Outsourcing Pregnancy

Pawan Kumar / Reuters Indian surrogacy is now a half-billion dollar industry. Doree Shafrir on why American couples—especially gay men—are having children abroad for less money and with fewer headaches.

Mike Griebe and Brad Fister had tried everything to have a child. They explored adoption. They researched what Griebe termed "a baby factory type deal," where you basically pay for a "ready-made baby." They went to agencies that promise to find babies in the United States. The Kentucky couple even paid $20,000 to a Virginia woman to be a surrogate, only to walk away when she insisted that if anything happened to Griebe, 38, and Fister, 30, that she would have rights to the baby.

“You get to see the whole process. I got to watch the embryos go in. Those are things you never get to see here. You follow them the whole way.”

Then, one day, while watching Oprah, they heard about a relatively new way to have a child: using an Indian surrogate. The segment featured Dr. Nayna Patel, the director of the Akanksha Infertility and IVF Clinic in Anand, India. (Dr. Patel declined to be interviewed for this article.) But at first, Griebe and Fister didn't think an Indian surrogate would be an option. "We just dismissed it because when we searched it, we found that that clinic would only deal with traditional couples," says Griebe—meaning straight couples. After searching online, they came across the Web site for Surrogacy Abroad, a Chicago agency run by Benhur Samson that guides foreign couples through the process of hiring a surrogate mother in India.

After talking with Samson and an embryologist in India, the couple drove to Chicago to meet with Samson. "We felt very comfortable with him, unlike everybody else we had dealt with after that time," says Griebe.

The two decided to use Fister's sperm for the pregnancy, and so he flew to India with Samson. Fister met his surrogate who, he says, is married with two children and told him the money she's making from the surrogacy will go toward her children's education.

Fister says he was surprised at how open the clinic was. "The whole process was a lot more hands-on than it would be in the U.S.," he says. "You get to see the whole process. I got to watch the embryos go in. Those are things you never get to see here. You follow them the whole way." After one failed attempt and one miscarriage, their surrogate is now due in April. They get updates, including ultrasounds, via email.

Samson, a native of India, started Surrogacy Abroad in 2006, when one of his sisters was having trouble getting pregnant. He'd worked in the medical field for 22 years, processing claims and benefits, before starting the agency. "I flew to India and checked out all the clinics," he said, before finally settling on Kiran. Commercial surrogacy was legalized in India in 2002, and it is now estimated to be a $445 million business. Griebe and Fister say they've spent around $40,000 on the surrogacy process so far; according to Samson, $8,000 of that goes directly to the surrogate mother. That may seem high, but Griebe said that friends of theirs who are attempting to use an American surrogate "are two years into this and still no baby, not even a miscarriage, and they're already over $100,000. Every time they try, they have to pay."

Samson's agency is one of the few to specifically target gay couples. Homosexuality was only decriminalized in India in July; even though it was rarely prosecuted, it was still a social taboo until a few years ago, says Dr. Samit Sekhar, the embryologist at the Kiran Infertility Centre in Hyderabad, which works with Samson's agency. "For us, it doesn't make any difference," he says of the couple's sexual orientation. However, the surrogate "doesn't know if she's carrying for a gay couple or not." He said that Kiran has delivered 24 babies via surrogates, with around nine of those going to gay couples.

It's illegal for surrogates to be recruited directly by the hospital. Instead, they're found by a social worker at an NGO, according to embryologist Samit Sekhar. (When asked if it would be possible to interview one of the social workers, Sekhar said that they do not speak English.) "They do the initial counseling for us. Then after the basic counseling is completed and the screening is done, they bring them to the clinic. Then we do more screening from there," he says, including medical and psychological screening.

"A year ago, I would have said it was very difficult to recruit a surrogate," says Sekhar. "Now it is becoming much more open. They get a decent amount of money. They get free food, free boarding, and free clothes, and they are housed in a nice place" for 12 months, away from their families.

Sakhar says that Kiran can house up to 50 surrogates at a time. "They stay at the clinic. The non-pregnant surrogates are housed in an apartment," he says. "There are two midwives who stay in the clinic 24 hours a day, who take care of food, clothing, medication and all that."

Of course, using Indian surrogates raises ethical issues. An article in a recent issue of the Indian Journal of Medical Ethics called into question some of the assertions by clinic operators and surrogacy agencies regarding the women who are surrogates. The practice of keeping the women at the clinic, ostensibly to oversee their health and welfare, can also be interpreted as keeping them held hostage, since they're not allowed to leave the grounds of the clinic. The surrogates are often poor and illiterate, raising questions about how much they understand about the contract they're signing—including what happens if they have health complications or have to terminate the pregnancy because of their own health concerns. There are also questions about what would happen if the parents decided they didn't want the baby.

Berkeley sociology professor Arlie Hochschild recently wrote in The American Prospect that Patel, the Anand-based clinic director, was perpetuating an "ideal of the de-personalized pregnancy that is eerily reminiscent of Aldous Huxley's 1932 dystopian novel Brave New World, in which babies are emotionlessly mass-produced in the Central London Hatchery." (Hochschild declined to be interviewed, emailing that she was too busy working on a project.)

But Samson implies that it's difficult for Westerners to understand the way that the money the surrogates get changes their lives—and how it would be nearly impossible for them to earn as much money in such a short amount of time doing anything else. "An engineer would earn the same amount in the same amount of time," he says. "They are happy with the money. It opens up a lot of windows for them at the same time. They can now lead a comfortable life, according to Indian standards at least. They can invest the money in a business, buy a small property. They can send kids to school or college."

Fister plans on being in India for the baby's birth; he's anticipating that he'll have to stay there for about three weeks after the baby is born, during which time he'll submit to a DNA test to prove he's the father and get a birth certificate issued by the American Embassy. "People think you're doing it in India because it's less expensive," says Fister, "but the main reason we went to India is because of the legal issues. Here, there would always be the chance of the mother coming back and saying, I'd like to have visitation. Over there they can actually have it legalized."

Doree Shafrir has contributed to The New York Observer, The New Yorker, Slate, and The Awl, and is the co-author of Love, Mom. She is a former editor at Gawker. Her Web site is www.doreeshafrir.com.

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