India – Booming Business in Assisted Reproduction…But Is it Ethical?

Yesterday we posted a little about how India is becoming a major destination for reproductive tourism in the form of gestational surrogacy. Today, we’re discussing some of the ethical ramifications associated with choosing a surrogate in India. These issues aren’t new – commercial surrogacy has been legal in India since 2002. It is typically associated with substantial cost savings over a gestational surrogacy in the United States ($25,000 versus $75,000 – $100,000). But the cost savings come at a moral cost. In a New York Times article from 2008, the reporter noted:

Surrogacy is an area fraught with ethical and legal uncertainties. Critics argue that the ease with which relatively rich foreigners are able to “rent” the wombs of poor Indians creates the potential for exploitation. Although the government is actively promoting India as a medical tourism destination, what some see as an exchange of money for babies has made many here uncomfortable.

And therein lies the rub. Although gestational surrogacy is legal in India, women still lack political power and financial resources in their own country. Pursuing a surrogacy arrangement in India means taking advantage of this situation. Furthermore, intended parents have to be comfortable with less disclosure than they would have within the United States, and they have to accept that the surrogate is unlikely to tell even her closest friends what she is doing and why.

In our surrogacy program, our gestational carriers are screened for physical, mental and emotional competence to handle the rigors of a gestational surrogacy. The women admitted must be healthy, maintain their own individual health insurance, and be employed outside the home (or, if not, must be in the home by choice). The women cannot be on any form of government assistance. We do not use women on Medi-Cal or Medicaid. The intended parents and the would-be surrogate meet prior to entering into a contract, to create a certain level of comfort and trust. The fertility specialist chosen by the intended parents will conduct a medical exam of the surrogate, in addition to reviewing her medical records. The surrogates in our program are encouraged to share their preferences regarding carrying a child for same sex couples, single people, inter-racial couples, selective reduction, and termination of pregnancy. We believe that these safeguards ensure the best outcome for all parties involved.

Compare this to a surrogacy in India: not only do intended parents not have the guarantees about the health of the surrogate, parents also have to be concerned about the overall environment in which the woman is living. These women, however healthy they may be, do not live in the same environment as you, the intended parents. For better or worse, India is a developing nation, with all that goes with it. You may see yourself as participating in a “win-win” – i.e. you get a child, she receives a not insubstantial sum of money to provide for her family, but you face the possibility that she is malnourished, illiterate, and, unfortunately, being taken advantage of, in spite of your best efforts to the contrary.

There are also legal issues at play, but those are for another blog. Check back periodically and see what else we have to share on these issues. In the meantime, if you are considering pursuing a gestational surrogacy, either as an intended parent or as a surrogate, visit our website to learn more, or call us at 1-800-877-1880.

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Surrogacy Abroad – The Latest Wave?

India is rapidly becoming a major player in the surrogacy business, for better or for worse. Many developed nations have outlawed commercial surrogacy as immoral, or they prohibit it for certain groups (homosexuals or single people). Therefore, individuals and couples seeking to grow their families through surrogacy are often forced to look elsewhere. India is becoming a favored destination for these families, since commercial surrogacy is legal, and a surrogate can be paid what seems a very small sum to the intended parents, but a fortune for the surrogate, thanks to differences in the standard of living and exchange rates.

Much has been made of the fate of the German couple who used an Indian surrogate to bear their twins, only to have the German government deny the children citizenship, and the Indian government do the same. But couples from Australia, France and other parts of Europe are turning to India over the United States for cost savings. Over the next couple of posts, we’re going to cover some of the drawbacks to using a surrogate in India (or anywhere outside the United States) to grow your family.

To whet your appetite, start here: a 60 minutes piece about an Australian couple turning to India for their gestational surrogacy. Watch it and comment below. We’d love to hear your thoughts.

