:00:00. > :00:00.have hit Indiana, Illinois and Kentucky. Search and rescue teams
:00:00. > :00:17.are looking for people said to be trapped inside buildings. Time for
:00:18. > :00:20.hardtalkmacro. `` `` In India, producing surrogate babies is a
:00:21. > :00:22.booming business. Reproductive technology allows childless, wealthy
:00:23. > :00:24.couples to hire impoverished Indian women as surrogate mothers `
:00:25. > :00:27.pregnancy and childbirth have become commercial transactions. We speak to
:00:28. > :00:36.Dr Nayna Patel, a pioneer in the field. Her clinic has been
:00:37. > :00:45.recruiting surrogates and delivering babies to order for a decade. Is
:00:46. > :00:47.this 21st`century way of making babies irresponsible and
:00:48. > :01:27.exploitative or a positive public service? Welcome to HARDtalk. Thank
:01:28. > :01:31.you. You are a doctor that has long specialised in reproduction and
:01:32. > :01:39.fertility. Just explain to me how you got into the business of
:01:40. > :01:44.surrogacy. I never did surrogacy for five years after starting my IVF
:01:45. > :01:48.practice. It was in 2003 that a couple from the UK, an Indian
:01:49. > :01:53.couple, needed a surrogate. For three months, we tried to find a
:01:54. > :02:00.surrogate and we were not able to find it. To be clear, that is a
:02:01. > :02:05.woman who would carry their baby. That is correct. The woman was born
:02:06. > :02:10.without a womb. We could not find anyone in India or the UK. And so we
:02:11. > :02:15.had her grandmother carried the babies and she delivered the twins
:02:16. > :02:20.in 2004. That was the first surrogacy case I ever did. When we
:02:21. > :02:25.saw the end result was very happy for the story get mother, the
:02:26. > :02:28.grandmother, why not do it for those unfortunate females who might not
:02:29. > :02:35.have a mother or a friend carry their baby? And that is how we
:02:36. > :02:39.started. We got the idea to do surrogacy and we started the
:02:40. > :02:45.surrogacy arrangements. Obviously, you thought early on that you could
:02:46. > :02:46.turn it into a business. In effect, you've turned pregnancy and
:02:47. > :02:53.childbirth into a commercial transaction. I would say there is a
:02:54. > :02:56.give and take of money but no amount of compensation can ever compensate
:02:57. > :03:03.a surrogate for what she is doing. The word business is to... Too crude
:03:04. > :03:08.for this practice. Surely it isn't too crude because you're not trying
:03:09. > :03:12.to tell me, are you, that the women you recruit as surrogates are doing
:03:13. > :03:17.it for any other reason than the money? Money is there but they also
:03:18. > :03:24.get joy and happiness for helping a couple who is childless. In India,
:03:25. > :03:31.childlessness is a stigma. Feelings when they know that this couple is
:03:32. > :03:41.not able to have a baby, when they know that she does not have a womb,
:03:42. > :03:45.women will go to any extent to help her have a baby. I'm sure people
:03:46. > :03:48.across the world would like to know the details of the money before we
:03:49. > :03:52.get into the complicated ethical issues that surround this. In terms
:03:53. > :03:57.of the money, and my right in thinking that a couple who comes,
:03:58. > :04:02.let's say from a western third country, they are childless and
:04:03. > :04:09.desperate to have a baby, they pay you about $28,000 for the service
:04:10. > :04:15.you offer? Approximately. 20 7000, 20 $8,000 US. How much of that goes
:04:16. > :04:23.to the woman who acts as this are get, who you take on this nine
:04:24. > :04:31.months of "work". They get about $10,000 US. If it's twins, it could
:04:32. > :04:40.be 13,000 US dollars. Otherwise, they get 10,000 to 12,000. Well over
:04:41. > :04:44.half, two thirds of the money, goes to you and your business. The
:04:45. > :04:52.remaining goes to be are in`house web based day. But that's your
:04:53. > :04:55.business. You pay for that. You cannot have free food for the
:04:56. > :05:02.surrogates. You have to pay for that. The breakfast, the lunch, the
:05:03. > :05:05.medicine, the antenatal checkups, the bloodwork, the ultrasound is,
:05:06. > :05:12.the referral to a surgeon if required. All of this is being
:05:13. > :05:18.done. And there are various people who do this and they get paid for
:05:19. > :05:24.that. Yes and they are all your staff because it's your business.
