Wednesday, October 23, 2013

Times of India article - INSTAR

Surrogacy stakeholders draw up guidelines

AHMEDABAD: Most of the women driving multimillion-dollar surrogacy industry in India by renting out their wombs to childless couples do so to beat poverty. Often, they are exploited by agents and even risk their lives.

While there is no legal framework enacted - the Assisted Reproductive Technology (Regulation) Bill, years after it was drafted, is yet to be passed - a handful of stakeholders have formed a society to assure surrogates get basic remuneration, compensation in medical crises and, most importantly, respect for carrying somebody's child for nine months and delivering happiness.

The first-ever Indian Society for Third-Party Assisted Reproduction(INSTAR) has now been formed. Infertility experts, lawyers, embryologists and social workers from 15 states including Gujarat have joined hands to enforce self-imposed moral and ethical guidelines for the welfare of surrogates in India.

"Disturbing reports have been emerging from parts of India about exploitation of surrogates, cheating by agents, poor compensation and no safeguards in cases of death or medical crises. This reflects negatively, not only on the profession, but also on the country as nearly 50% of couples opting for surrogacy in India are based abroad," says INSTAR president Dr Himanshu Bavishi.

Dr Bavishi said that the first scientific meeting of INSTAR was recently held in Assam, where it was decided that each surrogate will be paid a minimum of Rs 2.25 lakh. In the rare case of the death of a surrogate while carrying a commissioning couple's child, her family will be paid Rs 5 lakh at least.

A surrogates also risks medical conditions where fallopian tubes or the uterus may need to be removed. In such cases, they will be paid Rs 25,000 for the removal of tubes and Rs 1 lakh for a hysterectomy.

"It has also been decided that all INSTAR members will follow a system which ensures that documents related to the surrogate are made available in her mother-tongue or a language she can read and comprehend," says Dr Bavishi.

I wonder how they arrived at 500,000 for the death of a surrogate when most surrogacy packages are around 1500,000. This would only work if there was an independent body to oversee that payments actually get to the family in the case of death of a surrogate, which has happened in two cases reported in Indian media.


Choco Mayan said...

Unless it is put on a contract or included in the current proposed bill, there is no way this can be reinforced. Maybe they should start an insurance fund, funded by premiums paid by IPs.

Anonymous said...

How could this work when its members are all the people who make money out of surrogacy? Looks like they have their own interests at heart.

jon said...

If the new ART bill gets passed, then management of the surrogates and egg donors will be decoupled from the clinics. My understanding is that the government will create an agency to manage that aspect of the IVF industry. This gesture, which the Times reports on, could be a last ditch effort by clinics to try to preserve the status quo. I don't like the status quo because it is a black hole, no one really knows what is going on behind the scenes. However, transferring this to the Indian govt could be just as bad given the horrible corruption and bureaucracy that the govt is famous for. If the latter occurs, IPs will be forced to pay much higher premiums for surrogates as well given this function will not be trasnferred to the govt and that never comes cheap to maintain or implement. As of today though the ART Bill is not on the schedule of the Indian Parliament for discussion. When it will be scheduled is anyone's guess.

Megan said...

I guess it's a good start to get the service providers in contact and talking. Still need an independent arbitrator to oversee them, to advocate on behalf of surrogates; and one for clients. Escrow accounts would be a good idea, for clinics as well as not all IPs are nice folk, some have scarpered with the baby without paying accounts in full.

Anonymous said...

Anyone doing surrogacy overseas should expect to be be fleeced. Things don't always go right, IVF itself is a risky business. Surrogacy adds complications. You go to a country like India renowned for its corruption, what do you expect? Don't be so naive to think you won't be robbed. If its worth all the hassle and overcharges for you people to have a baby, then do it,but don't complain when they take your money - good luck, immoral country where half their government is on a criminal charge.

Megan said...

Anon, that's pretty harsh, do you have any facts to back up what you wrote, I thought twice about publishing your comment, it seems pretty racist to me, but sure, put it out there. Is there not corruption in every country?

Anonymous said...

Our surrogacy in India went very well in 2010. I think we were actually under-charged. The surrogate did have a problem in the last month and the hospital made it clear to us that our surrogate was the priority. We respected that because we would have done the same if it had been me, and that is the simple, plain, truth. Fortunately, it all worked out. Also, our surrogate wanted a C-section to be able to leave the hospital earlier, our baby, according to the doctor was fine, so we paid additional for the procedure to accommodate the surrogate. Our surrogate, of her own volition, wanted to see me after delivery. I went and met with her (not protocol). She asked me if I was happy and hoped that I was, truly. YES! We are truly and forever grateful. And no words that I can write here can explain this. I wish our egg donor could see our child and I wish our surrogate could as well. My husband doesn't, but I do. And I wish my daughter could meet these two women but that probably, will never happen, but I would be really OK with it. I'm her mom with the help of these two women and I guess I do think about them at least once every week or so and probably will for the rest of my life.

Amani (Meg) said...

anon - good you had a smooth ride. Surrogate care should be first priority for any clinic. There is a difference between hospitalising a surrogate for the sake of the baby and the surrogate, and hospitalising a surrogate for a treatment that would normally be managed out of hospital. Where a clinic has a financial interest in surrogates being hospitalised, then I don't think that is a good thing. Sure, care for the surrogates, we all agree on that, that is a no-brainer, but where you have one clinic with 40% or more of its surrogates in a hospital for whatever reason, a hospital that the actual clinic get payment, then one has to wonder whether it is necessary or not. Given that no-one gets any medical report about their surrogate or baby, just a flippant email from admin staff about "your baby is fine, your surrogate is fine" ... followed up by an invoice, is this good business? No.

Amani (Meg) said...

Re C-sections, expect it, 90% are C-section, with any clinic. Sometimes a surrogate requests this, but they are always guided by their doctor. No-one should ever expect to have a natural birth and avoid the C-section fee. No-one should also get pissed off when they are charged $2500 for a C-section (huge amount to pay in India when you pay less for the same in your own country, so do consider the markup) Just be prepared for C-section in any birth and budget for the same.