Surrogacy as a business

Excerpts from The Red Market: Cash on Delivery

"India legalized surrogacy in 2002 as part of a larger effort to promote medical tourism. Since 1991, when the country’s new procapitalist policies took effect, private money has flowed in and fueled construction of world-class hospitals that cater to foreigners. Surrogacy tourism has grown steadily here as word has gotten out that babies can be incubated at a low price and without government red tape. Patel’s clinic charges between $15,000 and $20,000 for the entire process, from in vitro fertilization to delivery, whereas in the handful of American states that allow paid surrogacy, bringing a child to term can cost between $50,000 and $100,000, and is rarely covered by insurance.
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"Dependable numbers are hard to come by, but at minimum, Indian surrogacy services now attract hundreds of Western clients each year. Since 2004 Akanksha alone has ushered at least 232 babies into the world through surrogates. By 2008 it had forty-five surrogates on the payroll, and Patel reports that at least three women approach her clinic every day hoping to become one. There are at least another 350 fertility clinics around India, although it’s difficult to say how many offer surrogacy services, since the government doesn’t track the industry. Mumbai’s Hiranandani Hospi- tal, which boasts a sizable surrogacy program of its own, trains outside fertility doctors on how to identify and recruit promising candidates. A page on its website advertises franchising opportunities to entrepreneurial fertility specialists around India who might want to set up surrogacy operations with an endorsement from Mumbai. India’s Council on Medical Research (which plays an FDA-like role—except that it has far less power to actually enforce its edicts) predicts that medical tourism, including surrogacy, could generate $2.3 billion in annual revenue by 2012. “Surrogacy is the new adoption,” says Delhi fertility doctor Anoop Gupta.

"Despite the growth projections, surrogacy is not officially regulated in India. There are no binding legal standards for treatment of surrogates, nor does state or national authority have the power to police the industry. While clinics like Akan- ksha have a financial incentive to ensure the health of the fetus, there is nothing to prevent them from cutting costs by scrimping on surrogate pay and follow-up care, or to ensure they behave responsibly when something goes wrong.