Transnational Commercial Surrogacy and the (Un)Making of Kin in India [Illustrated] 0199474362, 9780199474363

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Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Title Pages Anindita Majumdar

(p.i) Transnational Commercial Surrogacy and the (Un)Making of Kin in India (p.ii) (p.iii) Transnational Commercial Surrogacy and the (Un)Making of Kin in India

(p.iv) Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trademark of Oxford University Press in the UK and in certain other countries. Published in India by Oxford University Press

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Title Pages 2/11 Ground Floor, Ansari Road, Daryaganj, New Delhi 110 002, India © Oxford University Press 2017 The moral rights of the author have been asserted. First Edition published in 2017 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. ISBN-13: 978-0-19-947436-3 ISBN-10: 0-19-947436-2 Typeset in Trump Mediaeval LT Std 9.5/14.5 by Tranistics Data Technologies, New Delhi 110 044 Printed in India by Rakmo Press, New Delhi 110 020

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Dedication

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Dedication Anindita Majumdar

(p.v) To my parents (p.vi)

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Tables and Figures

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

(p.ix) Tables and Figures Anindita Majumdar

Tables 1.1 IVF and IVF-Surrogacy Costs in US, UK, and India 25 5.1 List of Respondents (Foreign Nationals) Who Had/Were Going to Have Children through the Transnational Commercial Gestational Surrogacy Arrangement during the Fieldwork 141

Figures 1.1 Average Expenditure Involved in Commissioning a Surrogacy Arrangement—Culled from Field and Newspaper Reports (2010–13) 23 1.2 The Process of TCGSA 29 2.1 Components of the Commercial Gestational Surrogacy Agreement 41 3.1 Collage of Indian Matrimonial Advertisements in Newspapers for Brides Wanted 88 (p.x) 3.2a–c Advertisements for Surrogate Mothers and Egg Donors in Hindi Women’s Monthly Magazines 89 3.3 ‘Eligible’ and ‘Ineligible’ Wombs in Altruistic Gestational Surrogacy 93 5.1 How to Get Your Baby Back Home in ‘3 Easy Steps’ 143 6.1 Philip and Trent’s Children 181

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Acknowledgements

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

(p.xi) Acknowledgements Anindita Majumdar

I remember my first meeting with Trent and Philip in a south Delhi neighbourhood in 2010. Their warmth was infectious, their joy evident, and their desire to share their story with me made me embark on my ethnography with more confidence. Over the years, we have stayed in touch—primarily through Facebook, where I have seen their three children become young school-goers. This book concludes with the story of Philip and Trent’s children, as do the many other children mentioned in my ethnographic study, who are going to school and becoming engaging youngsters. Their parents’ pride is obvious and infectious; I feel like I am part of their upbringing, thanks to the shared stories and my continuous communication with parents who opt for surrogacy. It is with a deep sense of gratitude that I would like to thank all these parents who gave me access to their lives, their children, and their personal stories. The same goes for my anonymous surrogates who were equally affectionate, even though at times the sadness in their eyes would tell another story, but without whom this tale of making and unmaking kin would have been incomplete. And yet this ethnographic study was ‘conducted’ in clinics, in spaces of medicine and commerce, in embassies, and in lawyers’ chambers. Everywhere the in vitro fertilization (IVF) specialist, the (p.xii) surrogacy lawyer, the bureaucrat in the consul office, the journalist and the documentary filmmaker, and most importantly, the surrogacy agent who traversed many spaces—of the clinic, the corporate office, and the local neighbourhood—came to my aid. They helped me get access, circumvent obstacles, and ask questions. Unfortunately, I cannot name them, but my thank you to all of them.

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Acknowledgements Since 2010, when my guide gently nudged me towards commercial surrogacy, I have been in debt of her intellectual and emotional support. Ravinder Kaur guided me towards a fruitful combination of my twin interests in kinship and medical anthropology. Her support of my writing and intellectual pursuit at the Indian Institute of Technology Delhi (IITD) has been absolutely essential. There are others who guided me through my initial journey in academia and through the writing of this book: Farhana Ibrahim, who encouraged me to write, giving critical feedback and support; Rita Brara, my teacher when I was completing my masters at the Delhi School of Economics (DSE), University of Delhi, who continued to give valuable inputs on my doctoral committee; Mohan Rao at the School of Community Medicine and Social Health, Jawaharlal Nehru University (JNU), New Delhi, who showed steadfast conviction that research on commercial surrogacy is topical and relevant; Rajni Palriwala, my MPhil supervisor at the DSE, who taught me how to write; Amrit Srinivasan at IITD, who believed that my research had potential and value; Sanil V., also at IITD, who pushed me to problematize kinship by reading works by Pierre Clastres and Judith Butler. My intellectual growth is, to a large extent, a token of gratitude to both the DSE, University of Delhi, and to the Department of Humanities and Social Sciences, IITD. Both these institutions helped me grow and understand my limitations and valued my research at critical moments. At DSE, Yasmeen Arif and Janaki Abraham were great teachers; Amrita Ibrahim was a great collaborator and critic; and at IITD Suman Sigroha, Paro Mishra, Gurmeet Kaur, (p.xiii) Mahendra Shahare, Lalita Sharma, and Junaid Hamdani cheered me on through the five intense years of research. Sarbeswar Sahoo, Reetika Khera, Simona Sawhney, and Arudra Burra at IITD have given encouragement and support even after the PhD. The Indian Institute of Technology Delhi had supported my research through a doctoral grant, and also facilitated travel to conferences and workshops abroad. The libraries at IITD, DSE, Teen Murti Bhavan, and Sahitya Akademi have come to my rescue in the course of my research and writing. Shalini Grover has been a wonderful academic colleague, guiding me through my PhD by being part of my intellectual conversations. Helle Rydstrom at the University of Lund, Sweden, found merit in my research and has encouraged me during my post-PhD stint at the Department of Gender Studies at Lund. Matilda Svensson Chowdhary, Maria Tonini, and Sara Goodman have been fantastic hosts and academic collaborators at Lund. I have been in conversation with fellow researchers, Holly Donahue-Singh and Daisy Deomampo, since we came to know of our shared interests in infertility and South Asia.

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Acknowledgements Gaining access to key respondents and sites in the field was initially a Herculean task. It was primarily thanks to the following people that I was able to bypass ‘gatekeepers’ or simply gain entry: Payal Kumar, Aimee Ginsburg, Srividya Rajaram, Jitin Chadha, Meghna Aggarwal, Simran Chadha, and Aparna Gupta. Their support and recommendation has been invaluable in establishing rapport. My special thanks to the Sama Resource Group for Women and Health, whose pioneering work has informed my doctoral and postdoctoral research in assisted reproductive technologies and commercial surrogacy. At Sama, Sarojini Nadimpally and Deepa V. continue to be mentors and collaborators; and Vrinda Marwah, Nazia Hassan, Prachi Joshi, and Vaibhao Ambhore as my post-PhD companions have contributed much to the writing of this book. (p.xiv) To Gayatri Koshy and Chandan Bose, a heartfelt thank you. They have been my intellectual companions since 2001 and guided me through the madness of writing, thinking, and critiquing. Their support, even though in different parts of the globe, has been invaluable. And thanks to Vineeta Rai for encouraging me to aim high. At Manipal, where this book began to take its final shape, thanks to Sundar Sarukkai, Nikhil Govind, and Gayathri Prabhu. Mrinal Kaul helped me focus and write the final drafts as we talked of language and anthropology over many cups of coffee. Varun Bhatta and Asim Siddiqui stood steadfast, coming to my aid whenever asked for. Thanks also to Dr Pratap Kumar for giving me access to the process of in vitro fertilization at his clinic that helped me understand the medical process in its entirety. And to Dr Praveena Pai who helped me see the ethical questions that medical practitioners face. I cannot forget to thank my students: from Jesus and Mary College, University of Delhi, where I began my teaching career, to engineering undergraduates at IITD, and finally to the masters’ students at Manipal Centre for Philosophy and Humanities—they have provoked me to think constantly and engage with anthropology anew. Last, but not least, without the constant and unwavering support of Archana and Gautam Majumdar, this book would not have seen the light of day. Their involvement was complete: from conversations to facilitating my research and writing in an environment that was comfortable and welcoming. Mayabhushan Nagvenkar has seen this book through. He has pushed me to write and think through the fieldwork and later. His constant questions about my research have made it better and more relevant. Thank you. Anindita Majumdar Hyderabad Page 3 of 4

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Introduction

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Introduction Transnational Surrogacy and the Making of Kin Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0001

Abstract and Keywords Chapter 1 introduces the reader to the practice of transnational surrogacy by looking at its scope, brief history, and the academic research on it. The chapter also gives an overview of the major theoretical debates that the book engages with, along with an overview of the chapters. Keywords:   reproduction, law, kinship, processual kinship, transnational trade, body trade, biology

In an air-conditioned conference room in one of the many significant government buildings in New Delhi, a high-level meeting is convened to discuss the draft legislation on assisted reproductive technologies in India in October 2015. In reality, the discussion is on transnational commercial surrogacy. Representatives from the Indian Council of Medical Research (ICMR—the author of the draft legislations and its many versions), the famous Nayna Patel (the doctor from Anand, Gujarat, the self-declared pioneer of commercial surrogacy in India), civil society activists, feminists, and academicians crowd the room along with representatives from the different state women’s commissions. There is anxiety at many levels, for whispers regarding a ‘ban’ circulate within the room. The central government is keen to regulate the ‘burgeoning’ commercial surrogacy ‘industry’ to protect the rights of poor women who become surrogates and the children who may be abandoned by foreign couples in case of problems with citizenship, or worse, disability.1 The draft bill circulates for discussion, (p. 2) critique, and debate; and it becomes evident that the anxieties are not unfounded. The government is thinking of a ‘ban’ in ‘hiring of our women’s Page 1 of 24

Introduction wombs’ by foreigners, and may also eventually ban commercial surrogacy altogether in favour of altruistic surrogacy. The shock and discomfort is evident, and for a brief moment the medical fraternity seeks allegiance with feminists (both of whom are otherwise at loggerheads over the rights of the surrogates) to curb this alarming development. The claims to protect the rights of the surrogate are espoused by both the doctors and the feminists and suddenly the draft law is not in focus anymore, as state representatives claim that commercial surrogacy as a practice is socially unacceptable and should be controlled. One government functionary calmly states: ‘I support the state’s desire to ban commercial surrogacy. Our culture has in-built mechanisms to tackle infertility. If a woman is unable to reproduce, the family steps in—often the sister-in-law would become a surrogate. We should have faith in the Indian family system to tackle the problem of infertility.’ It is the protection of social relationships within a practised milieu of tradition and modernity that later prompted the government to file an affidavit with the Supreme Court of India asking it to regulate commercial surrogacy so that it may be available to only ‘needy Indian couples’. Very soon after the aforementioned meeting, the Government of India suggested in its affidavit that foreign couples be banned from contracting commercial surrogacy arrangements in India.2 Earlier in 2013, in a memo from the Ministry of Home Affairs, Government of India, medical visas were made mandatory for foreigners coming into India to contract a surrogacy arrangement, and entry was restricted to married heterosexual couples.3 The Draft Regulation of Assisted Reproductive Technologies Bill (by ICMR) has itself been through many avatars (2008, 2010, 2012, 2014, 2015)—but only two of them have been circulated for public opinion and inputs. Though the Bill has sought to regulate the practice of assisted reproductive technologies (ARTs) such as (p.3) in vitro fertilization (IVF),4 the conversation has always been on surrogacy. It has been about the surrogate and her rights, as well as about the idea of parenthood itself. In the intermingling of technology, sex, and the family lies the complicated terrain of transnational commercial gestational surrogacy in India. The draft law on technology regulates bodies, relationships, and eligibility rather than the use of the technology. This is telling because it points towards the ways in which commercial surrogacy poses foundational questions about how we think and assume kinship to be what it is. Commercial surrogacy disrupts the taken-forgranted nature of our intimate relationships, through technological interventions in the form of IVF, and by involving third-party participation in the form of egg and sperm donors, and the gestate.

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Introduction In addition, even though these questions have been the focus of conversations in the academic research in the US and UK, in India the transnational nature of the commercial gestational surrogacy arrangement has disrupted many ideas of being and belonging.

The Cast of Characters At Surrogacy and Fertility Centre, one of the popular IVF surrogacy clinics in south Delhi that was part of my ethnographic study in absentia,5 a majority of its foreign clientele came through the recommendations of other couples who had successfully had babies through surrogacy at this clinic. ‘Dr Rupa’ (pseudonym), the owner–IVF specialist, advertised her clinic effectively by ‘posting’ details of the number of children born through commercial surrogacy at her clinic (and their parents’ nationality) on social networking websites and on her blog. In 2015, she was also part of an international surrogacy conference in Australia where she delivered a lecture, which was posted on her blog. Her participation was facilitated by a group of Australian gay fathers who had had babies through the clinic. Until recently, one of the fathers (p.4) had also acted as a liaison between prospective couples wanting to enter the surrogacy arrangement in India, and Surrogacy and Fertility Centre. However, such quasi-formal arrangements were not feasible with the growing demand for commercial surrogacy amongst Indian and foreign couples. This is why professional surrogacy agencies began to enter the expanding ‘surrogacy market’. ‘Building Futures’ (pseudonym) was one of these surrogacy agencies. It was part of a global conglomerate that sourced egg donors and surrogates from Europe, India, and elsewhere where surrogacy was legal. The company was headquartered in Georgia in the erstwhile Eastern Bloc and had branches in Southeast Asia, besides India. The agency was an ‘intermediary’ connecting couples to clinics, clinics to surrogates, and surrogates to clinics and couples. It maintained a database of egg donors and women wanting to be surrogates. The director of the agency, Andrea from Georgia, spoke of how Building Futures ‘[I]s information network ... we have IVF, surrogacy and egg donation in Armenia, Georgia, Ukraine, India ... currently we are heading to Europe ... we plan to open our own IVF clinic ... and ... a European clinic …’ With approximately four to five cases every month seeking surrogacy and IVF treatment, the agency was doing well in India—by mid-2012 (a year after the above interview) they had already opened an independent IVF clinic in a busy New Delhi neighbourhood. Building Futures, India, coordinated with their other worldwide branches to source Caucasian egg donors—in great demand amongst foreign couples coming to India to have babies. These donors would be brought to India on an allexpenses-paid trip to donate their eggs. The company organized for their accommodation, travel, medical appointment, and translators in case they did not know English. The preferred egg donor was below 30 years of age and married with one living child.

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Introduction One of the Czech egg donors had come to India to meet the commissioning couple Daniel and James. They were exploring the (p.5) surrogacy option through their agents Building Futures and another Delhi clinic Miracle Babies. In September 2011, after hiring the Caucasian egg donor, they were waiting for a suitable surrogate. Daniel and James were relieved that they had contracted their surrogacy arrangement (with the agency and the clinic) before the new law in Australia, which prohibited commercial surrogacy arrangements overseas, came into effect. The idea of a suitable surrogate was a notion constructed by IVF specialists, couples, and agents. Renu was one of them—she was docile, obedient, clean, and meticulous about her medication. She had given birth to a boy for a Black British couple in 2010. Renu had heard about surrogacy from one of her neighbours who had shown her a newspaper advertisement asking for women willing to surrogate a baby. In Allahabad, the city in the north Indian state of Uttar Pradesh where Renu lived, surrogacy and IVF were unheard of. After seeking the advice of the local gynaecologist, she had undergone a successful surrogacy at Metro IVF clinic—a clinic in central Delhi run by a charismatic IVF specialist and his gynaecologist wife. Back home, Renu’s family consisted of her husband who was a chauffeur, and her two children. She had also adopted the infant son of her deceased sister. Renu lived in a partitioned unit of her husband’s joint family household and had managed to keep her work as a surrogate mother a secret from the rest of the household. During the pregnancy, she had availed of the option of living in hired accommodation provided by the clinic, where she shifted in the third month of her pregnancy with her children and husband. In 2011, she was desperately looking to enter another surrogacy arrangement. These are some of the ‘characters’ from the ethnography that form the ‘global reproductive assemblages’ occupying the terrain of fertility tourism and transnational commercial gestational surrogacy in India. ‘A global assemblage is a collection of heterogeneous elements characterized by contingency, structure, organization, and change that reflect the manifestations, tensions, (p.6) and contradictions intrinsic to global processes’ (Browner and Sargent 2011: 9 citing Ong and Collier), but is nonetheless also very much embedded within ‘local biologies’ (Lock 2001) and morals that ultimately guide and make new forms of global life and processes. In that sense, ARTs, clinics, people, and relationships configured in transnational commercial gestational surrogacy are fitting examples of ‘how the “local” confronts the “global”: how local cultural factors reshape and sometimes constrain how global technologies are to be used’ (Inhorn 2002: 266). The Transnational Commercial Gestational Surrogacy Arrangement (henceforth TCGSA) places different sets of people in an intimate, yet distant relationship. Each of the participants in the arrangement is unrelated to each other, not only in terms of kinship ties in the conventional sense, but also in terms of being Page 4 of 24

Introduction socially distant. The social distance is exacerbated in case of the class and cultural differences between the participants. This plays out especially in the relationships between the surrogate mother and the intended parents, and between the doctors/agents and the surrogate. In this book, I examine how people occupied multiple intimate relationships across sociocultural spaces giving TCGSA its peculiar character.

Conflicted Kinship: Sex, Biology, and the Social In the different forms of surrogacy—especially genetic and gestational—the interface with the technology in creating a child for those unable to have it through sexual intercourse is evident. Technological innovations have facilitated asexual reproduction/ procreation, involving more than the two people required to create and birth a child. Thus, the different types of surrogacy involve people in relationships of intimacy and obligation due to the technological interventions that bring them together. While science and technology are able to provide alternatives to making kin in ways other than the conventional means of sex, marriage, (p.7) friendship, and obligation, the real question is our desire for biological kin. Born from our bodies, connected to our bodies, connected to ties of biological intimacy—we understand kin and kinship primarily through biology. Contemporary biology is at the cusp of new discoveries, reconstructions, and ideas—but the sociological–anthropological questions that come to mind are regarding the ways in which biology is perceived, understood, and constructed. So, when anthropologists speak of de-biologizing, re-biologizing, and reconstructing biology (Franklin 2003) what do they mean? Does it mean that biology as we know it has changed completely? If it has, what is biology in its ‘pure form’? Is it the gene? Or is it the fusion of egg and sperm? Or is it the DNA? What is biology? The metanarrative of biology continues to inform the contemporary study of kinship in anthropology. Exploring its sociocultural formulation has been the focus of many ethnographic studies and analysis. This book explores kinship from the vantage point of the new kinship studies (Franklin and McKinnon 2001) that emerged in reply, and critique to Schneider’s study of kinship in American society (Schneider 1968; Yanagisako and Delaney 1995). Through the analysis of kinship as it is understood and practiced in commercial gestational surrogacy in India, the attempt here is to explore the ways in which the anthropology of kinship has analysed the question of biology in interpersonal relationships. For some time now ‘reassembling’ the social (Latour 2005) by unpacking biology has been a favourite project of sociocultural anthropologists and sociologists, as is evident in the study of kinship. ‘[T]he biological and the social are coproduced and dialectically reproduced … the material and the social are both contingent …’ (Lock 2001: 484, emphasis in original). Thus, the ‘culturalbiologicals’ (Goodman 2013: 361) are moving, multiple biologies that are understood, constructed, and reconfigured within the sphere of multiple global– Page 5 of 24

Introduction local cultural contexts. In anthropological research findings the culturalbiologicals are ultimately resolved and tied together ‘neatly’ in what appears to be (p.8) a conflicted negotiation between nature and culture, biology and sociality, and nature and nurture. Thus, even though ‘nature’ is fractured into blood–biology–gene–DNA, ultimately these elements of nature are resolved in their multiplicity. It may be in social perceptions regarding kin and non-kin (Dow 2009; Edwards 2009), in the idea of risk that connects and disconnects relatives through diseases (Featherstone et al. 2006; Finkler 2001; Gibbon 2007), and in practices of reclaiming ‘strangers’ as one’s own (Carsten 2000b; Modell 1986; Sharp 2006)—biology provides the ideological apparatus par excellence in the study of kinship. Here, fictive kin are represented as fictions of the ‘real’ thing— biological kin. This is also true to some extent for relatedness and ideas of kinmaking through ‘alternative’ folk ideas such as locality (Lambert 2000a, 2000b), food (Carsten 1995), and friendship and choice (Weston 1991). Thus, when researching a practice of ‘making kin’ through assisted reproductive technologies, one must place biology at the centre. This is not just ‘nature’ in the classical–anthropological sense, it is truly the pursuit of ties of blood, genes, and connections. Kinship has constructed biology in ways that connect it to the social and vice versa. In addition, the practice of commercial gestational surrogacy engages with biology at many levels. To begin with, the possibilities included in commercial gestational surrogacy are a unique starting point itself. 1. In case of a heterosexual couple where the female partner is unable to carry a pregnancy—the eggs may belong to her, the sperm to her male partner, and the Indian surrogate carries the pregnancy. 2. In case of a heterosexual couple where the female partner is unable to gestate and contribute her eggs to the pregnancy—the eggs may be taken from an anonymous donor (Indian/White or any other race) or a relative, the sperm belongs to the male partner, and the Indian surrogate carries the pregnancy. (p.9) 3. In case both partners in a heterosexual relationship are unable to contribute eggs or sperm—there are anonymous/known sperm and egg donors and the Indian surrogate. 4. In case of a homosexual couple (more often a male homosexual couple) —one partner’s sperm (even though both may have contributed), may fuse with the egg of an anonymous/known donor (belonging to different racial and ethnic configuration), and the Indian surrogate. 5. The single woman/man contributes her/his egg/sperm as the commissioning individual along with the sperm/egg of known/anonymous donor and the Indian surrogate.

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Introduction The combination of gametes from foreign/Indian couples/individuals, anonymous donors of eggs and sperm, and Indian gestational surrogates—as well as a global technology operated through Indian medical expertise—has fuelled the need for renewed enquiry into the notion and practice of kinship. The intersections of race, culture, class, and governments in the commercial gestational surrogacy arrangement in India have led to unique negotiations with kinship and family. While disruptive of the traditional role and identity of motherhood—gestational surrogacy creates avenues for renegotiating these same categories. How do we then begin to understand and study commercial gestational surrogacy as a new form of engagement with kinship? How is biology configured in intimate relationships within a practice that engages peoples, borders, bodies, genes, and technologies across a transnational canvas? Where else in contemporary practices of ‘kin-making’ (besides transnational adoption) are gametes of foreign couples ‘incubated’ in Indian wombs? In the documentary Made in India (directed by Haimowitz and Sinha 2010) the plot unfolds across the global–local spaces of Texas, USA and Dharavi, Mumbai, India. These two spaces occupied by the American commissioning couple Lisa and Brian Switzer, and Aasia Khan, the Indian gestational surrogate (p.10) mother, respectively, are mediated through ‘liminal third spaces’6 (Bharadwaj and Glasner 2009) of the IVF clinic and the reproductive tourism agency. Rotunda, the Mumbai clinic that administers the treatment and commissions the arrangement on behalf of the Switzers; and Planet Hospital, the agency based in the US traverse the ‘glocal’ relationships that emerge in the transnational commercial surrogacy arrangement. The documentary highlights the movement between spaces, people, relationships, and governments as they come together in TCGSA. In such a context, as foreign, heterosexual, and gay couples form a significant section of the commissioning couples having babies through commercial gestational surrogacy in India (especially vis-à-vis the ethnography discussed in this book), I wish to question the idea of an emerging diaspora of families that ‘investigates what might be gained by reconceptualizing diaspora not in conventional terms of ethnic dispersion, filiation and biological traceability, but rather in terms of queerness, affiliation and social contingency’ (Eng 2003: 4). Here, I suggest that TCGSA in India actually involves a resurrection of ideas of biological traceability, while at the same time invoking ideas of social contingency especially when seen from the perspective of love and care. This involves a fascinating and dynamic interaction between interpersonal relationships and reproductive technologies. Thus, I posit that TCGSA is fertile ground for the examination of cross-cultural engagements with kinship and technology. The blending of Euro-American notions of kinship, biomedical ideas of kin and ‘kinning’ (Howell 2003) with South Asian ideas and practices of kinship and relatedness leads to important questions. What are the mechanisms by which kinship is understood and practiced in a comparative and crossPage 7 of 24

Introduction cultural milieu? How does biology and the social come to be configured within kinship in TCGSA? Or do they become redundant? How can anthropology develop a more nuanced notion of interpersonal relationships in a global, transnational setting? More importantly, are we in the realm of global transnational relationships? (p.11) ‘Transnational relationships’ have been the focus of many studies, each pointing towards the emergence of intimacy across borders—bound by and yet released from the confines of border identity. Included within such relationships are those of transnational marriages (Constable 2003; Faier 2007); transnational adoption (Dorow 2006; Howell 2001, 2003; Yngvesson 2010); and transnational care work (Parreñas 2001). In each of these engagements, different cultures intermingle, collide, and navigate bureaucratic hurdles of acceptance and delegitimation. The intimate in such an understanding undergoes upheavals and redefinitions. The ambivalence exhibited in adopting a child from China by Norwegian or American parents is seen in the efforts to assimilate the child without divorcing her from the culture of her birth (Dorow 2006; Howell 2003). Similarly, in wanting to retain the conjugal tie built with White American men, Filipino women are filled with anxiety while waiting for their American visas (Constable 2003). Again, Filipino women working as care workers in Rome and California try to keep alive their children’s love for them through gifts and money (Parreñas 2001). In case of transnational commercial gestational surrogacy, this is felt through the navigation of different cultures in facilitating the birth of the child (Deomampo 2013a). Is TCGSA a new way of approaching relationships that are global and transnational in character and identity? ARTs, surrogacy, and adoption have created possibilities of configurations amongst kin that may not necessarily be seen as ‘new’ (Schneider 1997). However, emerging research points towards the dynamism of cross-cultural kinship practices in the use of ARTs that are redefining the study of kinship in its theoretical core (Bharadwaj 2003; Pande 2009a; Roberts 2009). For instance, the process of ‘vernacularization’ of biomedical technologies actively combines religion and ‘local’ kinship ideas in differing cultural contexts (Simpson 2013). Thus, IVF and ARTs are unable to sustain universalized Western notions regarding science and technology and its impact on human lives. Ethnographic encounters with (p.12) ARTs in other parts of the globe point towards how they become subject to localized manifestations. Hence, ARTs take on ‘mutating’ characteristics (Inhorn and Birenbaum-Carmeli 2008) that differentiate the Indian (Bharadwaj 2007), from the Ecuadorian (Roberts 2007), the Egyptian (Inhorn 2009), the Vietnamese (Gammeltoft 2007; Pashigian 2009), to the American (Rapp 2000) experiences of IVF/ARTs. Essentially in such encounters, biology or ‘“Bio” … can be visualized as an ethnoscientific rendition of the “human biological” and as such stands—not necessarily opposed to—multiple cross cultural conceptualisations of human biology. Thus, bio can be gainfully conceptualised as an instance of biologically based biography, be it individual or Page 8 of 24

Introduction institutional’ (Bharadwaj 2007: 102). However, is the cross-cultural ‘encounter’ of kinship, kin, and technology so ‘fluid’ and easily translatable? Ultimately, the ‘procreative universe’, ‘a sociocultural space which in some way embraces the complex reality in which biotechnologies and assisted conception are embedded’ (Melhuus 2012: 4) is not universal. It is marked by differences where the cultural ideas of conception form an active field of multiple conflicts. It is these conflicts, differences, and multiplicities that this book wishes to engage with. However, in favouring multiplicities, one must give precedence to multiple ways of being and relating. In this endeavour, one is engaging with the study of ARTs and surrogacy within a transnational lens. Questions regarding kinship are analysed from the frame of processes and practices. The processual analysis of kinship though a long-term endeavour (Carsten 1995) is employed in the thesis to look at the entire surrogacy arrangement as it unravels in the respondents’ narratives. The processual view is both dynamic and diachronic. It also includes the many negotiations and conflicts that mark the practice of practical kinship (Bourdieu 1990; V. Das 1995). Yet, one cannot forget, ‘[a]nalyses that treat kinship as a fluid process rather than a “state” suggest the emergence of a new kind of anthropology, in which scholars have finally (p.13) succeeded in moving beyond the assumptions of a genealogical framework … the situation is not quite so simple … genealogical thinking permeates more than Euro-American conceptualizations of kinship’ (Bamford and Leach 2009 [2012]: 10–11). It is in reply to, and exploration of, the ‘genealogical thinking’ that TCGSA proves to be especially useful. In addition, in TCGSA, genes and kin are marked especially by the idea and conceptualization of mothers and fathers. When exploring a crosscultural engagement with parenthood, I begin purposely with the way in which popular cinema in India thinks of the mother and the father in surrogacy— reminding us that as practices surrogacy and third-party kin-making are not new.

