Transnational Reproduction Race, Kinship, and Commercial

Surrogacy in India

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Anthropologies of American Medicine:
C u lt u r e , P o w e r , a n d P r a c t i c e
General Editors: Paul Brodwin, Michele Rivkin-Fish, and Susan Shaw

Transnational Reproduction: Race, Kinship,

and Commercial Surrogacy in India
Daisy Deomampo
Transnational Reproduction
Race, Kinship, and Commercial Surrogacy in India

Daisy Deomampo

NEW YORK UNIVERSIT Y PRESS

New York
NEW YORK UNIVERSIT Y PRESS
New York
www.nyupress.org
© 2016 by New York University
All rights reserved
References to Internet websites (URLs) were accurate at the time of writing. Neither the
author nor New York University Press is responsible for URLs that may have expired or
changed since the manuscript was prepared.
ISBN: 978-1-4798-0421-4 (hardback)
ISBN: 978-1-4798-2838-8 (paperback)
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To my parents,
Fe and Dominador Deomampo
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Contents

Acknowledgments ix
Introduction 1
1. Public Health and Assisted Reproduction in India 27
2. Making Kinship, Othering Women 59
3. Egg Donation and Exotic Beauty 95
4. The Making of Citizens and Parents 123
5. Physician Racism and the Commodification of Intimacy 145
6. Medicalized Birth and the Construction of Risk 171
7. Constrained Agency and Power in Surrogates’
Everyday Lives 195
Conclusion 223
Appendix: Profile of Study Participants 233
Notes 239
Bibliography 245
Index 265
About the Author 273

vii
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Acknowledgments

First and foremost, this book would not have been possible without the
generosity and kindness of those who invited me into their homes and
lives in the course of this research. I have changed names and personal
information to protect privacy, and I regret that I cannot express my
thanks to everyone by name. I am grateful to the Indian women I met
who were or wanted to become surrogate mothers and egg donors—
thank you for telling me your stories and for transforming the way I see
the world. I am especially thankful to the woman I call Antara. Antara
welcomed me into her home, fed me delicious meals, and understood
the importance of this research from the very start; without her I would
never have met many of the surrogate mothers and egg donors whose
stories grace this book. I also extend my gratitude to the intended par-
ents and parents of children born through surrogacy in India. I am
thankful they shared their time and experiences with me, amidst stress-
ful stays in India and busy lives with small children. I also thank the
doctors, lawyers, medical tourism agents and brokers, and U.S. Con-
sulate General staff in Mumbai for taking time out from their busy
schedules to assist me in my fieldwork.
Although I studied Hindi before beginning fieldwork, I required
the assistance of translators for my interviews with surrogates and egg
donors (who spoke mainly Marathi and Hindi). Thus, I am greatly in-
debted to my research assistants, Prachi Bari, Kaveri Dadhich, Vasudha
Mohanka, and Mrinmayee Ranade; they proved to be skilled transla-
tors as well as astute observers, and I am grateful for their insights and
service. Prachi, who worked with me in the majority of interviews with
surrogate mothers, deserves special thanks for her enthusiasm for this
project, willingness to travel long distances, and tireless energy even
amid long days of interviews. I thank Abby Rabinowitz and Kainaz Am-
aria for keeping me sane during fieldwork. I owe profound thanks to
Abby, who was working on her own surrogacy project in India when we

ix
x | Acknowledgments

met and who introduced me to several key participants in this research.