Family Formation Law Offices has been in the family building business for nearly thirty years. Whether you are seeking to build your family through adoption, or third-party assisted reproduction, we have the skills and resources to help you. Call 1-800-877-1880 today for your free 15 minute consultation.

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Washington State Legislature Considering Gestational Surrogacy Bill

Washington State currently has a ban on paid gestational surrogacy arrangements. But that may change very soon. According to the Seattle Times, a bill has passed the State House, 59-39, allowing women to be paid to serve as gestational surrogates.

If it becomes law, the bill debated last Monday would set up a detailed system for entering into surrogacy contracts. The bill is now being considered by Washington State’s Senate.

Under the bill, House Bill 2793, surrogates would have to be at least 21 and have previously given birth to a child. Additional requirements include obtaining medical coverage for the pregnancy and immediately after birth, passing mental and physical examinations, and signing a written consent form. Intended parents also would have to meet certain requirements, including a mental health evaluation and an affidavit from a doctor attesting to a medical need for surrogacy.

Gay and lesbian couples would not need a medical affidavit. The measure also would give state-registered domestic partners access to the Uniform Parentage Act, a law regulating child support and custody.

California intended parents are very lucky, as you can see by this news article. California intended parents have long had the ability to obtain pre-birth judgments declaring them the legal parents of the children. While surrogacy is unregulated in California, there are many excellent programs run by experienced practitioners and attorneys, who can advise you on the best way to create your family. Family Formation Law Offices encourages you to visit our website to learn about using gestational surrogacy to build your family, including the costs, timeframe, and what to expect.

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California Assembly Member Introduce Bill to Regulate Surrogacy Business

On February 19, 2010, Assembly Member Bradford introduced a bill into the California legislature designed to regulate the practice of so called “surrogacy practitioners,” AB 2426. You can track its status here.

Surrogacy practitioners, as defined by the bill, are persons or organizations that engage in either (1) advertising for the purpose of soliciting parties to an assisted reproduction agreement or acting as an intermediary between the parties to an assisted reproduction agreement; or (2) charging a fee or other valuable consideration for services rendered relating to an assisted reproduction arrangement.

We’ve already covered how to choose an assisted reproduction program in some detail on this blog. One of the problems we’ve identified in this field is a lack of regulation. Unfortunately, several surrogacy agencies have closed their doors in recent months, and in so doing, took the money intended parents had placed with them to pay medical bills, the surrogate’s monthly expenses and her compensation. These parents were left with no recourse, since these agencies are not licensed or otherwise regulated by the state. Now, there are a few surrogacy programs run by attorneys, and we strongly recommend that families considering surrogacy work with an attorney owned and operated program, because the attorney has a license on the line, and you, the consumer, have recourse through the State Bar if the attorney commits malpractice.

The other part of the bill regulates how a non-attorney surrogacy practitioner handles client funds. The legislation would require the practitioner to deposit the client funds into either an independent bonded escrow depository, or a trust account maintained by an attorney. It further requires that client funds can only be withdrawn only by agreement between the surrogacy practitioner and the intended legal parent identified in the assisted reproduction arrangement.

This bill has only just been introduced into the legislature, and its going to take some time to work its way through the legislature. It will likely undergo some refinements between now and when its signed into law, whenever that may be. However, Family Formation Law Offices is pleased that the legislature is aware of the problems out there, and at least considering legislation. We will keep you informed of any updates!

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A Healthy Weight Translates to A Healthy Pregnancy and a Healthy Baby

Seems obvious, right? But there is increasing evidence that obesity rates not only affect overall health, but can contribute to increased risk of miscarriage, anovulation, c-sections, and decreased live birth rates. This is just as true in women who carry their own children as in women who act as gestational carriers. A recent article in the journal of the American Society for Reproductive Medicine, Fertility and Sterility, provides a retrospective analysis of cycles for a period of 8 years. It concludes noting the chances for live birth are dramatically improved by using surrogates with a BMI under 35.

