Mothers who turn to surrogacy to support their families face ostracism, study shows

BMJ 2014; 348 doi: (Published 12 May 2014) Cite this as: BMJ 2014;348:g3257
  1. Sanjeet Bagcchi
  1. 1Kolkata, India

Surrogate mothers face extensive social humiliation in India, a new study has found.1

Published in the May 2014 issue of the journal Affilia, the study led by Sharvari Karandikar of the Ohio State University in the United States has pointed out that surrogate mothers in India face stigma from extended family and community that forces them to leave their homes and relocate after surrogacy.

Karandikar and colleagues did a qualitative study—by conducting in-depth interviews with 15 surrogate mothers from the Gujarat state of India. All 15 women who participated were married and had had at least one biological child before becoming a surrogate mother.

The researchers noted that women were referred for surrogacy in clinics by agents hired by their doctor, or by husbands and close relatives. Most of the women were from very low socioeconomic backgrounds and had little to no formal education.

The husbands of the women had insufficient earnings to support the family, and they saw surrogacy as a way to alleviate poverty. “Of the 15 participants, 10 mentioned that their husbands were unemployed and they had no other choice but to become surrogates,” the study pointed out.

The parents who required the surrogacy service were from the United States, Japan, Canada, Australia, England, India, and Madagascar, according to the study. The women reported that they earned about $3000–$5000 (Rs180 000-Rs300 000; £1800-£3000; €2200- €3631) for successfully delivering a surrogate baby. However, the compensation for carrying twins was higher—between $4000 and $6000.

Karandikar and colleagues noted that although family members’ reactions to surrogacy varied from negative to relatively supportive, the reactions of community members were always negative.

As pointed out in the study, “Surrogate mothers were typically stigmatized if community members became aware of the surrogacy. This resulted in ostracism and one participant was even forced to move away from her village.” The study also added: “Surrogate mothers employed various strategies to avoid stigma and ostracism. These included living in the surrogacy hostel while engaging in false claims of alternative employment or even lying about the result of the pregnancy.”

“I had to stay in surrogacy home because people in [the] village would ask about how I got pregnant, especially with no husband,” said one of the participants (a widow).

Karandikar told The BMJ that surrogate mothers in India faced social humiliation because people were unaware and uneducated about the medical aspect of surrogacy. She added: “Getting pregnant in India has social implications. Families are involved with pregnancy. It’s difficult to hide it and surrogate mothers tend to stay in hostels to hide their pregnancy.”

According to Karandikar, surrogacy in India is carried out mostly for foreign couples, but the demand is also there for Indian couples. She said: “Basically [it’s] an expensive process and only the rich have access to it. It is not common, but it’s prevalent among some women who are in need of money and get connected with the clinics.”

Public health experts in India have shown concerns regarding the ethical issues related to surrogacy. Indira Chakravarthi, an independent public health researcher and fellow at the Nehru Memorial Museum and Library in New Delhi, said, “The Indian government needs to take note of such issues while drawing up regulations, and should not allow exploitation of poor women here in the name of medical tourism and economic growth of the healthcare industry.”


Cite this as: BMJ 2014;348:g3257


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