Often when Americans think of India, we think of an overly large third world country that is poor, filled with billions of hungry people, dirty faced kids, and unfortunate living conditions. We have our media to thank for reinforcing that image.
However, my own personal fascination and confusion surrounding India is endless – and probably always will be. There are so many diverse aspects to the country and culture: the caste system, the way extended relatives add to the richness of the family unit, the country’s progression, wealth, stagnation, rich faith of their people, their political history, poverty, the beautiful countryside, the Taj Mahal, the delightful traditions – there are so many layers to India its difficult to know where to begin.
What I do know is the American media does a very poor job of giving fair representation of India especially in regards to fertility treatment overseas, and how their gestational surrogates are treated. Much of American news portrays India’s gestational surrogates as prisoners of the process.
Our own Lauri Berger de Brito and Kathryn Kaycoff-Manos travelled half way across the world from the United States to check out the conditions in India and presented an unbiased report of what actually happens in India. What they encountered really surprised them and eventually changed their initial opinions about surrogacy in India.
The overall takeaway point for both women was that India is not as foreign as it may seem. India is indeed different than the USA regarding surrogacy for many reasons and most importantly we must not view Indian surrogacy with the same expectations as we have for American gestational.
Both women were pleasantly surprised with what they saw. Overall, the care, the quality of service was good. Was their bad? Sure – however, there’s good and bad, but there’s good and bad everywhere. One of our biggest challenges is to assume that India does surrogacy like the USA – they don’t and we need to make sure to remember to view surrogacy through a cultural filter.
Below we look at a few very different clinics/agencies that portray gestational surrogacy in India.
From Lauri’ and Kathryn’s personal journal, here’s an excerpt about Dr Rita Bakshi’s very personal clinic in Mumbai:
“Well, I hate to be all about appearances, but I can’t help myself for feeling a sigh of relief that this is a place that would appeal to a westerner. So much of what we’ve seen feels so Indian – which isn’t a bad thing, but when thinking of medical procedures I can’t help that I want to feel something that feels a little familiar. Even the exterior of Dr. Bakshi’s office is clean, modern and inviting. The interior too, was equally, clean, well decorated and had a friendly, inviting feel. Over the reception desk was a monitory, showing a series of happy families courtesy of Dr. Bakshi. The office too was a testament to her success-filled with wannabe-parents. One proud mother – a returning client from England was quick to rave about her and show off the product of their labors (literally!)
As for picking your surrogate – Dr. Bakshi said she sends profiles, but the best thing to do is let her pick them. The way she likes to work is that on the day of transfer she may have up to five surrogates prepped and ready to go, then on the day of she picks the one with the best looking uterus. They all have been medically and psychologically cleared – but this way it ups your chances. And as I said before, she is not adverse to putting embryos into two surrogates depending upon the quality of the embryos. She follows the surrogates through to the birth of the baby. And of course, the IPs can be there for the birth. There isn’t too much contact with the GSs but if the IPs desire, it can easily be arranged.
Next to the surrogate housing – just a few blocks from her office. Here, we entered a posh building in the middle of a nice part of Delhi. This house was clean and stylish (no surprise since Dr. Bakshi obviously has good taste.) A large chart showing the healthy meals for the week was on display. Here, some rooms had one to three beds, it isn’t uncommon for two GSs sharing one large bed. All of the sudden the women piled into the living room – it was time for a favorite TV show (I think it was India’s version of Who Wants to be a Millionaire the one featured in Slum Dog Millionaire – but I could just be imagining it!)”
In contrast, was the larger fertility organization, Bloom IVF in Mumbai.
“When we pulled up to Lilavati Hospital in Mumbai, we were a bit surprised. It was a huge hospital – bustling with people going in and out, boasting every medical specialty – basically a standard all facilities type hospital. That’s another difference between IVF in India and U.S. In the United States, it’s unusual to find an IVF center located within a large hospital, typically the IVF centers are stand-alone clinics/offices…. For us, it’s a bit of a culture shock.. to be walking through a general hospital, with people there for surgeries, emergencies, and other assorted ailments .. trying to find our way to the IVF clinic.