Mothers, Fathers, and Others: Identifying Parentage in Surrogacy The analysis of surrogacy in relation to motherhood has focused on the biological–social tie. The break in motherhood as seen in the surrogacy arrangement overturned ideas previously uncontested within kinship (Barnes 1975). As the tie closest to ‘nature’, the biological given-ness of motherhood, especially through the visible pregnancy, made it the other taken-for-granted foundation besides sexual procreation in the anthropology of kinship. For Barnes, fatherhood however was not similarly imbued. The possibility of two fathers made it contestable as opposed to motherhood. Yet, just as surrogacy challenges the unitary notion of motherhood, it similarly places the father as the only genetic–biological ‘standard’ within the arrangement. Therefore, while two mothers try to create meaning out of their links with the foetus, the father’s biological contribution in his donated sperm goes uncontested and is rarely Page 9 of 24

Introduction explored. The aspect of fatherhood within the surrogacy arrangement has been explored minimally by some researchers (Berend 2010, 2012; Pande 2009a; Ragone 1994, 1996) and will be discussed at length later in this chapter. The primary focus has (p.14) been on the mother(s) and the negotiations entailed in assigning identity, and to the kind of relationships that develop between the two women. Mothers in Popular Representations of Surrogacy in India

Motherhood in its fractured biological role of pregnancy and genes comes to embody surrogate pregnancy. The social conflict that surrogacy creates is primarily in relation to disrupted motherhood. This is most in evidence in films on surrogacy in mainstream Hindi cinema. The role of multiple mothers is played out in the context of the Indian mother as an ‘ideal’—juxtaposed with the nation and as a eulogized role for all women (Bagchi 1990; Bhattacharji 1990). Thus, the primary conflict is seen between the surrogate mother and the adoptive mother both of whom try to claim ownership over the nurturance of the child. Films on surrogacy tend to showcase the social ambivalence in the tie through the womb, as well as in that of marriage with the intended father especially in relation to the idealized representation of motherhood. Two films, Doosri Dulhan (directed by Tandon 1983) and Chori Chori Chupke Chupke (directed by Abbas and Mustan 2001), portray the surrogate mother as a ‘fallen woman’ willing to have sex with the intended father, and subsequently relinquishing the child conceived to the adoptive mother. They are portrayed as aberrant women in their ‘unmaternal’ desires to relinquish their own child. This is done through the continued juxtaposition of the arrangement with money. Madhubala, the prostitute–surrogate in Chori Chori Chupke Chupke says: ‘Pet ke vaste kamati thi, aaj pet hi kamake dega’ (I used to earn to feed the stomach, now the stomach will earn for me). The overt commoditization of their own bodies is seen in shots in both the films (Chori Chori Chupke Chupke was ‘inspired’ by Doosri Dulhan) where the prostitute–surrogates Madhubala and Chanda, respectively, are seen to haggle for the exact amount to be (p.15) paid for the entire arrangement. However, as the pregnancy draws to a close, this aberrant behaviour is overturned to reveal the surrogate mother as a woman drawn to her ‘natural-maternal’ tendencies of mothering and motherhood. Both Chanda and Madhubala get increasingly attached to the child they are carrying through their love for the intended fathers. This is a source of conflict for the adoptive mother who finds herself being excluded not only from the child she is waiting for, but also from her husband. The ‘natural’ attachment that a pregnancy creates in the woman for the foetus is a common theme in films on surrogacy. Even the cold-hearted, commercialprostitute-turned-surrogate is not able to escape her body’s destiny—even though her body is constructed for pleasure and not for motherhood (S. Ghosh 2011).7 In films where a friend of the adoptive mother plays the surrogate Page 10 of 24

Introduction mother this dilemma of natural attachment occurs again. In the early 2000s, after Chori Chori Chupke Chupke was released and went on to become a box office hit, Hindi films were exploring the idea of an altruistic surrogacy arrangement where the friend of the adoptive mother is willing to incubate a pregnancy for her. As a possible sign of acceptance of differing forms of family configurations, or possibilities of the same Filhaal (directed by Gulzar 2002) and Janani (directed by Bahl 2006) explored the theme of the friend-as-surrogate, but resurrected the conflict between the two mothers in the plots—in negation of alternative family forms. The refusal to relinquish the child in case of Janani leads to a complete breakdown in relationships between the surrogate and the adoptive mother. Here the tie of friendship and obligation that led to the birth of the arrangement is strained. Until, that is, the surrogate mother sacrifices her rights to the child. In this way, she overturns her aberrant motherhood by pandering to the idealized notions of motherhood as sacrificing. Similarly, the prostitute-surrogate in the earlier films too redeems herself by recognizing the adoptive mother as the mother by virtue of her earnest ‘desire’ and rightful claim—and eventually sacrifices the child. (p.16) The focus on motherhood within surrogacy also draws from certain cultural ideals of mothers and mothering. Thus, the relationship is seen within frames of altruism and sacrifice placing the surrogate mother within an acceptable lens vis-à-vis her relationship with the unborn child and the adoptive mother. This ‘altruism’ is played out in the relationship between the surrogate mother and the ‘adoptive social’ mother in the act of gift-giving that the surrogate enacts to transfer motherhood to the latter (Pande 2009a; Ragone 1996; Teman 2010; Thompson 2001). This involves strategies that Teman calls ‘birthing a mother’, in which the surrogate mother treats the pregnancy as alien and encourages the adoptive mother to participate in it. Ragone (1996) finds, similarly, that the genetic surrogate mother privileges the role of nurturance more than that of the pregnancy and gestation. The biological tie of kinship is made subordinate to the cultural nurturing role to displace the pre-eminence of the surrogate as representative of dominant notions of motherhood. Here, the role of the father is performed in the background. The fear of the unsaid implied sexual relationship between the intended father and the surrogate mother involves a different set of negotiations altogether. The role of motherhood is also wedded to that of the wife and marriage in the popular imagination. In the films discussed earlier, the surrogate mother is unable to fulfil this basic requirement that must link her to the father of the foetus she is carrying. Sexual relations do not confirm that tie—it is only the tie of marriage that grants legitimacy. The father within the surrogacy arrangement becomes an important locus for the mediation between the identity-giving process to the mothers within the arrangement. It is to him that we turn to next.

Page 11 of 24

Introduction Fathers and Others in the Surrogacy Arrangement

Despite the possibility of multiple fathers, especially in the use of donor sperm or in case of a male gay couple seeking surrogacy/adoption (Bergman, Rubio, and Padron 2010; Stacey 2006), in (p.17) anthropological analysis of surrogacy the ‘position’ of the father remains unscrutinized. Instead, research points towards the ways in which the surrogate mother and the adoptive mother negotiate the relationship with the father during the pregnancy. As Ragone (1996) notes, the father is purposely pushed into the background in favour of the adoptive mother—both to underscore the threat of a third-party involvement in the marital dyad, and also to give prominence to the nurturing role of motherhood. Thompson (2001) finds such negotiations to be even more acute when the surrogate is a relative of the intended parents. Thus, in a case where the surrogate was the sister of the intended father—the underlying incestuous relationship was negated in favour of the genetic tie the foetus had to the adoptive mother. The sister continued to focus on her role as a gestate carrier for her brother’s and sister-in-law’s child (Thompson 2001). The ways in which the gay and single fathers view the relationship with the surrogate mother and contribute to the child is a largely unexplored area of analysis—one to which this book aims to contribute. That fatherhood too can be disrupted in its genetic role is seen in the way in which the DNA test is used to reject and ascertain the biological father in his social role (Fonseca 2009, 2011). ARTs have also disrupted the role of fatherhood as is evident in the analysis of anonymous sperm donation and male infertility (Lundin 2001; Throsby and Gill 2004)—both of which are shrouded in secrecy. Fatherhood thus needs to be viewed in its role both as a patriarchal standard and as a negotiated experience within surrogacy. This would mean including the potential that the husband of the surrogate fulfils as a candidate for fatherhood, whose relevance within the study of surrogacy has not been explored completely. Berend (2010, 2012) finds that the surrogate’s husband occupies both a role of support and antagonism in relation to her role within the arrangement. His stance does have an impact on their relationship especially if he is not supportive of the surrogate’s involvement. (p.18) In case of the Indian surrogate mothers, Pande (2010b) finds that their husbands try to rationalize the wife’s involvement in surrogacy through notions of sacrifice and penance (tapasya). The couple works towards overcoming the stigma that involvement in the arrangement necessarily entails. The participation of those not directly involved in the relationship between the surrogate mother and the intended parents also creates important avenues for dealing with kinship and family within the arrangement (discussed in Chapter 4 of this book). Thus, in navigating the role of motherhood and fatherhood the missing ‘third party’ is the most glaring aspect of research on surrogacy. Relatives and friends of the couple, personnel connected to the state machinery help navigate the Page 12 of 24

Introduction arrangement as a ‘kin making’ enterprise. Here, Chatterjee’s (2004) formulation of ‘unfamiliar relationships’ is important to see the ways in which the family and kinship also include members and relationships that are invoked to negotiate and identify relationships of biology and marriage. While the clinician and the IVF specialist have formed the subject of study in the kinds of ‘kinship work’ they undertake in relation to ARTs (Bharadwaj 2003; Cussins 1998; Franklin 1997; Franklin and Roberts 2006; Inhorn 2009; Thompson 2001), in case of surrogacy the role of the ‘third-party’ has been largely restricted to that of the surrogate mother. Although Ragone (1994) does introduce the types of surrogacy programs in the US, based on the IVF specialist’s personality and philosophy, in the form of the ‘open’ and ‘closed’ programs—it is an emerging area of engagement in case of commercial surrogacy in India (Rudrappa 2015). In case of India the IVF specialist has been a source of criticism in academic and feminist research on surrogacy. Their role in socializing the surrogate into understanding her pregnant body as a ‘vessel’ within the arrangement is crucial (Saravanan 2010; Vora 2009). In fact, according to Menon, ‘In the context of new reproductive technologies, we find that potential parents contracting (p.19) with a surrogate are reassured by drug companies and medical practitioners that if the genetic matter is theirs (that is, the egg and the sperm), then the child is “biologically” theirs, since the surrogate’s womb only acts as “an oven”, “a rented room”….’ (2012: 49). Besides the IVF specialist, the agents (like the agency Building Futures discussed earlier) are now the focus of studies on the recruitment of surrogates and the creation of demand for the treatment (Bisht 2013; Deepa et al. 2013; Deomampo 2013b). Rudrappa (2015) engages with one of the owners and agents of an IVF-surrogacy clinic in Bangalore, India; as does Pande (2014), but their inputs in defining parenthood is not delved into deeper. This book explores the role of the IVF specialist and agents in the arrangement in the negotiation of the kinship dilemmas that the TCGSA brings forth (discussed in Chapters 3 and 4 of this book). It is within this context that the IVFsurrogacy clinic and the surrogacy agencies represent a particular form of ‘IVF culture’ that brings forth the contradictions of global–local imaginaries within the neoliberal economy of infertility medicine. The ‘figure’ of the IVF clinic as it is played out in multiple sites: on the Internet, on the bodies of surrogate mothers and intended parents, and in ‘travelling gametes and expertise’ occupies the operation and management of transnational commercial gestational surrogacy arrangement.

The Trade in Wombs: Technologies, Bodies, and Commerce TCGSA is part of the ‘IVF culture’ in India which aggressively markets and advertises ARTs as the only solution to replicating and recreating a ‘failed biology’ in the form of infertility. This IVF culture involves the commercialization of a medical service and treatment along with the associated reproductive Page 13 of 24

Introduction services such as egg/sperm donation, commercial gestational surrogacy, medical expertise, and the technology. It operates from IVF clinics and (p.20) superspeciality hospitals in Indian metropolitan cities and small towns and is focused on ‘selling’ the technology as ‘emancipatory’ (Arora 1996)—even though it is deeply flawed and unpredictable (Sarojini et al. 2011). Along with the technology, doctors, and specialists create a demand for their advice and expertise through selective accessibility and mythic reputations (Bharadwaj 2006b). The ‘IVF culture’ in India combines, successfully, the elements of local beliefs, practices, and policies and blends them with global understandings, protocols, and patents to not only engage with ‘local moral worlds’ (Kleinman 1992), but ideas that come to embody transnational, global modes of being. In creating a culture of glocalized practices and global technology, IVF culture is largely dependent on the fertility or IVF-surrogacy clinic.8 The IVF-surrogacy clinic, I suggest, occupies a contradictory space that is trying to follow global norms of uniformity—while unconsciously operating within and replicating local peculiarities. The IVF-surrogacy clinic in India occupies an important position within the globalization of reproduction. Recent research tries to understand and place it within notions of ‘experimental sociality’ (Vora 2014). In the transnational ART clinic, we can observe medicine shifting from a technique of caring for the body to one of producing bodies as the instruments of service work as part of an experiment with engaging a transnational, technologically mediated market that depends on socially mediated arrangements with local, relatively low-resourced women surrogates …. At the same time, the transnational reach of clinic directors and their ability to command technology and resources at a global level represents something unique. (Vora 2014: 79–80) Can the space of the surrogacy clinic—with its surrogate hostels, foreign clientele, and ‘state-of-the-art’ technology and expertise—be a new form of ‘outsourcing hub’? Is it possible that the IVF-surrogacy clinic is actually involved in a ‘globalization of (p.21) nothing’ (Ritzer and Lair 2009)? Some of the characteristics that Ritzer and Lair (2009) identify as being hallmarks of the outsourced service work—may be found in case of TCGSA. Thus, many of the characteristics such as ‘no face-to-face contact with the customer; with high information content; where the work process is telecommutable or internet enabled; where a high wage differential exists between similar jobs in different countries; where there are low set-up barriers; and where there is a low social networking requirement’ (Ritzer and Lair 2009: 40) are actively endorsed and initiated by the IVF-surrogacy clinic. Yet these characteristics also propagate an idea of TCGSA as part of the uniform, depersonalizing, outsourced terrain of the globalization of nothing. Just like the ‘McJobs’ (Ritzer and Lair 2009: 37) where Page 14 of 24

Introduction the employee has minimum interaction with the customer, and is under the surveillance and control of the employer-corporation—the IVF-surrogacy clinic attempts a similar exercise in the surveillance of ‘hired wombs’ (Saravanan 2010). As institutionalized biomedical ventures IVF clinics operated within the space of market logic or demand and supply. They are driven less by the considerations of treatment and more by the creation of demand. The market for infertility is largely dominated by private players. Prime players were niche infertility– surrogacy clinics in Delhi, Mumbai, Kolkata, Chennai, Bangalore, Hyderabad, and other major cities in India. Corporate hospitals have also entered the IVF business in a big way with speciality wings. In a metropolis like Delhi, many of the clinics were run by IVF specialists themselves—very few, like Miracle Babies, were run as corporations, managed and invested in by other corporations rather than doctors or medical establishments. Miracle Babies had third-party administrators (TPAs) as its sponsors who, in financial parlance, provide services for claims and cashless health insurance. However, in ongoing research of surrogacy clinics and agencies in Mumbai, Bisht (2013) finds that TPAs refer to agents or those who liaison between the clinic, client, and the surrogate such as Building (p.22) Futures. In the Delhi data, the agents were not specifically known as TPAs, but did work with the TPAs identified above. Primarily, the Third Party Affiliate or Administrator’s work as a conduit was different if seen as an agent, and completely different as a source of funding and investment. During the fieldwork, Delhi was fast becoming a hub for surrogacy. Its advantages were clearly felt in its global amenities, especially hospitals and qualified doctors—as well as in terms of having the headquarters of the Indian government machinery. International embassies too were based in New Delhi— making citizenship processes easier for foreign couples. Most of the IVF clinics, barring perhaps one or two of them did undertake surrogacy cases. The difference lay not only in the clinic’s level of involvement in a surrogacy case, but also in the way in which the IVF specialist/gynaecologist/embryologist/ laparoscopist approached the arrangement. In cities like Jaipur, where I undertook related and intermittent fieldwork, IVF clinics did brisk business,9 but not through surrogacy arrangements. Despite wanting to undertake them, IVF doctors found the venture difficult due to the paucity of women willing to be surrogates. Except for one or two cases in a year, most doctors felt that the stigma attached to the arrangement was the primary deterrent. However, according to Dr Joshi who ran an infertility clinic as part of a hospital in a Jaipur suburb, egg donors and women willing to be surrogates were both equally difficult to source. She had done two to three cases of surrogacy where the couples had arranged for the surrogates themselves and she and the clinic had acted as ‘third parties’. Most of the surrogates came from

Page 15 of 24

Introduction a lower class background and were sourced locally—within the neighbourhood, through maids. A typology of the clinics encountered in Delhi and Jaipur would be based on factors such as the kind of clientele they attracted, the cost of the treatment being offered, and the ownership of the clinic. Corporate clinics, mentioned earlier, were run by non-medical (p.23) personnel and were geared towards providing multiple services in a more organized fashion. They also had more doctors on board. In 2010–12, a commercial surrogacy ‘package’ would cost between US$ 12,000– 28,000 (Kohli 2011: 13). This may consist of the surrogate’s fees, the IVF/ICSI (intracystoplasmic sperm injection) costs, and other additional expenses (hotel stay, visa/passport fees, etc.). The fee for the treatment includes not only the cost of the technology, but the IVF specialist’s charges as well (Figure 1.1). The infertility clinic often prepares and offers these packages––just like the infamous Akanksha clinic in Anand, Gujarat, which garnered much international media attention (Carney 2010; Oza 2010). The clinic offers the medical treatment, the surrogate, and the anonymous donors (egg/sperm) going beyond the brief of pure medical treatment. This has of late attracted a lot of media (p.24) attention amidst allegations of human rights violations by clinics that ‘house’ pregnant surrogates in hostels, away from their families, for the period of nine months under strict surveillance (Carney 2010), prompting the Indian Council of Medical Research (ICMR—the apex Indian body that works in conjunction with the Ministry of Health, Government of India, in the area of legal regulation of medical practices) to suggest in its Regulation of ARTs (Draft) Bill (ICMR 2010) the setting up of parallel ARTs banks. Statistics regarding the kind of revenue the transnational surrogacy industry is earning are still not available in entirety, however the medical tourism industry in India10 was expected to be worth four billion dollars in 2012 itself (Reddy and Qadeer 2010, quoting a Confederation of Indian Industries [CII]–McKinsey forecast). The growing prospects of this economy have been thanks to state-of-the-art Figure 1.1 Average Expenditure Involved technology and qualified in Commissioning a Surrogacy personnel, at 20 per cent of the cost in the US and UK (Reddy and Qadeer 2010). India is increasingly being Page 16 of 24

Introduction recognized as the ‘surrogacy Arrangement—Culled from the Field and outsourcing capital’. This is also Newspaper Reports (2010–13) evident from previously Source: Author. collected data by the ICMR that recorded a growth in membership to Indian Society of Assisted Reproduction (ISAR) from 184 in 1999 to 600 in 2005 (Sarojini et al. 2011). There are some 3000 registered IVF clinics, which is a very conservative estimate, not including sperm banks, surrogacy agents, etc., whose numbers have burgeoned over the past five years. The ARTs industry was slated to bring in one to two billion dollars by 2012 as per a CII– McKinsey report (Sarojini et al. 2011). The low cost of ARTs in India, combined with even lower compensation for surrogates, is a major attraction for foreign clientele. Table 1.1 lists the comparative costs in arranging a surrogacy arrangement in India, the US, and the UK. Table 1.1 IVF and IVF-Surrogacy Costs in the US, UK, and India Type of Infertility Treatment

US

India

UK

IVF Cycle (single)

20,000 USD

2000 USD

7000 Pounds Sterling

Surrogacy Arrangement (including IVF cycle)

15,000

11,000 USD

10,000 Pounds Sterling

*

USD

*

Excluding IVF treatment.

Source: Sarojini et al. (2011). In the commerce surrounding the reproductive tourism and transnational commercial surrogacy industry, the surrogate’s fees are the lowest and the most compromised. This is why the exploitation of Indian surrogates as surplus biocapital forms the (p.25) predominant critique of the surrogacy industry amongst feminist academics and activists (Hochschild 2011; Qadeer 2009; Qadeer and John 2009; Rao 2012). Kaushik Sunder Rajan’s (2007) formulation of the ‘new surplus’ emerging from the developing world in the form of surplus bodies meant for clinical drug trials and experiments also captures the ‘trade in’ gestational surrogates from India, and egg donors from countries belonging to the erstwhile Eastern Bloc. The commodification of the woman’s body draws as much criticism as does the image of the commodified child. Mohan Rao (2012) in his trenchant critique of the surrogacy industry in India asks for a ban on commercial surrogacy. The unregulated nature of the industry, according to him, is the root cause behind the exploitation of poor Indian women as gestational surrogates. In such an enterprise, Rao finds reproduction as having become ‘denationalized’ with women’s bodies providing the ‘surplus reproductive labour’ to create commodities like the foetus and frozen embryos and eggs.

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Introduction However, feminist readings of exchange within kinship have already offered a rereading of the exchange of women as ‘goods’ (Levi-Strauss 1971) essentially for their reproductive labour. Here, women are not always the ones ‘exchanged’, or men the wielders of power through their possessions. In fact, amongst the Trobrianders, women undertake exchanges that are not limited to the economy (p.26) of goods, power, and prestige but embody larger concerns of the cosmogony of community and social reproduction (Weiner 1976). Similarly, in contemporary readings of Rubin’s (1975) ‘traffic in women’, the reproductive bioeconomy of eggs is seen to involve a ‘traffic between women’ of obligatory relationships that are played out through the exchange of eggs and financial favours amongst close and distant kin in Ecuador (Roberts 2009). What does this do to the idea of the gift in a transnational context where bodies and bodily services are sold to create kin? The ideology of the gift relationship is the bedrock of the commercial surrogacy arrangement. It creates a facade of altruism when there is none. This is what forms a large part of the euphemization of the contractual surrogacy relationship as a ‘gift relationship’ (Bourdieu 1977). The preponderance of such an ideology is meant to mark commercial gestational surrogacy with some level of sanctity and legitimacy considering its ‘negative’ positioning in relation to the commoditization of intimate relationships (Cannell 1990; Levine 2003; Teman 2008). However, in the transnational context, the ideology of the gift relationship cannot be appropriated. Anthropological analysis on commercial gestational surrogacy in India points towards the ways in which agencies and doctors actively promote a ‘gift rhetoric’ to not only distance the surrogate from the foetus, but also to draw the surrogate into an obligatory relationship (Pande 2011; Ragone 1996; Vora 2010/11). The ‘gift of life’ comes to be positioned as an exchange of ‘life for life’ (Vora 2013) wherein the Indian surrogate was willing to gestate a child in exchange for monetary compensation that would help her and her family survive. For them the ‘gift’ was positioned in terms of a cycle of debt and obligation (Vora 2013)—by ‘giving’ away a child they hoped to incur a lifelong obligatory relationship with the intended parents that would ensure their own survival. Many surrogate mothers saw their overseas couples as ‘saviors’ around whom they built fantasies of being rescued from their lives of drudgery (Pande 2011). (p.27) Here, however it is important to add a caveat regarding the academic obsession that seeks the local in the global and vice versa—within an overarching theory of globalization (Ritzer and Lair 2009). Thus, reproductive governance in India and the associated feminist activism charts its own journey that can not necessarily be mapped in a uniform manner on a transnational–global space (although Gupta [2006] suggests that transnational feminisms should draw from their local experiences to bring together a common shared narration on NRTs). As Mary Page 18 of 24

Introduction John (2011: 9) notes: ‘Affirming a politics of location means living with critical contestations that make clarity hard to come by and requires re-envisioning current constructions ...’ which is why it is important to situate TCGSA within the existing rhetoric of NRTs and ARTs in India. A comparative perspective is important keeping in mind Nussbaum’s contention that the notion of choice seems to be especially constructed in relation to women. Thus, to choose stigmatized work like prostitution or surrogacy, does not only mean the lack of other available options, but also a conscious choice in itself. In such situations, ‘we may grant that poor women do not have enough options and that society has been unjust to them in not extending more options, while nonetheless respecting and honoring the choices they actually make in reduced circumstances’. (Nussbaum 1998 cited in A. Majumdar 2014) In India, the paradox of women’s reproductive roles has placed them in positions of being both idolized and discarded (Samanta 1992). As mothers, Indian commercial gestational surrogates are living repositories of love and hatred. It is in the negotiations with the child, the ‘other’ mother and the father of the child that the surrogacy arrangement in India is understood and practiced in its contemporary form. The book captures each of these elements—of commerce, families and kinship—in its reading of the ethnography of reproductive tourism and commercial surrogacy in the city of New Delhi.

(p.28) On the Processual: The Process of (Un)Making Kin While the book draws primarily from a processual view of kinship—it is interested in chronicling the many conflicts, and their resolutions through the TCGSA and the act of making and unmaking kin. While the ethnographic narrative looks at the IVF process it does not go into an observation of the technology at practice because; it has been dealt with before in other ethnographic studies, and due to the limited access the ethnographer had to the IVF specialist-administered treatment. At each stage of the process, key players were identified and new participants introduced. Thus, each chapter deals with these key moments and addresses the question of kinship and relatedness that emerges out of these interactions—these ‘breaks’ are seen in the form of fractures and dissonances as well as through their resolution. In mapping the process of TCGSA and the ways in which relatedness is understood and ‘constructed’ within it, the book chronicles three primary stages. Akin to Howell’s (2003) stages of ‘kinning’ transnationally adopted children through ‘pre-pregnancy’, ‘pregnancy’, and ‘birth’ (2003: 470–1)— TCGSA comes to situate itself through three similarly conceptualized stages. These stages are not watertight—they are linked to one another, but may also pose impediments to progressing to the next stage, and may also lead to the collapsing of the stages into each other. Besides each stage has multiple other Page 19 of 24

Introduction processes encapsulated within it. The identification of TCGSA with the three main stages of ‘intention’, ‘pregnancy’ and ‘ownership/membership’ is not an attempt to create a ‘model’ of the process, but to track its dynamism and the different permutations and combinations that go into making it. However, these stages help navigate the ways in which ‘kinship work’ (Thompson 2001) is enacted/rejected during the process. They also trace the ways in which the process of commoditization may lead to (p.29) de-commoditization, especially in the gradual positioning of the arrangement and the process. Thus, as the Figure 1.2 depicts, the back and forth between Stages 1 and 2 meant repeated oscillations between commissioning an arrangement and getting pregnant. Failure in getting pregnant or a miscarriage means that Stage 1 may be enacted again with the same sets of people or through replacements of some of the key participants—such as the surrogate mother, or the clinician. Stages 1 and 2 often recur, especially when any of the follow-up steps within the two stages fails. The final stage in that sense is more stable—as it occurs after the birth of the child—but has other forms of negotiations within it. An analysis of the stages is also an exercise in looking at what the TCGSA entails and means for the different sets of people involved in the arrangement. The three stages have very different meanings for commissioning couples, surrogate mothers, clinicians, and (p.30) relatives and friends of the surrogate Figure 1.2 The Process of TCGSA mothers and the commissioning Source: Author. couple. In weaving together the diverse, often conflicting, experiences the TCGSA comes alive as a process mirroring larger social anxieties regarding technological interventions in interpersonal relationships. It is to these anxieties and dilemmas and their navigations to which the chapters speak. The social dramas have been insightful depictions of the processual dynamics involved in the working of the surrogacy arrangement. Here, I have employed a singular ‘impressionistic tale’ (Van Maanen 2011) right at the beginning of each chapter as ‘stand alone with or without elaborate framing devices or extensive commentary’ (Van Maanen 2011: 103). The attempt is to both make an analytic point in relation to the chapter, as well as to spark interest through the ‘telling

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Introduction of the story’. In employing the impressionistic tale I am also taking a reflexive stance in showcasing how an event in, or aspect of the field was perceived. Intention as Choice?