:05:25. > :05:31.It's not my staff entirely. An expert would be a freelancer. I
:05:32. > :05:35.intrigued by the degree to which India has become the global centre
:05:36. > :05:41.for this surrogacy business. It seems that there are two broad
:05:42. > :05:46.regions `` reasons. Indian law says that the birth mother, that is, the
:05:47. > :05:50.surrogates mother, has no legal rights when she signs a contract
:05:51. > :05:55.with you and with the couple who seek to have a baby. No rights at
:05:56. > :06:00.all accrued to the birth mother. Also, perhaps more importantly for
:06:01. > :06:06.India, there is a vast reservoir of desperately poor women who see no
:06:07. > :06:13.alternative but to make money in this way. Is that why India has
:06:14. > :06:17.cornered the market? I would say that a large numbers of surrogacy is
:06:18. > :06:24.are also being done in the US. But there has never been a mention of
:06:25. > :06:29.surrogacy done in the US. When a third, developing country is doing
:06:30. > :06:31.surrogacy, it becomes big news. But when the US is doing surrogacy for
:06:32. > :06:36.European couples, not only Americans, for so many European
:06:37. > :06:41.couples and for so many years... It's three times more expensive in
:06:42. > :06:46.the US. I understand but nobody mentions it. But because it's
:06:47. > :06:52.cheaper in your clinic, it's so attract if to so many people around
:06:53. > :06:59.the world. Would you accept on the legal front that in India, there are
:07:00. > :07:05.no legal rights enjoyed by the surrogates mother once she signs a
:07:06. > :07:10.contract? That is correct. That is one thing. The surrogates mother has
:07:11. > :07:13.no rights. She also has no duty towards the baby once the baby is
:07:14. > :07:18.born. The birth certificate will carry the name of the genetic
:07:19. > :07:23.parents. That is the second advantage. Third, when the couple
:07:24. > :07:26.comes from so far away, the surrogates will not be able to reach
:07:27. > :07:30.the couple wants the baby is born. These things happen in a western
:07:31. > :07:34.country, when a surrogates will come up after a few years to claim the
:07:35. > :07:41.baby. That's not possible when they are 10,000 miles away. I used the
:07:42. > :07:44.word work before. It struck me as surprising that you said when you
:07:45. > :07:48.sign up they deal with a surrogates, and let's not forget they are very
:07:49. > :07:54.poor women, when you sign a deal with them, they, you say, should
:07:55. > :08:00.regard what they are doing as like a labourer or a maid. It is simply
:08:01. > :08:03.nine months of work. Do you really regard pregnancy, childbirth, the
:08:04. > :08:10.intensity of that human experience as being like a maid or a
:08:11. > :08:14.construction worker? Well, I would say that it is a person 's personal
:08:15. > :08:21.choice. Do you stand by that comparison? I would stand by that
:08:22. > :08:26.comparison, yes. They are doing some work and they are being compensated
:08:27. > :08:30.for it. OK? And if it is work they can do and get good compensation and
:08:31. > :08:35.help a family change their life around 360 degrees, it is much
:08:36. > :08:41.better work than a labourer, a construction worker or a maid. The
:08:42. > :08:47.contract is very important. What proportion of the women you use as
:08:48. > :08:51.surrogates are illiterate? Illiterate, 100%, I would say that
:08:52. > :08:58.they do not know how to read or write. I would say only 10%. Let's
:08:59. > :09:02.say illiterate to the extent that they do not know how to write, read
:09:03. > :09:09.or understand a legal contract. I would say at least 30% would be like
:09:10. > :09:13.that. 70% to understand. I have had surrogates who are graduates and
:09:14. > :09:18.have done this to tide over the financial crisis of her family. I
:09:19. > :09:24.just wonder how much they understand what they are signing up for. Let me
:09:25. > :09:27.finish. It's important to lay out this deal. You require them when
:09:28. > :09:32.they sign the contract and then when they become pregnant, you require
:09:33. > :09:37.them to stay in your hostile. There is a guard on the gate of the
:09:38. > :09:40.hostel. They require your permission or the permission of your staff to
:09:41. > :09:48.leave the hostel. You control their lives. That is not exactly the
:09:49. > :09:54.truth. They can walk out. They go out into the park. With permission.