Fieldwork in Mumbai would have been far less rich, interesting, and
enjoyable without her. Thank you to the wonderful staff at the Tata In-
stitute of Social Sciences who welcomed me as a visiting research scholar
during my fieldwork in 2010.
I am deeply grateful to Leith Mullings, Katherine Verdery, Murphy
Halliburton, and Rayna Rapp for providing invaluable comments, ad-
vice, and support. Thank you also to fellow writing group members
for your enthusiasm for this project and for always challenging me to
think about this work in new ways: Ujju Aggarwal, Sophie Bjork-James,
Maggie Dickinson, Harmony Goldberg, Andrea Morrell, and Karen G.
Williams.
So many people offered encouragement and support at key junctures
along the way; crucially, they gave advice on research strategies when
I needed it, commented on conference papers and chapter drafts, and
were welcome interlocutors on all topics related to surrogacy and as-
sisted reproduction in India: Aditya Bharadwaj, Risa Cromer, Bishakha
Datta, Rebecca Haimowitz, Marcia Inhorn, Amar Jesani, David Kertzer,
Martha Lincoln, Lakshmi Lingam, Anindita Majumdar, Purnima
Mankekar, Lauren Jade Martin, Sarojini N., Vimla Nadkarni, Sharmila
Rudrappa, Chayanika Shah, Molly Shanley, Nayantara Sheoran, Holly
Donahue Singh, Vaishali Sinha, Sandhya Srinivasan, Elly Teman, and
Cecilia Van Hollen. I must also thank colleagues at the 2011 and 2012
Tarrytown Meetings, as well as the 2014 International Forum on Inter-
country Adoption and Global Surrogacy at the International Institute of
Social Studies in The Hague. Conversations at these meetings pushed
me to think about the social and ethical implications of my research
in critical ways; my sincerest thanks to Marcy Darnovsky at the Cen-
ter for Genetics and Society for inviting me to attend these meetings
and for her ongoing support of my work. Wholehearted thanks to my
current colleagues at Fordham University, especially Orit Avishai, Hugo
Benavides, Evelyn Bush, Ayala Fader, Jeanne Flavin, Christine Fountain,
Allan Gilbert, Micki McGee, Aseel Sawalha, and Matthew Weinshenker,
who offered generous camaraderie and advice on all things teaching and
research related. I am lucky to have landed at such a welcoming place at
the start of my career.
 Acknowledgments | xi

Multiple institutions provided the financial support and time neces-

sary for completing this book. They include the Foreign Language and
Area Studies (FLAS) Fellowship from the University of Wisconsin, re-
search grants from the National Science Foundation and the Wenner-
Gren Foundation, writing fellowships from the Ford Foundation and
the City University of New York, a faculty research grant from Fordham
University, and the Hunt Postdoctoral Fellowship from the Wenner-
Gren Foundation. Portions of this book appear in the journals Medi-
cal Anthropology, Frontiers: A Journal of Women’s Studies, and positions:
asia critique. An earlier draft of chapter 3 benefited immensely from
comments at the Workshop on Intimate Industries in Asia at Pomona
College; thank you to fellow participants as well as to the organizers,
Rhacel Salazar Parreñas, Hung Cam Thai, and Rachel Silvey, and es-
pecially to Rhacel for inviting me to participate. I presented an earlier
version of chapter 6 at the Conference on Population and Development:
Anthropological Perspectives at Brown University; I thank the organiz-
ers, Daniel Jordan Smith and Jennifer Johnson-Hanks, as well as fel-
low participants for their generous feedback. I owe profound thanks to
Jennifer Hammer at NYU Press for her enthusiasm and support of this
project, as well as to the anonymous reviewers whose comments greatly
improved the arguments set forth in this book. I must also acknowledge
the fine editorial work of Kate Epstein, without whom this book would
have been far less readable.
Lastly, I must thank my family and friends who have encouraged and
sustained me, and tolerated endless chatter about surrogacy in India
over the years: Jude, Joseph, Julie, Susan, Jesse, Daniel, Aimee, Erin,
Sarah, Saralé, Melissa, and of course my extended Lorenzo family in
LA. Heartfelt thanks to Sheila and Isaac Heimbinder for being the most
supportive and generous parents-in-law one could ask for; and thank
you to Isaac for tirelessly e-mailing news stories and sending clippings
over the years. My deepest gratitude to my parents, Fe and Dominador
Deomampo, whose own journeys from the Philippines have inspired
my enduring interests in globalization, inequality, and social justice. I
thank them for their unconditional love and support (even when I fol-
lowed a sometimes perplexing and winding career path). I regret that
I could not share this book with my late father and father-in-law; my
xii | Acknowledgments

father’s kindness and care and my father-in-law’s curiosity and interest

nurtured me throughout the years it took to complete this work. Finally,
to my husband, Michael, whom I cannot thank enough for his intel-
lectual engagement and practical support; from reading multiple drafts
to providing childcare, I could not have written this book without him.
And to our children, Mirabelle and Lorenzo, who have enriched my life
beyond measure.
Introduction

