As India still struggles with the stigma around infertility and unconventional methods of reproduction, the recently passed Assisted Reproductive Technology (ART) Regulated Bill brokers a dialogue on surrogacy and its impact.

The discussion surrounding surrogacy has resurfaced with celebrity couple Priyanka Chopra and Nick Jonas welcoming their first child through surrogacy. The news has awakened the moral squad of the society who consider surrogacy as an unconventional method.  Several social media users resorted to harshly trolling the couple for having a “readymade baby”, while the couple’s fans requested for the choice of motherhood to be respected. 

Bangladeshi writer Taslima Nasrin tweeted saying, “Surrogacy is possible because there are poor women. Rich people always want the existence of poverty in society for their own interests. If you badly need to raise a child, adopt a homeless one. Children must inherit your traits – it is just a selfish narcissistic ego”. Though the tweet wasn’t directed at the couple, the subtle dig at the new parents wasn’t missed.

While speaking to Patriot, Medical Director of Advanced Fertility & Gynecology Centre Dr Kaberi Banerjee explained the process of surrogacy, the stigma related to it and the effectiveness of the new Assisted Reproductive Technology (ART) Regulated Bill which was passed in the Lok Sabha in December 2021. 

Surrogacy and stigma

“In surrogacy, the eggs and sperms are collected post which they are fertilized, and then, the embryo is placed in the surrogate’s uterus. The reason for undergoing surrogacy is mainly multiple failed IVF cycles, damaged uterus, absent uterus due to surgery or from birth and medical conditions that do not allow pregnancy to continue. 

Surrogates come through agencies. Each surrogate is screened by the hospital to check their fitness regarding the chance of success of the IVF procedure. They are informed about the process and the  intended couple’s need for surrogacy. Their consent is taken, and they are explained the responsibility they are undertaking. Once they have understood the whole thing, they continue with the process of with their own free volition”, said Dr Kaberi Banerjee.

There’s still a stigma around infertility in this country; people want to hide their IVF treatments.  So, an alternative reproduction process like surrogacy is something people definitely want to keep hidden. They also worry as to how it would then impact the child in future. Not only in our country, but people all over the world are not too open about surrogacy, adds Dr Banerjee.

When asked about how the stigma can be reduced, she said, “I think, to reduce the stigma of surrogacy we have to reduce the stigma of infertility and fertility treatments. Most couples will not openly claim that they have had children through IVF. The only way to reduce such stigma is through empowerment and knowledge. Many people may also think that if you’re going for fertility treatments, you’re not using your own eggs or sperm. This is a complete myth. A lot of information needs to be given to the general public about fertility treatment, why it is needed and how it is done.”

Speaking about the recent comments on surrogacy as exploitation of poor women, Dr Banerjee said, “What is being done about the poor? Are we going out of our way to take care of them or raise their standards of living? What about the maids working in our homes? Are we not exploiting them? At least through this method, they used to get a sum of money. In the USA, commercial surrogacy is allowed which can improve their standard of living. So, I think it is easy to pass such remarks, but we need to introspect and ask if we are really concerned – and if we are, then what are we doing about it”.

“The rich and poor divide will be there in all countries. If a person is doing service and getting a fee for it, will we consider it exploitative or will we consider it a service to her to help improve her standard of living?”, asked Dr Banerjee.  

Surrogacy regulations in India

India has been the hub of fertility treatments and clinics. The surrogacy industry bloomed when foreign couples started approaching Indian clinics for their treatments. However, the first regulation came in 2005, when the government approved the 2002 draft on National Guidelines for the Accreditation, Supervision and Regulation of Assisted Reproductive Technologies in India. In 2013, surrogacy by foreign homosexual couples and single parents was banned. The government banned commercial surrogacy in 2015. To protect the reproductive rights of women, the Surrogacy Regulation Bill was passed by Lok Sabha on 5 August 2019. Moreover, the new regulated ART Bill of 2021 received a green signal from both Rajya Sabha and Lok Sabha. The Bill allows altruistic surrogacy in which no compensation will be provided to the surrogate mother other than medical expenses. Ironically, Union Health Minister Mansukh Mandaviya stated that “this is a progressive Bill that will curb the exploitation of women”.

The surrogacy option is available only to infertile heterogenous Indian couples with a man of 26-55 years of age and a woman of 25-50 years of age. The couple should be married for at least five years and should not have biological, adopted, surrogate children (except if the child is mentally/physically challenged or has a life-threatening disorder). The surrogate should be a married woman between 25-35 years of age and having a child of her own. She should also be a close relative of the family. She can perform surrogacy only once and the written consent of the surrogate mother is necessary for the procedure. The National Surrogacy Board will lay down the code of conduct for ART clinics and supervise the State Surrogacy Board. A central database will be created to manage the ART clinics and banks to keep an eye on their services.  Any offence under the Bill will be punishable with imprisonment up to 10 years along with a penalty of up to 10 lakh rupees. The Bill has opposition regarding the exclusion of single men and LGBTQ people, which is yet to be considered. 

With the newly passed ART Bill, Dr Banerjee thinks the government plans to provide high-level ART services to the people by ensuring regulation by involving state and national boards. “The principle is very strong, and  we all know we need to see the implementation. I am quite sure the government will devise machinery to ensure the success of this law. The government is very clear that commercial surrogacy will not be allowed and we will totally abide by that law, but it is subjected to debate. The life of several surrogates had transformed after performing commercial surrogacy. They gained the financial stability to buy land or educate their children. But the government has rightly pointed out that it needs streamlining as there is a chance of exploitation.”

With inputs from The Assisted Reproductive Technology (Regulated) Bill 2021

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