MumsnetGuestBlogs (MNHQ) Tue 01-Oct-13 11:52:21

BBC4's House of Surrogates - what did you think?

A BBC4 documentary last night explored the ethics of commercial surrogacy in India. Critics accuse Dr Nayna Patel of running a 'baby farm' for childless Western couples; the doctor counters that the sums the surrogates earn will change their lives forever. Read Sarah Ditum on a 'subtly questioning' film - and let us know what you think on the thread.

Sarah Ditum

Paperhouse

Posted on: Tue 01-Oct-13 11:52:21

(86 comments )

Lead photo

House of Surrogates: tonight (Tuesday), 9pm, BBC4

Humans have two fundamental drives, explains Dr Nayna Patel in House of Surrogates, a carefully observed and subtly questioning documentary about commercial surrogacy in India. We have a drive to reproduce, and a drive to survive. Commercial surrogacy fulfils both of these, says Dr Patel. The client couple get a child, the surrogate gets a life changing sum of money. Who could object to the mutual satisfaction of our most elemental desires?

The fee for the surrogate is paid in instalments through the pregnancy, adding up to $8,000 if the surrogate carries a single baby to term – a little over six times the GDP per capita for India. Vasanti, one of the surrogates and mother to two children of her own, puts it another way: “They’re all here out of their own desperation,” she says, looking at her fellow residents in the dormitory they share.

Dr Patel makes sure the surrogates get much more than just the money, though. For starters, they are given food, medication and accommodation for the duration of the pregnancy. (This isn’t just generosity, of course. Residency is compulsory for women, because controlling their nutrition and sanitation reduces the risk of miscarriage. It’s a way of protecting the clinic’s investment.)

They get advice, too: Dr Patel isn’t content to turn her surrogates loose with their sudden wealth, and during the film we see her advise her charges on getting bank accounts, purchasing property and disposing of abusive husbands. Dr Patel calls herself a feminist, and I don’t doubt her principles. If you feared seeing a reproductive class that looked something like the brutalised Handmaids of Margaret Atwood’s dystopia, this will be reassuring viewing.

Neither simple exploitation nor an uncomplicated exchange of money for goods and services, commercial surrogacy is where two great needs collide.


At times, House of Surrogates feels like an advert for international sisterhood: this is redistribution by way of the uterus. And then, you catch sight of the profound inequality in which this common womanhood exists. In a consulting room, a Canadian couple size up a prospective surrogate with an agricultural eye: is she sturdy enough, do they trust their precious genetic material to the width of her hips?

Next to the Canadians, an Indian woman holds a baby: the baby is the Canadians’, and she is their first surrogate mother, retained as a wetnurse for the first few weeks. For Barbara, the Canadian mother, this is clearly a kindness: “What could be wrong with more than one woman loving my son?” she asks. The implicit opposing question – what could be wrong with taking a baby away from a woman who loves and cares for him? – hangs unasked.

While Dr Patel is clear that the women understand the rights they have to the child (none whatsoever), the surrogates do bond with the babies they carry, and they do grieve when the legal parents carry them off. However rationally it is accepted, that combination of empty belly, sore breasts and empty arms seems a terribly wrenching one. And it’s not only the physical cost that the surrogates bear. There’s a stigma against surrogacy in India, one that means Dr Patel must live under heavy security while Vasanti talks about using her money to move so she won’t have to live with neighbours who know what she’s done.

Surrogacy is an act of altruism, but even when the client parents take the time to thank the birth mother of their child (which most do, but not all), do they truly understand what they’ve been given? Not simply a child, but the pain, shame and sacrifice borne by another woman so that they could reproduce? Barbara speaks of wanting her newborn son (born from egg donation) to explore the Indian side of his heritage; Vasanti, having delivered the baby of a Japanese couple (she calls it “my baby” though she never gets to see it) and bought her new house, only hopes that her own daughter will never have to take the decision to become a surrogate.

Neither simple exploitation nor an uncomplicated exchange of money for goods and services, commercial surrogacy is where two great needs collide. Both sides clearly benefit, but how can it be possible for hundreds of families and individuals to meet like this without great hurt occurring? After watching House of Surrogates, the moral consequences of this collision are felt more keenly but not necessarily any clearer - Dr Patel’s calm and smiling certainty the only beacon in the mist.

If you missed it, you can catch up with 'House of Surrogates' on iPlayer. Do come back and tell us what you thought here on the thread.

