Dateline steps into the middle of the great "Womb for Rent" debate. Video Journalist Yalda Hakim visits a so-called 'baby factory' in the Indian state of Gujarat.
Airdate: 
Sunday, February 22, 2009 - 17:02
Channel: 
SBS One

Dateline steps into the middle of the great "Womb for Rent" debate. Video Journalist Yalda Hakim visits a so-called 'baby factory' in the Indian state of Gujarat.

Hakim meets over 50 women live while they carry babies for well-off Western clients.

The women are poor and come from India's appalling slums. They are paid about US$ 7,000 for providing babies - a fortune in their terms - and receive good medical care and attention throughout their nine month term. With an increasing number of Australians travelling to India for the service, this surrogacy boom has sparked a fierce moral, ethical and legal debate.

"It's just horrific to consider this in moral terms as though this were some sort of legitimate transaction. It's not. Basically at the end of the day it's wealthy people exploiting poor people," says ethicist Nick Tonti- Filippini

That claim is strongly rejected by Dr Nayna Patel, co-founder of the Akanksha clinic.

"How can you say that couple is exploiting the female when the female willingly wants to do it?"

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Transcript

The whole idea of surrogate mothers bearing children for couples who can't have their own babies has always sparked pretty ferocious debate. But if the surrogate involved is a poor woman from the developing world, paid for her work, if that's the word, by well-off Westerners, then you're really asking for a verbal brawl. The question being - is commercial surrogacy a justifiable way out of poverty or just another excuse for wealthy Westerners to rip off the Third World? Yalda Hakim was recently in the Indian state of Gujarat, where she managed to film inside, quite literally, a baby factory.

REPORTER: Yalda Hakim

After years of failed IVF treatment Collin and Bal Pierpoint, from Britain, are about to be introduced to their 4-day-old baby daughter for the first time.

BAL PIERPOINT: I don't think I have the words... It's a dream come true, a lifelong dream. I've always wanted to be a mum and it's eluded me...
Ah! Look at you! Aren't you gorgeous! ..
a very long time I've wanted to be a mum. Lots of prayer and lots of disappointments, a roller-coaster ride which that little thing there now is about to change forever.

The Pierpoints are the genetic parents - they supplied both egg and sperm but for the last nine months this tiny baby has grown in the womb of another woman. One of a small army of surrogate mothers who live here in a virtual baby factory, growing embryos for wealthy Western women - an increasing number of them from Australia.

DR NAYNA PATEL: That's the baby. This is the heart sound - the heart of the baby.

Dr Nayna Patel runs the program with her husband Dr Hitesh Patel.

DR HITESH PATEL: Surrogacy is meant for those people, for those ladies whose uterus cannot carry a child. Rather they have a chronic disease or they might have hysterectomy or their child must have died or they have an absence of uterus or many failures of IVF. If they cannot conceive otherwise then they will be taken for surrogacy.

The Patels allowed me to film inside the surrogate house but I was carefully monitored and steered only to certain women. There are more than 50 women who live here for the term of their pregnancies. They are apparently well looked after and receive regular medical checks.
Inside the house, I meet 18-year-old Vanna. She has already had three children of her own and like many women here, has spent her entire life living in a slum. She's afraid to show her face, fearing that someone from her village may see her and think she's involved in something shameful.

VANNA (Translation): They don't like it, they think it is wrong.

REPORTER (Translation): Wrong?

VANNA (Translation): Yes.

REPORTER (Translation): But why? You are really helping someone.

VANNA (Translation): But they don't see it that way, maybe they will if you explain.

The doctor says Vanna will receive a payment of about US$7,000 that's more money than she has ever seen and a way out of India's poverty trap. It would take her husband about 15 years to earn as much.

VANNA (Translation): I have a house but not a very good one, it needs fixing.

REPORTER (Translation): And for the kids?

VANNA (Translation): Yes, I will use some for their education, we will try to make them work hard and study more.