What drives the desire to be part of the commercial surrogacy arrangement in India? Chapter 2 seeks to answer this question by looking at an important aspect of transnational commercial surrogacy: informed consent from the commissioning couple and the surrogate mother. A ‘declaration of intent’ by both participants is a mandatory document within the surrogacy contract. What does intention mean? It is not merely a willingness to participate and agree with the modalities of the commercial surrogacy contract, but also to ‘choose’ to be part of it. Within this ‘choice’ and the use of the nomenclature of the ‘intended parent’ and the ‘fertile’ surrogate are the processes of screening eligibility to be part of the arrangement. Thus, in the examination of the notion of ‘intention’, the ‘contract’, couple/individual and the surrogate mother ‘speak’ of their choice of surrogacy. In this way, motherhood and fatherhood are explored in relation to ideas regarding kinship, genes, and nurturance. (p.31) Much of the debates on commercial surrogacy are marked by the interventions and involvement of the assisted reproductive technologies such as IVF. In Chapter 3, the medico-technological process of commercial surrogacy is seen through the involvement of IVF specialists, embryologists in their identification and understanding of genes and kinship. The chapter also explores the ways in which fertility clinics negotiate with the practice of commercial surrogacy by invoking the Indian Council of Medical Research’s draft law on surrogacy and reproductive technologies. The chapter also looks at how medicine does not always operate within a tradition of rationality but often invokes local-folk wisdom of kin and kinship to understand the consequences of assisted conception. In that sense, IVF specialists, clinicians, and embryologists often become ‘matchmakers’ invoking an idea of genes and biology that is not embedded in scientific rationality. Disembodied Relationships

In the process of making kin—which is what transnational commercial surrogacy is geared towards—the surrogate pregnancy becomes a ‘goal’ for all participants involved. However, the liminality of the pregnancy becomes both risky and transgressive when navigated through the bodies of ‘alien’ others. Both for the surrogate mother and the intended parents the pregnant body becomes a source of ambivalence and conflict. In Chapter 4, the ethnography maps the role of the ‘others’—agents, relatives of the intended parents, the surrogate’s husband—in making meaning out of an ‘alien pregnancy’. Here, the embodied/disembodied pregnancy leads to ‘disembodied relationships’. Cross-cultural notions regarding conception, pregnancy and birth intermingle in a conflicted narrative of ‘kinning’ a soon-to-be born child. The idea of shared bodily substances within the

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Introduction foetus mark out not only the intended parents and the surrogate mother—but their other relationships as well. (p.32) Claiming Identity/Membership

The birth of the child in transnational commercial surrogacy leads to a protracted process of staking claim. In Chapter 5, the focus is especially on the national and international laws that are invoked by foreign parents and foreign consulates to grant citizenship to the newborn. The applications for citizenship from their home countries and the exit visa from India lead to many processes of bureaucratic verification and authentication of the genetic tie between the child and the intended parent(s) and the surrogate mother. Seeking identity here are both the new parents and the newborn. Through the birth certificate and the DNA test paternity is identified, while a parallel process seeks to ascertain maternity through the surrogate mother—who incidentally has rejected her tie to the newborn as part of the contractual requirements! Through the narratives of three foreign nationals navigating the citizenship process—international laws regarding surrogacy, kinship, and citizens are analysed. The concluding chapter sums up the findings of the book and presents the theoretical idea of ‘conflicted kinship’ to understand the ways in which the process of commercial surrogacy makes and unmakes kin. More importantly, the chapter looks at the issues of reproduction, the state, and procreative tourism to understand the ways in which kinship may never be the same again.

Notes:

(1.) The Thai surrogate Pattaramon Chanbua courted much controversy in 2014 when she decided to raise one of the twins she was carrying for an Australian couple, after reportedly, the child was rejected by the commissioning couple due to Down’s Syndrome. The couple received much criticism, when 22-year-old Pattaramon claimed that they had asked her to abort the fetus once Down’s was detected. She refused and kept the baby boy Gammy, while the commissioning couple left with the twin baby girl. Later, Thailand reviewed its legislation on surrogacy and banned commercial surrogacy for foreign and gay couples. (2.) ‘No Commercial Surrogacy, Only for Needy Couples, Govt tells SC’, Indian Express, New Delhi, 25 December 2015, http://indianexpress.com/article/india/ india-news-india/govt-to-make-commercial-surrogacy-illegal-panel-to-decide-oncases-of-infertile-couples/ (3.) ‘Instructions relating to foreign nationals intending to visit India for commissioning surrogacy’, Ministry of Home Affairs, Government of India, 2013, http://mha1.nic.in/pdfs/Surrogacy-111013.pdf

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Introduction (4.) ARTs and IVF have been used interchangeably in the text. IVF is part of a large body of ARTs including ICSI (intracystoplasmic injection), IUI (intrauterine injection), amongst others. ARTs, in turn, are part of NRTs (new reproductive technologies) that include technologies for termination and prevention of pregnancies as well (Gupta 2000). Doctors in this ethnography have also been referred to as IVF specialists as that is what they were known as during the fieldwork. (5.) Surrogacy and Fertility Centre was an important part of my research even though I did not get access to the clinic beyond a brief meeting initially in my fieldwork. Dr Rupa was not very keen to give me access to her clinic, patients, and surrogates. However, as my fieldwork progressed I met many couples, surrogates, and agents who were attached to Surrogacy and Fertility Centre. Through conversations with them the clinic emerged as a real site of engagement. Even though in absentia, its importance as a field site cannot be negated. All names of clinics, doctors, surrogates, intended couples and other participants are pseudonyms to protect their anonymity. (6.) According to Bharadwaj and Glasner (2009), a characteristic of the intersection of the global and the local in the ‘bio-crossings’ that technologies, people undertake, is the emergence of a liminal third space which ‘is anomalous, that is unpredictable. It provides an open-ended opportunity to critique, challenge and change state of affairs … these spaces are both a challenge to the official governance models and to the moves to reformulate the ethical and moral controls on science within India’ (2009: 9). (7.) Aditya Bharadwaj (2016) finds the Madonna–Whore thematic in Hindi films on surrogacy as representative of the linkage between surrogacy and the prostitute. The whore comes to represent her choice in a free market against patriarchal control and by wresting the male public sphere for herself. (8.) The infertility clinic has been studied extensively in terms of the technology used (Cussins 1996); especially in the way treatment and space is demarcated to objectify the patient (Thompson 2005). ARTs have also been seen in terms of their use to create new notions of reproductive subjectivity (Braff 2009), or through the creation of ‘designer’ babies (Franklin and Roberts 2006). The dependence that ARTs such as IVF create on patients seeking a way out of their ‘infertility’ has been documented by Franklin (1997)––who speaks of how women and men (Inhorn and Birenbaum-Carmeli 2008) in their ‘desperation’ see the technology as hope-technology. (9.) Despite observing packed waiting rooms in most of the clinics, doctors had to provide IVF treatment at what they called ‘SMS rates’ (Rs 35,000 for an IVF cycle)—as cheap as text messaging and much less than the market rate. This

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Introduction was to attract clients from the lower middle classes and lower classes who could not afford expensive treatment. (10.) The medical tourism industry in India caters to most major health services including organ transplantation, intensive surgeries, and intensive care.

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Mothers and Fathers

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Mothers and Fathers Intention and Parentage in Commercial Surrogacy* Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0002

Abstract and Keywords What drives the desire to be part of the commercial surrogacy arrangement in India? This chapter seeks to answer this question by looking at an important aspect of transnational commercial surrogacy: informed consent from the commissioning couple and the surrogate mother. A ‘declaration of intent’ by both participants is a mandatory document within the surrogacy contract. What does intention mean? It is not merely a willingness to participate and agree with the modalities of the commercial surrogacy contract, but also to ‘choose’ to be part of it. Within this ‘choice’ and the use of the nomenclature of the ‘intended parent’ and the ‘fertile’ surrogate are the processes of screening eligibility to be part of the arrangement. Thus, in the examination of the notion of ‘intention’, the ‘contract’, couple/individual and the surrogate mother ‘speak’ of their choice of surrogacy. In this way motherhood and fatherhood are explored in relation to ideas regarding kinship, genes, and nurturance. Keywords:   intended parents, surrogate mothers, majburi, surrogacy contract, reproductive choice, gay fathers

The notice on the glass door of the clinic was of a list of successful candidates through 2010–11. The list was exhaustive and on a monthly basis—it had columns that listed the couple’s first names, number of IVF cycles, and the success rate for the month. The surrogacy cases were identified with either an (S), or by saying (surrogacy). The list for April 2011 displayed a success rate of 43 per cent representing 42 IVF cases, of Page 1 of 33

Mothers and Fathers which the number of successful pregnant surrogates came to four. Out of these four surrogacy cases three had become pregnant after the first cycle itself, while one was pregnant after the second cycle. The number of IVF cycles that couples went through to get pregnant varied from 1–5. An IVF cycle as Dr Ruchi explained to me was actually the number of attempts the couple had made at getting pregnant—each cycle consisted of the entire IVF procedure/process. ‘The number of cycles has been put up on the list to give “confidence” to those who may have failed in the first cycle, or subsequently. It is to encourage them to continue at it and not feel disheartened or give up hope.’ The ‘list’ always attracted attention in the waiting room—husbands, wives, in-laws, and parents of the couple would mill around it. It was also the USP of the clinic—another advertisement that showcased how successful the clinic was, this time by using numbers, (p.36) data, and statistics. An elderly lady, who had accompanied a patient, looked at the list and exclaimed: ‘A fifth cycle! People have attempted five cycles!’ Today, the new attractive PR manager, Shruti, introduced a young couple, who had come to the clinic for the first time, to the ‘list’. She told them, ‘Soon your names will be there too!’ To which the woman replied, ‘In that case we will see the list once we are successful, and not now.’ (Field Notes, May 2011) The list in the above extract was both an advertising ploy as a well as roster of the couples who ‘made it’. It spoke of determination, trust, and endurance through the process of IVF and the desire to have and bear a child. The list displayed the intention to have a family and the lengths to which a couple/ individual and clinic would go to fulfil the same. In TCGSA, the term ‘intended parents’ (IPs) signified many things—a change in status, an entry into the surrogacy arrangement, an entry into a contractual relationship with anonymous gamete donors and relatively unknown surrogate mothers, and an engagement with an equally anonymous technology. However, most importantly it signified the desire to have/bear children. For not only were the IPs marked out in such a way, but so were the commercial gestational surrogates. Beyond just a stance towards the future, intention involved negotiations and relationships that the TCGSA entailed and expected. By becoming part of the arrangement, it seemed everybody (the couple, the surrogate mother, and the IVF specialist) was entering an agreement of ‘intended intentions’. The notion of intention in this chapter will be mapped in ways that take into consideration ideas of infertility, childlessness, the choice of technology, and the ways in which the idea of ‘genes’ and genetic ties are constructed within TCGSA. Page 2 of 33

Mothers and Fathers It will also be mapped in relation to two sets of intended parents—the gay couple/single gay father/the adoptive mother, and the surrogate mother. Within TCGSA, intention comes to embody more than just a ‘planned course of action’—it also comes to signify matters regarding motivation, choice, desire, and agency. Choice and agency have (p.37) very important anthropological traditions tracing their involvement in the analysis and study of social life. They are connected and at the same time different from each other. Yet, they are of essence to the understanding of the idea of intention. Intention, in turn, is a conceptual tool by which an analysis of the ‘nature’ of the surrogacy arrangement can be approached. While the surrogate mother in India continues to be a source of much scrutiny worldwide in terms of her reproductive choices—the scrutiny on the gay couple and their reproductive choices is a relatively new area of analysis. Similarly, the adoptive–intended mother has been analysed in anthropological studies on surrogacy (Ragone 1996; Teman 2010), but the overwhelming focus has been on the engagements of infertile women with ARTs (Franklin 1997; Taylor 2000). The idea of intentionality, from the standpoint of parenting and childlessness, is seen in the analysis of the distinction between the desire to parent and the active pursuit of that choice (Carmichael and Whittaker 2007; Edwards, Gillies, and McCarthy 1999; Feldman 1981; Riskind and Patterson 2010). Studies point towards how the intention to become parents identifies the voluntary and involuntary childless—thus bringing forth a new dimension to the understanding of infertility beyond its socio-medical identification as a disease (Sandelowski and de Lacey 2002). That some people may desire to have children but may be unable or unwilling to do anything about it does not qualify intention (Riskind and Patterson 2010). However, such a stance is also part of the larger biomedical identification of infertility that assumes the ‘intention to parent’ as a given in seeking infertility treatment (Greil and McQuillan 2010). Thus, Greil and McQuillan note that medical constructions of infertility presume that parenthood can only be achieved in ways that are ‘planned’ and therefore intended—excluding unplanned parenthood and multiple modes of being and relating. No wonder then that intention comes to be a qualifying standard for separating biological and social parenthood (Edwards et al. 1999). Intention as a form of ‘eligibility’ is most often used (p.38) in cases of adoption. The social parent must qualify with the sincere intention to parent—as opposed to the biological parent who is given that right by virtue of the genetic tie. But then such an idea of intention takes for granted the immutability of the genetic tie—and positions it in opposition to non-genetic parenthood, which has to be ‘proven’. This cultural construction of natural facts wherein the biological relationship is built as a fact of nature (Strathern 1992b) embodies intention automatically. However, Page 3 of 33

Mothers and Fathers what happens in case of genetic reproduction that is not based after the ‘fact of nature’ or sexual reproduction—as is the case in the use of non-coital reproductive technologies such as ARTs where the social and biological ideas of parenthood may intermingle? In the ethnography, intention was mapped across diverse combinations of interrelationships. Many of the gay couples were in committed relationships of more than five years, all the heterosexual couples were married, and some of the gay and heterosexual men who entered the commercial surrogacy arrangement were single. Surrogate mothers form an important and essential part of this chapter—their intention is mapped within the arrangement to understand the choices and motivations that they bring into the TCGSA. All of the surrogates were married and had between 2–5 children on an average, this was also mandatory as per the draft legislation. However, between these two groups—of intended parents and surrogate mothers—the motivations for entering into the arrangement were mediated by factors that had a lot to do with infertility, fertility, and the notion of having children.

Intention as Contracted: The Commercial Gestational Surrogacy Agreement The surrogacy contract has attracted much scrutiny in the anthropology of law and in legal studies. The primary debates have argued on the rights of the surrogate mother to enforce a contract regarding her body and the unborn child (Andrews 1990). Taking a cue from liberalism, the contract is held up as the surrogate’s (p.39) right to choice and bodily integrity (Jaiswal 2012). Others argue against this liberal tendency to fetishize the contract, focusing on the unequal relationships embedded within a contractual relationship. Here, the focus is again on the surrogate mother’s choice as not individualistic, but as linked to the interests of the unborn child, and her own living children’s links to the child (Brinig 1995). Discussions in relation to the surrogacy contract focus primarily on the surrogate mother especially in relation to her ‘choice’ within a relationship based on commerce and the renunciation of a child she carries for nine months. A significant section of the socio-legal analyses sees the contractual nature of the agreement as an impingement on the surrogate’s reproductive rights. Invariably this right is pitted against the right of the couple to procreate (Field 1988; Robertson 1996; Shanley 2001). Thus, preconception ‘agreements’ are invoked in favour of the couple/intended parents based on their ‘planned’ investments into the surrogacy arrangement (Shanley 2001). Legal scholars such as Robertson (1996) and Schultz (1990) actively advocate the ‘contractual’ right of the couple–parent over the child. Here, the desire to parent is embedded

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Mothers and Fathers in the intention to enter the contract—and thus their legal status as parents can never be challenged by the sudden ‘change-of- heart’ of the surrogate mother. The ‘surrogacy agreement’ as defined by the ICMR ARTs Bill (ICMR 2010: 4) is ‘a contract between the person(s) availing of assisted reproductive technology and the surrogate mother’. These ‘person(s)’ are identified primarily as ‘commissioning parents/couples/individuals … who approach an ART clinic for providing a service that the ART clinic is authorized to provide’ (ICMR 2010: 3). ‘Couples’ may be married or unmarried—but do not get identified as intended parents anywhere in the document—that is a nomenclature used by doctors, agents, couples, and the contract. Infertility and IVF specialists use the Bill and other quasi-legal documents as a standard for screening surrogates and couples (discussed in the next section)— but like the agreement itself the (p.40) entry into the process is based on negotiable conditions and circumstances. What are these terms of engagement for the couples and the surrogates? How do they come to reflect divergent concerns within the surrogacy arrangement? How do these terms and negotiations as found in legal documents come to define the arrangement itself? The Contract as a Form of Relationship

‘If you remember the fairy tale of Rumpelstiltskin, the surrogacy arrangement is a bit like that …’ (Himanshu Kalra, lawyer with Miracle Babies) Of course Himanshu Kalra does not qualify his statement by clarifying whether the intended parents are like Rumpelsteltskin and the surrogate mother is like the poor princess who seeks help out of a difficult situation, in return for her firstborn. Nevertheless it was implied. As Himanshu talks to me in the room allotted to him as Miracle Babies advocate, there are many more ‘conspiracy stories’ than actual information on the arrangement. He is 34, slightly heavy and jovial—and every time he mentions the way in which a surrogate managed to jeopardize an arrangement there is horror in his eyes. Himanshu drafts all surrogacy contracts for the clinic, and he tells me that he has seen enough ‘kala dhanda’ (illegal and immoral acts) to be wary of not only the surrogate but the couples involved in the arrangement. For him intentions cannot be limited to one document, but unspool over a period of time. The contract creates a relationship between the surrogate mother and the intended parent on similar antagonistic lines. Different legal firms had differing contracts, but the basic template was drawn from the ICMR guidelines. Doctors, lawyers, and agents tried to stick to the basic guidelines as far as possible. The paperwork was essential to secure the rights of the intended parents—in fact, it was the contract that identified the commissioning couple as the intended parents. The signing of the contract changed the ‘status’ of the people entering the ‘agreement’. (p.41) Page 5 of 33

Mothers and Fathers The idea of intention as it developed in the legal paperwork sought to create ‘owners with entitlements’—the others facilitated this ownership. The ‘Commercial Gestational Surrogacy Agreement,’ as the contract is called, declares its intention of starting a relationship between the Intended Parents and the Surrogate Mother, and the Conforming Party (in other words the surrogate’s husband). ‘There are three types of agreement that go into the surrogacy arrangement—intention (preconception), conceived (after conception), on the day of the birth (adoption agreement) which becomes a state agreement’ (Himanshu Kalra). The contract is a document that lays down the modalities of the ‘agreement’ between the clinic, the surrogate, her husband, and the intended parent(s). ‘The surrogacy agreement is an agreement and not a contract. The underlying idea is that it is undertaken out of the goodness of one’s heart and not under duress of any kind’ (Himanshu Kalra). Figure 2.1 is a diagrammatic representation of the agreement, and the documents contained within it. The number of documents differ from one clinic to the other. (p.42) There are primarily five parts of the contract that are signed by the different stakeholders in the arrangement. 1. The financial agreement— terms of payment, etc. 2. The surrogacy agreement between the surrogate mother and the intended parent 3. The agreement with the IVF-surrogacy clinic 4. Declaration of intent on the part of the surrogate mother—that she will relinquish the child on birth 5. Affidavit from the surrogate’s conditions of the contract

Figure 2.1 Components of the Commercial Gestational Surrogacy Agreement Source: Author.

husband agreeing to the terms and

The agreement further consists of four more documents: the declaration of intent (on the part of the surrogate), affidavit of surrogate mother’s husband, endorsement by the IVF-surrogacy clinic, and the agreement of financial terms and conditions of surrogacy. According to the lawyer, Himanshu Kalra, who drafts contracts for the couples and surrogates, the documents required for the contract to be legal and valid were proof of marriage, proof of age, and proof of address.

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Mothers and Fathers The agreement begins with the identification of the couple/individual entering the agreement as the intended parent/s—and in that sense the stakes of the parties are clearly demarcated. Even though the agreement is ‘created when the property is not in existence’ (Himanshu Kalra, emphasis mine), namely the child, the intentions on the part of the couple, surrogate mother, her husband and the ARTs clinic are clearly defined, that is, to bring forth the non-existent property. In this sense, the contract brings all parties together before conception to bring forth stage one of the gestational surrogacy process. The intended parent is identified as ‘an adult, keen to have a child through a particular process by way of obtaining placement of embryo obtained by inseminating an anonymous donor’s eggs with his sperm, into the uterus of the surrogate mother through IVF …’ (This contract was between a single father and the clinic, which is why the reference to anonymous donor eggs). (p.43) While the ‘Declaration of Intent by the Surrogate Mother’ says that she ‘agrees to carry a pregnancy and give birth to a child conceived by the intended parent and anonymous egg donor, outside the body through IVF’, she also has ‘no intention of having physical or legal custody or any parental rights and duties with respect to the child’. She goes on to relinquish full custody to the intended parent keeping in mind the best interests of the child. The surrogate also agrees to submit herself to complete medical examination and scrutiny for the nine months. The surrogate, along with her husband, must make a complete disclosure of her medical history. She must undergo medical tests and give details of her living children and her abortions/miscarriages. The subjection to the physician’s–gynaecologist’s examination is mandatory. The surrogate agrees to be tested upon and inseminated with the fertilized embryo and ‘working towards’ a pregnancy and keeping it by following a healthy lifestyle, as per the instructions of the infertility specialist. The husband of the surrogate mother, in turn, ratifies her intention by declaring that he will help her honour the agreement, abstain from sexual intercourse during the period ascertained by the physician, undergo medical tests, nondisclosure of identity (but disclosure of medical history), seek compensation from the intended parent, and that the child morally and contractually will belong to the intended parents. The insistence on the surrogate’s husband’s declaration of intentions is linked to ideas of how a married woman’s body is also a property of her husband. This makes it mandatory for the surrogate to be married and with previously born children. In case the husband is missing or dead, the family of the husband may step in to endorse the contract and give ‘permission’. The mother-in-law was the most common figure who would sign for the daughter-in-law’s participation as a surrogate. In one of the cases discussed in the book (Chapter 4) the father of a widowed surrogate stepped in as the signatory.

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Mothers and Fathers The IVF-surrogacy clinic merely ‘endorses’ that it has explained the modalities of the process and the contract to the intended parent(s) and the surrogate to the best of their knowledge (p.44) and ability. This form of one-sided involvement is also seen in the way intention in the document is mapped in the steadfast resolve and belief in the treatment and technology being used. The technology and the specialist are not to be held at fault for bodily drawbacks and failures; this is the primary stance of intention that the ARTs clinic wishes to declare. Thus, there is no assurance that a pregnancy would definitely come through in the arrangement, or even if there is a positive pregnancy that would necessarily lead to the delivery of a ‘normal’ child. In the notion of intention lies the consent that all the parties to the agreement conform to. This kind of consent accompanies the responsibility of nondisclosure of the modalities of the agreement and identity—thereby insisting on a form of anonymity for the surrogate and her husband, and upholding the primary identity of the child as belonging to the intended parent(s). The agreement is at pains to establish this point in the way the document insists on the ‘renunciation’ of the child for the commissioning party. Yet, the document also mirrors the paradox of entering into an arrangement wherein the success of the enterprise depends upon the surrogate’s wholehearted surrender to a medical process that shall govern her body for nine months. The exchange of compensation, however euphemized, makes the surrogate ‘unsuitable’. As intention is judged legally on the desire to nurture and parent— the surrogate is rejected for any claims made on the child she has nurtured for the past nine months. Both in Baby M’s case and the Fasanos’ case in the US, the judge(s) posited the contractual agreement superior to the surrogate’s right to the baby (Grayson 2000). This is in extension to the adoption document that sees the right of the willing—intended as superior to that of the relinquisher. In the Durkheimian notion of contractual relationships as preserved in restitutive laws, cooperation amongst similar parties is the basic rule. Yet, the commercial gestational surrogacy contract is based on the premise that the parties are unequally (p.45) positioned with relation to the ‘service’ rendered and the ‘product’ obtained. Unlike adoption, here the biological is not pitted against the social, but privileged differentially. Thus, the compensation awarded aims to devalue the surrogate’s labour in a way that subordinates her biological role, and at the same time contractually obligates her to her pregnancy. This is linked to the idea that the surrogate is offering a form of ‘labor’ that is exchangeable (Pande 2010a). By creating a ‘commodity’ of her uterus—she effectively disassociates, gives up her claim to the child. ‘She consents to the constitution of her uterus as an asset class, able to generate monopoly rent … The surrogate, by signing the contract, agrees to rent her excess reproductive capacity … In short, the surrogacy contract requires both parties to agree that Page 8 of 33

Mothers and Fathers the surrogates parturient biology can be both (semi)-detached and instrumentalized in order to be rendered as an exchangeable, quantifiable entity’ (Cooper and Waldby 2014: 84–5, emphasis in original). The contract thus depends upon and actively advertises the ‘free choice’ and agency of the surrogate mother. Sangari (2014) notes that the ‘fictiveness of the contract’ emerges in the ways in which it positions the procreative autonomy of the surrogate mother within a neoliberal marketplace. The state champions this form of ‘contractual violence’ (Sangari 2014) which is akin to bonded labour wherein the surrogate is tied to ‘deliver’ (both literally and metaphorically) the child whose filiation is ‘pre-arranged’. According to Sangari, the ICMR ARTs Bill ensures that biological filiation belongs to those who commission the arrangement, thereby creating a contract not ratified by law, but by the market: ‘altruism is redefined—is used by the market for its own ends’ (Sangari 2014). However, the conflict emerges in the reproductive labour positioned within the ‘sacred role’ of motherhood—a non-contractual role, and an idea that inspires mechanical solidarity. Durkheimian constructions of mechanical solidarity based on a collective conscience privileging primordial loyalties of kin and community clash with the organic solidarity of modern societies based on (p.46) the contractual relationship (Durkheim 1997). In addition, even though the surrogate mother embodies an extreme form of specialization and division of labour—the ‘nature’ of her labour places her within the idioms of inherent loyalties that are wedded to social notions of the indissoluble. It is in the reconciliation of the conflicting demands of the contractual labour, and the primordial ties of mechanical solidarity that commercial surrogacy resurrects the ideal of the ‘gift’ (Berend 2010; Levine 2003). However, in case of commercial gestational surrogacy in India the ‘idiom of the gift’ operates in ways that create a double bind on the surrogate—asking her to honour the contract in an obligatory relationship with the intended parents. Thus, Indian surrogates perceive surrogacy ‘as a divine gift from God … [converting] the picture of the angelic gift giver, which one sees in the global North and Israeli contexts, to a needy gift receiver’ (Pande 2014: 95). Here, the foreign IPs are ‘bestowers of gifts’ for poor Third World women thereby creating an unequal exchange (Markens 2010/11; Pande 2011; Vora 2013) and turning the contract into a classic patron–client relationship (Sangari 2014). Neither strictly contractual, nor a euphemized gift relationship—the commercial gestational surrogacy contract in India draws from patriarchal, market principles of property ownership to enforce an exploitative, unequal relationship. Even before the ‘property’—the foetus—comes into being, intentions are identified in ways that include usurping and reallocating. The commercial gestational surrogacy agreement in India embodies aspects of the gift exchange where persons and relationships are involved in exchanging, and the aspects of Page 9 of 33

Mothers and Fathers commodity exchange where the individual exchanges his/her labour as an object (Strathern 1988). While the IP is encouraged to view the surrogate mother as a ‘commodity’ or a source of philanthropy alienated from her labour (Hochschild 2011), the surrogate mother is ‘enchained’ to the contract and to her relationships with her husband, IP, and clinic to make the exchange viable. It is in negotiation with such conflicts that the notion of ambivalence (p.47) emerges within the surrogacy arrangement and is intrinsically linked to the proclamation and performance of intention.