:09:55. > :10:01.With permission or without permission. They live like a
:10:02. > :10:05.dormitory. It's a hostel. They are not like the bonded labourer.
:10:06. > :10:11.Absolutely not. They go home for 15, 20 days as well. They go and they
:10:12. > :10:15.come back after 20 days. We have a caretaker who just make sure that
:10:16. > :10:19.they see the take the medicine properly. They can go out, go to
:10:20. > :10:27.temples, see the festivals, anything like that. Can they go home if they
:10:28. > :10:33.want? Of course, for 20 days if they want. Without permission? Of course
:10:34. > :10:38.not. The director has to know that the student is at home for 20 days.
:10:39. > :10:42.That is all they want to know. One lawyer working in surrogacy says
:10:43. > :10:47.that the sort of rules imposed by you are unlawful confinement under
:10:48. > :10:54.the Indian criminal code. Absolutely wrong. It's nothing like unlawful
:10:55. > :10:58.confinement. The surrogates's husband, children, they stay with
:10:59. > :11:03.them over the weekend. Every Sunday, the children come to visit. There
:11:04. > :11:10.are so many surrogates. Most of them spend two months out of nine in
:11:11. > :11:14.their own homes. Here are the words of one surrogates featured in a
:11:15. > :11:18.recent documentary, which, of course, you call operated with and
:11:19. > :11:23.offered access to. It was revealing. She didn't have a
:11:24. > :11:25.negative experience but at the end of it, after giving birth to a child
:11:26. > :11:30.who was immediately whisked off and taken to the client family, she said
:11:31. > :11:36.not in my entire life would I want my own daughter to be a surrogates.
:11:37. > :11:42.Yes. It's not a positive experience, is it? Is a positive experience for
:11:43. > :11:46.her because she has helped. But what she dreams of is that my daughter
:11:47. > :11:50.could become a dog, an engineer, that sort of thing, and not go
:11:51. > :11:56.through this sort of fruit. `` become a doctor. So your opinion is
:11:57. > :12:00.that no woman herself would ever want to be a surrogates. Your
:12:01. > :12:06.statement that it is all free will is not really true. It's like a maid
:12:07. > :12:09.servant saying I would never want my daughter to be a maid servant or a
:12:10. > :12:13.labourer saying I would never want my son to be a labourer. He would
:12:14. > :12:19.want him to be an office worker or some them. You talk about empowering
:12:20. > :12:24.the poorest of the poor women in India. How is it that you know that
:12:25. > :12:32.when you give them a substantial sum of money, $8,000, $10,000 for one
:12:33. > :12:35.baby, how do you know that given the nature of power dynamics within
:12:36. > :12:39.Indian families and the patriarchal society that we see in so many
:12:40. > :12:46.traditional Indian villages, how do you know that they enjoy the fruits
:12:47. > :12:49.of this work that you describe. We have a team for this when they come
:12:50. > :12:54.to sign up as a surrogates, the first counselling session, they are
:12:55. > :12:58.asked why they are doing this. Why do they need this money. Some say
:12:59. > :13:06.they want to buy a house, educate their children, start a business
:13:07. > :13:11.with their husband. And we see to it that this is being done. We have a
:13:12. > :13:14.lawyer to see that the papers are genuine. 80% of the surrogates use
:13:15. > :13:21.the money the way that they have dreamt of. And that is how we are
:13:22. > :13:25.different from the others. You might like that to happen but there's no
:13:26. > :13:30.way you can enforce that. There's no way we can enforce it but for nine
:13:31. > :13:35.months, they can cancel them. They see the positive experience of the
:13:36. > :13:40.other surrogates. `` they can counsel them. Are you aware that
:13:41. > :13:43.there are so many critics that look at the positive spin you put on this
:13:44. > :13:50.and simply do not buy it? Margaret Somerville, a respected researcher,
:13:51. > :13:54.she says that what you are doing is totally commercialising and
:13:55. > :14:00.dehumanising the most intimate of human relationships, that between
:14:01. > :14:05.parents and children. What I would say is that this is not her child in
:14:06. > :14:09.any case. It is a genetic baby of some other couple. She has done this
:14:10. > :14:12.knowing that she has her own children to take care of. I don't
:14:13. > :14:18.want one extra mouth to feed, OK? But by giving... The surrogates
:14:19. > :14:22.feels that she is not cheating anybody, she is not doing any
:14:23. > :14:25.murder, but she is helping a couple bring a beautiful life on this earth
:14:26. > :14:30.and in return bless that baby and bless that couple and bless her own
:14:31. > :14:34.children. So, why do you criticise someone who was doing this?
