The Health Risks for Women in Surrogate Motherhood: Insights from an Ethnographic Study in Anand and Gurugram, India

In understanding the sociocultural context of reproduction in India, one notes the historical emphasis on fertility and child-rearing for women. This obsessive focus on reproduction and its confrontation with infertility has opened spaces for assistance in reproduction through commercial surrogacy. While the ethics of surrogate pregnancies, the commodification and market intrusion in it, and the demand to recognize it as work-labor have been discussed by scholars and policymakers, little attention has been paid to the health aspects that underpin it. Based on an ethnographic study in two surrogacy hotspots in India, this chapter reflects on the health risks (sexual-reproductive, mental, and social) for women in surrogate motherhood. It argues that in surrogate pregnancies, women have also found empowerment, one that translates into better health opportunities and access. Despite the socioeconomic benefits and the upward mobility resulting from surrogate arrangements, it is undeniable that the challenges faced by women in surrogacy are significant and must be addressed. The sexual, reproductive, and overall health of surrogates should be accorded equal priority. Addressing this issue is crucial to improving the current surrogacy arrangements. Bringing narratives from the field, it argues that the debates on surrogacy should proceed from exploitation only to see it, as empowering and subordinating at the same time and in different ways. It argues for the need to recognize surrogacy as a form of work-labor, one that should be guarded with health provisions that ensure dignity. Addressing this issue is crucial to improving the current surrogacy arrangements. Essential steps include better information dissemination among surrogates, a robust regulatory framework to monitor hospitals and clinics, and the establishment of clear guidelines. Additionally, the issue of over-medicalization of the surrogate’s body, particularly through excessive caesarean sections, must be tackled through improved regulation. Highlighting the inadequacy of laws framed so far, this chapter also points toward the critical role that legislation like the Surrogacy (Regulation) Act (2021) can play towards addressing the challenges that women in surrogacy face. By designing mechanisms for redressing exploitation, it argues that the law can go a long way in making surrogate motherhood more empowering than surrogate women feel it already is.