Choice as Intention/Intention as Choice The medico-legal definitions and understanding of intention place it firmly within constructs of a form of biology that is both culturally and ‘economically’ mandated. Part of the process of mapping choices and agency is through the analysis of personal narratives. In this section therefore, three narratives are related to the motivations that led participants to choose surrogacy as a viable option to have and bear children. In this process, the idea is to also simultaneously explore the idea of intention as it opens up in relation to choice and agency. Of interest is the diverse terrain that is mapped in the three narratives (and associated references of other respondents) which covers race, sexual, class, and ethnic variability brought together in the analysis of divergent views of choice and agency. Here, the importance of personal narratives or ‘personal stories’ (McNeil 2007; Riessman 2002) cannot be ignored. Infertility narratives have been invoked in recent studies to explore ideas of choice, agency, and intention—as well as the ways in which larger structures of biomedicine, family, and society come to influence these stories. Listening to infertile women’s ‘voices’ has led to reengagements with the way ARTs/NRTs are identified, understood, and most importantly, ‘experienced’ (McNeil 2007). Thus, Riessman finds that the infertile Indian woman identifies herself through a dynamic, agential personal story that creates a sense of selfhood and completeness—especially in the face of social censure and approbation and an alienating medical discourse; focuses on nurturance of ‘nonbiological’ children through adoption; and positions infertility within a marital relationship, which extends beyond the husband—to a larger web of relationships. I posit that these elements of the ‘infertility narrative’ are played out not only by the infertile woman seeking surrogacy, but also by the surrogate mother and gay (p.48) dads who are trying to understand their relationships and choices through their participation and intent to conceive in the TCGSA. Are they then the ‘moral pioneers’ that Rayna Rapp (2000) identifies in her ethnographic study of amniocentesis in the US? Are the surrogate, the adoptive mother, and the gay couple in their negotiations with their reproductive selves and the biomedical impositions on the same ‘moral philosophers of the private’ (Rapp 2000: 307)? In the narratives that follow the participants’ sense Page 10 of 33

Mothers and Fathers of identity and intention is part of moral, life-changing deliberations on the social predominance given to the biological tie with kin in their choice of TCGSA, and in that sense they certainly were ‘moral pioneers’. Majboori: The Discourse of the Choiceless Choice

Rukhsana remembers her surrogacy with this candid moment from her caesarean delivery: aur mera pet wagera saaf kiya ... phir aaye doctor leke gaye mujhe ... phir leta ke ... mujhe yahan pet main injection diya ... par mein to hil rahi hoon … maine baate kar rahi hoon ... mera aankh khula hua hain ... baccha dekhne nahi dete ... aankh maine pati lagaya hua tha ... jab mere pet se baccha nikal liya na kat ke ... toh main na bangali main boli: ‘dekho aamar chele ta kaandche na??!’ maine bola: mera ladka ro raha hain ... Anindita (A): aapne bola ‘mera ladka’? Rukhsana (R): haan mera dil ka awaaz toh aaya … mera ladka ro raha hain ... mujhe dikhai de raha hain ki uske haath paao itne mote mote ... lekin leke chale gaye usko ... maine badme ward boy ko bola mujhko photo kheech ke le aa de maine phir husband ko photo dikhaya toh, woh bole: ‘baap-re! itna bada baccha tere pet mein tha ... yeh toh abhi chalne lage ga ...’ [Rukhsana (R): They cleaned my stomach, etc., and the doctor came and took me (to the operation theatre) and laid me down. They injected me in the stomach, but I was moving ... talking (p.49) and my eyes were open [referring to local anaesthesia]—they still didn’t let me see the baby… they blindfolded me … When they took the baby out of my stomach, I exclaimed in Bengali: ‘Look, my son is crying no??!!’ I said again: My son is crying … Anindita (A): Did you say ‘my son’? R: Yes, the cry from my heart told me that my son is crying … I could see his plump arms and legs … but they took him away. Later, I requested the ward boy to get a picture of the baby for me … When I showed the picture to my husband, he exclaimed: ‘My God! You were carrying such a big baby—it seems like he will start walking any minute!’] How does one make sense of such ambivalence? Rukhsana’s love for the newborn baby did not dampen her involvement in surrogacy. Any form of ‘birth pangs’ were quickly resolved through the involvement with further procedures of egg donation. At Surrogacy and Fertility Centre, Rukhsana was feted and Page 11 of 33

Mothers and Fathers welcomed to join the surrogacy program, first as an egg donor—and later as a surrogate. She met the clinic director, Dr Rupa through her friend and neighbourhood relative and was immediately inducted. Ten years ago, Rukhsana came to Delhi from Kolkata with an infant and a stranger. Initially, when she came to Delhi without any connections and family, Rukhsana survived as a beggar on the streets of Delhi. Begging was not new: she had done it in Kolkata after her in-laws drove her out of their home in Giridih, Bihar, once her husband died of a mysterious ailment in a hospital in Patna. Brought up in an orphanage in Kolkata she returned to the city heavily pregnant and gave birth under a flyover to a baby boy. There she was rescued by a local doctor only to be told that she could work as a domestic at his place while he would adopt her son. The caveat to this was that Rukhsana could never claim her son as her own child, and would only be allowed to see him once in a while. She took the next train out of Kolkata to Delhi. (p.50) That, she remembers, is how her life was. Until, she met her second husband in Delhi. A street food vendor, her husband helped hospitalize her ailing son, leading to a relationship between them. After a few years she converted to Islam when she married her husband and became pregnant with her second son. Rukhsana began to do domestic work in Delhi neighbourhoods, just getting by: ‘I washed utensils in other’s homes … worked in other people’s homes … just ask me what kind of work I did not do … except for stealing … I never did the wrong thing … I have even cleaned people’s refuse and thrown it … I have begged as well … so for me the kind of money that surrogacy brought in meant that my children’s lives would be better …’ Rukhsana finds surrogacy as deeply rewarding, rescuing her from her life of desperation, of precarity. Amongst the various jobs she undertook, being a domestic and begging pushed her to the brink, and were extremely demeaning–– the mention of picking people’s refuse is one such example. But surrogacy was different,‘I liked doing it [surrogacy] … there is so much ganda kaam (prostititution/soliciting) in Delhi anyway … many of the other Bengali women do that kind of work [prostitution] … what is the need? We also do body work … then what is the need to do this kind of work [prostitution] … get some injections and give birth to a kid …’ Labour has a different meaning for her as is seen when she invokes sex work and her role as a surrogate. Rukhsana recounted the money she had earned slowly and deliberately— remembering the purpose and expenditure of her earnings through surrogacy in particular. R: See, even though my husband and I go out to work we cannot afford to eat fruits, meat, and fish everyday [which is required during the pregnancy], so they gave us Rupees 12,500 [195 USD] per month during Page 12 of 33

Mothers and Fathers the pregnancy. So you can add that up and see how much I got for nine months [it comes to Rupees 1,12,500—approximately 1,800 USD] … then the remaining amount is given to you afterwards [after the delivery]. It’s better to take the amount through a cheque … I already have a bank account so I would always get paid by cheque ... (p.51) A: Was the monthly payment in cash though? R: Yes, that would be in cash … A: So what was the amount you got a cheque for? R: Well … that was … do the math … I got Rupees 2,00,000 [approximately 3,000 USD] and an additional Rupees 45000 [approximately 700 USD] for the operation [caesarean delivery], three-months rent for the home is separate during the period … for the period of convalescence, of inactivity I got Rupees 2,500 [approximately 40 USD] more which came to Rupees 7,500 [approximately 115 USD] for three months … and what the client [commissioning couple] gives has no count … A: So the final count was ...? R: Between Rupees 5,00,000 to 6,00,000 [approximately between 7,500 to 9,500 USD]… A: Does everyone [surrogates] get similar kind of money? R: No … this has a lot to do with one’s kismet [luck]…like Indian couples are very miserly … they think that we have already spent so much money on the arrangement what is the need to further thank the surrogate [give gifts] … but they should thank us, right?’ Rukhsana was clear about where she wanted to put the money after she got it. ‘mere toh age peeche koi nahin ... main to aanath alaye mein badi hui. … aur yeh mera bada beta pehla ka hain ... ab yeh tehni tod loge aur doosre paide main lagane jayoge toh lagta nahin hain ... toh phir mera baccha toh mera hi hain na..uss ka thodi na hoga ... isliye maine yeh kaam kiya ... ki mera bada beta padai mein bhi accha hain ... uske liye thoda kaar loongi ...’ [I have no family … after all I was brought up in an orphanage … and this son of mine is from my first husband. Now you can not cut a branch and attach it to another tree … so my son is mine alone—he will not become his {her second husband} … that is why I did this work {surrogacy} my elder son is also good in studies … I wanted to do something for him.]

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Mothers and Fathers (p.52) This meant that Rukhsana had deposited a bulk of her earnings for her eldest son, triggering a jealous outburst from her husband. She had to eventually placate him by entering into an egg donation procedure soon after her delivery, against the advice of the doctors, to be able to buy her husband a motorbike from the earnings. Her distaste at having to do this was evident—but so was her power over the household. Now she works for the clinic in an administrative capacity, delivering files and medicines to surrogates, which has helped her employ a servant to care of her home. However, she hopes to undertake another surrogate pregnancy—or get involved into regular surrogate recruitment. A pragmatic solution to surviving for women who are down and out: for Rukhsana the body is involved in both sex work and surrogacy, while one is disreputable the other is respectable—at least in comparison. And this is what draws her in: the sui [needle] that will induce a pregnancy without having to sleep with anyone or indulge in prostitution. Instead, Rukhsana underwent injections, transvaginal probes, and finally the birth of a baby to be able to earn the amount of money she had only heard of. Here, majboori, a common refrain amongst many surrogates does not immediately and obviously appear in Rukhsana’s narrative. Majboori or desperation has become a common trope of engagement to describe a form of choice that may signal different forms of agential acts (Grover 2011; Pande 2010a). For surrogates too majboori was a common refrain. Many of the surrogates I interviewed articulated their majboori in entering the surrogacy business. However, the import of the word oscillated between two ends of helplessness and desperation. For Pande, majboori is articulated as a form of ‘higher calling’ giving credence and value to the surrogate’s choice to undertake surrogacy as a sacrifice (2010a). The surrogate’s choice is positioned as relational in the context of seeking to fulfil the necessities of (p.53) her family. This is linked to the idea of surrogacy as a form of ‘calling’—associating it with destiny/luck forms a major part of the Indian surrogate’s narrative, according to Amrita Pande (2014). In Anand, surrogates worship and give their thanks to ‘surro-dev’, the god of surrogacy who literally ‘chose’ them to be a surrogate (Pande 2014). This also means that surrogates are made to believe of their role in the arrangement as a form of good fortune, embedding them further into a cycle of obligation. This is opposite to the idea of the ‘gift’ of the child or of motherhood that most American and Israeli surrogates articulate (Berend 2010; Ragone 2004; Teman 2010). The Indian surrogate receives a gift from couples, especially foreign couples, who are ‘helping’ them overcome their state of duress (Pande 2011). Even though Rukhsana believes it is her good luck or ‘kismet’ that got her the surrogacy, she nonetheless reinvokes the ‘gift’ as ‘thanks’ (dhanyawaad) that many couples do not give on the birth of the child even though they are Page 14 of 33

Mothers and Fathers obligated to. The obligation is on the couples too, for the months of non-activity and enforced unemployment that she undergoes. For Rukhsana, the payment break-up signifies many things for her. Each amount of money brings in hope and stability. She is now able to quantify her good luck (kismet) and pass it on to her children. Rukhsana forgets and denies the pains of taking the medication, undergoing massive swelling, to be able to privilege the money she gets for her labours. Her remembrance of hearing the baby’s faint cries after the delivery are the only markers of her pregnancy, as she was not allowed to see the baby. But the pain is invoked in lost chances, in derecognition. She remembers how after her first egg donation procedure, before she participated as a surrogate, her labour was devalued through the involvement of the agent. ‘I got Rupees 30,000 [approximately 460 USD] and the agent ate up most of it … Rupees 10,000 [approximately 150 USD] … I felt so bad. I mean if someone is gifting you out of happiness Rupees 10,000–20,000 [approximately between 150–300 USD] then its ok [to share some] … but I will do all the hard work and half the money will be taken away by the agent … this is not right’. (p.54) However, ‘good luck’ is not an insurance against the form of stigma that follows participation in a surrogacy arrangement. The disassociation from sex work helps justify surrogacy in a way that creates notions of work-labour that are preferable in circumstances necessitated by majboori. ‘[M]ajboori, a vernacular term signifying vulnerability, powerlessness, and helplessness—is a statement that a woman is experiencing a tumultuous phase, that she lacks alternatives, and that she is no longer in control of her life … while majboori conjured powerlessness, it paradoxically also signals agency’ (Grover 2011: 75). Helplessness comes with a certain sense of power to wrest back control from the life circumstances that any woman in stigmatized work is faced with. And in that sense majboori is both choiceless choice, and a form of agential intervention. It is not without reason that Rukhsana does not articulate majboori, the ways in which other surrogates in my research, or in Pande’s research did. For many of the other surrogates, such as Prema, an upper-caste Hindu trying to fund her husband’s surgery through surrogacy, shame, majboori and the sin (paap) of doing surrogacy went together in a complicated narrative. This form of narrative followed the desire to retain the notion of being a ‘good woman’, chaste and without sin that dogged many of the surrogates I interviewed. Not without reason, then Aditi, another surrogate hid her surrogacy from her conjugal kin while living with them, noting, ‘kya karein … majboori hain. Itni mehangayi hain …’ [what to do … its majboori … things are so expensive these days]. But Rukhsana, has lived a life on the edge. For her surrogacy is better than begging or cleaning people’s refuse. There is no majboori in her desire to be part of surrogacy—only something that fulfils many of her life’s desires. In this Page 15 of 33

Mothers and Fathers her relational mooring are also open to scrutiny—as she sees through her husband’s intentions vis-à-vis her money. It is also starkly felt when she recounts how her husband describes the newborn she delivered—as a ‘big baby’— identifying him more as a commodity than a child. For her, the money is meant to sustain and nurture her relationship (p.55) with her son—who unmoored seeks support. Rukhsana is a mother and a woman privileging her motherhood— in her love for her sons, and in the suppressed love for her surrogate baby. In that sense how is one to understand the surrogate’s choice in the very fraught terrain of reproductive choice? I deliberately focus on majboori as one such term that encapsulates the varied hues of this ‘choice’—and as a cultural intervention to questions surrounding the surrogate’s motivations that have informed analysis of reproductive choice in surrogacy (Teman 2008). The surrogate’s reproductive choice has been the subject of debate in many academic conversations. However, most of the analysis seeks to position the surrogate’s choice in terms of her seeking social approbation. The surrogate is embedded within social relationships that constantly judge her for her choice to participate in the arrangement—thus, the ‘relational perspective’ (Holman and Hagan 2001) suggests that the surrogate’s motivation and justification emerges from her complex relationship with her husband, intended parents, doctors and extended family. Predominant focus in most of the studies on the surrogate’s choice/motivations is on the idiom of altruism—wherein the surrogate distances her choice away from financial motivations (Levine 2003; Ragone 1996; Van Den Akker 2003). And the rhetoric of ‘gift giving’ predominates in clinical and popular discourse in order to position the surrogate’s choice in a positive light, away from conversations on ‘abnormal motherhood’ (Parker 1983). Such ‘constructivist models’ identify surrogates as opposed to, or distinct from the ideas associated with motherhood (Teman 2008). In such constructions, the difference between biological and social motherhood is exacerbated, especially within the Euro-American framework—though anthropologists such as Ragone (1994, 1996), Berend (2010; 2012), Roberts (1998) have suggested otherwise. It is this very biological essentialism that marks surrogate as divergent and aberrant, leading to questions regarding her ‘choice’ In case of Indian surrogates, the ‘rhetoric of choice’ (Williams 2010), however, takes on questions regarding the surrogate’s labour, with (p.56) Western feminist academic Arlie Hochschild (2011) and Indian feminist academics and activists (Qadeer 2009; SAMA 2010, 2012) questioning the exploitation of the poor surrogate from the South, being exploited by the rich woman from the North (Ginsburg and Rapp 1995). Despite multiple readings, the overwhelming understanding of the surrogate comes across as one that lacks agency due to her marginal status. Hochschild (2011) suggests that surrogates exhibit a form of false consciousness

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Mothers and Fathers as they are alienated from their work, further paving the way for their exploitation in a ruthless global economy. Rukhsana presents to us a narrative of engagement—she welcomes me and the audience to understand her experience as one that enriched her, and rescued her from continued poverty. Her intentions are not cloaked, and neither is her majboori—in many ways both are the same. Ultimately, conversations on choicemotivations or intention-majboori traverse spaces of individual agency, however coercive social structures and practices maybe. ‘Our marriage needs a baby now!’: Infertility as a Heterosexual ‘Lack’

I will tell my child that it [the birth] was a joint effort by three people—and the birth meant a lot to us. I want to spin a yarn, but let the child know—so that he or she grows up to be strong without any emotional issues. This is how Rita imagined her role as mother to her unborn child. At 33, she was a successful fashion designer married to an equally successful entrepreneur. In between her hectic schedule—both professional and social—Rita realized that motherhood was a role that she had to fulfil and live. It was a decision that she was deliberating on for more than two years. Through conversations over the period of a year, Rita had changed her stance on surrogacy a number of times; however, she had been unable to reject it as the only viable option before her to have a child. Her negotiations (p.57) were symbolic of the dilemma that other couples went through when deciding on surrogacy. Suffering from a peculiar auto-immune (AI) strain inherited from a mixed parentage on her father’s side—she lead a regimented life of particular diets and a strict lifestyle. The fear of passing this disorder to her child had been the primary reason why she wanted to go in for surrogacy. In an introductory email she had written— I’m contemplating a surrogacy myself and I’ve been researching on the subject for over two years. I have a mild auto-immune condition [AI] that I wish not to tamper with and I also do not wish to have a high-risk pregnancy, should the AI strain act up beyond reasonable limits. If you want to have a chat, I could tell you about the taboos surrounding the said topic within my own maternal family and also share some facts that I’ve discovered for myself. I must also confess that I’m quite vain ... after the initial heartbreak of deciding to forego the entire child-bearing role and after interviewing fifty women, I’m happy to remain a size zero. [Email dated 20 May 2012] Body image remained a recurring theme in Rita’s narrative on pregnancy. Often it oscillated between a moral stance and wishful thinking. After three months of

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Mothers and Fathers the first meeting, when she had been completely convinced about surrogacy, Rita began to speak of wanting to be pregnant, and being unable to. So I started looking for surrogates. The moment you start looking at files of girls—it becomes real. You begin to have doubts. My family began to ask me if I was sure about it and if it was not possible to do the whole process the normal way. As in my Mum and Tarun [husband] asked me if I could get pregnant … they were supportive … But … I asked my doctor again and was told there were risks involved … I mean I really wish I could have one on my own … (emphasis mine) The peculiarity of Rita’s condition meant that she could and could not get pregnant at the same time. This took on an increasingly moralistic–social dimension. She noticed and remarked on how relatives and friends treated her desire to go in for surrogacy with derision—seeing it as a ‘lifestyle choice’ rather than one (p.58) prompted by circumstance and medical lack. She was constantly trying to fight off negative perceptions regarding her ‘inability’ to be a mother and wanting to ‘outsource’ it. In her attempts to be open and critical of social appraisal, Rita spoke of social expectations as debilitating. The ability to bear a child seems to be the primary identification of a woman. This sense of social recognition is placed over and above the idea of the wife and even the rearing mother. The gestational power becomes a form of ability. This often meant that she was ‘judged’ on her stance against adoption. Rita was clear that she did not want to mother and nurture a child whose genetic and familial background were unknown. For her adoption meant taking in homeless, poor children—she did not think it was her responsibility to shoulder the burden of parents who had ‘discarded’ their children. Yet, she began to recognize the need to safeguard her marriage with the birth of a child. After almost a year since we first met, during one of our monthly conversations, she spoke of having consulted an astrologer. This astrologer had predicted that her AI strain was not a result of genetic inheritance (totally in contrast to what doctors had been telling her all along) but a result of environmental factors. He suggested that through an even stricter diet she could be cured of it and would bear a child by the time she was 40. Unfortunately, Rita was unwilling to wait that long. I don’t want to wait till 40 to have a baby … I know my husband would make a good father. I have seen him around his friend’s children … I don’t have a choice in this [surrogacy] … everybody keeps saying that I do, that I am doing this because I am career oriented … or want to safeguard my

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Mothers and Fathers figure … but I want a baby for my husband. Our marriage needs a baby now. Over the course of a year while Rita met doctors, agents, and prospective surrogates in India and the US, she began to understand (p.59) and ‘repackage’ her intentions as an intended parent according to the reception and feedback she received from doctors and agents, as well as from her social milieu. For her the ‘right’ surrogate changed from a known friend or relative to a woman who will not be too ‘hungry for money’, to finally—an unknown Indian woman she will never meet. From wanting to keep the surrogate with her during the pregnancy to never meeting her, Rita changed her stance on wanting an equitable relationship with her surrogate to not wanting one at all. Her gynaecologist, Dr Bakshi exercised a great deal of influence on her which was further strengthened after her experience in the US. Upset over the ‘racist’ attitude of agents and doctors in the US who saw her (much like her relatives) as a rich Indian ‘daring’ to hire a White surrogate, Rita found them to be far too ‘pro-surrogate’—to the point that ‘they favored the surrogate more than the foetus’. Her focus on the Indian surrogate began to be more on the lines of a preoccupation with her emotional health.1 She was willing to pay up to Rs 1,00,000 [approximately 1,600 USD] for a ‘fat and happy’ surrogate. May be it’s my imagination but I found that my cousin’s daughter born through surrogacy, though very sweet, looked a little lackluster. I think the surrogate’s emotional state is certainly passed on to the baby. My doctor told me that the embryo in the womb is protected by many layers. So, 80 per cent of the baby’s make-up comes from its genetic parents—but 20 per cent comes from the woman carrying the baby. This is the link the baby has to the mother through the umbilical cord. This is directly impacted by the emotional health of the surrogate mother. I don’t want my surrogate to be this emaciated poor woman with abuse issues. She must be healthy and emotionally well. Genetics can be handled. (emphasis mine) Rita remained confident about genetics, but not about the womb and the surrogate, or about surrogacy. On being asked if the egg that she would give for the pregnancy may end up carrying the same AI strain, Rita had thought of an expensive medical (p.60) testing method, ‘genetic embryo testing’ (the prenatal genetic diagnosis test or PGD) that could ascertain if the foetus carried the genetic disorder as well. In case it did, she would be forced to abort the pregnancy. However, she was certain that her husband’s ‘strong sperm’ would placate the fears of the foetus inheriting her AI deficiency. The paradox of Rita’s situation lay in how the AI deficiency had every chance of being inherited by the foetus with or without a surrogate.