:14:35. > :14:38.Otherwise she has nothing to do. It's not criticism but teasing out
:14:39. > :14:42.the ethical dilemmas raised by what you do and the commodification of
:14:43. > :14:48.some in that most human beings regard as so personal, intense, so
:14:49. > :14:53.intimate. One complexity I can see is that it's extraordinary how many
:14:54. > :14:57.Caesarean sections are performed on your surrogates mothers. The Indian
:14:58. > :15:02.national average is 8%. It's over 50% in your clinic. Is that because
:15:03. > :15:08.it suits the client? Because they can schedule a visit? They know the
:15:09. > :15:10.timing, when the baby will come out? It's so much more convenient for
:15:11. > :15:24.them even though it's more dangerous for the birth mother? It's not like
:15:25. > :15:36.that. The rate is much higher. That's not the Indian national
:15:37. > :15:40.figure. Yes it is. For all IDF pregnancies. And when IVF was
:15:41. > :15:45.started in London, people said it was an unnatural way of having a
:15:46. > :15:54.baby and that's the what they're saying surrogacy now. But IVF is now
:15:55. > :16:02.well accepted way of treating infertility. Similarly, there are
:16:03. > :16:05.females who are unfortunate and need a surrogate. The second question you
:16:06. > :16:14.asked is about the see section rates, it's not for the convenience
:16:15. > :16:22.of the couple. It is because there are many multiple pregnancies,
:16:23. > :16:28.twins, and there are high risks. You must have seen in the documentary
:16:29. > :16:38.there was a natural birth. Yes, but that exception, not the rule. I want
:16:39. > :16:43.to move on. What happens if there is a miscarriage? Does the surrogate
:16:44. > :16:47.mother, because she is suffering something physically traumatic and
:16:48. > :16:56.psychologically traumatic, but she get full recompense? Is she still
:16:57. > :16:59.paid the full fee? After three months of pregnancy, it's around 300
:17:00. > :17:05.US dollars. After five months it is 1200 US dollars. After birth,
:17:06. > :17:15.whatever happens to the baby, whether it survives not, they get
:17:16. > :17:23.the full payment. You were about this process and the most
:17:24. > :17:29.businesslike coldhearted way. It is about taking care of the couple and
:17:30. > :17:36.the surrogates and the baby. The baby is the most important person in
:17:37. > :17:41.this. Really? You're telling me the surrogates more important even a
:17:42. > :17:45.client who is paying you? So what happens if, I don't know this has
:17:46. > :17:51.actually been experienced in your time, but what if a sorry at mother
:17:52. > :17:55.dies in childbirth or sufferers serious long`term health
:17:56. > :17:58.publications? Do you make an open`ended commitment to their
:17:59. > :18:04.families that you will do what it takes to look after them? That goes
:18:05. > :18:09.without saying, I would say. It has not happened. If something like this
:18:10. > :18:15.does happen, the sorry it will definitely get a lot of
:18:16. > :18:29.compensation. We have a trust. It would be around, considering Indian
:18:30. > :18:36.rupee, we give some to the husband and there is a fixed deposit for the
:18:37. > :18:48.children and the education of the children. Do you take a moral stand,
:18:49. > :18:53.in a decade`long experience, have helped a single person go through
:18:54. > :19:01.the surrogates process and acquire a baby? A gay couple? We have mostly
:19:02. > :19:09.had heterosexual couples. We have had a handful of single parents. I
:19:10. > :19:22.would say for single fathers. You think that's wise? One was an Indian
:19:23. > :19:29.we knew, it was an interesting case whether father wanted the sums baby
:19:30. > :19:35.because the father had an attack. What about gay couples? I would
:19:36. > :19:42.respect their sexuality, but in India it is not currently allowed.
