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The Invisible Mother: The ‘Stigma’ of Surrogacy

The pregnant bellies of three women standing in a line. One of them wears a green saree, the other two wear red sarees.

Mobility is undertaken for varied reasons across contemporary global spaces. One emerging reason for travel and mobility is reproduction.

‘Reproductive tourism,’ as it is popularly known,has far-reaching consequences for those involved in it. At the crux of this is India’s rapidly growing and currently unregulated commercial surrogacy industry, estimated to be worth US $445 million per year (Warner 2008, Kohli, N., 2011).  These estimates, provided largely by commercial conglomerates such as McKinsey and The Confederation of Indian Industry (CII), have projected massive earnings for this industry.

Commissioning couples from across the world come to hire the services of Indian surrogates.  However, attention has been concentrated on transnational surrogacy, i.e. on overseas commissioning couples coming to India for surrogacy, more than on residents of the country who commission surrogacy within India.  Access to surrogacy in India today is within the frame of acceptable notions of heteronormative relationships and family. According to the recent guidelines issued by the Ministry of Home Affairs, Government of India only heterosexual couples married for a minimum period of two years will be allowed to access commercial surrogacy in India through a medical visa.

India is a surrogacy ‘hub’ with research and reportage suggesting its thriving existence in most of the major cities in India.  Despite this proliferating million-dollar industry and the multiple players involved in it, the surrogate women who are central to the arrangement continue to be the most invisible.

Stigma affects the way in which surrogates approach, and are in turn approached to become part of a surrogacy arrangement. Even though the arrangement is sold to potential surrogates and commissioning couples as an asexual exercise that includes technological interventions in the form of assisted reproductive technologies (ARTs such as IVF) – its association with sexuality, with sex and prostitution – continues to mark the participation of the surrogate. It is the desire to escape these associations linked to surrogacy that pushes many of the surrogates to ‘invisibilise’ themselves. This form of invisibilisation is also encouraged by the clinics and surrogacy agents controlling the arrangement to create an inequitable relationship.

Sama’s research on surrogacy (Birthing a Market: A study on Commercial Surrogacy) conducted in Delhi and Punjab found that surrogates oscillated between positioning their work as a ‘good deed’ and one that has to be hidden from relatives, neighbours and their own children. Strategies include deciding who to confide in from a close circle of acquaintances, creating a narrative around the pregnancy, and shifting residences. Travel from their home town to another city was undertaken by surrogates to hide their pregnancy andto escape the stigma of commercial surrogacy. One of the surrogates in Sama’s study for instance had shifted residence from Indore, her hometown, to Delhi during the period of her surrogate pregnancy. She did so to maintain her anonymity and hide the pregnancy from her neighbours and relatives. In such situations,the clinic or surrogacy agent usually provided alternate housing for the surrogate. Surrogate hostels have increasingly becomes forms of residence where many surrogates are housed during the period of the pregnancy. This means that surrogates are under the direct control and constant supervision of agents and clinics. For surrogates the movement from home to a surrogacy hostel in the same city may be insignificant, but it still entails living separately from their families and children for a substantial period of time.

However, the study found that surrogates also lived at home and enacted other forms of invisibilisation. These included telling relatives and neighbours that the child they were carrying was meant for adoption to a relative, or lying about a still-birth after the child was born.

The separation from home we concur adds to their already subordinate position within the surrogacy arrangement. The process of invisibilisation that begins with hiding participation in the arrangement continues with the surrogate’s tacit responsibility in keeping the commissioning couple’s infertility a secret as well. In such situations, the double bind of the shame attached to infertility and undertaking surrogacy has a direct impact on the surrogate. It appears from the study that the stigma of infertility led the commissioning couples to create an elaborate pretense of pregnancy in the same way in which the surrogate mother often tried to hide her pregnancy. Here, the clinic and the agent were actively involved in catering to the demands of the commissioning couple rather than the needs of the surrogates.

Invisibilisation has a detrimental impact on the surrogate in terms of her physical, emotional and psychological health. The surrogate’s silence is placed as a virtuous and sought after aspect of the arrangement.  She is encouraged to not ask too many questions, not seek to know or meet the commissioning couple, be less assertive and view the arrangement as a form of ‘altruistic gift-giving’ to the commissioning couple.

Unable to communicate openly or seek information about her health and other aspects of the arrangement, surrogates have to look for innovative ways to create some form of visibility. So many of the surrogates wish to be remembered for their contribution to someone’s family by staying in touch with the newborn and the commissioning couple. They want to be able to tell their children the sacrifice they have made as surrogates to be able to secure a safe future for them.

However, the insidious culture of silence and invisibility is followed and endorsed by all who are part of the arrangement. This is evident in case of the almost mandatory cesarean sections that are being performed in cases of surrogacy delivery to suit the requirements of the commissioning couples and to reduce supposed notions of bonding links between the surrogate mother and the child she gives birth to.

These and many other aspects impact the ways in which a surrogate is positioned within the arrangement in relation to her body, family and her sense of self.

Meanwhile, the Draft ART Bill by the Indian Council of Medical research (ICMR), Ministry of Health and Family Welfare (MOHFW) to regulate the ART and surrogacy industry is pending and its provisions do not consider these and other critical issues and concerns.

Pic Source: Creative Commons