By Sarah Ditum

Twitter: @SarahDitum

Waffling Wed 02-Oct-13 05:33:46

Locks on the outside of the dorm rooms. shock
Having to request permission to go and see your family - prove validity of visit.
Not being trusted not to "dance". (wtf?)
Checking afterwards what the women did with the money.
The doctor's husband mediating in that excruciating meeting between the Canadian woman and potential host mother.

So many issues. And they're just the ones we saw.

Salbertina Wed 02-Oct-13 07:36:54

Clean dorm, free board and healthcare and large lump sum payment?? speaking as someone who lives in a developing country where -like much of India- families live together in overcrowded 1-2 room shacks, this is a pretty good deal!

The ethics of it a v different matter however.

Grennie Wed 02-Oct-13 07:47:05

I think ethically this is totally wrong. Well off couples are buying these women's bodies for 9 months, and then she has to give away the baby she has given birth to. This is not about altruism, but about desperation.

And presumably if the woman already has a child, they are without their mother for 9 months.

This is sheer exploitation.

beachyhead Wed 02-Oct-13 08:05:19

Economically, I agree with Salbertina, it works for both parties. The surrogate gets food, money, healthcare and a future which will benefit her other children and may take them out of their cycle of poverty. The Western woman receives a child which may be biologically hers, which has hosted in a clean and medically supervised womb for 9 months.

Ethically, no persons body should be for sale - slavery, prostitution, forced organ donation..... however, I'm not sure where MY ethics should determine THEIR actions. I may be uncomfortable with the transaction taking place, but if it is to be done, then here it seems to be in the best possible way.

I think the management of money section of the film was so important and I see no problem in advising the women on how to deal with the huge lump sum they are going to receive. It would be immoral to deliver a huge sum and NOT advise them. A huge proportion would just hand that money over to family or husband and really receive no tangible benefit themselves. I think where the surrogate had specific targets, (to send her children to an English speaking school) and managed to achieve them, then you can see the motivation very clearly.

Fascinating film and makes me wonder if India will shut down this legal loophole or will encourage it going forward. Thanks MN for drawing my attention to it.

wannaBe Wed 02-Oct-13 09:10:07

I think that we like to judge this because we see it as exploitation of women in a country which has one of the highest rates of poverty in the world. We like to see it as baby farming and to judge the couples who pay money for a baby and then collect it as if they were collecting a puppy from a breeder.

But ultimately surrogacy is baby farming regardless of whether it happens in a dorm in a third world country or whether in a suburban neighbourhood in some well-off part of the UK. The only difference is that in the third world these women are honest about their reasons for doing it – in order to support their families and lift themselves out of poverty. But in the UK (or US) women equally rent out their bodies and even give up their biological children (in the case of straight surrogacy) in return for payment. The only difference is that in this country the payment is dressed up as “expenses” (up to £15000. But the concept is no different other than the fact that it’s not done under strict supervision and the surrogates in this country have freedom of movement. But the ultimate outcome is the same – a couple pays for a baby and someone receives payment for that baby.

But we feel we can moralise about it in this country because it’s illegal and the amount of money received is largely undisclosed so we don’t need to know about it iyswim.

In a country with poor healthcare, little state provision and high mortality these women are given the opportunity to get themselves out of that state and make themselves financially independent. They are also encouraged to make something of their lives after they have been a surrogate, in order to sustain their financial independence. And there is a limit to the number of times they can be a surrogate – something which does not apply in the UK.

I think that we need to think of surrogacy as either wrong or not. Just because something happens in an environment we might not approve of by our own moral compass (and which we often don’t understand due to the fact we do not live in that environment) doesn’t necessarily make it any more (or less, depending on your attitude) wrong than if it happens in our own civilised country where we can see the supposed tangible outcomes.

YDdraigGoch Wed 02-Oct-13 10:05:41

Apart from the appalling attitude of the woman assessing the surrogate for suitability - "she looks sturdy enough" (think that was the Canadian) - I thought it all seemed OK.
I could carry a baby for another couple. You'd know from the start that it isn't yours, genetically, or in any other way, and the reward is immense. It's a service, just like giving blood really, and a way out of dreadful poverty for the women and their families.

Grennie Wed 02-Oct-13 10:13:41

wannabe - I think surrogacy for money is always wrong.

And those who think this is okay. Would you be happy to pay a homeless woman in the UK money to stat in a dorm for 9 months, and carry and give birth to your baby?

