* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.Many Indian fertility clinics and banks advertise surrogacy services online, providing information for overseas clients from countries such as Britain, the United States and Australia.
In a globalised world where everything at home is becoming more costly, outsourcing your needs to a third party thousands of miles away for less money makes a lot of sense.
For a country like India, one of the top global destinations for outsourcing, the benefits are tremendous – creating millions of jobs in sectors ranging from garment, software and car manufacturing to call centres and back office operations.
But over the last decade, a more controversial sector for outsourcing has emerged in India: pregnancy and childbirth.
With infertility rates on the rise and a growing acceptance of same-sex couples, thousands of people annually are opting for surrogacy as a way of having genetic children through a process of in vitro fertilisation (IVF) and embryo transfer.
With commercial surrogacy banned in most nations, many are flocking to India – a country free of regulation and with top medical professionals and low costs – to hire the wombs of women in what is known as "surrogacy tourism".
Many Indian fertility clinics and banks advertise online, providing a range of information for overseas clients from countries such as Britain, the United States and Australia.
It is a lucrative, $400 million-a-year business with over 3,000 fertility clinics across India that recruit poor, uneducated women to carry the embryos of others through to birth.
EMPOWERING WOMEN, CHANGING LIVES
The industry sees it as a win-win situation: childless couples see their dream come true with a genetic child and the impoverished Indian surrogate mother gets a generous sum – up to $8000 – more than she would likely see in a lifetime.
"The surrogates are the major beneficiaries in this process. They are given good compensation, which helps to improve their standard of living and that of their children," says Nayana Patel, who runs the popular Akanksha clinic in Anand, a small town in the western region of Gujarat.
Patel has delivered over 500 babies since she started surrogacy in 2004 and says her surrogate mothers are well looked after and empowered by the large financial reward.
Diksha, 31, a mother of three who has carried two surrogate babies for clients of the Akanksha clinic, agrees.
"There is nothing wrong in this. It is a blessing to give people who have no children the chance to be parents,” she says. “In exchange they give us money that makes our lives better."
Diksha, whose husband is a driver on a monthly wage of $40, said the $7,260 she earned for her first surrogacy changed her life dramatically.
She bought a new house and filled it with new furniture, paid for her husband's kidney operation and put her children in an English-language school. With her second surrogacy, she bought land.
"We are not selling babies, but actually helping each other," she says.
COMMODIFYING AND EXPLOITING
But social activists say the surrogacy business not only reinforces the gender stereotype that women are commodities, but also leads to the exploitation of surrogates who often do not understand what they are signing up for.
"Surrogacy is going totally unregulated and any activity like this which involves a lot of money changing hands tends to go underground and into an informal sector where irresponsible people get involved," says Ranjana Kumari, director of the Centre for Social Research, a gender rights think-tank.
As a result, some fertility clinics use unscrupulous agents who recruit vulnerable women who are desperately in need of money and lure them into renting out their wombs, she says. There have also been reports of women being trafficked into the industry.
There is no fixed amount paid to surrogates and many surrogates do not get the full amount promised, while others get nothing if they miscarry. Often there is no insurance for the mother post-delivery.
Given the high value of a surrogate baby – foreign couples are charged about $20,000 to $30,000 – many clinics try to ensure that full-term healthy babies are delivered.
This means housing surrogates in hostels for the nine months to monitor their health and ensure they are not doing anything to jeopardise the child they are carrying.
Kumari does not buy the argument that this is an ethical way of helping India's women empower themselves.
"If you want to look at it from the point of view that the poor woman is getting something out of it, then I would say the poor woman gets something also from selling her organs and selling her body, but is that the most dignified way we can offer her to make a livelihood?" says Kumari
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