Many programs seek women with BMIs with a top range lower than 35. It is not intended to discriminate against women with a BMI of say 33, 34, or 35, but many fertility clinics have their own preferences for women with BMIs of 30 or under.

Obtaining a healthy weight is preferable for your own health, but if you are trying to get pregnant, or considering becoming a surrogate, its important for you to look at the different BMI requirements for different programs and doctors. For some women, losing as little as 5 lbs can drop them into the next BMI range, or maybe they are still nursing, and when that stops, their BMI will drop.

If you are interested in becoming a gestational surrogate, or you think you’re in need of a surrogate to build your family, we encourage you to give our office a call, visit our website, or send us an email.

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Guest Blog: Adoptive and Intended Parent Nursing – It IS Possible!

Contrary to popular belief it is NOT necessary for a woman to have been pregnant to breastfeed.
During pregnancy a woman’s body produces increasing amounts of progesterone, estrogen (via the placenta), and prolactin (via the pituitary). These hormones prepare the woman’s breasts for breastfeeding. Once her baby is delivered, progesterone and estrogen levels drop and prolactin levels increase and this results in the woman’s milk production or lactation.

A woman who is planning to build her family through adoption or via surrogacy can follow certain guidelines which are designed to mimic what happens during pregnancy and after the birth of a baby. The result for a woman who follows these guidelines is milk production or “induced” lactation. She will actually be inducing lactation and her breasts will begin to produce milk!

Once the milk supply is established, milk continues to be produced on a “supply and demand” basis. Milk will continue to be produced as the baby continues to ‘demand’ milk. The more often and the more efficiently the baby withdraws milk from the his/her mother’s breast, the more milk will be produced by the breast. As the baby suckles at the breast, a signal is sent to the brain from the breast to release oxytocin which initiates the milk ejection reflex (MER) and causes the milk to flow. The release of oxytocin and the emptying of milk from the breast causes the breast to produce more milk. And, so the circular feeding pattern and production of milk continues. Baby eats, breasts empty, breasts fill, baby eats……

Studies have shown that the breastmilk of a mother who has induced lactation is compared to that of a birth mother’s breastmilk at 10 days postpartum.

There are two issues in nursing an adopted or intended baby. One is getting a baby to breastfeed. The other is producing breastmilk. It is important for mothers to set their expectations at a reasonable level. Since there is more to breastfeeding than breastmilk, many mothers are happy to be able to breastfeed without expecting to produce all the milk the baby will need. It is the special relationship, the special closeness, and the biological attachment of breastfeeding that many mothers are looking for. As one adopting mother said, “I want to breastfeed. If my baby also gets breastmilk then that’s icing on the cake!”

Adoptive and intended mothers CAN breastfeed. The International Board Certified Lactation Consultants (IBCLCs) of Virtual Breastfeeding Help provide the “induced lactation” guidelines, technical assistance and support necessary to turn your dreams into reality!

Please visit their website to make an appointment TODAY: www.VirtualBreastfeedingHelp.com

By: Laurie Haessly, MA, RD, IBCLC

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Building Your Family – Surrogacy

Surrogacy involves a woman agreeing to gestate a child for a single adult or couple. Surrogacy can be either traditional (artificial insemination of sperm into the Surrogate’s womb) or gestational (in vitro fertilization with genetic material supplied by the Intended Parent(s) and/or Donors and transferred into the Gestational Carrier’s womb).

In a California gestational surrogacy, the Intended Parents’ parental rights are secured by court order between the fifth and ninth months of the Gestational Carrier’s pregnancy and take effect upon birth. After birth, the Surrogate releases the child to the Intended Parent(s) to love and raise. This is the most common and most secure form of surrogacy.

In a traditional surrogacy, few courts will adjudicate the Intended Parents as the lawful parents before birth. Typically, parental determinations are created via paternity judgments and stepparent adoptions. We do not recommend traditional surrogacy because of the legal concerns outlined above.

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