DR HITESH PATEL: Whoever wants to become a surrogate, she should be married, she must have delivered one, two or three healthy children at full term. She should be willing to accept our surrogacy program. And psychologically, also, we assess how the lady is, whether she is mentally or psychologically fit enough to carry this baby through this program.

The Patels are proud of their work and happy to tout their success. Nayna Patel shows me a host of positive press articles and testimonials, but her favourite is an autographed photo from Oprah Winfrey after she appeared on her show.
The program may be attracting good news stories but commercial surrogacy is a controversial procedure raising profound moral, ethical and legal questions and customer satisfaction certainly isn't guaranteed.

MR AL DIXIT, VOICEOVER: Start going in and I'll follow you. This is Dr Nayna Patel's IVF hospital in Gujarat.

This is Lisa Dixit, an American woman, filmed by her husband in a home video ultimately meant for their surrogate child.

MR AL DIXIT: Good luck. Pray to God. This is your mother after egg retrieval, so when you're born you're going to see what your mother had to go through. This is right outside the surrogate house.

Diagnosed with uterine cancer, Lisa Dixit was prepared to try surrogacy. When by remarkable coincidence she saw Dr Patel on television.

MRS LISA DIXIT: So, ironically, a week after my diagnosis, I saw a program on Oprah with a couple that had the same problem as I did in conceiving and being able to afford surrogacy. And they were promoting a clinic in Anand, India, and I did a lot of research on the Internet and I emailed the doctor and the doctor gave me some references and everything checked out fine, so my husband and I decided to fly out there and try the process of in vitro and surrogacy.

At the Patels clinic they met the young woman who was selected to carry their baby for the next nine months - the surrogate mother.

MRS LISA DIXIT: This is Manisha, she is my surrogate and these are my children.

But things went downhill from here. The Dixits say they were quoted a price of US$11,500 for IVF and the surrogacy.

MR AL DIXIT: Pregnancy and check-up medicine charges will be another $3,000. That's another $6,000 extra. You have to pay another 150 times 9 months.

But as Al Dixit found out when he got to India, there were more and more costs that he says hadn't been mentioned.

MR AL DIXIT: We were told that he was going to charge us a certain amount and then when we went there it nearly doubled and that same day we were like, I was ready to walk out, but then it's a very emotional thing, and she was upset, she started crying, and I said, "Okay, we'll somehow manage it" So that is when we decided to carry on with it.

MRS LISA DIXIT: Egg retrieval day.

The Dixits claim they were never adequately told why their costs had doubled to almost US$20,000, and it seems they were not alone.

MR AL DIXIT: There was one guy in the lobby where he was calling American Express and he was yelling at them, literally in tears, to help him to give him a bigger line of credit because he didn't have any money left.

The Patels reject the Dixits' accusations. In an email to Dateline, Nayna Patel writes that they informed them of the IVF charges, but in relation to additional costs...

DR NAYNA PATEL: Normally we explain them in advance, but because we tried to call them (to India) very fast, it was missed.

This reply has sparked a furious email response from the Dixits.

MR AL DIXIT: All this info is coming out from you now? Show me one email where you have mentioned all this detail?

MRS LISA DIXIT: This was the hotel. I'm in the office where Dr Hitesh met all the couples.

But worse was in store for this increasingly desperate couple. Not only had their costs skyrocketed, but after returning home they were informed that the surrogacy had failed. The eggs implanted in the surrogate mother had not taken.

MRS LISA DIXIT: For me, it's been very emotional. I've been having a very hard time throughout this whole process.

When the Dixits approached a US doctor about their situation they say they were told the Patels' surrogacy procedure had no chance of success.

MR AL DIXIT: He just took a look on his computer with the CD and when he saw the size of the eggs and the size of the embryo he said they should have waited at least two more days to plant them, he says, as it is, there was no chance of it happening.

