The booming business in international surrogacy, whereby Westerners have begun hiring poor women in developing countries to carry their babies, has been the subject of plenty of media buzzing over the past few years. Much of the coverage regards the practice as a win-win for surrogates and those who hire them; couples receive the baby they have always wanted while surrogates from impoverished areas overseas earn more in one gestation than they would in many years of ordinary work. Heartening stories recount how infertile people, as well lesbian and gay couples who want to have children (and who often suffer the brunt of discriminatory adoption policies), have formed families by finding affordable surrogates abroad. The Oprah Winfrey Show has even portrayed the practice as a glowing example of “women helping women” across borders, celebrating the arrangements as a “confirmation of how close our countries can really be.”
But make no mistake: This is first and foremost a business. And the product this business sells—third-party pregnancy—is now being offered with all sorts of customizable options, guarantees, and legal protections for clients (aka would-be parents). See for example the December 2010 Wall Street Journal article “Assembling the Global Baby,” which focused on high-profile PlanetHospital, a Los Angeles-based medical tourism company that has become one of many one-stop-shops for overseas surrogacy and that is going to great lengths to woo customers. "We take care of all aspects of the process, like a concierge service," company founder Rudy Rupak told the Journal.
The Journal article didn’t go into much detail about how surrogates’ rights might figure into this “concierge service.” But interviews with those running the operation, information that was available on PlanetHospital’s website until it was redesigned last year, and an information packet called “Results Driven Surrogacy” that the company distributes to prospective clients, begin to fill in the picture. The version of the packet that PlanetHospital sent me in July assures clients that each surrogate is “well looked after.” Surrogates spend “the entire duration of the pregnancy at the clinic or a guest house controlled by the clinic” where their habits, medications, and diets are carefully regimented and monitored. PlanetHospital promises clients that when surrogates have a history of smoking, “we make sure they do not suddenly get a craving for it during pregnancy.” Like most other surrogacy clinics and brokers, PlanetHospital accepts only surrogates who already have children of their own. While the usual reasoning for this sort of requirement is that having children proves a woman can safely carry a pregnancy to term, PlanetHospital’s literature notes that the policy also ensures that she does “not bond with your baby.”
In addition, PlanetHospital offers customers a novel means of accelerating their bid for a family: The option of having embryos implanted into two surrogates at the same time. The selling points of this package (which was previously marketed under the name “India Bundle”): Implantation in two surrogates at a time increases the chance of immediate impregnation and decreases the waiting time for a baby. As the company’s website used to explain:
PlanetHospital innovated the idea of routinely performing IVF on two surrogates simultaneously thus increasing the odds of pregnancy by more than 60%. The notion of hiring two surrogates in the US and doing IVF on both surrogates would be financially prohibitive, PlanetHospital has negotiated rates with a highly reputable clinic in India that not only provide couples with two surrogates, but also four attempts.
Of course, this approach could also leave a couple with multiple babies, possibly gestating in multiple women. Until recently, if both surrogates became pregnant—or if either surrogate became pregnant with twins—clients could opt to have the extra pregnancy aborted or twins reduced to a singleton, depending on how many babies the clients wanted or decided they could afford. As PlanetHospital’s website used to explain, “The simple answer to that is it is up to you to decide what you wish to do, you can choose to have all the children (which will cost slightly more of course…) or you can request an embryo reduction.” Founder Rudy Rupak told me via email that the company no longer allows clients to elect either reductions or abortions under the advice of its lawyers, who worry that it could open up some “nasty debates” as Indian authorities discuss the possibility of surrogacy regulation. “If a client wants both surrogates then they have to accept it if both are pregnant,” he wrote.