Medicine, Markets and the Pregnant Body: Indian Commercial Surrogacy and Reproductive Labor in a Transnational Frame
Transnational commercial surrogacy in India is a small but growing
industry attracting media attention as part of a larger popular interest
in surrogacy in the U.S. and elsewhere. The doctors at the clinic in
northern India where I did fieldwork in early 2008 were aware of a
handful of other clinics in the Indian cities of Chennai, Mumbai,
Hyderabad, and Ahmedabad. The path for this industry was paved by
already-existing infrastructures of transportation and communication,
discourses about outsourcing and the cheapness of Indian labor, and
epistemologies of the body and kinship as they have been influenced by
Western science and medicine. These conditions of possibility are
interwoven with the continued development of biotechnologies of human
reproduction in ways that increase the choices of those with access to
these technologies. For women implicated in new technologies through the
biological materials or labor they provide, for example through the
roles of egg donor or gestational surrogate, advances in reproductive
technologies can increase the range of income options while
simultaneously compromising the desirability of these options. The
enabling conditions for transnational surrogacy occur in a context of
contested cultural domains, where multiple understandings of the
significance and social meaning of reproductive technologies have to vie
for traction. By tracing some of these understandings, this article
considers how transnational Indian surrogacy reflects aspects of the
privatization and commodification of reproduction and reproductive
labor. This article also addresses how commercial surrogacy, in the eyes
of some participants, operates within economies of altruism that
re-signify the meaning of the act of surrogacy and the social relations
it entails.
Scholarship on assisted reproduction in India suggests that for the
middle class elites who can afford them, assisted reproductive
technologies can reduce the social stigma for otherwise childless
married women and help provide old-age security for couples who have
been unable to have children in other ways.[1]
There is evidence that
the reach of these technologies is expanding,[2]
but the economic
constraints on women who become surrogate mothers means that women in
their own social and economic strata are not candidates for the
potential benefit of these technologies
themselves,[3] and it therefore
serves as another example of "stratified reproduction."[5]
In early 2008, I observed and interviewed doctors, lab technicians,
clinic staff, commissioning parents who were in the process of having a
child through a surrogate, and women working as surrogates at the
Manushi fertility clinic in northern India.[5]
In the tradition of
medical anthropology, I approached the clinic as a contact zone where
unique interactions and relationships occur, and these constitute the
center of my study. In the tradition of both subaltern historiographies
and feminist methodologies, I aim to point to possibilities in the
subject positions of those from whom I learned during fieldwork without
representing this knowledge as anything but a particular reading
produced from my context as a scholar based in the U.S..
After outlining the surrogacy process at the Manushi clinic, I will
look at how commercial surrogacy in India relies on a Western medical
understanding of the body that constructs the uterus as surplus, and a
genetics-based model of parentage that creates a connection between the
intended parents and fetus, and a distance between the surrogate and the
guest-fetus. I then look at discourses of altruism in the clinic that
contain understandings of the act of surrogacy and the clinic's
surrogacy practice that exceed or supplant this medical discourse and
the associated alienation and commodification of gestation. I look
specifically at how the clinic portrays surrogacy as a form of social
work, emphasizing the ways that fees paid to surrogates through the
clinic materially improve their lives rather than serving only as wages
and profit to the clinic, and the ways that the understanding of the
divine nature of the act of surrogacy provides another narrative of the
meaning and value of commercial surrogacy outside of market logic. I
will conclude by briefly addressing what the co-existence of these
different ways of making meaning about surrogacy suggest about the roles
played by transnational Indian surrogacy and the fertility clinic in
decolonizing and neoliberalizing contemporary India.
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