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Mothers and Fathers Despite the genetic deficiencies, Rita would go the extra mile to have the baby that would belong to her and Tarun. Her confidence in Tarun’s fathering abilities went beyond his fulfilment of the role—it also rested in his physiological–genetic ability. Therefore, when a close friend volunteered to be the surrogate in an altruistic arrangement, Rita immediately rejected the idea fearing the development of intimate feelings between her husband and the friend. ‘What if she falls in love with him?’, and he with her, was an unsaid yet recurring doubt. The third person had to be distant and hired—it protected Rita’s marriage and gave her a child. Rita finds the ‘ability to gestate’ as an eulogized and coveted role for every woman. The physical representation of motherhood, despite the genetic link to the foetus through the egg, tends to be a more important marker of motherhood.2 The physical ‘lack’ for women in a heterosexual relationship becomes not only a question of fertility and nurturance, but also a symbol of the marital tie. Progeny are an important sign of stability, love, and desire within a marriage (Franklin 1997). Even for successful, ‘unmaternal’ women, like Rita, children were a sign of happiness—a sign of the shared state of conjugality. In that sense marriage and the married state ‘demands’ a child. It is created for the creation of children and in keeping with social sanction—according to which a marital relationship may not live up to its social ‘status’. (p.61) This meant that she was unwilling to go in for adoption. She had vehemently stated that she had no interest in ‘taking in the street children of Delhi in her home—what if the father was an alcoholic and the mother an abused woman?’ That their unknown genes collided with her notion of her very own shared genes was amply evident in her reasoning regarding having children. Yet, she reiterated that she had no choice. She was bound by her condition, which threw up issues of further ambiguity. For instance, Rita was willing to go through an expensive post-conception testing procedure to trace if the foetus had inherited her AI strain—rather than get pregnant herself. Her no-choice stance was similar to that of the surrogate. Adoptive mothers often positioned their intentions vis-à-vis the surrogacy arrangement as a form of ‘no-choice option’, like the surrogate. This stance was in keeping with the creation of a ‘norm’ within the overwhelming discourse of abnormality that pervaded the social reception of surrogacy. Thus, most of the women willingly abdicated agency in order to escape the stigma attached to being ‘aberrant mothers’. Motherhood in the physiological sense of the visible pregnancy is not only eulogized, but normalized. Of course, only the married pregnant mother is desirable socially. The unmarried mother is chastized and stigmatized, just like the ‘barren’ infertile woman is (Nandy 2013). Motherhood positions itself in this Page 20 of 33

Mothers and Fathers paradox of differing perceptions of normality and abnormality in relation to the ways in which the ‘normal’ is perceived and constructed (Demeny 2009; Dow 2009). This is also seen in the adoptive mother’s ‘choice’ in seeking surrogacy or infertility treatments to fulfil her desire for progeny. This choice lacks agency— but manages to convey its rebellion through the ambivalent emotions that exist. Thus, Rita’s ambivalence regarding childbirth and her husband’s love for children, and her corresponding fears regarding the loss of her marriage become overwhelming reasons for positioning her intention as a (p.62) nonchoice choice. Singh (2011) refers to the ‘reproductive aspirations’ of infertile women in north India who have to ‘manage’ familial pressures and the, often, secret pursuit of ARTs for the desired kin. The desire for children may not be felt with the same kind of enthusiasm as is positioned by many of these women. The counsellor at Miracle Babies mentions how many of the women who visited her were accompanied by fierce, controlling mothers-in-law or unreceptive husbands. Many times, she noted, the woman openly detested her husband, which she attributes was a major reason why the body would ‘shut down, and refuse to get pregnant’. Another respondent, Puneet Kaur (discussed in detail in Chapter 5), who after more than 30 years of unsuccessful infertility treatments had a boy in 2011 through surrogacy, seemed visibly tired of the lifelong struggle to get pregnant. For her the whole exercise had been for her husband’s sake, something she confessed to after the baby was born, and not during the pregnancy when she continued to pray and obsess about her quest for motherhood: I am mother to my many nieces and nephews … I didn’t want to be a mother, he wants to be a father [pointing to her husband] ... he wants his own child. My nieces and nephews look at us as Mummy and Daddy. We never miss out Mother’s Day or Father’s Day celebrations … bacche toh bacche hote hain ... unko pyar karo bas ... [children are after all children, they just need love]. The ambivalence and the conflict in seeking the birth of children and understanding the ‘diminished’, negotiated role they play in their child’s birth fractures the intentions of many of the adoptive mothers. They enter the arrangement to become mothers that fulfil roles seen as important to them and their husband’s families. Most importantly, they wish to restore and preserve their husband’s genetic identity as they believe that their own infertility has compromised it to a great extent. This is despite the importance that many of the mothers attributed to their genetic contribution (p.63) through the egg. In purposefully resisting to own responsibility to enter the surrogacy arrangement, and by placing it within the obligations of the marital bond and the patriarchal family many of the adoptive mothers recreated their own notion of intention. By Page 21 of 33

Mothers and Fathers positioning it as a ‘non-choice choice’ (Strathern 1992a) they were able to both conform to the norm of positioning themselves as ‘different’, and yet socially acceptable. Intention in the case of the adoptive–genetic mother is not just the desire to be a ‘mother’. Unable to, and often, unwilling to be pregnant—intention itself comes across as complex and ambiguous (Greil and McQuillan 2010). This ‘fractured’ intention is different from the presumed, steadfast, taken-for-granted involvement of the infertile woman in the infertility treatment. The perception of ‘lack’ itself appeared in different ways in case of the adoptive mother in a heterosexual relationship—and the gay couple, or single father. The ‘lack’ of infertility became an interesting trope in the case of a gay couple, who actively sought to overturn their stigma of being in a ‘non-procreative tie’ through surrogacy. Here, choice became a term that did not convey agency as much as negotiations between heteronormative and dominant ideas of biology and genes and the right to make a family away from these standards. The desire for a child is deeply connected to the intimate relationship. A marital relationship, which despite having the potential, is not able to lead to progeny marks the infertile heterosexual relationship as a ‘lack’. This defines the medicosocial discourse on infertility. The way in which infertility comes to be positioned within the surrogacy arrangement implicates the woman as the infertile partner within a heterosexual relationship. Here, there are no secrets and ambiguity regarding the infertility. IVF-surrogacy as a technology positions itself as an answer to the woman’s problem. The ‘technological dilemma’ becomes more acute when the couple has to navigate the visible pregnancy while claiming genetic ‘connect’ to the foetus. (p.64) The psychiatric counsellor at Miracle Babies dealt with many of the infertile couples who came to the clinic. Even though none of her patients were IPs entering the surrogacy arrangement as ‘they had already made up their mind’, couples undergoing unsuccessful IVF cycles would come seeking advice and counselling. She found that many of her female patients burdened with infertility issues suffered from marital disharmony—exacerbated by and exacerbating the situation of childlessness. She noted how the couples would be trying to retain their marital relationship with the birth of a child.3 The social completion of the familial unit in India and elsewhere in the world has always rested on the birth of the child. Here, the child makes up the triad of the marital union, giving it legitimacy (Bharadwaj 2003). The infertile are incomplete in that sense. Seeking infertility treatment through donor or surrogate participation means including a third person to an otherwise intimate tie of two people creating a child through the intermingling of their genetic substance. Page 22 of 33

Mothers and Fathers For married women, infertility turns into a symbol of ‘incomplete conjugality’ (Franklin 1997). This is often the first impetus to seeking infertility treatment in case of heterosexual couples. Here, the ‘gap’ began to be seen as a ‘lack’—a missing key to a complete happy married life. That the ‘gap’ is felt primarily by women within an infertile marriage also points towards how the positioning of the treatment is highly women-centric. Despite equally high rates of male infertility, the ‘lack’ lay with the woman, the adoptive–social–genetic mother in the surrogacy arrangement. The nature of TCGSA however merely repositions the woman as the ‘real infertile partner’ in the context of an already existing overwhelming discourse that tends to blame the female partner between the infertile couple. The notion of ‘barren-ness’ comes to impact the woman in a detrimental way, even when the man may be suffering from infertility. Often women willingly take on the burden of covering up for their husband’s ‘lack’ by reinstating (p.65) the dominant stereotype of the infertile woman (Lundin 2001; Throsby and Gill 2004). In case of gestational surrogacy a new form of ‘lack’ is exhibited at the cost of privileging the presence of the genetic tie. Many of the women who were part of the ethnography insisted on the viability of their eggs, thereby delegitmizing the gestational role as the form of motherhood. This was especially important considering that women are traditionally socialized to believe in the importance of ‘bearing’ more than conceiving. North Indian procreation ideologies privilege the role of the womb as the only contributing factor of the mother within kinship, as exemplified in the ‘seed and earth’ ideology (Dube 2001; Fruzzetti and Ostor 1976). Yet, a new narrative on motherhood came to be repositioned as per the renewed importance of the embryo, through the emergence of ARTs. Thus, Meera, whose second son was born through IVF was shocked to find that friends and relatives were derisive of her choice to use an anonymous egg donor, while they seemed to be at ease with her using a surrogate mother. However, because Meera’s womb was fine—she was ostensibly not producing healthy oocytes/eggs—surrogacy was never an option. Most of my friends told me that the surrogate would be merely incubating the foetus, at least the egg would belong to me … but I disagree. I think pregnancy and being pregnant is an important qualification for being a mother. The one who gives birth is the mother … as a role that is closer to nature. This is similar to what Anitha Jayadevan (2009) recounts in her autobiographical narrative of a flawed infertility treatment. After the miscarriage of her IVFinduced pregnancy she came to know that she ‘had been reduced to the role of a surrogate mother’ when she found that the embryo was fertilized with the oocytes/eggs of an anonymous donor. Page 23 of 33

Mothers and Fathers In the transformed terrain of ARTs the idea of procreation and nurturance changes to reflect newer sensibilities. In the gestational (p.66) surrogacy arrangement ‘the cultural “imaginings” of visible social triad of mother/father/ child as underscored by an invisible biological triangle of womb, semen, and foetus are intimately linked …’ (Bharadwaj 2003: 1870) is lost. Unlike other forms of ARTs whose successful administration restores the ‘visible triad’ through the pregnant adoptive mother—in case of surrogacy it becomes further fractured. In such a situation, a combination of secrecy in seeking the treatment and ingenious strategies mark negotiations amongst adoptive mothers. These are meant to cover many ‘lacks’, but most importantly require negotiations that reflect their own acts of ambivalent conflicting choices in entering and sustaining the surrogacy arrangement. They may take strategic ways of ‘naturalizing’ the tie of genes and connectedness (Thompson 2001), or may involve giving it the garb of altruism (Ragone 1996). The navigation of the complicated, alienating and yet critical surrogacy arrangement requires that adoptive mothers understand ‘lack’ in ways that involve the creation of fiction around having and bearing children. Rita does the same while contemplating her choices in relation to entering the surrogacy arrangement. Two Dads and Two Babies: Sharing Unshared Substances

By the time their two children were eight months old, Vincent had completely said no to the idea of having more children. Despite John’s obvious interest in expanding the family, Vincent the stay-at-home-dad insisted that he had his hands full taking care of their two infants. In October 2011 while waiting to take their newborns, Alisha and Mike, back home to Victoria, Australia, Vincent had been reluctant but willing to think about more children. He had told John that they ‘could discuss it in a year’s time’. John insisted that he wanted them to have another child who would be genetically (p. 67) connected to the other parent—the one who was not the biological father of Alisha and Mike. However, both refused to divulge who amongst them was the genetic father. John (J): We are okay and comfortable talking about this [surrogacy] ... what we are not comfortable talking about or answering is which one of us is the biological parent … Vincent (V): I have a friend back home who came over and found out and wanted to know whose was it and we were unwilling to tell ... but she said ‘Oh we are going to be able to find out anyway because if it’s John then they will have brown hair and brown eyes’ … and John and I went like ‘the

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Mothers and Fathers biological mum is Indian’ … so … [both burst out laughing] … but we love the fact that both of them have blue eyes … J: Usually people will ask who the bio dad is and we don’t tell them and 99 per cent of the people move on … but there are some people who insist on knowing … V: At a coffee shop we go to the lady asked who the father was … and we say we both are … and she says oh fair enough and moves on … Vincent and John’s unwillingness to share the identity of the ‘bio dad’ played itself out in relation to the way in which they approached the surrogacy arrangement in India. After narrowing down on Surrogacy and Fertility Centre through common networks of gay parents in Australia who had had babies through the clinic, they decided to invest the money they had earned from the sale of John’s family home into the surrogacy arrangement. They realized very early on in the arrangement that the choice of the surrogate mother was best left to the doctor. The doctor’s opinion and judgement had been predominant in the selection of both the surrogates: the first who was unable to get pregnant; and the second who was pregnant with, and gave birth to Alisha and Mike. However, when it came down to choosing the egg donor both Vincent and John were shown profiles of egg donors and asked to choose. They chose an egg donor, who as per her profile, was not (p.68) very educated but looked remarkably like one of the female relatives of the non-‘bio dad’. John (J): We did get the profile of three donors from the doctor and we went through them … Vincent (V): In the end it came down to which of the donors looked best like the women belonging to the non-biological side of the family … Anindita (A): Were you able to find somebody like that? J: We were ...! Very similar … we found two! We can actually see links to members of our family even though there is no genetic link there … A: You can see that already ...? V: Yes … Mike does things with his face … or his eyebrows that you can trace to some members of the family … [laughs and looks at John knowingly] J: So I wouldn’t mind having another kid with the other biological dad … but with the same egg donor … so that the babies have a connect between them … (emphasis mine)

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Mothers and Fathers Their children’s links to India were established through the donor, and for both of them the choice of the donor had not been based on education or personality, but on looks and another important factor. Vincent and John had insisted on knowing about other couples who had used their donor’s eggs in a surrogacy arrangement. They had been told that her eggs had led to the birth of three other children, living in the US. Though an Australian couple may have used her eggs while they were simultaneously trying, they could not be sure. The concern stemmed from fears regarding their children’s future. Vincent (V): So if Mike comes home and says he has fallen in love with a girl who was also born through surrogacy, then we will ask the girl’s parents who is your donor … (p.69) John (J): There is a lot of activity within our group [of gay fathers who had children through surrogacy] … so there is a very good chance that in 15 years time ... our kids might fall in love with each other ... V: We do know that so far in our group our egg donor has not given her eggs to anyone else ... but of course it’s a minefield. J: But this is also another reason why we have to be honest about how they were born … they will be conscious of it when they meet someone … The fear of incest with siblings born of the same donor, but not of the same surrogate played on their minds. That more and more children were being born through surrogacy in India, especially amongst gay couples in Australia had become a lived reality. In a situation where most gay couples were not allowed to legally adopt either through domestic or international channels, surrogacy had been a blessing. Besides fostering and co-parenting with lesbian couples—both of which had not proved viable—John and Vincent had given up hope of ‘having our own children’. Until, of course, they heard of surrogacy in India. In addition, even though the word ‘SURROGATE’ featured on the birth certificate as an entry next to ‘MOTHER’, they were clearly unwilling to meet and engage with the surrogate. Their gratitude apart, Vincent and John wanted to move to Australia and start the parental order process in the Australian courts were the non-biological father could also claim his parental rights on the children. Like Vincent and John, many of the gay couples were averse to discussing who the ‘bio dad’ was. They purposely did not claim genetic connections to the child —even though they had to be part of the mandatory DNA test required for the purpose of getting (p.70) citizenship for their newborns. In many ways the rejection of social identification of genes meant the proclamation of the couples as intended parents together—rather than separately. This meant actively seeking the parental order so that the other partner may have equal rights in the Page 26 of 33

Mothers and Fathers children. This was also a way of reinforcing faith and priority in their ‘mutual parenthood’—often over and above the ‘biological truth of DNA’ (Melhuus 2012: 86). However, as John insists, the other ‘non-bio dad’ should also have genetic stakes in the children, so that there is a ‘connection’ between the siblings. This was to be achieved by choosing an egg donor who ‘looked like’ a relative on the side of the ‘non-bio dad’, or by having a common egg donor for children born of the ‘two dads’. The tie between the couple was being established through genetic commonalities between their children. The notion of resemblances as constructed between both the fathers was seemingly at the level of separate yet, conjoined genetic paternity. In many cases the desire to create equal rights in the children meant that the ‘non-bio dad’ would come back to have another child through surrogacy—as was the case with Philip and Trent. The importance of the genetic tie did not just exist in a vacuum but became a question of shared ties in this situation. In case of the gay couples, this was shared with two unknown Indian women. Most gay couples thought of the egg donor as the genetic mother of the baby as opposed to the surrogate who carried the baby for the nine months. This is why the desire to screen and choose the egg donor was more frequent than in case of the screening of the surrogate mother’. The ‘appearance’ of the egg donor, her personality became important windows into the kind of baby they would have. We had one friend who offered us her eggs. Oh dear! ... but we know her too well and we don’t like her much … she is very stubborn … very scary, very picky … perfectionist ... going out to dinner with her is madness ... I couldn’t do it … with two children like her …! [laughs] (Vincent) (p.71)

Trent and Philip were more than willing to borrow eggs from a friend, but ended up selecting an anonymous Indian egg donor based on an interesting logic that combined considerations of race and genes. Trent: We were looking at the Hispanic donors and Native American ones … you see we liked the idea of a little pigment in the children’s skin to help protect them from the fierce Australian sun ... so I have very White English skin and in Australia … when the heat comes … we bolt the windows, hide in the houses until evening. So we found that it was an important thing to protect our children’s skin from cancer through some color. Now because of my natural logic we were looking at Hispanic donors … We were originally looking for an egg donor from England ... then the clinic told us about an Indian egg donor ... and Indian women are so beautiful and those big brown eyes ... and I grew up in London at the university there … and I Page 27 of 33

Mothers and Fathers have always been exposed to a lot of people from the subcontinent ... So we made up our mind and a friend of ours … known her for 20 years, she kept saying why aren’t you taking Tara’s eggs ... and Tara is her niece ... and Tara kept saying ‘that ‘take my eggs, I would love it’ ... So we went through the process of getting her all the medicine, bringing her to Mumbai and getting a collection … Philip: The idea was that we would collect Tara’s eggs and separate them into two halves—I would fertilize one batch, Trent would fertilize the other and we would transplant it into two surrogates … uhm … but unfortunately Tara did not have enough eggs to do that ... and they had collected some eggs from an Indian woman that morning who was similar in facial features and type to her. Trent: Just as an aside, Tara is Pakistani … so our children were always destined to have part of the subcontinent in them. (emphasis mine) The creation of resemblances between egg donors and unborn children emerged from the Western-medical notion of the shared genetic tie with the egg, rather than the womb. This grudging, yet undeniable linkage with an anonymous other hid anxieties similar to the infertile heterosexual union. The bond of lovers (p. 72) was threatened in the presence of an ‘other’ in the body of their child and offspring. This was exacerbated especially when one of the partners was not connected to the child ‘biologically’. Thus, there came about these elaborate pieces of fiction that gay fathers created around the choice of the egg donor. Vincent and John chose a donor who resembled someone from the non-biological father’s family to be able to create a linkage where there was one. This ‘choice’ mirrored notions of familial resemblances, race, and class. For the lesbian couple the issue of artificial insemination became their negotiations with ‘biology’. The act of artificially inseminating the partner with the turkey baster was a form of resistance to the heteronormative moment of sexual procreation (Goslinga-Roy 2000). Pregnancy and childbirth came positioned in the same being: the act of creating linkages occurred with the ‘non-bio mother’ who symbolically inseminated to create that linkage. However, in the case of the male gay couple—who formed the majority of the clients accessing transnational gestational surrogacy—the desire to create genetic connectivity was more problematic. How does one understand this desire for genetic connectivity and the overwhelming ‘rhetoric of choice’ in relation to the gay family? The choice of having children itself signalled a major declaration of intention on the part of many gay couples. The replication of the genetic tie was just another aspect of the ‘choice’, though not the primary aspect of wanting to go through surrogacy. The most important aspect was the desire for a family with one’s Page 28 of 33

Mothers and Fathers partner and lover. As Melhuus notes, ‘[B]y insisting on being recognized as a family with two … fathers, they [gay fathers] are creating new forms of relatedness (2012: 86). Yet, ‘Biological relatedness appeared to be a subsidiary option ranged alongside adoption, coparenting … within the dominant framework of choice that constituted families we create … At the same time, the distinction many gay people made between biological and nonbiological parents perpetuated the salience of biology as a (though not the) categorical referent for kinship (p.73) relations’ (Weston 1991: 189), marks the kind of negotiations that gay couples were grappling with in their identification and negotiations with ‘choice’. Thus, despite Weston’s assertion that, ‘Kinship began to seem more like an effort and a choice than a permanent, unshakeable bond or a birthright’ (1991: xv), the choices that gay fathers made in choosing surrogacy also corresponds to ways in which they still considered some aspects of blood and biology as unshakeable. This is evident not only in the ways in which Vincent and John worry about incest between two sets of children born from the same anonymous donor, but also in the way Chen found the process of surrogacy more ‘predictable’. To be able to keep and nurture your children without the fear of losing them to social and legal laws that privilege procreative heterosexual ties meant that homosexual couples despite ‘exercising choice’ felt vulnerable. Three years ago today, while in England, we got that phone call from the doctor saying, ‘Congratulations! You’ve had a baby boy!’ It was a whirlwind couple of days before we got to finally meet you, and our lives have been the richer because of it. Happy third birthday, our little singing, dancing, noisy, boisterous ‘peanut-butter on toast’ monster ... I love you so, so much. (Philip, Facebook Post, 4 September 2013) The surrogacy arrangement also favoured the desire for shared substance in the child—especially in the case of gay parents where such a possibility could be explored only through co-parenting with lesbian couples, or through having fathered a child in a previous heterosexual relationship. ARTs gave the option of intermingling biological connectedness with an otherwise ‘non-procreative’ tie (Cadoret 2009). However, the way in which gay fathers dealt with the genetic tie with the baby gave interesting insights into how they perceived and understood ‘genes’. Most of the homosexual couples interviewed had been in serious, committed relationships for two to five years. Many of them (p.74) testified to how they came together because of their shared love for children. The desire to ‘parent’ as opposed to having a child began with sharing space and time with nieces and nephews. This led to exploring viable options including adoption, fostering, and finally surrogacy. Here, the national laws governing sexual practices in terms of Page 29 of 33

Mothers and Fathers legitimacy, right to marry, and legal standing impacted the couples’ access to the right to adopt and foster. Of the seven gay couples, single gay men—three had explored the option to adopt or foster, coming away not too fulfilled with the exercise. In Australia (to which most of the gay fathers in the ethnography belonged), for instance, homosexuality has a legal status in only a few states, and none of the states allow gay marriage. More importantly gay men are not allowed to legally adopt children. They may only foster children for a few years after which they may have to relinquish rights over the child to either the child’s biological parents or to the state. Gay couples had to undergo training to be able to qualify for fostering. One of the couples called fostering a ‘short term option’ and not very satisfactory. Roger: We qualified through the fostering and got to take care of a child through a Catholic organization … We were placed with one child … our luck, the first time we were taking care of children … we got a child with ADD [Attention Deficit hyperactivity Disorder] … the child had a history of violence, against other children, against his parents … just couldn’t sit still. It was too much responsibility for the first child … After we refused to take on the fostering the organization did not contact us again. Chen: So fostering is a short term option … Another couple tried fostering: We looked at fostering children in Australia … We did a course in Sydney probably for eight to ten weeks … and we passed the course … but then we decided not to go ahead because there was a possibility of having the children in the family ... because the situation with fostering is to return the children to their birth mothers, or to (p.75) families who will take them in later … and we thought that would be very hard for us to come to love a little child and then say goodbye. So we decided not to go ahead with fostering. (Saul, 50, Australian father of twin daughters) The only other option available besides surrogacy is that of co-parenting or shared parenting. This involves an informal or formal agreement between a gay and lesbian couple to undergo artificial insemination with shared sperm and eggs to have a child. The formal agreement is called a parenting order and is recognized in the family court in Australia. However, this may or may not work out depending upon the dynamics between the two couples. The dismissal of co-parenting and fostering led many of the couples to explore options of international adoption, which they are legally allowed to explore by the Australian government, but not however by many of the other nations such as India and China. These countries have an ambiguous legal stance towards Page 30 of 33

Mothers and Fathers homosexuality and homosexual men adopting children creating an unwelcome atmosphere for international adoption. The elimination of these options led the couples to seek information regarding surrogacy in countries such as the US, UK, and Southeast Asia. However, India came into the picture thanks to the recent international publicity it got. First, on the popular US talk show ‘The Oprah Winfrey Show’ where surrogacy in India and the Indian infertility clinic Akanksha was showcased to international audiences, and second, through networks of gay men who began to explore the ‘India option’, as they called it, and began to recommend it to their peer group. Anindita: So how did you zero in on surrogacy? Saul: I had heard about surrogacy five years ago ... heard about it in the USA … some 100,000 dollars and more ... and had always thought that that was a lot of money when there are children around the world who need a home and foster care. Then four years ago (p.76) we moved to Melbourne from Sydney and we started to meet some families … gay families who had children through surrogacy. Nice people. Some [had children in] from America ... some from India ... and we realized that the India option made more sense … But the three most important factors that began to sway couples towards India were the cheap prices of treatment as compared to the US, the competitive success rates, and the lax legislation. Many of the gay couples I met later did not explore the option of adoption or fostering at all. They chose surrogacy as their first option and stayed with it until they had their child. If you want children in your life it does not matter if they are genetically related or not … but this option [surrogacy] was just a little easier—and predictable, unlike foster parenting—foster parenting is not predictable. If there is attachment to the child in fostering somebody will eventually come and take away the child. If co-parenting is shared with a lesbian couple the birth mother has more importance than the birth father. There is a risk of the gay couple’s rights [on the child] being not so predictable. In surrogacy the situation is predictable in terms that your child is not taken away from you. (Chen, early 40s, father of twins) This sense of predictability was what drew many of the gay couples towards surrogacy, but the process itself was far from predictable (as discussed in Chapter 5). Yet, the predictability that Chen speaks of has to do with his rights over the children. The desire to have children through surrogacy is an option that homosexual couples exercise keeping in mind the perspective of having children in a relationship that is ‘conventionally’ not meant to create one, Page 31 of 33

Mothers and Fathers ‘naturally’. The right to parent just as the right to reproduce is what Chen stressed on as a basic human right, irrespective of sexuality, age, gender, and race. For gay couples wanting to share in the joint parenting of their children social parenting was not enough anymore. Excluded from adoption, but presented with the option to assisted procreation (p.77) through IVF–surrogacy they began to seek ways by which genetic connections could be shared to create a sense of ownership in the children. In this sense Butler’s (2002) reservations regarding the resurrection of the heteronormative biological family amongst homosexual parents has a parallel in commercial gestational surrogacy. Conforming to a mainstream idea of family and parents the ‘two dads’ seek children who carry their identity and resemblance in themselves. Like married heterosexual couples, it seems, that gay fathers began to place a lot of importance on shared genes in their children. However, unlike Cadoret’s (2009) observations of how homosexual parents sift through different forms of relatedness—biological and social—to create families and connections with their children, gay fathers in the commercial surrogacy arrangement are at pains to keep away the maternal link (Melhuus 2012). They choose the egg donor with care, almost always preferring an anonymous donor; and actively avoid, or at best, have ephemeral relations with the surrogate. Out of all the gay couples/single gay fathers interviewed, only one had stayed in touch with the surrogate. ‘Is intent the new biology?’, asks Charlotte Krolokke (2012: 315) in her analysis of how motherhood comes to be positioned in the transnational discourse around commercial gestational surrogacy. When biology gets complicated in a narrative of shared substances and bodies, identification is granted on the basis of ties of nurturance and the ‘intent’ to parent as opposed to the ‘intent’ to relinquish. In reality, intention traversed ideologies of biology and the social. Biology was defined in ways that followed the medical understanding of the same. However, for many others biology was reconstructed to fit the idea of the norm—as is seen in the case of gay couples and adoptive mothers. Most importantly, the norm itself was established through the doctors (p.78) who administered the technology. However, the norm came across as fractured in its construction— whether in the contract, or in the choice of the surrogate and egg donor, or in the choice to enter TCGSA. In the analysis of intention, ideas regarding genes and biology were resurrected through ways in which agents construct their choices in and around them. The emotions that biology and genes evoke are both culturally constructed as well as in opposition to cultural and social conceptualizations of the same. Intention, as discussed in this chapter, comes to resemble ideas regarding ‘potentiality’ (Simpson 2013) that embody the choice of seeking particular, Page 32 of 33

Mothers and Fathers possible futures. ‘[P]otentiality as a hidden or inchoate force, or matter of choice, and a way of thinking about the social and material world that points to a genuine sense of plasticity and possibility … [in case of] … ARTs to achieve pregnancy and parenthood and the ways in which this accomplishment entails wider questions of relationality and exchange’ (Simpson 2013: S87). Thus, ‘frustrated reproductive desire (Simpson 2013: S92) often works as the other side of potentiality to create narratives and ‘strategies’ whereby ‘intent’ comes to be mapped in relation to the desire to have a child despite the inability to have one. The narratives discussed in this chapter speak of potentialities in the face of ‘impotentialities’ or failures—and the steadfast intent to overcome them. In the ‘reproductive quest’ motherhood remains the primary theme of engagement in the analysis of choice and kinship especially in the case of surrogacy. However, as we go further into the ethnography the reproductive journeys in commercial surrogacy come to embody mothers, fathers, and others in more ways than one. Notes:

(*) Parts of this chapter were published in, ‘Surrogate Mothers and Gay Fathers: Navigating the Commercial Surrogacy Arrangement in India’, in Adi Moreno and Susanne Hofmann (eds), Intimate Economies: Bodies, Emotions and Sexualities on the Global Market (pp. 213–31). UK: Palgrave Series on Globalization, 2016. (1.) Rita attributed her tendency for depression to her parents’ strained relationship during her mother’s pregnancy. According to Rita, her mother’s emotional state had been transferred to Rita, while she was in the womb. (2.) Kiran Rao (wife of Bollywood superstar Aamir Khan), in a newspaper interview, talks of her son, Azad, born through surrogacy as a ‘gift from her IVF specialist’ (retrieved from IDiva 7 May 2013, available on: http://idiva.com/newsentertainment/kiran-rao-i-had-a-great-desire-to-have-a-child-with-aamir/21305). Yet in the same breath she says, ‘I am not really maternal but had a great desire to have a child with Aamir.’ Aamir, a father of two children with his ex-wife had an already existent triad, but not with Kiran. (3.) Melhuus and Howell (2009: 153) note in reference to idealized notions of marriage, family, and motherhood in Norwegian legal discourse on assisted conception, ‘Motherhood was the manifestation of successful womanhood. Indeed, psychological literature of the 1950s explained childlessness in women as the result of psychological abnormality.’