We took the elevator up to the 2nd floor and the doors opened on a cafeteria area. Again, just a bit odd for our Western views of IVF clinics, but nothing we couldn’t get used to. The IVF clinic was off to the side, right next to the ENT (Ear, Nose, Throat) and Opthamology DepartmentsAgain, a bit different for our Western sensibilities, but that’s the whole point of coming to India and checking things out for ourselves. We walked down the hallway, it was quite cramped and there were lots of people standing around. We had to take off our shoes before we got to the IVF area (we’ve seen this at a few places) and then we were ushered into a tiny office to wait for Dr. Nandita Palshetkar. Her office was much nicer than the cramped waiting area.. it was simple, but modern with a glass desk, large monitor/TV screen on the wall and an exam bed with a curtain drawn around it.
Dr. Palshetkar came into the room. She is a blur of positive energy. (we’re finding that many of the fertility doctors in India have this incredible amount of personal energy – sure wish we could tap into it ourselves!!) We like Dr. Palshetkar, she lets us know that she’s no-nonsense, that she plays by the books and she’s an incredibly hard worker (she’s been up working since the crack of dawn! – she’s already done more ultrasounds and transfers than many doctors will do in a day and it’s barely mid morning!) Bloom Fertility did 2400 embryo transfers last year. Dr. Palshetkar does NOT follow the surrogates throughout the pregnancy. (this was different than most of the fertility doctors that we’ve met with so far… and more like the Western model of surrogacy where the fertility doctor releases the surrogate to her OB after 10-12 weeks pregnant). Consequently, Dr. Palshetkar is not that involved in the surrogacy process, she is the fertility/IVF expert and has relationships with specific outside surrogacy agencies.”
In addition to Mumbai and New Delhi, Kathryn and Lauri traveled to Southern India to meet more physicians and explore other surrogate housing. They travelled to Kochi. Kochi is a vibrant city on the southwest coast of the Indian Peninsula in the prosperous state of Kerula – and is often called ‘God’s Own Country‘. It is a popular vacation spot for wealthy Indians and others who live abroad, and even the airport is hospitable with a vacation feel to it. As they make their way to Bourn Hall Clinic, they meet with Pooja, the surrogate coordinator for their outside surrogacy agency Ethical Surrogacy India. She takes them for a tour of their surrogate housing. Here is an excerpt from their journal after that visit:
“The home was in an upscale area close to the clinic. The women are monitored daily and have an on staff nurse and cook to help make sure they eat nutritiously. The house, like some of the others, was quite lovely. It had cool marble floors – which I’m guessing in the hot summer months is a blessing, and each bedroom sleeps up to three. The women congregated in the living room and seemed happy to be talking and spending time together. They looked healthy and happy. The clinic offers courses while pregnant so they can learn marketable skills for when they are no longer living in the surrogate housing. Like all of the clinics they are allowed to bring small children with them. “
Another highlight of Lauri and Kathryn’s trip was to visit Dr. Kadam at the Corion clinic, also in Mumbai. They found Dr. Kadam to be a very warm, friendly woman that goes well with the overall feeling of her clinic. She was very personable and had an ease with conversation and had a protocol much like Dr. Bakshi’s.
“Dr. Kadam allows the IPs to choose their own surrogate but during a cycle, she will have a few surrogates being additionally prepared, so that if the surrogate that was chosen by the IPs is not having a good response, the cycle does not have to be cancelled. This was an interesting concept to us. Basically, if the surrogate chosen by the IPs was not responding well, then Dr. Kadam would let the IPs know what other surrogates were currently available (and ready for transfer – meaning their uterine linings were well prepared) and then she would allow the IPs to choose one. She would not transfer an embryo into a surrogate until she had approval from the IPs regarding that particular surrogate. “
Like many of other fertility clinics, Corian has a separate but in-house division that handles surrogacy and egg donation. They also house their surrogates in surrogate housing which was about 5 minutes from the clinic. Their clinic is sparser and simple – more Indian like. The surrogates stay in the housing from the time of embryo transfer all the way through delivery. Their children can stay with them – up to the age of 5. The housing can accommodate 20 -25 surrogates at any given time. The house has guards (visitors are allowed until 8pm), a maid, cooks and a staff nurse who visits every day to administer medications. “
Overall, it was clear to Kathryn and Lauri that the surrogates were not living in ‘prisoner- like’ conditions at all. In fact, most of the surrogate housing they saw was quite comfortable. But the most important lesson that we must remember that India is a much different country than the USA, the UK, or even Europe. We all have our own cultures and what Kathryn and Lauri learned on their trip to India was a little about India and it’s cultures – and most importantly a bird’s eye view of their clinics, its operations and how their gestational surrogates were cared for and in general, they were happy to say that they were impressed with what they saw.