:19:43. > :19:46.There are those you don't always seem to stick to, for example they
:19:47. > :19:52.see a maximum of three embryos should be placed in one cycle,
:19:53. > :19:54.whereas you sometimes use for, running a high risk of multiple
:19:55. > :20:01.births and publications, so you don't always stick to the
:20:02. > :20:06.guidelines. Four is only for those couples or this e`mail is more than
:20:07. > :20:16.40 years old. 90% of the eggs are abnormal in that case, so the
:20:17. > :20:25.chances are just higher. Sorry to corrupt but we are a little short on
:20:26. > :20:31.time. What is the maximum age for a woman you'd agree to help? We go up
:20:32. > :20:42.to 50 years, but not with her own eggs. I suggest a donation over the
:20:43. > :20:49.age of 45. So you help couples who are 50, 60? 60 would be really
:20:50. > :20:55.difficult. Even if there were prepared to pay you? No, we would
:20:56. > :21:03.counsel them, what happens if the child if you are there any more. But
:21:04. > :21:09.if she is 48, 49 and her husband is 60, we would do it. In some
:21:10. > :21:15.countries there are clear laws against commercialised agency driven
:21:16. > :21:22.surrogacy is. There is a danger, if they want to take the baby out of
:21:23. > :21:28.India to their home country, but the contest is injured for the baby and
:21:29. > :21:40.it is left in legal limbo. We had a problem with a German couple. But
:21:41. > :21:44.now we know that these countries have legalised surrogacy is and we
:21:45. > :21:52.do it. We asked the German couple, is it legal to take the baby? But
:21:53. > :21:54.now it is made very simple by the Indians guidelines, they need to
:21:55. > :22:02.produce a certificate that they will be able to take the baby. Are you a
:22:03. > :22:09.religious person? Very special, very religious. You said that you believe
:22:10. > :22:17.what you do is godlike. It's not godlike. I would characterise it
:22:18. > :22:23.that I am doing something different, something controversial, but
:22:24. > :22:28.ultimately it's what God wants, and that's where he has given this
:22:29. > :22:34.arrangement to this world and he has made certain people involved in it.
:22:35. > :22:41.But you are interfering with nature. Nature has dictated that some of us
:22:42. > :22:46.human beings are infertile or incapable of having children. You
:22:47. > :22:58.meddle with that reality. Do you ever think that that is perhaps
:22:59. > :23:04.unwise? A young cancer patient, nobody asks, nature wanted to die of
:23:05. > :23:09.cancer, why do you want treatment. But infertility isn't a disease. It
:23:10. > :23:14.is a disease. The couple who are suffering from it, you should
:23:15. > :23:23.experience one day of their life and you would no. They don't know what
:23:24. > :23:30.they are doing without a baby, there are socially cut off. Finally, your
:23:31. > :23:34.Indian surrogates have produced hundreds of babies are now live in
:23:35. > :23:39.rich Western countries. You want to expand your business. You are
:23:40. > :23:46.building a new $6 million clinic. How far can this surrogacy business
:23:47. > :23:53.go? This can be a business in a big way, but that is for any new thing
:23:54. > :23:58.that comes up. It is taken up as a business by everyone. But surrogacy
:23:59. > :24:06.is much more than business. There are a lot of emotions involved in a
:24:07. > :24:10.lot of humanity. We have turned them. Thank you very much. `` we
:24:11. > :24:27.have to do and `` end there.