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Couples who can't conceive a child look for all kinds of alternatives in order to become parents, including surrogacy, when you pay a woman to carry and give birth to your baby. India is preparing to ban this practice altogether. As NPR's Julie McCarthy reports, that move could protect women who serve as surrogates from exploitation, but it could also take an economic toll.
JULIE MCCARTHY, BYLINE: Isha Devi hails from Agra, home of the Taj Mahal, built by a grieving king for a beloved queen. Isha now lives three hours and a world away from any such romantic ideals. Renting a small, dingy room, this mother of a 12- and 14-year-old has come to the outskirts of Delhi to live close to her fertility clinic. Isha is 30 and six months pregnant with someone else's twins. She groans, shifts uncomfortably in her pink floral sari and says she became a surrogate to expunge a family debt.
ISHA DEVI: (Speaking Hindi).
MCCARTHY: "I would never have done this, but my husband had a terrible accident when his rickshaw slid under a bus. He fractured his hip and can't work. That was our only income," she says. Her husband earned $5 a day. His medical bills are $3,000. She is paid $160 a month during the pregnancy with a lump sum after the birth. But Isha says the stipend is too small to pay off the debt and buy the food her doctors recommend she eat. The petite woman with a basketball-size bulge in her stomach says she's often hungry.
ANOOP GUPTA: Good morning. Yeah, you're calling from which place? London.
MCCARTHY: That's Isha's doctor, Anoop Gupta. His clientele is international, mostly couples using IVF to conceive their own child. Gupta's surrogacy practice inside his fertility clinic, one of Delhi's largest, is small. And embryologist Gupta says he performed the first surrogacy in 1997.
So you've been doing this for 19 years.
GUPTA: But it has picked up. Like, last 10 years we are doing quite a bit. See, we have 650 surrogacies delivered by now. And we have a lot of gay couples coming. Then a lot of single females also we have done.
MCCARTHY: No law governs surrogacy in India, but the one the government proposes bars gays, singles, foreigners and Indian couples married under five years from commissioning a surrogate. The bill limits the practice to altruistic cases where a woman would provide the services of her womb for free. Gupta says the going rate today is 1 million rupees, or $14,000. Surrogates such as Isha receive less than half that - doctors, agents, lawyers, labs and technicians all get a cut. Still, Gupta considers such surrogates well-compensated and blanches at criticism that India's poorest women are being taken advantage of.
GUPTA: Even if they don't do surrogacy, they will get pregnant themself. So they get pregnant, pregnant, pregnant - that's it. Now, if they get an opportunity to help somebody who is childless and they help themself with the money which they can never think of in lifetime, nobody has been exploited.
MCCARTHY: Manasi Mishra disagrees and says the industry is, quote, "run by haves to exploit the have-nots."
MANASI MISHRA: And this pregnancy is precious - the mother is not.
MCCARTHY: Mishra is with the Center for Social Research and conducted studies on 200 surrogates in 2010 and 2012. She found many were cheated out of money and deceived about the procedures they must undergo. She also discovered some couples had commissioned more than one surrogate to boost their chances, with the less desirable fetuses eliminated through a pill-induced miscarriage. Mishra says the unwitting surrogate gets blamed.
MISHRA: She doesn't know it is an induced abortion. She has been made to believe that it is because of her carelessness that she has aborted.
MCCARTHY: Mishra says Indian surrogates like Isha typically have no more than a fifth-grade education. They often cannot read contracts drafted in English. It makes a mockery of consent, she says.
KARUNA NUNDY: I think informed consent is something that's absolutely essential.
MCCARTHY: Karuna Nundy is a Supreme Court advocate.
NUNDY: The information that's lacking is that what does the contract really mean? What do I do if all of these promises aren't panning out the way that you promise they are?
MCCARTHY: A decision on whether to ban or to regulate surrogacy can only be taken, Nundy says, after hearing from the women whose bodies are being rented in the first place.
NUNDY: So if you've got a bunch of, you know, commercial surrogates who are saying that we need a ban, you have a ban. If you have a bunch of commercial surrogates say, no, I want to do this, but it's not fair, I need more money, then that points to a regulated industry.
MCCARTHY: Back in her room, Isha Devi says she would hope to meet the woman whose twins she is carrying. That's not likely. Doctors discourage it. It's one more uncertainty in a life bundled with them. But Isha has no doubt about one thing.
DEVI: (Speaking Hindi).
MCCARTHY: "Whatever I'm going through," she says, "nobody should go through." Julie McCarthy, NPR News, New Delhi.
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