On a Sunday afternoon in the midst of monsoon season, I sat in a hotel

restaurant sipping coffee with Eben,1 a Middle Eastern entrepreneur
who had landed in Mumbai several days earlier. Eben’s company facili-
tates surrogacy arrangements in India for prospective parents from all
over the world. Eben, whose daughter was born via gestational surrogacy
in the United States, explained to me the core motivation for starting
his company: to make gestational surrogacy a feasible option for more
infertile straight couples and gay couples like him and his male partner.
According to Eben, most of his clients simply couldn’t afford surrogacy
in the United States, and many of them required the assistance of egg
donation and preferred a white egg donor who might physically resem-
ble them. Yet surrogacy and egg donation in India seemed daunting;
many of Eben’s clients were concerned about the quality of medical care
and viewed India as a chaotic, poverty-stricken Third World country.
Eben thought, pragmatically, “Let’s find a way to mix the two [egg dona-
tion in the United States and surrogacy in India].” His first clients were
a Middle Eastern gay couple; Eben shipped frozen sperm from one of
the male partners to the United States, where doctors used it to fertilize
donor eggs from a white U.S. woman, then froze and shipped the result-
ing embryos to India. There, Indian doctors thawed and transferred the
embryos into the uterus of an Indian woman.
As Eben went on to explain different aspects of his business, he noted
that he does not match clients and surrogates prior to embryo transfer.
Instead, doctors transfer embryos into the wombs of surrogates who
happen to be prepared to undergo transfer at that time, and the commis-
sioning parents and surrogates sign the contract only after pregnancy
is confirmed. In fact, he explained, “Just today I came from a meeting
with twelve pregnant surrogates for my clients. We met today and we
did all these signatures [for the contracts].” As I imagined Eben in a
room filled with a dozen pregnant Indian women, distributing and ex-

1
2 | Introduction

plaining the contents of the surrogacy contracts, I thought about how

this piece of paper, the contract—as well as the fetuses growing inside
them—connected the surrogates to parents who lived half a world away
and whom they would likely never meet.
Several days later, I was sitting on the floor of Nishi’s single-room
home in Nadipur,2 a city located less than forty miles outside Mum-
bai, snacking on samosas and sipping hot chai. Nishi, a surrogate who
was then five months pregnant, proceeded to tell me about her week.
She excitedly told me that several days earlier she had discovered where
her commissioning parent was from: “My client is Muslim! He is from
Dubai, and his name is Omar Chasan.” (Surrogates and doctors typically
refer to commissioning parents as clients.) When I asked how she knew
all this, she explained that she had not actually met Mr. Chasan. In fact,
no one had provided her with any information about him, apart from
the fact that he was a foreigner. Instead, she told me, she guessed the
client’s place of origin from the name she read on the contract she had
signed earlier that week. She went on to explain, “I didn’t meet the client,
I met with somebody else who came to get the agreement signed. He was
carrying twelve contracts with him and we were twelve surrogates in the
room. He took my photograph, asked me my name, and went away.” The
“guest” pressed a five hundred-rupee bill (approximately U.S.$11)3 into
Nishi’s hand, took photographs of Nishi and the other surrogates, and
left with the signed contracts.
I had been meeting regularly with Nishi over the past several months,
so I was struck by the coincidence when I realized that she must have
met Eben on the day she signed the contract—the same day I met with
him, one of just a few for which he would be in India. I thought about
how Nishi’s narrative, like Eben’s presence and departure, revealed con-
nections and absences—connections with a “client,” the future father of
the child she was carrying, who nonetheless remained distinctly absent
throughout her pregnancy and, later, recovery from childbirth via ce-
sarean section.
More connections and absences would unfold in various ways in the
course of my research. That same week, I met with five white South Afri-
can women who had traveled to Mumbai as “traveling egg donors,” four
of whom were returning as second-time egg donors in India. All had do-
nated multiple times in South Africa. They regaled me with their stories