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Matchmaking Genes

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Matchmaking Genes Assisted Conception and Kinship Information Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0003

Abstract and Keywords Much of the debates on commercial surrogacy are marked by the interventions and involvement of the assisted reproductive technologies such as in vitro fertilization (IVF). In this chapter the medico-technological process of commercial surrogacy is seen through the involvement of IVF specialists, embryologists in their identification and understanding of genes and kinship. The chapter also explores the ways in which fertility clinics negotiate with the practice of commercial surrogacy by invoking Indian Council of Medical Research’s (ICMR) draft law on surrogacy and reproductive technologies. The chapter looks at how medicine does not always operate within a tradition of rationality but often invokes local-folk wisdom of kin and kinship to understand the consequences of assisted conception. In that sense IVF specialists, clinicians, and embryologists often become ‘matchmakers’ invoking an idea of genes and biology that is not embedded in scientific rationality. Keywords:   matchmaking, egg donors, ICMR, draft bill, information, anonymity

I met Srijata today on her way back from the field. We chatted for a while, exchanging niceties and field notes. Srijata mentioned how her interviews with gay men and gay women in Delhi were now finally yielding results. Suddenly, excitedly, Srijata mentions, ‘Oh dear! I must tell you what happened to me recently! One of my respondents, a middle-aged single gay

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Matchmaking Genes man interrupted our interview to pointedly ask me if I would donate my eggs for a surrogacy arrangement he was planning to commission!’ ‘What did you say?’ ‘Oh, I said no! I couldn’t do it! I mean, how could I? The thought that I have a child out there … frankly, that’s frightening!! What if he or she comes looking for me?! I will have a family of my own then … how will I explain this child to them?!’ (Field Notes, September 2011) To introduce the notion of ‘information’ as it is understood within kinship relations is to also speak of the idea of anonymous kin and the revelation of secret ties of kinship. Srijata is worried (p.81) about the repercussions of her act of donating her genetic matter on her future progeny and family; having immediate damning consequences for her relationships in question, but also for society that supports the anonymity of third-party reproduction. This chapter seeks to explore the idea of kinship information as it is constructed and understood in the practice of artificial/assisted reproduction—specifically the TCGSA. There are different kinds of permutations within the arrangement, such as: a heterosexual infertile couple giving their gametes (egg and sperm) to be incubated in the uterus of the surrogate mother; a heterosexual couple using donated gametes to be incubated in the uterus of the surrogate mother; a homosexual couple using their sperm and donated eggs to be incubated by the surrogate mother; and a single individual using his/her gametes along with the donated eggs/sperms of a donor to be incubate by the surrogate mother. ARTs like IVF facilitate myriad combinations of genetic matter to ‘create’ a pregnancy (and ‘help’ in the birth of a child) for infertile couples and individuals from India and across the world. Because TCGSA in India is based on the use of gametes from anonymous donors —and espouses anonymity and limited interaction with the surrogate mother— the notion of kinship information is heavily guarded. The Indian Council of Medical Research’s (ICMR) Regulation (Draft) of Assisted Reproductive Technologies Bill, 2010 that regulates TCGSA in India1—is particularly stringent regarding the protection of the identity of donors and surrogate mothers. The Bill asks ART clinics to obtain ‘relevant information’ from donors and surrogates for scrutiny by the clinic and the commissioning couple (Chapter IV, Clause 20: 2). This ‘relevant information’ is ‘specific’ in nature—including (‘but not restricted to’) aspects such as ‘height, weight, ethnicity, skin colour, educational qualifications, medical history’ (Chapter IV, Clause 20: 4). However, this information must exclude name, identity, and address—all of which must neither be sought nor divulged. Only in case of exceptional circumstances, such as lifethreatening (p.82) diseases or a specific medical condition in the child, the identity of the donor may be made available on a court injunction and with the Page 2 of 19

Matchmaking Genes consent of the donor. Otherwise, the child born of the arrangement may seek information about the donor or surrogate mother at the age of 18, that will exclude personal identity (Chapter VIII, Clause 36). In addition, this limited information can be procured from a ‘central database’ that will be maintained by the Department of Health Research, ICMR (Chapter IV, Clause 22). The ‘record-keeping’ by clinics and the government of anonymous gamete donors’ and surrogate mothers’ identities becomes an interesting form of intervention in the circulation and availability of kinship information. The legal injunctions towards maintaining anonymity are different from those practiced in the West, especially in the UK where there is a move towards more ‘openness’ (Strathern 1999). Thus, new legislations in the UK deem it necessary that details of gamete donors and surrogates be made available to the child(ren) born from ARTs. Strathern finds this form of ‘regulative knowledge’ regarding kinship that governs rules and practices as a hallmark of ‘Euro-American’ kinship. In case of Euro-American kinship, biology exists both as a cultural construction and as a scientific fact (Carsten 2000b; Edwards 2006; Schneider 1980; Strathern 1992a). Here, ‘biogenetic facts’ (Schneider 1980) stemming from shared genes come to embody an individual’s identity and personhood. Thus, knowledge regarding one’s biological origins consumes Euro-American ideas of kinship and identity (Carsten 2000b; Edwards 2006). In such situations adopted children or children born through surrogacy and/or donated gametes find it necessary to seek information regarding their kinship ties to feel ‘complete’ (Carsten 2000b). The knowledge regarding anonymous kin has implications not only for the individual seeking it, but also for all others involved. At the core of biological kinship is the notion of information. This information about kin, kinship, and relationships has been a favourite preoccupation of anthropologists. Classical kinship took (p.83) for granted the basic kinship information emerging from the tie of sexual procreation, and the physical birth of the child by a woman. All other relationships oscillated around this basic social fact. Biology as represented in Euro-American kinship had to be refashioned according to the new information that was emerging from the use of ARTs. Strathern (1999) notes that the process, desire of ‘knowing’ has led to both connections and disconnections through technologies that disrupt biology (such as ARTs), and at the same time seek their verification (such as the DNA test). In such a scenario the knowledge that ‘kinship makes children part of the bodies/persons of their parents’ (Strathern 1999: 66) comes undone—thereby impacting ‘kinship knowledge’ (Carsten 2007). In the Euro-American context the disruption of kinship knowledge, and by extension, of the self, the person has led to legal intervention in the way in which kinship information/knowledge is regulated. Thus, Strathern notes that ‘new kinship information’ may have a wide-ranging impact on a ‘host of other relations’—‘The significance of Page 3 of 19

Matchmaking Genes knowledge for personal identity … the fact that kinship knowledge is about identity in the context of relationships, so that choice between facts is also choice between relationships … [and] the relationships between types of information which meant that one piece of information can automatically obliterate another, taking away the status of previous information’ (Strathern 1999: 75). However, legal regulation has had consequences for kinship and interpersonal relationships, and how we think about them, especially since countries like the UK have begun deliberating on the need to make information about anonymous sperm and egg donors public (Strathern 1999). Thus, a child born of donated gametes may seek information regarding the donor. This form of ‘constitutive knowledge’ (Carsten 2007; Strathern 1999) has consequences for intimate relationships as is seen in the case of adopted children seeking their birth parents (Carsten 2000b). And even though ‘kinship knowledge, by itself, does not create kinship … whilst (p.84) knowledge of a person … is crucial to being close to them … knowledge must also be activated in relationships’ (Carsten 2007: 422). However, in case of the ICMR ARTs Draft Regulation Bill, 2010, any information regarding the identity of the anonymous gamete donors and the surrogate mother has to be kept anonymous. These records are not to be made public except in case of medical emergencies and through a legal order. Such an idea privileges ties of nurturance of kinship through familial networks—it privileges a different idea of kinship information, closer to that of folk forms of relatedness that emphasize the growth and fulfilment of relationships over time. The transnational commercial gestational surrogacy arrangement brings to the fore the collision of different folk understandings of kinship and relationships. The Indian notion of kinship information affirms other notions of personhood and kinship, contrary to the ‘search for roots’ that Euro-American kinship feels is necessary to complete a person. It is this aspect that the chapter seeks to explore in the selection and sifting process of gametes and wombs by clinicians in TCGSA. However, I wish to posit that in the context of TCGSA the stringent requirements towards anonymity arise from South Asian kinship understandings that do not necessarily bifurcate nurturance and biology in the way that Euro-American kinship does. Relatedness in the South Asian context is invoked in the identification of multiple ties of belonging and kinship (Carsten 2000a; Lambert 2000a). However, the ways in which the ICMR Draft Bill positions anonymity also involves the negotiation of class and racial identity—something that is an important element in the transnational surrogacy arrangement (Deomampo 2016). Thus, the ‘enforced employment’ of an Indian surrogate by both Indian and foreign couples and individuals coming to India to have children, requires elaborate forms of knowledge regulation. Here class and race are part of the Page 4 of 19

Matchmaking Genes legal narrative that keep her identity and self both visible and yet anonymous. (p.85) This is most in evidence in pictures of pregnant Indian surrogate mothers where the focus is on her swollen belly, excluding her face from the image. Along with the control of the identity of the gamete donor the form of kinship knowledge that emerges gives a particular image of kinship information. I map this kinship information through conversations with IVF specialists navigating anonymity and the choice of gametes and womb. In their search for eligible surrogate mothers and egg donors, I found that doctors identify kinship and kinship information by borrowing folk idioms of relatedness. Most importantly, the Euro-American model of sexual procreation is found to be subservient to and largely influenced by considerations governing ties of marriage and alliance— Indo-Aryan kinship ideology is used to mark the progeny that would come forth from the surrogacy arrangement. The medical process of ‘matching’ donors, surrogate mothers, and commissioning couples finds parallels with the act of marital matchmaking.

Matchmaking Genes: Medical Doctors as Matchmakers The ways in which the IVF specialist and other medical practitioners marked their intention in the TCGSA was seen in relation to the exercise of seeking egg donors and surrogate mothers for IPs (the choice of sperm donors—though following interesting trajectories of its own—does not form part of the analysis here). By employing socio-medical markers, IVF specialists and surrogacy agents act as ‘matchmakers’. ‘Matchmaking’ within the surrogacy arrangement follows a definite trajectory. Here ‘biology’ and its sociocultural identifications mark the ways in which couples, donors, and surrogate mothers are brought together. In many ways similar to the adoption process found in transnational adoption (Dorow 2006; Howell and Marre 2006) where a ‘fiction’ of resemblances is created, the agents (p.86) and doctors in the surrogacy arrangement do the same. However, ‘matching’ becomes a fragmented exercise not only between the egg donor and the surrogate mother but also in the ways in which couples and doctors identify suitable candidates. This ‘matchmaking’ is meant to mediate between the gestational and genetic roles within the arrangement, but the ways in which the doctors position the discourse on ‘biology’ comes across as deeply conflicted implicating their intention within the arrangement as well. It is they who finally decide the perfect ‘match’ between the couple and the surrogate, and their importance in mediating/negotiating the arrangement cannot be ignored. What are the ways in which these ‘matches’ are made? How is medico-technological knowledge regarding the gestational–genetic role constructed in surrogate motherhood?

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Matchmaking Genes Matchmaking genes begins to replicate the practice of matchmaking grooms and brides for the same purpose—the birth of ‘suitable progeny’. The role of matchmakers was found to be of importance in the context of marital matchmaking, once eulogized in traditional and colonial India. In British India, specifically colonial Bengal, the ‘ghatak’ or matchmaker held great power in creating and bringing together viable matches between families. Their knowledge of the genealogical history of each family was an important factor in the exercise of their power and influence (R. Majumdar 2004). The IVF specialist and agents similarly employ ideas of a different form of genealogy and biology to ‘make matches’ between viable bodies and relationships. But that is not the only thing that they do. Akin to the traditional art of matchmaking in Indian marriages, the commissioning couple/individual is privileged in the choice of suitable gamete donors and surrogate mothers to create healthy, suitable progeny. Thus, the ‘right person’ comes embedded within the ‘right background’ (Kaur 2014). While issues of caste and religion did not appear predominantly in my fieldwork— references to the same as criteria for the selection of suitable surrogate (p.87) mothers is mentioned in Pande’s study (2009a). The issues of race and class especially exist in relation to both Indian and foreign commissioning couples in both the choice of the surrogate mother and the egg donor. The legal stipulation of anonymous gamete donors and distant surrogate mothers is channelized in forms of inclusion and exclusion based on identities and familial background. The surrogacy matchmaking is a mix of both old and new forms of marriage matchmaking combining structural hierarchies of caste, race, class as well as modern consumerist desires of ‘suitable matches’ that combine individual choice and aspirations. Akin to matrimonial websites in India, the matchmaking enterprise in TCGSA employs another ‘new’ technology —that of ARTs—to create viable combinations of genes and identity. As Kaur notes with reference to matrimonial websites in contemporary India: ‘A cultural appropriation of the new technology has taken place, which functions to keep older requirements of matching intact while allowing certain new elements to be added … choice itself is being redefined in the context of the marriage market … [as] … self choice resulting from a romantic relationship or … a market style “informed choice” …’ (2014: 289). In the process of matchmaking, eggs and wombs differed interestingly in the ways in which doctors placed them in relation to the foetus. However, the foetus was not the only focus here. It was connected to the couple, the surrogate mother, and other relationships. Thus, the positioning of the egg donor and the surrogate mother in relation to anticipated future relationships meant that the doctor and the surrogacy agent had to actively propagate an idea of genes and biology that privileged the commissioning couple. This was easier in case of a gestational surrogate mother, but became difficult in case there were both a Page 6 of 19

Matchmaking Genes surrogate mother and donated gametes. The process of ‘strategic naturalizing’ wherein the clinic staff propagated a particular idea of genes and genetic ties through their medical expertise (Thompson 2005) did not (p.88) work as successfully in the Indian IVF clinic. In the conversations that follow, ideas regarding the placement of egg and womb in relation to the foetus and the intended parents began to pose challenges to medical processes that make the separation possible in the first place. This is seen in the selection and eligibility criteria for egg donors and surrogate mothers—and in the ways in which particular forms of genetic ties are privileged or rejected as ‘viable kinship’. The recruitment of surrogates and egg donors in commercial arrangements followed the advertisement route. English and Hindi language women’s newsmagazines carried advertisements asking for surrogates, and egg donors. Figures 3.2 (a, b, and c) look suspiciously like matrimonial advertisements (Figure 3.1). (p.89)

Figure 3.1 Collage of Indian Matrimonial Advertisements in Newspapers for Brides Wanted Source: http:// www.bollywoodshaadis.com/img/ article-201351288455331553000.jpg, (accessed on 28.06.2014).

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Matchmaking Genes The use of a close/distant kin as egg or sperm donor is legally not allowed. The ICMR ARTs Bill stipulates that, ‘No ART clinic shall obtain sperm or oocyte donated by a relation or known friend of either of the parties seeking ARTs’ (Chapter IV, Clause 20: 12). The same ICMR ARTs guidelines are much more tolerant regarding relatives as surrogate mothers: ‘A relative or known person may act as the surrogate to the couple’ (Chapter VII, Clause 33). This leads one to question the way in which the law understands the ties of genes. While both gamete donors and surrogate mothers (p.90) remain anonymous within the arrangement, it is important to note that the gamete donor is referred to as the ‘genetic parent’. Thus, ‘personal Figures 3.2a to c Advertisements for identification of genetic parents Surrogate Mothers and Egg Donors in or surrogate mothers may be Hindi Women’s Monthly Magazines released only in case of a life threatening medical condition Source: Sarita (March 2011) and …’ (Chapter VII, Clause 36, Grihashobha [‘The Adornment of the emphasis mine) At the same Home’]–Mother’s Special (March 2011). time, the name or any mention of the surrogate is strictly forbidden in the birth certificate, which will bear the name of the commissioning couple/individual as parents. The ‘separation’ of the surrogate from sharing any kind of ‘genetic’ tie with the foetus means that she is also not allowed to donate her oocytes/eggs to the couple/individual that she is acting as a surrogate for (Chapter VII, Clause 33). She may act as an egg donor independent of her role as surrogate mother to some other couple. Sama, the Indian feminist group that has been involved in advocacy on ARTs and commercial surrogacy for over a decade, suggests that ART Bill should allow commercial surrogacy to be genetic wherein the surrogate does not have to go through invasive technological interventions by carrying a pregnancy that Page 8 of 19

Matchmaking Genes involves her own eggs (SAMA 2010; Shah 2009). Such a stance is meant to give the surrogate more agency within the arrangement. However, at a deeper level it leads to questions regarding the ways in which kinship information is configured by law and in practice. Matching Kin

The case of altruistic surrogacy arrangements is an interesting way to analyse the way wombs and eggs are positioned within the medical discourse on surrogacy. Altruistic surrogacy arrangements were marked by the absence of a contractual, paid arrangement between the couple and the surrogate. The surrogate was usually a close relative, and the couples would give the embryo and pay for the treatment. These arrangements were closely guarded due to their intimate and intrafamilial nature. Quite a few of the doctors interviewed had conducted them. (p.91) Dr Lata, one of the IVF specialists at Miracle Births, was categorical about differentiating between egg donors and surrogates in case of close kin. ‘The surrogacy arrangement involves different combinations. I prefer that relatives are not used as egg donors—actually I forbid it because of the congenital, genetic defects that may arise in the child. However, a relative can volunteer as a surrogate—provided they are healthy as in this case they are mere carriers’ (emphasis mine). Another doctor mentioned how most altruistic surrogacy arrangements involved sisters-in-law stepping in as surrogates. The bhabhi (BW) and the wife’s sister were the most common, while in some cases the mother of the woman wanting to have a baby would also volunteer (as reported in the first surrogacy case in India).2 [W]e do not insist on taking surrogates … if they get their [IPs] own surrogates that’s fine … we do tell them that we will test them [the surrogate] … they do not know all the technical aspects and then we will take them … Ya … in the northern part [north India] … they get their sister-in-law, or sister … bhabhi [brother’s wife]. Yes … one of my patients brought her nanad [husband’s sister]. Also … normally in the northern part of India they prefer relatives … maybe one of the factors is that there is a lot of money involved in paying the commercial surrogate ... [Dr Richa, Metro IVF Clinic, Delhi] The HZ (nanad) was not a common volunteer, due to fears of incest. Bharadwaj notes that while many doctors do not encourage the donation of sperms from male family members, such as brother-in-law, or others—the same in case of women is not necessarily taboo. Thus, sisters can donate eggs, and woman-towoman egg donation was seen to be completely asexual, as compared to man-towoman semen donation. ‘[A] female third party is not seen as invasive, or as Page 9 of 19

Matchmaking Genes significant a threat to the socio-political stability of the family as a semen donor, i.e. the boundaries of a family are less threatened by egg donation than by donated semen’ (Bharadwaj 2003: 1873). (p.92) Anindita (A): What is the profile that you are looking at in surrogates? Your assistant told me that you prefer that couples bring their own surrogates? Dilip (D): We are very stringent … we don’t go for that professional [commercial surrogacy] thing. Most of the time it’s [the surrogate] from their family … it may be the sister or the sister-in-law, or the younger sister. It becomes easy for them [the couple] and for us. But if the husband is going through sperm donation … you cannot use his sister's womb … I mean they are siblings … A: Have there been cases where the sister has volunteered to give her eggs? D: No … usually the thing is that the female patient’s sister gives the ovum … never been the case that the male patient’s sister has given her eggs. A: This is interesting. So its fine if the woman’s sister donates her eggs? D: No … no … not egg donation! I am talking about surrogacy. Nothing about egg donation. That’s a different issue. I am talking only about surrogacy. In this convoluted, confused dialogue with the embryologist Dr Dilip the egg and the womb get mixed up in conflicting narratives. Here, the identification of the ‘carrier’ as a mere gestate becomes implicated as well because she cannot be reduced to that role alone. The doctor is against the intended father’s sister incubating the pregnancy, and/or donating her eggs. Both seem to be an indication of ‘incest’. However, the intended mother’s sister may act as the surrogate, but not necessarily donate her eggs.3 Here, I believe a form of ‘gene sutra’, or folk ideas associated with genetic quality and upbringing operated (Bharadwaj 2003) in association with notions of marriage and intrafamilial relationships—as discussed in reference to Figure 3.3. In the structure of kin relationships, I (p.93) posit that doctors follow ‘local’ ideas of substance and relatedness to understand who can or cannot act as a possible surrogate or egg donor.

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Matchmaking Genes The ‘fear of incest’ with the intended father’s sister (nanad [HZ] in Hindi) meant that she was ineligible to be both surrogate mother and egg donor. Similar objections were not put forward in case of the intended mother’s sister—while egg donation amongst close relatives was not preferred (though not out of bounds) being a surrogate–carrier was Figure 3.3 ‘Eligible’ and ‘Ineligible’ acceptable (Figure 3.3). Such Wombs in Altruistic Gestational proscriptions were also in Surrogacy evidence in the Draft ICMR Bill, Source: Author. which stated that sperm or egg donors could not be relatives of intended parents—though there was no such clarity regarding the surrogate mother. The intended mother’s sister was an acceptable candidate because she fitted in with the Indo-Aryan kinship practice of the flow of women in one direction (Dumont 1983; Madan 1975; Vatuk 1975). Thus, wife-givers (WG) transfer women and gifts to (p.94) wife-takers (WT) at the wedding, and subsequently through the marriage and into the birth of children and other life cycle rites. This unidirectional flow was kept intact in the eligibility of the intended mother’s sister as a potential surrogate to the wife-taker’s family, even though they were a different set of affines from those of the intended mother’s in-laws. The practice of sororate marriage, where the sister of the deceased wife ‘replaces’ her as the new bride of her once brother-in-law, is a socially endorsed practice in many parts of India. The wife-givers maintain their unequal relationship of gift giving with the wife-takers by supplying another woman from their family to fulfil the reproductive needs of the affinal kin.4 The nanad or husband’s sister (HZ) is not an acceptable candidate for surrogacy and/or egg donation because: first, she belongs to another family of wife-takers who are superior to her own natal kin; and second, because seeking her reproductive ‘potential’ jeopardizes the hierarchy on both sides. Wife-takers and wife-givers on both sides of the intended father’s in-laws become equal. By claiming the sister as the surrogate mother, her in-laws are suddenly in the position of wife-givers and his wife’s natal kin become his equal by seeking a child for their daughter from his kin. Thus, besides the fear of incest, the wifegiver–wife-taker hierarchy is seriously challenged with the HZ as surrogate mother.

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Matchmaking Genes On the other hand, the brother’s wife (HBW) and the brother-in-law’s wife (bhabhi) (WBW) are perfect and preferred candidates for surrogacy. They both come from wife-giving families and are in a similar relationship as the intended mother to the intended father’s family. This is the perfect blend of anonymous ‘genetic ties’—through the daughter from another set of wife-givers—and yet in a relationship of reproduction in relation to the wife-takers. Here, anonymity had a different meaning. It was linked with ideas of shared substance as well (Bharadwaj 2003). The shared genetic tie was preferred in ways that did not destabilize other forms of kinship. The correct blend of shared anonymous ties informed the altruistic arrangement. However, (p.95) unlike Bharadwaj’s (2003) assertion wherein doctors connived with couples in keeping the use of intrafamilial and anonymous genetic matter a secret, the doctors interviewed, as part of this ethnography, were against this. Inseminating the intended mother with her father-in-law’s or brother-in-law’s sperm gave rise to unsavoury notions, often articulated by doctors and then internalized by the patients. Doctors preferred to undertake non-commercial surrogacy arrangements as ‘medical experts’ who created appropriate forms of ‘matching’. In this doctors were guided by participants’ notions of genes and biology: which also had linkages with ideas regarding incest and affinal relationships (Edwards 2009a). However, one would surmise from the above discussion that anonymous egg donors and unrelated surrogate mothers would be more easily navigable in terms of ‘kinship dilemmas’. Yet, doctors and medical practitioners found themselves navigating, defining, and understanding the role of genes and biology in making sense of the role of the womb, egg, and the subsequent pregnancy. Just a Carrier

Making ‘matches’ involved the creation of viable, anonymous bodies for those who could afford to pay for them. Here, the intentions of doctors and agents were pitted in favour of intended couples and their ‘needs’. In a stratified landscape, where the local and global were increasingly crossing paths through ‘biocrossings’ (Bharadwaj and Glasner 2009)—the need to ‘dress-up’ available resources was entirely upon the medical staff. Through the use of medical metaphors doctors were able to sell hegemonic social ideas of fertility, infertility and desirable bodies to bodies that lacked those same traits. Here, race and class collapsed easily into established ideas of medico-social eligibility. The surrogate’s tests were primarily meant to ascertain her viability as a ‘carrier’.5 Yet, many of the IVF specialists spoke of (p.96) how the surrogate’s socio-economic background, family scenario, relations with husband, and the number of children they had were important markers for eligibility. One successful marker of her fertility is that she should have ‘naturally’ born Page 12 of 19

Matchmaking Genes children of her own through the tie of marriage. To have children helped facilitate, bolster the candidature as a surrogate. During fieldwork, women with as many as six children were enthusiastic to enter the arrangement. Most of the women were married though there were cases narrated of unmarried, divorced, and widowed women who entered the arrangement as well. The single unmarried girl was not preferred as a candidate for surrogacy. The IVF specialists carried out the medical screening of the surrogate mother, but the agents, touts, and facilitators did the recruitment. [C]linic ka yeh role hota hain [the role of the clinic is] that we screen them [surrogates]––whether they are fit for pregnancy or not … Their age, their socio-economic background … their health during pregnancy, her past obstetric history, whether she has her own children or not … how many years old, any medical complications … So we screen them, and we act as a third party. [Dr Bajpai, owner of an infertility clinic in Jaipur] Most clinics and agents made the ‘match’ of the commissioning couple and the surrogate mother without their ever having met each other. Many of the foreign couples did not wish to question the doctor’s or facilitator’s choice of the surrogate mother, as they felt that the former knew better. I went through the process with three surrogate mothers. The first surrogate mother did not get pregnant … she did not even undergo ET [embryo transfer] … it seemed she was not emotionally prepared to undergo the procedure and be a part of the [surrogacy] arrangement … I talked to her once the clinic zeroed in on her for me … Later the clinic told me that she was not ready to take on the pregnancy––they said she was not emotionally or physically ready to take on the pregnancy. The clinic did not want me to waste my money on the process when it might not work … So they found me (p.97) my second surrogate … they said she was from a good family––but the pregnancy didn’t happen. I never met her. [Xavier, Spanish, 40, father of twin girls] The classification of the surrogate on the parameters of her identity in terms of her coming from a ‘good family’ was important. Here, the trappings of a ‘good family’ ensured that she was wedded to a familial network of dependence and control. In this sense, the matchmaking process is gendered both in the marital arrangement and within TCGSA (Kaur 2014; R. Majumdar 2004) primarily against women and their exercise of agency. As Majumdar (2004) notes in case of colonial Bengal where women were constructed within the frames of domesticity and the good family to be ‘eligible’ and sought after within the marriage market. Similarly, in contemporary India despite the possibilities of individual choice the single woman seeking a groom navigates the online matrimonial website through her familial networks and desires (Kaur 2014).

