Medicine, Markets and the Pregnant Body: Indian Commercial Surrogacy and Reproductive Labor in a Transnational Frame

Medicine, the Body and Power in Decolonial India

Is the process of becoming biological workers for women who participate in commercial surrogacy a process of neoliberal subject-making that echoes processes in the colonial period, when Western medical discourse functioned as part of European experiments with modernity in their colonies?¹ The precise answer cannot be determined without extensive research over time, and in fact might need to be written and theorized in part by the surrogates themselves. At the least, the context of commercial surrogacy in India raises fascinating questions that continue observations about the role of medical discourse, the body, and power made since the time of British colonial rule.

Putting Indian commercial surrogacy in the context of the scholarship on the role of Western medicine in the colonial period suggests that the body has been and remains an independent signifier and site of subaltern modes of being even in the clinic, and even when surrogates themselves at least partially reproduce and utilize the rhetoric of the Western medicalized body. The work of David Arnold and Gyan Prakash tracks the entanglements of empire, economics, science, power, and the formations of culture and subjectivity during British colonial rule. In his work on epidemic disease in 19th century India, David Arnold has demonstrated how the body, and particularly the Indian colonial body, has historically been a site of colonization and conquest.² This observation points to the corporeality of the British colonial project in India, but also yields the body and discourse about the body as sites for contestations of power in Indian history. Indian transnational surrogacy provides an important lens to view ways that specific technologies, instruments of measure and examination, and materializations of the body continue to manifest contested power and subjectivities within medicine as an institution and a global market. For example, the re-formulation of the surrogates’ bodies as empty spaces that can be cultivated to re-produce Western society and Western lives recapitulates the colonial epistemology of land as property, where resources, including native labor, were used to sustain the metropole. This contemporary racialized and gendered political economic relationship rests upon a biopolitical order undergirded by access to technology, in this case reproductive technology.

As political and economic structures in India have been re-organized through independence and later neoliberalization, these precedents have been recast in interesting ways that share continuity with what Arnold observed in 19th century colonial structures of power and governance. We can see evidence of the effort to create neoliberal subjects in the coaching of surrogates into a particular relationship to their body and its abstraction through the medical gaze into parts with specific utility to the market. Similarly, the process of imagining surrogates as workers through the alienation of pregnant women from the process of pregnancy is encouraged by medical discourse and technology. In pointing to the dimensions of transnational Indian commercial surrogacy that operate as a neoliberalized form of reproductive labor, and specifically as a form of biological labor, I aim to contribute to a feminist analysis of the bioeconomy called for by Catherine Waldby and Melinda Cooper in their discussion of human oöcyte vending. They describe such labor as unrecognized as such, due to the fact that it is comprised of giving clinics access to the productivity of women’s bodies, rather than consisting of specific tasks.³ They also note a larger dynamic in the global economy for this “clinical labor,” which, when taken together with scholarship on the trade in human organs⁴ and clinical trial subjects,⁵ points to the outsourcing of the clinical labor with the highest risk and undesirability to populations in the Global South. Masao Miyoshi⁶ has pointed out how transnational corporations, central global neoliberalizing forces, have extended and rearticulated colonialism, and by looking at the global market for biological labor⁷ and clinical labor,⁸ it would seem that neoliberal logics organizing labor markets similarly rearticulate colonial logics.

The meaning of surrogacy to different participants is complicated by their different understandings of the process itself, as well as different understandings, experiences, and expectations of the social relations involved and generated in the clinic. Gestational surrogates at the Manushi clinic are subjected to the medical gaze in a way that they have not been in prior pregnancies, and are encouraged by clinic staff to see their own bodies and pregnancies through the medical gaze in order to work towards separating surrogacy from non-commercial gestation, and to see surrogacy as a way to improve their lives materially through the financial opportunity it provides. Yet surrogates maintain that the divine aspects of their participation outweigh material considerations. The Manushi clinic’s surrogacy practice proves to be a valuable lens for examining the intersection of reproductive technologies, the worldviews and self-understandings of various participants, as well as the general neoliberal disciplining of biological reproduction as a form of labor.

1. Kalindi Vora,”Indian Transnational Surrogacy and the Commodification of Vital Energy,” Subjectivities 28.1 (2009): 266-278; Gyan Prakash, Another Reason: Science and the Imagination of Modern India (Princeton, NJ: Princeton University Press, 1999): 13. [↩]
2. David Arnold, Colonizing the Body (Berkeley and Los Angeles: University of California Press, 1993): 15; “Touching the Body: Perspectives on the Indian Plague,” in Selected Subaltern Studies, Ranajit Guha and Gayatri Chakravorty Spivak, eds. (New York: Oxford University Press, 1988): 391-426; Gyan Prakash, Another Reason: Science and the Imagination of Modern India (Princeton, NJ: Princeton University Press, 1999). [↩]
3. Catherine Waldby and Melinda Cooper, “The Biopolitics of Reproduction,” Australian Feminist Studies 23 (2008): 55, 57-73. [↩]
4. Nancy Scheper-Hughes, “Commodity Fetishism in Organs Trafficking,” Body and Society 7.2-3 (2001): 31-62; Lawrence Cohen, “The Other Kidney: Biopolitics Beyond Recognition,” Body and Society 7.2-3 (2001): 9-29. [↩]
5. Adriana Petryna, “Globalizing Human Subjects Research,” in Global Pharmaceuticals: Ethics, Markets, Practices, Adriana Petryna, Andrew Lakoff, and Arthur Kleinman, eds. (Durham, NC: Duke University Press, 2006); Kaushik Sundar Rajan, Biocapital: The Constitution of Postgenomic Life (Durham, NC: Duke University Press, 2006). [↩]
6. Masao Miyoshi, “A Borderless World? From Colonialism to Transnationalism and the Decline of the Nation-State,” Critical Inquiry 19.4 (1993): 725-751. [↩]
7. Kalindi Vora, “Other’s Organs and the Production of Life: South Asian Domestic Labor and Human Kidneys,” Postmodern Culture 19.1 (2009). [↩]
8. Catherine Waldby and Melinda Cooper, “The Biopolitics of Reproduction,” Australian Feminist Studies 23 (2008). [↩]