussion.

Along with many posters, I agree we need to know more about what is actually happening, how it is experienced by the Indian women, their families and the US couples. From my knowledge of surrogacy (and ivf methods), it seems we have the practice of wealthy white educated American women (who undergo treatments to extract their eggs, presumably) and their husbands providing sperm to create a viable embryo. They pay desperately poor uneducated women to inject a range of drugs to their bodies in order to accept the implanted embryo (which may/not cause long term health damage to both the surrogate and the adopting mother). The surrogate is then implanted with a fertilized embryo and will carry a pregnancy to term (~ 40 weeks +/- 4); assume long term risks associated with pregnancy and birth; manage a postpartum without lactating, by use of drugs to suppress milk production (unless she will be expressing the colostrum and early breastmilk for the baby's optimal development; deposit check in bank and then what?

The babies will leave an environment and experience they have come to know in that 40 weeks, and be taken into one with new smells, rhythms, sounds and emotions. If they are treated like most babies born in America, they will be provided suboptimal nutrition (manufactured formula); probably less than optimal skin-to-skin contact and baby wearing, unless supplemental nursing systems are utilized by the new mother; possibly impacted by adopting mother's employment status--how much maternity leave does she have, if any; or is she resourced enough to not need to work for income for some months? The babies are nurtured, loved, indulged, and treasured. Their lives are worth the cash paid for them, $6K, plus the travel expenses, $6K, plus whatever else is laid aside for their immediate and future expenses. How much money do these parents put into the nursery? clothing? toys? How many of these purchases are 'essential' to baby's developmental needs and how many are 'optional' or 'culturally determined needs'? What is the value of this child compared to the previous child born of the same woman? Socially? Morally? Economically? Politically? Hard questions.

The western women will have a baby. They will have demonstrated their right, and ability to have a baby, via a network of new relationships and technologies and economies.

Some questions I have (which were not answered in the Marie Claire article on the same topic last year).
On average, how many attempts does it take to be impregnated? What health consequences are faced with this process?
How many attempts until the presenting surrogate is rejected? What compensation does she receive?
How are labors managed? How many cesareans are performed?
How do women plan to spend the the money they receive? How _does_ it get spent? How will their new found wealth be viewed in their own communities? Where are the blogs in low income India on this topic?
How do the contracting couples relate to the baby? What are the long term health consequences for surrogates and the infants they produce?

Clearly many folks posting have strong moral, ethical, economic, political views on the practice. Also clear is that in the US and Indian cultures, a free market mentality rules, in contrast to several European countries where such transactions are illegal. Where is the social science and medical research showing us what these practices are and what they mean in both cultures? Where is the funding for this type of research and its dissemination in useful, relevant, and trustworthy venues to the greatest number of people?

This is a new social experiment. wow.