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Tilak Rishi, born in India, has been working as a career corporate executive, after doing his MBA. Passionately pursuing his hobby for writing, he also remained a regular contributor to newspapers in India and the U.S. Many true happenings and characters he came across in life, including interaction with former president Bill Clinton, inspired Paradise Lost and Found, his first novel. A family saga, it starts from Kashmir, when this paradise on earth is lost for the tourists who thronged in thousands every year to enjoy its scenic splendor. Terrorists have turned it into one of the most dangerous places in the world. The family is not only a witness to the loss of this paradise, but also to another tragedy of much bigger magnitude. In the aftermath of the partition of India, along with millions uprooted from their homes in Pakistan, the family leaves behind all that it has in Lahore. Starting from a scratch on the difficult path to progress, it still has many joyful moments when along the way it makes a difference in many a life. The survival-to-success story climaxes in California where the family finds the paradise that was lost in Kashmir.

Thursday, October 22, 2009

Outsourcing Surrogate Pregnancy

Mention surrogate mother, and the mind goes back to the high-profile Baby M case in the U.S., the first of its kind, in which the surrogate was the baby's biological mother and unsuccessfully sought custody after the birth. Or to the controversial but bold Bollywood movie of its time, in which Preity Zinta playing the surrogate mother to the child of the married couple, Salman Khan and Rani Mukherjee, gives up custody of her child, though very reluctantly, to create happy ending for the film. For many years, surrogate pregnancy was a somewhat immoral method by which intended parents could attempt to have a child. The surrogate mother was always the biological mother, pregnant from another person, but with the intention of relinquishing the child to be raised by the biological father and his spouse. Much has changed since then the way surrogacy is practiced now. In gestational surrogacy, commonly used instead of the traditional, the surrogate becomes pregnant via embryo transfer with a child of which she is not the biological mother. It is no longer considered unethical or immoral, as extramarital relationship between the surrogate mother and the biological father is not involved. As such, the practice is now not only legal and widely accepted, it has become a big commercial opportunity for the agencies involved in it. Indian women earn more than they otherwise could, and infertile couples get a genetically related child. The clinics in India feel that this vital service they are providing is a ‘win-win’ situation for both the parties, ” we are facilitating each one of them to achieve what none of them could achieve on their own.” More importantly, staying detached from the genetic parents, helps surrogate mothers give up their babies and get on with their lives - and maybe with the next surrogacy.

These days U.S. outsources everything to India. So why not pregnancy? Especially when a growing number of Indian women are willing to carry an American child. By some estimates, Indian surrogacy is already a $445-million-a-year business. Commercial surrogacy was legalized in India in 2002. The cost comes to about $25,000, roughly a third of the typical price in the United States. That includes the medical procedures; payment to the surrogate mother, which is often, but not always, done through the clinic; plus air tickets and hotels for two trips to India (one for the fertilization and a second to collect the baby). Surrogate mothers in India, under commercial surrogacy programs are usually cared for with amongst the best highly advanced medical, nutritional, and overall care available in the field anywhere in the world. Having English speaking doctors available in India is another reason for people choosing to go with this option. This makes people feel far more comfortable with the doctor understanding them and the concerns that they may be having.

In Anand, a city in the western state of Gujarat where the practice was pioneered in India, surrogate mothers are pregnant with the children of couples from the United States, Britain and elsewhere. Most of them live together in a hostel attached to the clinic there. The Akanksha clinic is at the forefront of India's booming trade in so-called reproductive tourism — foreigners coming to the country for infertility treatments such as in vitro fertilization. The clinic's main draw, however, is its success using local women to have foreigners' babies. The business has taken off beyond anything it imagined. At any given time, it has about 150 foreign couples on its waiting list, and every week three new women apply to be surrogated, including clients from Taiwan, Japan, the U.S., Europe, and Australia.

The government is actively promoting India as a medical tourism destination. India now has about 350 facilities that offer surrogacy as a part of a broader array of infertility-treatment services. Last year about 1,000 pregnancy attempts using surrogates were made at these clinics. This year, it is estimated the figure will jump to 1,500. Since 2005, the practice of surrogacy has been operating under guidelines established by the Indian Council of Medical Research, a government body. But a new law is in the works that aims to regulate the surrogacy industry by standardizing such things as contract terms and surrogate compensation. To avoid potential legal disputes, it will also govern what parental information is given on birth certificates. What's more, the new law, which could be introduced in Parliament as early as December, would require clinics to register surrogacy cases and report their outcomes. At the end of the day, we're going to have statistics, which is very important, partly because of the implications for India's burgeoning medical-tourism industry.

Surrogate pregnancy is a rising trend that will most likely only gain in popularity. While there are many positive things to be said about outsourcing pregnancy, there are also other issues to be considered. The most difficult issues to face when considering outsourcing surrogate pregnancy are and will continue to be the ethical ones. While surrogacy can be viewed as a paid job, it may still be unethical to think of the mental and physical strain of childbirth as a simple rental of a human body. Some would argue that outsourcing pregnancy is exploitation at it its worst. On the other hand, surrogacy is the only option for some childless couples. With the exorbitant costs of in vitro fertilization and other treatment methods in the U.S., India seems like a dream come true for some couples. Both sides do benefit, and as long as standards are in place, the best option for the childless couples in the U.S. continues to remain outsourcing surrogate pregnancy.