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Western couples are now using Indian surrogate mothers to bear their genetically related children. The benefits are: Indian women earn more than they otherwise could in 15 years, and infertile couples get a genetically related child. Given the limited earning potential of many Indian women and the enormous cost of fertility treatments, this can look like a win-win arrangement. But 2 tragedies embedded in this story help explain why it doesn’t sit well with many people: Women in India are so poor that as little as $6000 is equivalent to 15 years' wages, and wannabe parents would rather have a genetically related child than an adopted one, even if it means years of fertility treatment costing tens of thousands of dollars. We should not scorn the couple who turns to a surrogate mother. But why is genetic relatedness so highly valued, and why does another path to parenthood -- adoption -- receive such short shrift? Infertile couples say they are yearning for "a child of their own." Parents of an adopted child would respond that their adopted son or daughter is their "own" child, and that they could not love her any more even if she were genetically related. So the question -- should people in the United States outsource surrogate pregnancy to India -- almost becomes a red herring. Once we've reified genetic relatedness and opened up world labor markets, of course infertile couples will use Indian surrogate mothers. But if we ask ourselves how we got into this conundrum in the first place, we'll see 2 problems that we can work towards fixing: a world of incredible financial inequity and a culture that tells potential parents that only a child made from their egg and sperm is really "a child of their own."
We Physicians Preach What We Practice, and That Matters
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