Interviews with Indian Gestational Surrogates: Exploitation or Entrepreneurship?

Background and Purpose:  Social workers have a role in adoption, but the profession’s potential role in global surrogacy arrangements and in any emerging international and national regulations on surrogacy has only recently been recognized. As the profession begins to initiate a thoughtful discourse on surrogacy, there is a need for social work scholars to be further engaged in research on the surrogate experience. While surrogacy arrangements have come under great scrutiny and studies have been underway to identify potential human rights abuses, empirical research on the practice has only begun to emerge. For this project, we conducted a qualitative study, utilizing in-depth interviews with 25 surrogates in India, where commercial global surrogacy has been recently banned. Our overarching research question was, “what were the lived experiences of surrogates in Gujarat, India?” Through this research, we captured women’s experiences, from their perspectives, without making assumptions about human rights abuses and exploitation. 

Methods:  We conducted 25 interviews with women in Gujarat, India, who followed through with at least one surrogacy arrangement. We initially identified women through the local clinic and then used a snow-ball sample to garner more participants. The interviews were conducted in the women’s homes by a trained research assistant fluent in the language. Women were paid a small fee for participation. Interviews were recorded, transcribed, and translated to English. Interview data was subsequently coded by the researchers. Several themes emerged through the iterative coding process.

Findings: The participants were from impoverished backgrounds, the majority working as housewives or maids prior to their surrogacy arrangements. Some reported earning an average of US$30 a month in their current jobs and have earned US$5,000–$7,000 in the surrogate pregnancy, an exponential growth in income for them, unavailable in any other venture. Surrogacy was both a positive and negative experience for the surrogates. Some notable themes that emerged through the interviews were 1) the women’s sense of economic empowerment through the arrangement, 2) the use of caesarian-sections (n=25) for all of the surrogate births, 3) the emotional turmoil for the surrogates that resulted from the experience, and 4) the use of a cost-benefit analysis by the surrogates to make the decision to engage in an initial surrogacy arrangement. Overall, the women saw themselves as entrepreneurs, rather than victims of exploitation.    

Conclusion:  None of the women interviewed reported any dissatisfaction with the medical process or any abuses of their human rights in the surrogacy arrangements. The women were clear that they viewed the experience to be positive on the whole, even with the emotional burdens, and most were interested in future contract pregnancies. However, without a doubt there are unscrupulous surrogacy clinics and we cannot speak to the related unethical and illicit practices from an empirical perspective, as our study did not extend into this area of human rights concerns. As regulations on surrogacy begin to take shape internationally, social workers need to be engaged in research on surrogacy and in current and future policy recommendations.