Dr Nayana Patel and her team of doctors with the surrogates at the Akanksha Infertility Hospital in Anand. (Photo: Bhupendra Rana)
Minister of Health and Family Welfare, Dr Harsh Vardhan, introduced the Surrogacy (Regulation) Bill, 2019, in the Lok Sabha on July 15, 2019. The Bill defines surrogacy as a practice where a woman gives birth to a child for an intending couple. It prohibits commercial surrogacy but allows altruistic surrogacy that involves no monetary compensation to the surrogate mother other than the medical expenses and insurance coverage during pregnancy.
Commercial surrogacy includes surrogacy or its related procedures undertaken for a monetary benefit or reward (in cash or kind) exceeding the basic medical expenses and insurance coverage.
The Bill states that the intending couple should have a ‘certificate of essentiality’ and a ‘certificate of eligibility’ issued by the appropriate authority. It also lays down that the intending couple should be Indian citizens and married for at least five years, with the wife aged between 23 and 50 years old and husband between 26 and 55 years old. The couple should not have any surviving child, whether biological, adopted or surrogate, including any child with mental or physical challenges or a life-threatening disorder.
While surrogates unanimously disagree that the bill will do any good, they say that they agree that guidelines must be in place to regulate the same. “There must be guidelines that would help someone who lands up in the wrong institute. Today the awareness among women opting for surrogacy has increased as much as among the society that does not look down upon it. Here, we don’t have to deal with the commissioning couple at all. Everything is taken care of by the doctor. We have been counselled along with our families to ensure that we are aware that the baby we deliver does not belong to us,” says a surrogate, who has her daughter living with her in the ward of the Akanksha Infertility Hospital in Anand that pioneered commercial surrogacy in India.
The surrogates say that while the surrogacy requires them to stay in the ward, Dr Nayana Patel makes arrangements for their safe travel home if need be. Waghela says, “My children are also living with me here and the hospital even helps me teach them.” In the months of their stay in the center, the women follow a disciplined time table that includes prayers, exercise, meals and vocational training in stitching, beauty treatments, spoken English and craft courses for which teachers arrive at the center.
Ahmedabad resident Manisha Parmar, 35, has been a surrogate twice — to a South African couple in 2013 and a Rajkot-based couple in 2016. “I have delivered six babies — three girls of my own, one baby girl for the South African couple and twin baby boys for the Rajkot couple. We were in need of money and my family completely supported me,” says Manisha, adding that she has seen seven women referred by her being successful surrogates.
“I feel surrogacy is a boon for women who are looking to make ends meet. It is wrong to say that surrogates are exploited. We are not forced to come here and deliver babies. We come here by choice,” she says, as a group of pregnant surrogates nod in agreement.
Dr Patel says, “We have a team that works to make every surrogacy successful as well as comfortable for the women too. We have an in-house counsellor, assistant gynaecologists and a legal department.”
Dr Patel’s appearance on the Oprah Winfrey show in 2007 brought fame to Anand in Gujarat and also her center, which was involved in IVF treatment until 2004 although India legalised surrogacy in 2002. The booming surrogacy industry in Anand has also given rise to ancillary businesses like hotels, lodging, travel and baby products stores in the town along with paediatric hospitals as well. The sprawling three-storey hospital cum research center that Dr Patel inaugurated three years ago, however, is also equipped with guest rooms for intending couples.
Dr Patel doesn’t think much about critics who claim that she is advocating against the bill for her commercial gains. She says, “People forget that if surrogacy is banned, the IVF cycles will continue and couples will continue to opt for those trials and I will continue to have patients. We also have been advocating to bring in the bill for Assisted Reproductive Technology (ART) before the surrogacy bill. Ultimately, surrogacy is possible only because of ART but they are not thinking of the ART bill and instead rushing to surrogacy.”
She says that in her representation to the government, the issue of foreign couples is the lowest priority. “It doesn’t matter if the government wants to ban foreign couples, but our main argument is that they cannot make it altruistic and within the family. It is impractical and will leave many couples childless. Today, we are in an age where women themselves don’t want to have children until middle age and often prefer only one child. In such a situation, looking for surrogates within the family under the age of 35 is anyway tough,” she says.
Pointing out that the bill does not consider the emotional complications involved in having a surrogate from within the family for the well being of the child, she says, “It will always leave room for family conflicts. We have also asked for an approval on the number of surrogacies a couple can be allowed to commission to be increased from one to two. Many people want to have two children. ,” she says, adding that among the listed recommendations is also a push to allow NRIs and persons of Indian origin to be able to commission surrogacy in India.
“Celebrities who opt for surrogacy can go abroad as they can afford it. Our centers here are a boon for Indian couples who can spend only a few lakhs to live the dream of having a family. This bill is not a regularisation of surrogacy but instead a complete ban on surrogacy and it will end hopes of many childless couples. That is what it will mean if it is passed,” says Dr Patel.