|LETTER TO EDITOR
|Year : 2014 | Volume
| Issue : 3 | Page : 200
Surrogacy in India: A lifeline or livelihood
Kalaivani Annadurai, Geetha Mani, Raja Danasekaran, Jegadeesh Ramasamy
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Thiruporur, Kancheepuram, Tamil Nadu, India
|Date of Web Publication||5-Jan-2015|
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Thiruporur, Kancheepuram, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Annadurai K, Mani G, Danasekaran R, Ramasamy J. Surrogacy in India: A lifeline or livelihood. J Med Soc 2014;28:200
Surrogacy is a method of assisted reproduction, whereby a woman agrees to become pregnant for giving birth to a child for others to raise.  Surrogacy may be commercial or altruistic, depending upon whether the surrogate receives financial reward for her pregnancy.
Until the introduction of modern assisted reproductive techniques, adopting a child was the only means of helping couples who have a zero chance of bearing a child. In more recent years, either artificial insemination of sperm or transferring fertilized egg has been used in surrogate mother to help childless couples.
Commercial surrogacy is legalized in India since 2002. Indian government has drafted legislation in 2008 and finally framed the assisted reproductive technology regulation draft bill in 2010, that is yet to be passed in the parliament. 
India has become a favorite destination of surrogacy because of legal reasons and also it takes one-third of the cost of what it is in most of the western countries. According to estimates, the business of surrogacy in India is already touching $445 million a year.  There are over 3000 fertility clinics across India, where women can be paid to carry another's child. Clinics charge patients between $10,000 and $28,000 for the complete package, including fertilization, the surrogate's fee, and delivery of the baby at a hospital. Surrogate mothers get insurance cover for 10 months, besides being paid a monthly salary of Rs. 3000. They're paid around Rs. 2-2.5 lakhs after the baby is born. The entire exercise is done through a legal contract. 
Surrogacy carry social stigma in the society as it is equated with prostitution and by virtue of that it is argued that it should be disallowed on moral grounds. Given the extreme vulnerability, one-third of the Indian women due to poverty, exclusion from and marginalization in labor and job markets, patriarchal social and family structures and low educational levels, the financial gain through surrogacy become a key push factor.  In case of surrogacy in India, it is hard to tell that whether these women are exercising their own personal rights or whether they are forced to become surrogate mothers due to their mother-in-law's or husband's desire to fulfill material and financial needs.
Even though, a controversial subject, over the years the attitudes towards surrogacy has changed. This has been evident from the increased number of surrogacy child births in India, as many as 2000 surrogacy births for women overseas, were recorded in India in 2011. 
Although India's first surrogate baby was delivered on June 23, 1994, the practice started receiving widespread international attention in 2004 when an Indian woman delivered a surrogate child for her daughter in the United Kingdom.  In 2008, the Supreme Court of India in the Manji's case (Japanese baby) has held that commercial surrogacy is permitted in India and it has again increased the international confidence in going for surrogacy in India.  The number of surrogate mothers has gone up from 2009.  Surrogacy is a blessing if used in the right manner, but it has been misused on many occasions.
| Acknowledgment|| |
We are very grateful for our institute for their support and encouragement.
| References|| |
Committee on Ethics. ACOG committee opinion number 397, February 2008: surrogate motherhood. Obstet Gynecol 2008;111:465-70.
van den Akker OB. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod 2007;22:2287-95.