For Canadians travelling to South Asia, tourism is usually associated with monkeys and money belts, sunburns and food so delicious that you binge eat in spite of the hot peppers that turn your face scarlet and trigger more tears than The Notebook.
A relatively recent type of travel has emerged between North America and South Asia: "fertility tourism."
Fertility tourism generally refers to the process by which western couples who are not able to bear children may contract a third party to serve as the gestational mother or surrogate. Why choose expensive and risky surrogacy treatments over adoption? With assisted reproductive technologies, it is possible for a third party to carry a child that contains your genes and the genes of your partner. With the high cost of contracting a gestational mother in North America, western couples have increasingly looked to South Asia as a more affordable option.
As a Human Rights Internet intern working in Nepal with funding from the Canadian International Development Agency, I recently had the opportunity to attend a workshop in Kathmandu on international fertility services. Hosted by the Women's Rehabilitation Centre, Nepal, the group included Nepali nurses and journalists, members of the Indian women's health organization SAMA, and the co-founder of American organization Our Bodies, Ourselves. Seated Nepali-style on cushions on the floor - between Indian folk songs and Nepali hip-shaking dances - the opportunities and risks associated with international reproductive services were mulled over and debated.
In India, the primary destination for American couples seeking a surrogate, there is no standardization of care for gestational mothers. Health-wise, lack of bargaining power can lead to the gestational mother unknowingly receiving untested fertility drugs or undergoing risky medical procedures. Financially, she is at risk of not receiving the payment she was promised. Good intentions on behalf of the genetic parents are not enough. Either party can be financially exploited by the private agent or due to contractual confusion regarding the costs and fees of the procedure. Furthermore, lack of standardization heightens not only health risks and economic insecurity but, also, emotional stress for both the genetic parents and the gestational mother.
Surrogacy hostels have popped up to provide physical care for the women during pregnancy, providing physical necessities but isolating the woman from friends and family. The gestational mother's right to maintain control over her environment and to receive health or counselling services post-pregnancy need to be reflected in written contracts. Parties involved also need to take into account the social repercussions that a gestational mother may encounter. The experience of being a gestational mother does not end with childbirth; her decision to act as a surrogate may affect her relationship with her spouse, parents, in-laws, existing children and community.
One issue in particular that needs contractual clarity is whether the gestational mother has the right to change her mind after childbirth and keep the child. While she may intend to hand the child over to the genetic parents, her emotional response to the child could be different than what she had expected. After nine months of dreaming and planning, the genetic parents are heavily emotionally invested in the child. Losing this opportunity to become parents could be a highly traumatic experience.
Overall, the issue is largely under-researched. Anecdotally, it has been reported that the incidence of American couples seeking Indian gestational mothers has increased dramatically. For countries such as Canada and Nepal, where international fertility services are budding rather than fully blooming, opportunities exist to learn from the Indian-American experience. We need to form strategies to ensure that the rights of both the Canadian parents and the gestational mother are respected.
Tanya Lee, 26, grew up in Coquitlam, where she attended Hillcrest middle school and Centennial secondary, and where her family still lives. She's contributing a column to The Tri-City News about her work with a human rights NGO and maintaining a blog at goneadventurin.wordpress.com.