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Matchmaking Genes Anindita (A): What are the criteria you are looking at when selecting a surrogate? Surrogacy Agent (SA): Their family should be cooperative, their obstetric health is very important ... A: Do you have facilities for housing surrogates? SA: No … not our policy. Don’t want to separate the small baby [the surrogate’s baby] from its mother or … the family situation … they are in their homes ...The criterion is that there should be social harmony in this endeavor … the family’s support should be there … [the family] should treat her properly ... Matching Anonymous Kin

However, in case of the egg donor, her profiling became a process of marking out the embryo. In assessments of a viable oocyte/ (p.98) egg, the embryo was also implicated. Thus, both the egg donor and the embryo were ‘graded’ on socio-medical markers of viability, relatedness, and survivability. In the differentiation, yet combined representation, of egg donor (and not the egg) and the embryo—the perception of genes became magnified. Medical ‘perceptions’ regarding ownership, biological connectedness, and substance were marked in the link that the egg shared with the embryo. Because the sperm donor in most surrogacy cases was the intended father (his intention secured through the contribution of his sperm), questions regarding the contribution of the sperm to the embryo were not discussed or debated upon, as much as in the cases where the egg or oocyte was donated. The anonymous egg donor becomes an important intersecting point within the exercise of matchmaking. In gestational surrogacy arrangements, the doctors give access to ‘choose’ the egg donors—letting couples see pictures of the donors along with other features listed with each donor, primarily phenotypical features such as height, colour and eye colour. But with these were also listed other, more ‘social’ identificatory aspects such as education, number of children, and aspirations. Surrogacy and Fertility Centre, for instance, encouraged the couples to select from a ‘graded’ list of Indian egg donors. Grade A donors were graduates and postgraduates, professionals, and models and actresses. Grade D were, as one respondent put it, ‘ordinary people’, usually school dropouts with children and in financial duress. Each donor profile had a picture with a description of likes, dislikes, religion, diet specification (vegetarian/ nonvegetarian), a photograph, and a statement about themselves. We were shown … well first of all we were shown the egg donors … a list … they were graded … It’s a horrible word to use ‘grade’ C … but there were ‘A’ list and ‘B’ list donors and there were financial differences between the grades. The difference in grades was based on education and social class, Page 14 of 19

Matchmaking Genes which for me I didn’t mind at all … So ‘A’ grade donors had higher level of education … to me that does not necessarily mean that they are more intelligent people … I didn’t (p.99) necessarily think that I should pay two–three hundred extra dollars for that … We chose the egg donor entirely based on the image on the page and gut feeling. Whether you like the look of the person … sorry more like the attractiveness of the person … sense the personality from the photo … so that’s how we chose the egg donor. (Nigel, British, father of a boy born in 2011) Eggs or oocytes in such a situation occupy an interesting terrain within the commercial gestational surrogacy arrangement. Unlike their use in stem cell research where they are completely objectified and commoditized for the purpose of medical treatment and research (Bharadwaj 2007; Waldby 2008) and are separated from their personal biographies—in the case of surrogacy, eggs embody multiple stories.6 Yet, despite the objectification of the oocyte there are efforts made to match eggs with recipients based on similarities in facial features or shared interests (Pollock 2003). Pollock notes that this leads American egg banks to sift through desirable and undesirable donors based on certain criteria of acceptability—a large part of this selection being dominated by issue of race and ethnicity. Thus, Black women continue to be chosen as surrogate mothers, while egg donors are overwhelmingly White. This is similar to India where Indian surrogate mothers are discouraged to be egg donors. Many of the Indian surrogates had previously been egg donors and had later been persuaded to become surrogate mothers. As one of the agents at Building Futures, the surrogacy agency, said that they encouraged Indian women to ‘volunteer’ as surrogates rather than egg donors due to the ‘lesser demand’ for Indian eggs. Building Futures tapped its overseas market in oocytes for foreign couples coming to India for surrogacy. It helped that the headquarters of the organization was based out of Georgia, giving access to Caucasian egg donors from the erstwhile Eastern Bloc. Indian surrogate mothers who had ‘volunteered’ as egg donors viewed it as a medical procedure of extraction and sedatives. It (p.100) was a way to make quick, easy money after following a prescribed course of hormonal injections. For them their egg was secondary to the womb, and the physicality of the pregnancy. The anonymity of egg donation was preferred though—as anonymous eggs are like objects that are dissipated with no history beyond that mentioned in their log books. This was in keeping with Lacquer’s (2000) differentiation between the importance of egg donation in relation to the surrogate mother. ‘Because there is no historical model for women’s reproductive substances venturing forth, that is because motherhood has almost exclusively been construed as “bearing” and not as begetting … There are few assumptions about ova … Ova do not colonize; Page 15 of 19

Matchmaking Genes they do not reproduce the blood of the ancestors’ (Lacquer 2000: 81). This is seen in the way ‘anonymity’ in case of the egg donor in oocyte clinics in California is not seen as a ‘major issue’. It is safeguarded but is not seen to challenge any form of familial relationship. This means that egg donors do not have to prove any significant form of eligibility except that ‘they have to show themselves to be sufficiently “masculine” to be willing to give up their eggs without a fuss, namely, to treat ova as if they were sperm at the moment of ejaculation’ (Lacquer 2000: 82). The gendered profiling of the egg/oocyte however meant that they were treated differently from sperms not only in terms of compensation and eligibility, but also in the way they were implicated in the formation of the foetus (Almeling 2007). Yet, oocyte were resources that were given for the fertilization of the most important commodity of all—the embryo. Secondary to the womb in Indian notions of kinship unlike in the West (largely due to the unified role of pregnancy, and the contribution of nurturance rather than identity to the unborn child), the embryo has come to dominate the Indian mindscape in narratives around female feticide and the declining sex ratio. Abortion has never occupied a pro-choice and pro-life debate in India, again largely due to the population policies of the state that have encouraged (p.101) family planning (Menon 1995). Thus, in such a context embryos have not been exalted at the level at which they are perceived in the West. Access and use of embryos by the scientific community as per new mandates on R&D and as part of new forms of ‘biocommerce’ (Bharadwaj and Glasner 2009) have been encouraged by the neoliberal nation-state. The major source of ‘unused, excess’ embryos are infertility clinics that utilize the bioavailable bodies of infertile couples to their advantage (Bharadwaj and Glasner 2009). In such a situation, embryos in the surrogacy arrangement have also come to mark their own territory through a terrain that identifies and classifies them in ‘grades’ and in ‘correct types’ of combinations. IVF specialists and embryologists presented a confused and conflicted narrative of embryo grading. Anindita (A): So what’s the compensation for egg donation? Dr Shekhawati (S): It varies from Rupees 15–30,000. A: Does it depend on the quality of the egg? S: Not the quality of the egg … it depends on how you negotiate for your price. A: Ok … but I have also come across in my fieldwork: quality A, quality B, quality C eggs … What is that?

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Matchmaking Genes S: See you cannot predict that this person will produce good quality eggs. You cannot predict beforehand. Usually we take egg donation or surrogacy from those ladies who have already had their children. So they have proven fertility. So that means their eggs must be OK … but in IVF you cannot predict. In one cycle you can get poor quality eggs, in another cycle we might get good quality eggs. It’s very difficult to predict beforehand the quality. A: Absolutely. I just wanted to know how you identify an egg as A, B, C? (p.102) S: Embryo quality. Egg quality also matters. Basically ageing of the egg is the most important factor. We have to fill in the egg group. If the egg quality is not good then the embryo quality will not be good. Even the fertilization rate … and the quality of the egg will not be good. See … the ovarian reserve quality also varies—the older you get the more your ovarian reserve deteriorates. But that is not always right … people have very good ovarian reserves at 35, and some may have weak ovarian reserves at 30 or 38 … As Dr Dilip (D), an embryologist based in Ahmedabad noted: A: I have heard of egg profiling—like grade A, grade B eggs. What is that? D: That is … see … every lab has its own grading system … usually oocytes don’t break … usually they are graded in terms of their maturity. M1, M2 like that. Usually grading in 1, 2, 3 comes later and differs from lab to lab. A: So there is no uniform system? D: No … no … A: But isn’t that a problem …? D: I know … I know … but you know it’s a 30 year old science … what can you expect? You cannot expect miracles! The grading and classification of eggs was a problematic notion. IVF specialists and embryologists disagreed on the idea of what and how an egg could be ‘graded’. But graded they were, whether on medical parameters or on the basis of the socio-economic background of the donor. Here, embryos too were sans history and genetic connections—they were commodities that would come to embody the body of a supposed parent or a surrogate. Despite requiring fertile bodies, the embryos the eggs spawned were separated from the bodies in laboratories were doctors took over in the process of matching and linking. As commodities par excellence, embryos could be put to

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Matchmaking Genes (p.103) use in stem cell research, or in the commercial surrogacy market, or in infertility treatments. IVF specialists act as matchmakers in the process of figuring out viable combinations of making children. In case of TCGSA this becomes a Herculean task in maintaining links to the intended parents. The linkages with kinship information and matchmaking mean that IVF specialists must invoke a sense of folk genetics to be able to place the surrogate and the egg donors. It is as Nivedita Menon (2011) says, for the surrogate the focus is on the lack of genetic ties, while for the intended parents the focus is on the connections through gametes whether sperm or egg. However, what is also important is the differentiation between the egg and the womb that is now invoked on a hierarchy of genetic connectedness and relevance. Thanks to the emerging reproductive technologies that are able to separate the gestational from the genetic, the idea of how to seek connectedness becomes that much more difficult. Matchmaking is an important part of this establishment of relatedness—and with the help of the ICMR Guidelines which invoke a folk–medical sense of relationships, TCGSA particularly tries to navigate it in forms of cross-cultural conversations on genes and kinship.

Notes:

(1.) The legal injunctions mentioned in this chapter and the rest of the book draw from the 2010 version of the draft Bill, which has remained constant in most of its modalities and has been the one that has received most public scrutiny. (2.) In 2004, an Indian woman delivered a surrogate child for her daughter— reportedly the first case of gestational surrogacy in India (retrieved from http:// www.indialawoffices.com/ilo_pdf/publications/ Legalizing%20Surrogate%20Baby%20Business%20in%20India.pdf). (3.) In conversation with a woman who sought her sister’s eggs to get pregnant for her second child (she was unable to produce healthy oocytes, but was capable of carrying a pregnancy), she noted the disgust and horror with which her brother-in-law treated the suggestion. ‘My sister was willing, but her husband threw a fuss and said that he couldn’t think of his wife’s children being born to someone else.’ (4.) The possibility of conjugal and sexual rights is also replayed in the popular saying ‘saali toh hain aadhi gharwali’ (the wife’s sister is half a wife)—which also marks the joking relationship between the brother-in-law (jijaji) and the saali (wife’s sister).

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Matchmaking Genes (5.) The medical tests conducted on the surrogate as part of the screening process include: VDRL (venereal disease research laboratory—for STDs, especially syphilis), blood count, thalassemia check, hepatitis check, TORCH tests (belongs to a category of blood tests called infectious disease antibody titler tests—for examination of viral group of infections), HIV, and TB. (6.) The ‘fictions’ created around oocytes and their quality and type helped create viable markets in genetic material. This is what fuelled prices for eggs, along with the desirability of the donor. In a newspaper piece, young college students in Delhi were reportedly flocking to IVF clinics to donate eggs to earn extra pocket money (Sharma 2010). This pocket money was in the region of Rs 50–60,000 (between USD 800 and 1,000). College students were the best bet because they were young and educated. The fairer, prettier ones would get more money.

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Waiting with the Womb

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Waiting with the Womb Nurturance and Kinship in Surrogate Pregnancy* Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0004

Abstract and Keywords In the process of making kin—which is what transnational commercial surrogacy is geared towards—the surrogate pregnancy becomes a ‘goal’ for all participants involved. However, the liminality of the pregnancy becomes both risky and transgressive when navigated through the bodies of ‘alien’ others. Both for the surrogate mother and the intended parents, the pregnant body becomes a source of ambivalence and conflict. In this chapter, the ethnography maps the role of the ‘others’—agents, relatives of the intended parents, the surrogate’s husband—in making meaning out of an ‘alien’ pregnancy’. Here, the embodied/ disembodied pregnancy leads to ‘disembodied relationships’. Cross-cultural notions regarding conception, pregnancy, and birth intermingle in a conflicted narrative of ‘kinning’ a soon-to-be born child. The idea of shared bodily substances within the foetus mark out not only the intended parents and the surrogate mother—but their other relationships as well. Keywords:   disembodiment, pregnancy, risk, surrogacy agents, kinning

Daniel and James wait anxiously in the plush waiting room of Miracle Babies to meet their egg donor. Paromita, the agent, walks in and introduces the Czech egg donor Svetlana to the couple. Tall, blonde Svetlana makes heads turn in the waiting room. She is left alone with Daniel and James for a tête-à-tête. Out of the corner of my eye, I can see that the conversation is easy-going and there is much laughter.

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Waiting with the Womb A few hours later, while interviewing Daniel and James, Paromita enters, again, with a heavily pregnant surrogate. She is Asha and seven months pregnant with Daniel and James’ friend Anthony’s unborn child. Daniel: Any problems? Asha: [nodding her head to say no] James: Can we take some pictures? Paromita: I have taken some pictures when she was six months pregnant … (p.106) Daniel: Any questions for Anthony? Paromita [to Asha]: Kucch pucchna hain … client se ...? [Do you want to ask … the client something?] Asha: Nahi … baas … woh aate nahi hain …?? [Nothing … just that … he doesn’t come??] Daniel and James look quizzically at Paromita. Paromita: She is asking when is my client going to come …? She is always asking when can I see him? She has not met him for so long––and once only for a short time … Daniel: Uh … Anthony is so busy … preparing the nursery … he is very excited. He has painted the walls green and yellow … Paromita: Yes … he keeps calling me for details on nappies, etc. … he is very excited. By the way if you guys want to meet your surrogate … I can arrange the meeting … (Field Notes, September 2011) The vignette above is an example of how the nine months of surrogate pregnancy is both dreaded and anticipated. Daniel and James embody the ambiguity that their friend Anthony holds towards his surrogate Asha. So while Anthony dresses up the nursery, but avoids Asha—she carries a child she is uncomfortable about. The wait for the unborn child comes to be an anticipated part of the process which is navigated by the parents-to-be, the surrogate, and the clinic. The difficult trajectory of medicine, treatment, technology, and interpersonal negotiations becomes an important part of this process. Postconception, retaining and nurturing the pregnancy for nine months requires different forms of investment as well—whether monetary, emotional, or that of time into the arrangement. These investments are seen especially in the way ‘waiting’ with the surrogate becomes a form of kinship negotiation. It is during the pregnancy that the ambivalence (Peletz 2001) in kinship relations come forth

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Waiting with the Womb and have to be understood (p.107) and framed in ways that can be understood by all the groups and individuals involved. Waiting with the womb are several others whose relationship to the surrogacy arrangement determines and is determined by the relationship between the surrogate mother and the intended parents. These include the agent–facilitators, husbands of the surrogate mothers, and other kin of the surrogate, as well as the kin of the intended parents who navigated the pregnancy too. The agent– facilitators often monitored the pregnancy with the doctor—their stakes were higher especially if the client/intended parent was a foreigner and dependent upon them to ‘safeguard’ the pregnancy till birth. Similarly, husbands of surrogate mothers had stakes in the pregnancy for the sake of their wives, and for the anticipated compensation. The focus of this chapter is on the idea of disembodiment as felt in relationships marked by ambivalent emotions—which may arise from shared feelings of risk and intimacy—as seen in TCGSA. ‘Disembodiment’ encapsulates within it ideas of how relationships are configured within the ‘surrogate pregnancy’. This is seen in the ways in which the surrogate pregnancy comes to embody multiple conflicts and negotiations between the various participants within the arrangement. The pregnancy is felt by the surrogates, intended parents, doctors, agents, and others in the form of ‘disembodied relationships’. The nine months of the surrogate pregnancy redefine and re-categorize the notion of biology and substance. Here, substance and risk are implicated in making sense of a problematic, yet essential stage of making children and parents. The ‘wait’ thus becomes a kind of involvement that looks towards the future—to the anticipated and the unanticipated. In addition, to this end the nurturing of the foetus and the womb is geared towards a future kinship tie with differing levels of importance. Just like the body emerges as a ‘subject’ of cultural practice in forms of embodiment (Csordas 1990)—so does disembodiment. Here, it is important to note that disembodiment may be seen (p.108) not only in the ways in which the body is configured/understood/created in cultural imagery, rituals, etc., but also in its relational aspects. Thus, in kinship the idea of embodiment–disembodiment is also explored in relation to discussions regarding personhood—especially through the act of conception (Conklin and Morgan 1996; Middleton 2000; Ostor et al. 1983). The cultural understanding of personhood oscillates between the notion of the Western self-contained individual—and the multiple, disparate ‘dividual’ selves found in non-Western cultures, such as India (Marriott 1989). The non-Western person is formed over a period of time through shared substances and relations. Identified as the ‘processual–relational system’—these are literally ‘communities of substance’ (Conklin and Morgan 1996: 667–8) that Page 3 of 24

Waiting with the Womb invest in incrementally building personhood and identity over a period of time (Carsten 1995). Yet, irrespective of the fixity or fluidity of personhood and ‘body boundaries’ in different cultures—pregnancy becomes the locus for such bodily investment, achieved through sexual intercourse. A person can be created out of a minimal social interaction; traditionally, all that was required was for two people to have sexual intercourse once ... with new reproductive technologies (such as in vitro fertilization), even body-to-body contact and the physical presence of a sexual partner disappear from the person-making scenario. When personhood is understood to be ascribed by nonsocial factors, it cannot be readily rescinded, attenuated, or truncated by social action. Western persons, once established, are not easily undone. (Conklin and Morgan 1996: 665) So what happens when the pregnancy becomes displaced, disembodied—both culturally and physically? What happens to the notion of personhood as felt by the varied relationships entwined with the pregnancy? In addition, because the act of conception and the ‘pregnant body’ are the mediating points for identifying relationships in relation to the foetus—how does the surrogate pregnancy create meaning out of ‘disembodied relationships’? (p.109) The notion of disembodied relationships is inspired by the idea of embodiment as represented in the analysis of pregnancy (Draper 2003; Lupton 1999) and organ donation (Heinemann 2011; Sharp 2001). Relationships forged through organ transplantation describe ways in which donor kin and recipients form fictive kinship based on replication of natural blood ties. This replication is grounded in the idea of a shared body and blood. The ‘sentimentality’ (Sharp 2001) that comes to identify these relationships is based on the fusing of notions regarding shared notions of biology and biogenetic substances. However, unlike organ donations, in surrogacy the desire to create fictive kin is constrained and often actively discouraged. In this case, I posit that the aversion to creating ties arises from the nature of the relationship—which is deeply intimate, and yet distant. The birth of a child and future kin becomes part of a complicated narrative regarding class, race, gender, and blood and genes. While in the case of organ donation fictive ties help overcome grief and loss—in the case of surrogacy a latent sense of aversion and distance between the intended parents and the surrogate mother act as strategies used to keep the pregnant mother in context. Her pregnant body is a ‘real’ reminder of disembodied kinship. The embodiment of the pregnancy comes as a threat to the relationship of parenthood and shared substance. The imminent ‘risk’ with which the surrogate pregnancy is identified comes to be mapped on a moralistic compass of kin and kinning. Here, I draw from the Featherstone et al. (2006) formulation of ‘risky relations’ that are so imagined due to the perception of risk amongst intimate relations. Relatives are Page 4 of 24

Waiting with the Womb implicated: ‘[T]he medically defined calculus of genetic risk … mapped onto an equally significant moral calculus of family relations’ (Featherstone et al. 2006: 23). Thus, within such an idea ‘risk’ becomes a lived anxiety and emotion that is primarily seen in the context of substance and the contractual relationship. This chapter charts the period before and after conception by looking at the ways in which kin and technology position the period of pregnancy within the (p.110) surrogacy arrangement. The choice of the surrogate, the difficulties of getting pregnant and the care of the pregnant surrogate is seen from the lens of people who nurture this all-important tie without being involved in it directly. Thus, the ‘vicissitudes’ of kin relationships (Pashigian 2009) as they position themselves in the arrangement become relevant to the ‘wait with the womb’. How do IVF doctors and agents navigate between biomedical and cultural, indigenous understandings of sexuality, kinship, parenthood, and family? How are emotions and beliefs treated in the surrogacy arrangement? Who is the mother in the arrangement—legally, socially, culturally? How are the relationship between the surrogate and her husband, the parents-to-be, and the relatives of the latter implicated in the pregnancy? Who are the support networks for both the surrogate and the parents-to-be? How do they impact the arrangement? These are some of the questions that this chapter analyses in the course of the ‘wait with the womb’.

Nurturing an ‘Alien’ Pregnancy: Caretakers in Commercial Gestational Surrogacy The academic focus on the surrogate pregnancy has been centred on the surrogate mother (Levine 2003; Pande 2009a), and her relationship with the intended mother (Ragone 1994; Teman 2010; Thompson 2001). Entitlement, issues of class, race, etc., become important nodes within the charting of the pregnancy. The pregnancy relayed its ambivalence through the negotiations of commerce, substance, and persons. The unborn child in another’s womb or the unborn strange child in one’s own womb gave rise to detachment, concern, and fear. However, the ‘alien-ness’ of the surrogate pregnancy is most remarkable when perceived from the viewpoint of those who ‘nurture’ it. In the ethnography, many such people emerge who were important to the arrangement and to the primary participants. Agents, husbands of surrogate mothers, friends, and relatives of the (p.111) intended parents were important actors within the arrangement. Their presence was felt mostly during the pregnancy as ‘caretakers’. Through negotiations with the opposing emotions of love and hatred, the caretakers tried to make sense of the alien pregnancy. The ‘caretakers’ (Deomampo 2013b) therefore became this group of people, relations—other than the intended parents and the surrogate mother—who nurtured the ‘alien’ pregnancy.1 ‘Alien’ for the intended parents because it is Page 5 of 24

Waiting with the Womb ‘housed’ in another’s body—and ‘alien’ for the surrogate mother because it does not belong to her. This alien, disembodied pregnancy is also nurtured by those who do not have any direct or indirect genetic links to the foetus.2 The nature of the arrangement involves foreign intended parents who are unable, and often unwilling, to physically be present during the pregnancy making the presence of ‘caretakers’ absolutely essential to the nurturing of the nine months of pregnancy. How to Make a Pregnant Mother

Paromita’s daily rounds included a trip to Miracle Babies with the surrogates for their check-ups, ETs, and other necessary medical tests. She would often take some of the pregnant surrogates for their ultrasounds to another clinic close by (which was run by one of the visiting doctors at Miracle Babies). On one such occasion, a few of her pregnant surrogates had registered a low Beta hcG test count.3 When asked about what it meant, she gave a rudimentary idea of the test. ‘I am unaware of the technicalities of what the test means, but it usually signifies the health of the embryo–foetus. A “50” on the Beta test means pregnant—after which a 500+ count means that the embryo is growing and is healthy. Both our surrogates have a very low count of 250’. Paromita admonished the surrogate Rubina for the low count, ‘Embryo ko toh khana hain, usko grow karna hain ... isiliye khana dena hain’ [The embryo has to eat … it has to grow ... that is why you have to give it food]. Within a week, Rubina had started bleeding and aborted simultaneously. (p.112) Paromita knew where the surrogate was positioned within the arrangement. She made sure that the surrogates and their husbands understood that the pregnancy was a responsibility—‘zimmedari’ that they had been entrusted with. Yet, navigating the terrain was difficult especially when the ‘sense of responsibility’ on the part of the surrogate mother and her family was fuelled by financial considerations. Paromita felt that she could empathize with them from her position as a mother of a 7-year-old. In being more ‘sympathetic’ of the surrogate’s and her family’s tryst with the pregnancy, Paromita insisted that the surrogate should live in her own home. ‘I want my surrogates to stay in their own homes. But if there is a request for a separate home—we can arrange for it … but we try to convince our clients that it is best that they stay with their families.’ Yet, ‘surprise visits’ were the norm and included checking on their living conditions, hygiene, etc. Entry into the surrogacy program at Building Futures (which Paromita supervised) was open to only healthy, married women with at least one living child. For Paromita, their blood tests and scans were often more important in eliminating or choosing a potential surrogate, than her marital status or where she lived and her age. ‘Only if the doctor says “OK” we recruit the surrogate.’

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Waiting with the Womb Though the doctors’ perception of the health of the surrogate was the primary marker, the eligibility of a woman to be a surrogate traversed socio-medical notions of suitability (also discussed in Chapter 3). This was a subjective judgement that created divisions between agents and IVF doctors. In conversation with an agent–facilitator one such case was discussed. It seems that one of the surrogates I had met earlier, Cheena, had been rejected by the doctor because of her ‘appearance’. Referring to her case, Paromita did not think that this was a very good idea as the surrogates had no contribution whatsoever to make to the baby. Neither genes nor looks–– they were mere carriers. So this concern for the ‘right looking’ surrogate seemed to be a little out of place. Paromita noted that the IVF specialist refused to cooperate with (p.113) the surrogate because she was worried that the couple may not like their child being carried by this woman. [Cheena had buck teeth––and was extremely emaciated. The day I met her she had come from her home in a hurry without having had the time to make herself look ‘presentable’.] Paromita felt that this kind of objection fell flat because after all it was ‘they’ [the agency] who were dealing with the couple-clients and not the IVF doctors. So this concern for the couple’s sensibilities seemed misplaced. Paromita had retained Cheena for later. (Field Notes, 2 August 2011) The foetus was important—it was not however the ‘baby’, but an organism growing in her body that she needed to nurture because she had undertaken to do so contractually. Paromita wanted to stress on the responsibility of the pregnancy without creating any emotional linkages or sense of ownership to the foetus. When Building Futures suffered a set-back with two of its four surrogates suffering an early miscarriage, Paromita was visibly upset; after all, the kind of money that clients/intended parents invested into the arrangement meant that nothing could be taken-for-granted. Paromita’s reference to the unborn child as an ‘embryo’—almost like a depersonalized robotic being in an artificial pregnancy drove home the need to keep the pregnancy distant. Yet, too much distance meant that the pregnancy and the embryo might suffer—as did happen in the simultaneous multiple miscarriages that three of Paromita’s surrogates went through. The role that agents and doctors play in the surrogate pregnancy is akin to the ways in which adoption agencies and government bodies negotiate transnational adoption for adoptive parents (Dorow 2006; Howell 2001; Howell and Marre 2006). ‘Kinning’ a transnationally adopted child involves creating ‘biological links’ to the child by recreating the image of sexual procreation and childbirth. However, the role of agencies and parents is often at (p.114) conflict here as the former constantly try to remind the latter of the child’s ‘origins’ and ‘roots’

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Waiting with the Womb as part of a ‘healthy’ psychological development (Dorow 2006). In the process, the biologization becomes ‘de-biologized’. The surrogacy agents–facilitators as caretakers undertook the process of biologization on behalf of the parents, and de-biologization for the surrogates and their families. Their role went beyond just monitoring the pregnancy —‘accompanying surrogates to the hospital for medical procedures, to ensuring surrogates receive their medications’ (Deomampo 2013b: 178)—it also involved the positioning of the pregnancy as an asexual act, in relation to the foetus and the intended parents. The lack of sexual intimacy de-personalized the pregnancy into an alien act—almost as if occurring in an impersonal technologically induced cyborg fantasy (Haraway 2004). Many of the surrogate mothers recalled their disbelief on knowing about the process of becoming pregnant through ARTs. They said that their initial reaction to the asexual conception was to doubt the arrangement. ‘Matlab baccha banane ke liey toh aurat–mard ka sammbandh chahiye—maine kaha aisa bhi hota hain kya? Machine se bacche?’ [I mean that children are made through the relations between a man and a woman—so I said, does this really happen? Children from the machine?]. Through visual aids and detailed explanations, the agents convinced surrogates and their husbands of the ‘artificial nature’ of the pregnancy. While negotiating the physical pregnancy with the surrogate, agents have to constantly create narratives of alien-ness—purposely de-biologizing the foetus and the pregnancy through the mechanical asexual act of insemination/embryo transfer (even though it is hardly a ‘mechanical’ act, considering the way in which insemination is deeply invasive. However, the ambivalence exhibited in de-biologization is in conflict with received wisdom regarding the role of nurturance in the womb. Oscillating between the discourse of ‘distance’ and ‘care’, agents eventually embark on a surveillance (p.115) of the surrogate pregnancy. The investment of money and time meant that their role of monitoring, cajoling, and maintaining routine became all the more important during the pregnancy. Failed pregnancies were always blamed on the surrogate. Thus, the other side of the surveillance meant making the surrogate responsible for the alien pregnancy. She had to treat it like an investment in her body and kin. Miscarriages were her fault, the inability to increase the Beta hCG was also her fault, and the inability to conceive too was seen as her fault. Strangely, the ‘fertile’ woman was turned into an ‘infertile’ surrogate in her negotiations with the technology. Kinship work in that sense was charted beforehand while embarking on the surrogacy arrangement. This included strict stipulations against breastfeeding the baby immediately after birth. The clause of no-contact with the surrogate mother was strictly followed—however, the creation of contact with the intended parents had to be negotiated.

