Surrogacy: boon or bane


Dr Alka Sehgal ,   MD, DNB, MNAMS Associate Professor, Departmnt of Obstetrics & Gynecology, Government Medical College & Hospital, Sector 32, Chandigarh. India


Surrogacy: boon or bane

Science is a boon or a bane remains a debate, even while we witness both it’effects, like two sides of the coin. However, in a society one can try to tilt the balance towards positive contributions to universe. Surrogacy is scientific boon using borrowed eggs, sperms or womb for childbearing for some unblessed couples. The debate is between use of this scientific progress on pure humanitarian grounds to misuse of the same for commercialization. It is a need-based temporary relationship between borrower looking for cheaper resource for genetic makeup of the baby of their own and the lender for financial gains compromising with her social, physical & emotional health while nourishing the dream child which may came at the cost of her own family.

This consented arrangement outside wedlock is beyond our traditional outlook of our family norm & society apart from other legal, social, emotional & health aspects. Economists have compared the cost effectiveness of surrogacy in India & abroad to be much cheaper in India. With international demand, overenthusiastic professionals, India a proud provider of cheap international labour, is getting geared up for cheaper Labour for labor on its own land, as a economy source for the individual, professionals and nation.

After IT services," "it's now the turn of babies to be outsourced from India. In these times of globalization and market-driven economies, there's considerable demand for this service.” remarks a leading gynecologist stinking of commercialization. Legal aspects are being taken care of for associated implications. Indian council of medical research (ICMR) established the guidelines for ART centers to ensure some bare ethics, health facilities & legalities. Encouraged debates by ICMR lead to objections & suggestions by professionals.

Lagging behind is the conscious voice of the resource, the surrogate mother who is either unaware or unconcerned of short & long term impacts of the whole issue. Even if she will have a voice, there may be no better options for earning the money in offering which maybe a dream amount for her family. The decision maker for her would be her husband or in-laws? A nation still struggling with problems like dowry burning, domestic violence, separations and above all gender imbalance because of fetal feticide it is female at receiving end. An NGO rightly pointed out “If surrogacy becomes an avenue by which women in richer countries choose poorer women in our country to bear their babies, then it is economic exploitation, a kind of biological colonization."

The debate is endless, hence restricting to health aspects of the would be mother & child certain issues of concern are being brought out. With exclusion of friends & relatives for surrogacy, unscrupulous middlemen would definitely entice and push uneducated and poor women into surrogate motherhood to fulfill international needs.

ICMR guidelines permit a woman with 2 children of her own & 3 for surrogacy completely ignoring the woman at the receiving end likely to be exploited even by her own family that too without defining interpregnancy gaps, even ignoring the route of delivery which could be caesarean section with delirious effects on early conceptions.

Human fetus is the best parasite of earth & pregnancy depletes the mother not only of iron & calcium the much talked upon minerals but of other nutrition as well. The poor surrogate mother starting with a poor health has to cope up with the needs & stresses of pregnancy with health impacts on herself, while the bounty earned is going to be shared property of the whole family.

The ICMR guidelines are totally silent on the information & awareness programme amongst the needy women to discuss the possible psychological & other health effects of surrogacy, which may not be the same as a wanted child of her own.

There may be short & long term effects & side effects of use of drugs, which will be required in preparation of the surrogate for the planned implantation.

The increased possibilities of multiple pregnancies & its implications on the surrogate as well, including selective fetal reduction.

The impacts of failure and increased chances of abortions spontaneous or induced for various reasons with deleterious effects on the health. The ICMR guidelines are silent on any failed attempts of in vitro fertilizations or of abortions for surrogacy.

The increased possibility of complications like Pregnancy induced hypertension with a new genetic makes up of the baby and associated both maternal & perinatal morbidities & mortalities.

The possibility of the other pregnancy associated complications like diabetes or collagen disorders, which may get unmasked for the first time with advancing age of the surrogate or even worsen in subclinical patients.

The surrogate mother is also prone for increased possibility of blood loss with increasing parity of the surrogate mother and blood transfusions with possible transmission of as yet unidentified blood associated diseases.

Motherhood is a second life to the woman. What compensation is in offering to the children of the surrogate if the woman looses life in the event of inevitable blood loss, or episode of thromboembolism etc.

Is there any monetary compensation for inevitable need for surgical intervention like scar on the uterus & its long-term health impacts?

Mushrooming of medical colleges, f undergraduate & postgraduate courses on sale with poor quality of doctors & such blooming businesses are the possible long-term flesh business India may get entrapped into.

Above all nobody appears to be concerned about the psychological impacts of the children of the surrogate mother how they are going to cope up with the long period of separation required right from the preparation of implantation of embryo to delivery & the facts of surrogate mother exposing her exploitation & poverty etc.

In case due to pregnancy related events the outcome of the birth is not a healthy child who shall be responsible for the child’s welfare.

The individual cases with the above implications may be anecdotal but they need to be addressed before it is too late.

The Breast feeding the international health agencies keep crying hoarse on needs to be sacrificed to avoid emotional bonding of the surrogate mother with the newborn & because of legal implications of the new heirs.

The individual cases with the above implications may be anecdotal but they need to be addressed before it is too late.

Issues related to the life created in laboratory bypassing the natural method of conception, potential to select embryos & to excess frozen embryos created, their possible misuse or destruction or selective termination of embryos etc. are other issues being raised.

The crux of any technology hence lies in use of the same in a balanced way & any commercialization of surrogacy specially outsourcing to international level may need to be taken with a pinch of salt.





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