Again the clinic rejects this, saying Lisa Dixit was...

DR NAYNA PATEL: repeatedly very well counselled about their chances. Each clinic will have its own protocol on embryo transfer.

MRS LISA DIXIT: This whole thing makes me sick.

With the Dixits still hurting from their Indian experience they are now seeking to adopt a child.

MRS LISA DIXIT: We spent all this money in India, you know, hoping that this would really take, and now I come back and I've just had my hysterectomy and obviously I can't have children and we desperately want to have children and we're not getting any younger. And I think it's time now that we should adopt and I'm really worried about the cost of everything and I honestly don't know how we're going to do it, you know.

And as the commercial surrogacy industry booms so does the fierce debate that surrounds it.

NICK TONTI FILIPPINI, ETHICIST: It's just horrific to consider this in moral terms as though this were some sort of legitimate transaction. It's not.

Nick Tonti Filippini is a Melbourne-based ethicist. He's appalled by the Patels' baby business.

NICK TONTI FILIPPINI: There are all these uncertainties about who really is the mother of the child and those women would be entitled to assert that this is their child. And that happens sometimes where the woman who carries the pregnancy says "No, I want to keep this child" and there's nothing the law can do about that, that's their choice. If she gives birth to the child she's considered the mother of the child in law and so if she wants to keep it, she can. And so there's a whole range of very difficult issues that arise there but basically, at the end of the day, it's wealthy people exploiting poor people.

But Dr Patel says there is a genuine benefit to the surrogates and besides, all parties are willing participants.

DR NAYNA PATEL: How can you say that couple is exploiting the female when that female willingly wants to do it? You can call it exploitation when somebody is forcing, you cannot force surrogacy like any other organ transplant because it's a whole procedure of one year - almost nine months.

Dr Aniruddha Malpani also uses surrogate mothers in his clinic in Mumbai but disagrees with commercial surrogacy. He says India offers no protection for parents desperately wanting a baby and even a contract is worthless.

DR ANIRUDDHA MALPANI: You need to understand the contract does not work, the paper that's written on, because that contract is never going to stand up in a court of law. There is no legal sanctity or validity. Contracts, by nature, are designed to be disputed and there is no court which will say "Yes, fine, this contract has been signed" because Indian law does not allow those contracts.

But Dr Malpani says he understands why the couples who come to India are prepared to cut corners.

DR ANIRUDDHA MALPANI: Yes, we read in the newspaper that there are so many Australians going to India for surrogacy treatment, and they're all taking their babies back. So I'm going to go - never mind about the problems, if they managed to solve their problems, I'm sure we'll figure out a way to sort out our problem. People are taking risks, and when you are that desperate then I think your logical side of the brain doesn't function as well as the creative side. Of course, you take shortcuts because you are dealing desperation.

Dr Patel though, accuses her critics of hypocrisy.

DR NAYNA PATEL: The maximum number of surrogacy cases are being done in the US and that also for couples from Europe because in Europe, most of the countries surrogacy is not allowed. So European couples fly off to the US and do surrogacy. I have never heard people say that the Europeans are exploiting American females, or Americans are outsourcing wombs to European couples. Why when it comes to India, why do you say so?

NICK TONTI FILIPPINI: How much money is the Patel Foundation itself making out of all this? I mean, are they a for profit agency? I think they are, and so I think this is all just window dressing for what is a for profit scheme basically to sell children. It's what they're doing. If you are selling pregnancy, you're selling children. It's no different from making a payment to buy a child.

While the surrogacy debate continues, the Pierpoints will return to Britain ecstatic about their new baby and the start of their new life.

Reporter/Camera
YALDA HAKIM

Fixer
SABRINA AZIZI

Editors
DAVID POTTS
NICK O'BRIEN

Producer
ASHLEY SMITH

Subtitling
AESH RAO
NITAL DESAI

Original Music composed by
VICKI HANSEN