Salbertina Wed 02-Oct-13 10:29:18

Can't judge by first world values, imho. They're not "homeless", they're a few of the millions who are poor and living in tiny shacks in India. That is the norm. Not saying that is right/fair or otherwise, just stating as is.

Grennie Wed 02-Oct-13 10:32:31

So it is okay to exploit women in another country if many are just as desperately poor as her?

Salbertina Wed 02-Oct-13 10:34:46

Not saying it's ok...
A poor woman with no other options sees it as a legitimate way out of poverty for their entire family to be able to afford house/education etc

Grennie Wed 02-Oct-13 10:36:25

For her it will seem a legitimate way out of poverty. I am not judging her. If she already has children, she may see it as her only way to give them a better life.

I am judging those well off couples who buy and exploit the women in this way, by buying her body for 9 months to grow and give birth to a child.

Salbertina Wed 02-Oct-13 11:02:57

I judged them too- the Canadian in particular was (edited to seem?) fairly objectionable, patronising and racist.
However. Where does the debate end??

I don't theoretically "agree" with people spending a fortune on IVF when theoretically they could adopt.

I don't theoretically agree with NHS funding IVF cycles when, in my view, this money would be better spent on treating sick people.

Yet, if we had had fertility problems, who knows? I'd provably be exploring all the above options!

Grennie Wed 02-Oct-13 12:15:05

That is why there are laws in place, to protect people. In tthe UK paid surrogacy is illegal because it is recognised as exploitative and that people desperate for a child, may exploit others in this way.

Salbertina Wed 02-Oct-13 12:32:01

But laws not in place internationally. And as this prog highlights this is a global issue.

In my experience also, even when laws are in place in developing countries, they often fail to protect the very poorest.

I think if it were made illegal in India, it would go underground and, as with prostitution, would therefore be much more dangerous and far less advantageous to the women.

Monique2013 Wed 02-Oct-13 12:35:17

Grannies- in the UK it's covered up as expenses sometimes up to £20 000, is that not the same thing?

Grennie Wed 02-Oct-13 12:48:47

Monique, yes it is. And it is wrong.

Monique2013 Wed 02-Oct-13 12:54:26

I don't think it's wrong, these are grown women who choose to do it no- one is forcing them....do rather have them give birth look after the child for a few month (expenses paid) and give it up for adoption?

Grennie Wed 02-Oct-13 12:59:44

I would rather they had the money to look after their own children and themselves properly, and not to have to rent their bodies out for 9 months to grow and give birth to a baby.

And desperate people do desperate things. In poor countries people donate a kidney for money for example. Do you also see that as right, and just their choice that rich people can buy a kidney from someone desperately poor?

Monique2013 Wed 02-Oct-13 13:07:07

They are doing it for the families and to better the lives of their children so good for them in my option. The ones I might have reservations about if any are the ones who do it here for the so called expenses.

sallievp Wed 02-Oct-13 13:09:14

I live in India and the surrogates shown in the programme would probably have to work ten years on a building site - back breaking work - often ten hours a day -to earn the same amount of money.
I can honestly say hand on heart that If I was offered ten years income -£300k -to be a surrogate in the UK, I would 100% do it. Life changing money for me and my family.

Monique2013 Wed 02-Oct-13 13:16:45

Very true Sallievp most of us would and remember this is a life changing gift for the couple as well.

Grennie Wed 02-Oct-13 13:47:24

But it isn't a gift Monique. The couple have bought a baby

rhetorician Wed 02-Oct-13 13:51:29

I was curious about the criteria used by Dr Patel and her staff - I wondered if there were any rules used in terms of the couples selected, or is it purely financial (e.g. does the clinic use surrogate for gay male couples?)? What kinds of terms and conditions are binding on the couple? I thought some of them were very dismissive of the surrogates, but suspect that they are not encouraged to form relationships with them. I really felt for the woman who had nursed the little boy when he was taken 'home' to Canada. He was very clearly bonded to her, and she to him, which is why I had such a problem with the blurring of the boundaries in this particular case. And I felt that she simply wanted the woman's breastmilk for her baby...I was touched too by the surrogate calling 'look after him, look after him' in a language that the woman leaving with the baby couldn't understand

Monique2013 Wed 02-Oct-13 13:58:41

The couple have not bought a baby genetically it's theirs, they have just rented a womb to bring their baby to life.

Thants Wed 02-Oct-13 14:01:38

I don't agree with surrogacy at all and this programme was so difficult to watch from the beginning. These women were just objects being used by the doctor and couples.

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