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Waiting with the Womb The recurrent fear of the surrogate mother running away or deserting the couple warned of the kind of risk that the surrogate pregnancy entailed. It was also symbolic of the disconnect between the surrogate’s position within society as a lower class/caste, economically dependent woman and the upper class Indian or rich and racially different foreign couples (Pande 2011). Agents and doctors propagate this fear freely making the estrangement during the pregnancy complete. Very few couples amongst those interviewed stayed in the touch with the surrogate during the pregnancy (or after). Foreign couples relied heavily on the IVF doctor and agent to conduct the pregnancy on their behalf. This distance from the couples/intended parents affected the surrogate mothers who got intermittent information from and about the couples. Added to this was the anxiety over the distance with one’s own children that many of the surrogate mothers left behind during their pregnancy. Paromita, however, understood the need for ‘connections’. She tried to understand the pregnancy (p.116) from ‘their’ perspective, noting, ‘Tum doosre ka baccha kya karoge [how will you make someone else’s child] if you are separated from your own child’. To empathize was an important part of the process of biologization—of kinship work. In the struggle between empathizing and distancing oneself from the alien pregnancy, all the participants had to deal with ambivalent emotions regarding it. The delicate balance of nurturing someone else’s pregnancy while implicating yourself and your body in it meant that agents and doctors had a big role to play. Right from screening, selection, and the ultimate care of the pregnant mother, the responsibility of nurturing the alien pregnancy as both alien and related lay with them. From the very beginning the surrogate mother is socialized and constructed for the purpose of a healthy pregnancy, and the eventual relinquishment of the child. The discourse around TCGSA is based on creating ‘owners’ with entitlements. So while the surrogate and her family are convinced regarding the asexual nature of the arrangement and the ‘alien’ pregnancy; at the same time, the intended parents are told of how they are the true owners of the pregnancy and the foetus. In this endeavour, the IVF specialist and agents actively propagate mistrust between the surrogate and the intended parents. They discourage meetings between the couples and the surrogates––and in case of foreign couples take over the reins of the pregnancy entirely. This means that often the couples do not meet the surrogate at all. In keeping with the requirements of the contractual nature of the surrogacy arrangement, relations between the intended parents and the surrogate mother are strictly businesslike. ‘Horror stories’ about jeopardized, failed, or conned surrogacy arrangements where the surrogate mother cheated the intended parents and the clinic, either financially or by not relinquishing the baby, were freely circulated amongst Page 9 of 24

Waiting with the Womb couples, surrogates, doctors, and agents as cautionary tales. The precarious nature of the relationship is reason enough to enforce strict surveillance (p. 117) mechanisms to monitor the pregnancy. Thus, the recurring need for surveillance of the surrogate pregnancy forms the crux of the medical discourse. In contemporary medical discourse around pregnancy and the pregnant body, self-surveillance is already an established tradition, seen as forcing women to subordinate their bodily and emotional well-being for the sake of the foetus (Lupton 1999)––but in case of the surrogate pregnancy it takes on a different dimension altogether. Ethnographic analysis of Indian surrogate mothers has pointed towards the practice of ‘housing’ gestational surrogates in hostels that are run by IVF clinics and agents (Carney 2010; Pande 2009b; Saravanan 2010; Vora 2009). In these hostels, the surrogate women follow strict codes of behaviour and nutrition. Many of them feel trapped and imprisoned in the hostel atmosphere (Madge 2013), unable to move out and participate in any activity beyond the ones mandated by the clinic and agent. Madge notes that the long hours of ‘resting’ that the surrogates have to forcibly undertake tires them out. This pregnancy is unlike their other pregnancies where they actively participated in household activities while carrying their own children. The surrogate pregnancy is monitored based on ideas that regard the surrogate mother as untrustworthy, and convincing the parents-to-be of their parenthood. Agents and doctors constantly try to reaffirm, convince the couples of their genetic links to the unborn child, while at the same time telling the surrogate to treat the pregnancy as not theirs (Menon 2012). Kalindi Vora notes something similar, ‘The clinic staff’s medical explanation of reproductive technologies to potential and active surrogates works to distance actual individuals from the embodiment of reproduction, and creates a framework for commissioning parents, doctors and surrogates to imagine the act of gestating a child as a paid occupation, where a service (gestation and childbirth) is exchanged for a fee’ (Vora 2014: 72). To bring such a pregnancy to fulfilment requires a concerted effort on part of all the participants concerned (p.118) to carry forth the basic idea that the pregnancy belongs to the intended parents—those who are funding the arrangement, and not only those to whom the foetus is connected genetically. Dealing with the Pregnant [M]other

Mrs Chadha’s tryst with surrogacy occurred in relation to her son and daughterin-law’s desire for a child. Her daughter-in-law was diagnosed with infertility due to ‘multiple issues’, which she never clarified, which led to their opting for surrogacy in India. Post-retirement, Mrs Chadha had been cajoled into contracting the arrangement on behalf of her NRI (non-resident Indian) son. Along with her samdhan (in-laws—here Mrs Chadha’s daughter-in-law’s mother) Mrs Chadha went through the drill of looking for a surrogate and finalizing a young widow with an infant to be the surrogate mother to bear her grandchild. Page 10 of 24

Waiting with the Womb After the surrogate conceived, she came to live with Mrs Chadha thereby beginning a relationship that Mrs Chadha was still trying to understand, even after a year of her grandsons’ birth. Mrs Chadha found herself at the crossroads of wanting to stay in touch and connect with the surrogate despite her son’s express instructions not to do so. ‘My son always tells me, “Don’t get emotional, it was just a contract. She got paid and left”.’ The secret calls between the surrogate and Mrs Chadha continued despite the bitter end to the arrangement. The couple blamed the surrogate for the immature birth of their twins and their subsequent ill health, a recurring grouse that Mrs Chadha also articulated. She blames herself for the lack of proper screening of the surrogate— She seemed very eligible. Her father was negotiating. She was young. She was a widow. With married surrogates there are some or the other problems. She already had a delivery. But now we realize we made a big mistake … and our doctor advised against it … She had a small baby and ideally there should be a window between (p.119) the first child to have another child. And she was very young. And we thought she would be very fertile—which she was … Mr Chadha too made similar observations, ‘In our case one of the biggest mistakes was that the girl had to lose a child [sic] (her own son) who was just a year old … and the gap between the two pregnancies was very little—I would strongly recommend looking at that … the doctor should have pointed this out.’ The surrogate did ‘lose’ her own child for a year. She was not there for her son’s nurturing or care, which was done by the surrogate’s mother—but this was a point that was only articulated by Mr Chadha. For Mrs Chadha their mistake in being unable to understand that high fertility could come with its costs—here the lack of a respectable time gap between two subsequent pregnancies— seemed to carry forth in the guilt regarding the health of her grandsons. The premature birth at 27 weeks had meant that the babies’ lungs and eyes had to be surgically ‘developed’, and they were just a kilogram in weight. Their stay in the hospital and their precarious condition lasted for some time leading to a harrowing time for the family. Mrs Chadha blamed the surrogate for this. She found the surrogate’s attitude to food, medical examination, and medication restrictive. [H]ad a difficult time convincing the father and the surrogate that she needs to eat well … She became very big in the last few weeks [before the delivery], but her father used to say, ‘itna khila diya aur kitna khaye gi— isme jaga hi nahin hain’ [you have fed her so much, how much more will she eat—she does not have any more space to digest] … I would insist on Page 11 of 24

Waiting with the Womb feeding proteins but the father and daughter would not agree … you see poor people have this conception that if the woman is overfed then there will be problems in delivery—the surrogate’s parents were worried about the safety of their daughter and not of the children she was carrying. If you have your own children then you want them to eat well … the surrogate was doing this as per the contract. Her family was not bothered ki patle bacche honge ki nahin [whether the children will be weak or not] … the children were so small … my son and daughter-in-law were very upset … (p.120) for the rest of their life they are going to carry this baggage—it will affect their cognitive, physical, and emotional growth … The womb for Mrs Chadha had not done its role of nurturance by detaching itself from the foetus. In that sense she placed the lack of ‘connect’ and not being ‘her own’ children as the reason behind the surrogate’s indifference to their health. This indifference on the surrogate’s part was manifest again when, [T]he last time the surrogate went to the doctor for a check-up the doctor said that her cervix was dilated, so she would have to stitch her up … so that she doesn’t deliver earlier. She [doctor] wanted to examine her from inside, but the surrogate did not allow her to do so … she was very, very adamant about not being examined intrusively … in this there was some misconception that they are going to use the camera [in laparoscopic examination] and send the photographs to the US [to Mrs Chadha’s son and daughter-in-law] of the baby inside … the surrogate’s father did not want it. If she had allowed the doctor to examine her then the doctor would have guessed if there was going to be a premature delivery and would have stitched her up, or put her on steroids—so that the labor would have happened later. That is why my daughter-in-law is upset … if it was their own child they would have done it … for the interest of the children she would have done it. The daughter-in-law’s anger and disappointment regarding the surrogate, for not being the proper custodian of her children, comes through in most of Mrs Chadha’s narratives. This is pitted against the surrogate’s father’s attitude of over-protectionism towards his daughter. His ‘dakyanoosi’, supercilious approach to his daughter’s body, health, and diet led him to also tell Mrs Chadha ‘agar isko kucch ho gaya toh hum to kahin ke nahin rahenge’ [if something happens to her then we will be done for]. The fear of losing their own child added to the pressure of caring and nurturing for the surrogate. Mrs Chadha found herself caught in her role as a ‘middle class carer’ as she called herself. She was grappling between a conflict (p.121) of values between a ‘lower class surrogate’ and ‘upper class genetic parents’. She herself admitted that the class factor was an important aspect to the exchange—colouring her interactions with the surrogate and in her interpretations of the events during Page 12 of 24

Waiting with the Womb the pregnancy. She found the surrogate both sympathetic and wanting in her custodial role of carrying her grandsons. ‘I think she also became a little altruistic … she met my daughter-in-law and realized that they wanted a child. She wanted to help. She was very quiet and submissive … but the fact that she was going to make so much money gave her some power and she would reply back to her father …’ The conflict with their respective kin (both in case of the surrogate mother and Mrs Chadha) exacerbated the interpersonal dynamics of ownership and belonging. Mrs Chadha inadvertently blamed her, following her son and daughter-in-law for not being ‘sacrificing enough’ for the sake of the children. It was only Mr Chadha who identified her sacrifice for her infant in coming forth to carry the difficult pregnancy for the couple. Unable to deal with the ‘alien-ness’ of the pregnancy, Mrs Chadha fell helplessly in love with the surrogate. She took care of her not only because she cared for her unborn grandchildren, but because she genuinely felt for the young surrogate, who was also a mother. She failed to disassociate the pregnancy from the pregnant mother in a way that was conducive, ultimately, for her grandsons. When the surrogate showed disinterest in eating, Mrs Chadha appealed to her by highlighting the need to safeguard her own health. ‘I realized I had to approach the surrogate by not positioning the pregnancy as a responsibility, and for the sake of our babies—but in terms of her own health. After she fainted once, I told her to eat more for her own sake, for her strength—she understood immediately.’ Here, ambivalence made the work of ‘naturalization’ of creating seamless connections between pregnancy–motherhood– (p.122) nurturance difficult. The biologization of the pregnancy came undone when faced with the ‘[C]oexistence of (two or more powerful) contradictory emotions or attitudes (as love and hatred) towards a person or thing’ (Peletz 2001: 414). In Mrs Chadha’s case, this breakdown occurs in the clearly fraught identification of mother and gestate— extending into the impact the surrogate has on the children, even though the egg belongs to her daughter-in-law. Her lasting impact is felt in the way in which they will carry the ‘baggage’ of her reluctance to contribute to their nurturing. Another intended parent, Udit, expressed similar anxieties of foetus–nurturance vis-à-vis his surrogate, equating her physiological labour with his own ‘physical labor’: Anindita (A): So ... how have you and your wife reacted to the whole process? How was it for both of you for the nine months? Udit (U): Quite exhausting ... for me ... very emotionally exhausting. The amount of physical labor that goes into the process ... the surrogate needs constant attention … whether she is taking her medication or not ... is she taking her meals ... taking her to the doctor ... a long process … Then as Page 13 of 24

Waiting with the Womb the months progress you are attached to somebody [the fetus] ... you see it as a possibility ... once it crosses a year you feel its going to happen now ... then the whole idea of doing it again is very emotionally painful ... and you are in constant fear of the woman running away … A: Is that a recurring fear? U: She is human ... and one is unsure, after all she was living in her own habitat … A: Did you monitor her diet to some extent? U: As much as we could … we did provide her regular money for her diet ... A: She was staying at her own place? U: Yes (p.123) A: Did you visit her there or did you see her at the clinic? U: Clinic Udit echoed the lack of trust that many of the couples felt vis-à-vis the surrogate. Mrs Chadha too articulates it in her reproach against the surrogate. This was largely fuelled by issues of class and poverty. It was also fuelled by a discourse that ‘imagined’ the poor surrogate as hungry for money and putting her interests above that of the foetus she was carrying. The hierarchies of class and difference in cultures come undone in the surrogate pregnancy. ‘She sat with us at the dining table and ate’, says Mrs Chadha, not without a mixture of pride, honour, and reluctance—an unheard of practice even in contemporary middle-class India. However, within the conflicting concern for the pregnant ‘other’ and the owned pregnancy was a ‘rhetoric of love’ that Mrs Chadha battled with. Her ambivalence also stemmed from a ‘culture of servitude’ within which class and culture were deeply implicated (Ray and Qayum 2010). The identification of the surrogate mother with a particular class that was poor and needy meant that Mrs Chadha often placed her in the same class as her ‘faithful retainer’. She mentions how during the period of the pregnancy, her old servant took great care of the surrogate knowing her importance for the family. ‘He was surprised to see a woman like her eating with us at the same table … we had to take him into confidence about why she was there. He served us and her with great devotion. I know that he never discussed it outside the household with anyone.’ But the surrogate herself did not behave like that. She ‘lived like a queen’ in the household taking in the love, but refused to be drawn into a culture of servitude where she had to act subservient and do as the employers suggested.

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Waiting with the Womb Mrs Chadha’s case and that of foreign couples hiring surrogate in India is similar to what Ray and Qayum claim is embedded within a ‘culture of servitude’ that clashes with modern contractual (p.124) arrangements and traditional feudal patron–client relationships. In their ethnography of domestic help and their employers in Kolkata, the authors note that many of the employers were nostalgic of a time when their relationship with their domestic help and themselves thrived on a notion of ‘rhetoric of love’ (Ray and Qayum 2010: 92). This rhetoric was a fiction that both the servants and their employers indulged in to create idealized notions of loyalty, reciprocity, obligation, and trust. Such a system gave rise to ambivalence amongst domestics and their employers within the present-day contractual arrangement that privileges impersonal ties within a constricted time frame. The part-time servant is not at the mercy of the benevolence of the employer anymore, but cannot expect ‘love’ and reciprocity from them either. The surrogacy arrangement positions surrogates within this culture creating ambivalent feelings of love and contractual professionalism. Couples, both Indian and foreign, know and are often informed regarding the economic circumstances of the surrogates, and are subtly encouraged to create contractual ties (Pande 2014; Vora 2013). Indians such as Mr and Mrs Chadha who retain their family retainer believe in the traditional patron–client relationship of love and obligations, and are unable to reconcile their relationship with the surrogate on a contractual basis. Despite the ‘shared’ biological tie with their unborn grandchildren through the surrogate, a fact they were grappling with, they were unable to rid themselves of perceptions of her as a domestic help. This clashed with their son’s and daughter-in-law’s negotiations from a distance with the surrogate on a purely contractual basis. ‘She was part of a contract, which is over.’ Here, there is no bodily juxtaposition, or transcendence through the pregnancy. The ‘encouraged’ distance with the surrogate due to her class status means that intended mothers are unable to and unwilling to create ‘shifting body’ metaphors of a shared pregnancy (Teman 2010). Instead, intended parents create narratives of pregnancy through images of the foetus. (p.125) Many of the foreign intended parents shared the pregnancy with others on social networking websites through sonography images of the foetus. ‘Our baby at 11 weeks’, was a common caption below the images. The only way the pregnant body figured in these narratives was through the image of the swollen belly. Salma remembers her relationship with her Italian intended parents as ‘distant’, and mediated through pictures of her pregnant stomach. Anindita: How was your nine month pregnancy? I mean, did you get to meet the couple? Page 15 of 24

Waiting with the Womb Salma: Yes … they came and took pictures (of me) at two–three months (of the pregnancy) … they would email too … they want to feel it, but can’t. You know they too want to know what it would have felt like to be pregnant … she [the intended mother] thought of how if she was pregnant she would also have been resting, looking like this … isn’t it? So she would feel it through the pictures taken and sent to her. Mostly, the clinic would take pictures and send to the client … they would take a picture of the stomach … They would send stuff as well … the husband–wife (the intended parents) came during the ultrasound … (emphasis mine) This distance is fostered in a way that panders to the intended parents’ comfort level, especially if they are foreigners unfamiliar with the culture and uncomfortable with what they see. The contractual relationship means that the anonymous surrogate remains as strange and ‘far-away’ as the egg donor. As opposed to the anonymous egg donor who they never met (except for in rare cases such as the one discussed in the beginning of the chapter), the surrogate mother was a live, unavoidable presence for nine months or more. Many couples had to go through more than one surrogate in case there were miscarriages, or other problems. There are references of many of the intended parents, especially foreign couples never meeting the surrogate through the arrangement. As mentioned earlier, this may be due to the IVF specialists’ advice (p.126) against meeting the surrogate, or something that the intended couples themselves believed in. We did meet her briefly ... I know there are people who make a big deal about meeting the surrogate mother … know her better … but I wanted to know what were her thoughts ... I mean a large part of me did feel a lot of worry and concern for her … like for what she would feel or do afterwards … how she felt like, her emotional health … and yes I did feel a lot for her, but what I gathered from the clinic was that she wanted to do this and get it over with so that she could move on with her life ... We could send a message through the clinic ... but I don’t think we felt the need to have a relationship forever … she also didn’t want that … I always have her best interests in my heart … so then to force a relationship with her when she didn’t want it didn’t make any sense … (Nigel, gay father of baby boy born in 2011) However, there are also cases, of couples seeking to create relationships with the surrogates irrespective of their cultural and national background. Xavier, a Spanish single father who had twin girls through the surrogacy arrangement in Delhi, notes:

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Waiting with the Womb I didn’t want the birth of my babies to be reduced to a business transaction. It was after all a different, complicated situation—I was going to a place to create life—[I] needed it to feel emotionally well. I’m in touch with her son who always likes to have some news about my babies, but not directly with her. I think the money is helping the education of their son and daughter but she wanted to buy a new house (I’m not sure if she did). Resembling the contemporary relationship between the Indian gestational surrogate mother and the foreign intended parents—the dai was restricted to her role of breastfeeding the infant English child in colonial India (Banerjee 2010). She never posed a threat to the mother–child bond the way the nanny or ayah did, but the relationship between her and the English mother was marked by antagonism (Sen 2009). The mother tried to control her diet and hygiene for fear of the baby’s health as it ingested (p.127) the dai’s breast milk—whose diet and living conditions were even more suspect than that of the ayah. In many ways, this was similar to the current preoccupation with the surrogate’s diet and living conditions. The dai was also similar to the surrogate mother in the sense that her milk and breasts were the essential part of her identity and bargaining power. Their representation in household advice manuals in colonial India warned against their conniving and greedy nature. The fee for the services of a dai were high and many English mothers complained of the former’s constant efforts in trying to fleece their employers of more money (Sen 2009). This was also a sign of how easily these women were expendable in their reproductive role. In Mahashweta Devi’s Stanadhayini (Breast-giver—Devi 2002), the wet nurse becomes the primary wage earner for her own family by feeding over two generations of children of her zamindar (landlord) patrons. For this, she gives birth to over 20 children—none of whom come to her aid when she is finally discarded and left to die of breast cancer. The need for ownership, as seen in the case studies, drove most of the intended parents to actively ignore or play down the role of the surrogate. Like an albatross around the neck, the surrogate represented the ‘other’ in an intimate relationship. This was a reflection of their fear of the ‘third party’ in the birth of their child (Bharadwaj 2003). For foreign couples, the Third World surrogate came to represent the desperation of poverty. It was discomfiting for intended parents to enter the surrogacy arrangement and see it through the nine months. In addition, even though the encounter was couched as ‘philanthropy’ (Pande 2011), its real machinations were problematic and complicated. This was the case not only for the couples, agents or couple’s relatives—but for the surrogate and her family as well.

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Waiting with the Womb The Unwanted Pregnancy

It was Aslam’s first time in an upmarket New Delhi IVF clinic waiting room. He was there with his pregnant wife Rubina and (p.128) infant son Adil. Rubina was very happy but looked a little tired due to the long travel. After waiting for what seemed like an eternity, the doctor asked Rubina to come in for a check-up. Aslam, twenty-five, sat in the clinic waiting room with his two-year-old son trying to make sense of what he had got himself into. Like the husbands of other pregnant surrogates who came for their weekly check-ups to the clinic, Aslam seemed lost and a little tense. However, his responsibilities towards his pregnant wife were very clear. Anindita: The doctor says you will have to take extra care of her now. Aslam: I take care of her anyway … so nine months is no big deal … yes! She forgets to take her medicines also … I have to remind her … I have to give her her injections. I keep telling her to eat something … after all this is a zimmedari [responsibility] (in relation to the pregnancy) … we have to fulfil it. Aslam had been married to Rubina, twenty-two, for five years. They had married after a few months of courtship—their son was born two years into their marriage. Aslam was a little jittery about Rubina’s surrogate pregnancy. He did not know much about the intended parents—only that they were ‘videshi’ (foreigners). He and Rubina had not met them—now that she was pregnant, they may actually end up meeting each other. They had entered the arrangement to pay off a loan that Aslam had taken to be able to buy back a share in family property that was recently partitioned. He had paid off most of the debt of Rs 9,00,000 (around 15,000 USD)—the remaining one lakh rupees, he hoped, would be resolved after the surrogacy arrangement ended. They had received part of the entire amount by cash, and were being given a monthly stipend for Rubina’s diet and health. The amount that would be given for the surrogacy seemed to be all right to them. ‘We are doing this out of desperation [majboori]—we need the money, that’s why … Amongst us [Mohammedans] this kind of work is a sin [paap] … amongst our people [family] (p.129) this is bad … if someone comes to know then our lives will be ruined …’ Their family wanted Aslam and Rubina to have more children, and would not be able to understand the arrangement. Their one-and-half year old son Adil would never know about the pregnancy and the child. Aslam and Rubina thought that he was too young to understand and notice the pregnancy, and they felt that there really was no need to share it later.

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Waiting with the Womb Despite the secrecy, Aslam had entered the arrangement knowing that ‘it was not his child’ Rubina was carrying. The procedure had been explained to him, and he had no objections to the arrangement, as the pregnancy seemed to be ‘simple’. This view stemmed from the knowledge regarding the artificial insemination quelling fears and anxieties about sexual intercourse, especially since Aslam accompanied Rubina to every medical examination and procedure. Rubina added that they were helping someone have ‘heirs’ by positioning her pregnancy as a ‘good deed’ for someone’s benefit. Rubina’s medical reports suggested weakness, she was told to eat more and help the ‘embryo to grow’—Aslam looked concerned and repeated that ‘this is after all a responsibility [zimmedari] that must be fulfilled’. He insisted that he took care of her—her diet, medication, and health—for if not him, then who would. The surrogates’ husbands saw the pregnancy as a responsibility, especially in relation to their own children and family. The asexual nature of the pregnancy helped them to come to terms with their wives’ swollen bellies. Yet, the positioning of the responsibility within the tropes of ‘paap-punya’ (sin–piety), that many of the surrogate mothers and their husbands did, was representative of the moral ambivalence on their part. While they ‘sinned’, they tried to position the pregnancy as an act of virtue too. ‘Yes, I am (p.130) feeling really nice that I helped someone have a child … I mean I have done a good deed … I am very happy that I was of use to someone.’ (Meena, 25, gave birth to twins for an Indian couple). Surrogate mothers in this ethnography did not try to create biological linkages with the foetus, unlike Pande’s (2009b) findings regarding the same—though this did not mean that they did not feel bad at not staying in touch with the intended parents or after giving birth to the baby. The constant assertion by surrogate mothers that ‘Unki cheez thi, sab unka tha, hamara kucch bhi nahin’ [It was theirs, everything was theirs, nothing belonged to us] was not only in keeping with the clinics’/agents’ mandate, but also helped position the pregnancy as a business venture. Thus, the compensation formed an important part of the unwanted pregnancy— sometimes the only reason that it was sought after and wanted. Planning around the compensation helped to justify and understand why one was undertaking an alien pregnancy. Once convinced of the asexual nature of getting pregnant, many of the husbands of the surrogates encouraged/coerced their wives to become pregnant to earn the extra money. It is here that the husbands as nurturers came in handy. They positioned the pregnancy in a way that helped them overcome its transgressive, risky nature. The reproductive capacity of the wives was channelized by the husband and her kin to their advantage. This was evident in the way Ajay tried to convince his wife Kavita to go ahead with her surrogate pregnancy. Ajay was very clear that he was undertaking this for the sake of his two unmarried younger sisters whose weddings were on hold because of the lack of funds. The surrogacy would pay for the weddings—Kavita Page 19 of 24

Waiting with the Womb was helping him fulfil his responsibilities as the eldest son of the family. In addition to the Rs 2.25 lakhs (approximately 4,200 USD) that they would get for one baby, Ajay had heard (from another surrogate) that in case of twins and triplets every subsequent live child would get Rs 75,000 (approximately 1,200 USD). This, for Ajay, was unacceptable. ‘Twins are after all two children … one is (p.131) not less than the other … then why should we be paid less for the second child’. The pregnancy and the unborn child were already commodified in the contract and by the agency/clinic. Thus, to objectify it further helped the surrogate couple deal with the pregnancy in a better way. Similarly, Aslam spoke of how he would use the money earned from the surrogacy arrangement to pay off an outstanding loan on their house. The surrogates themselves had plans for how they would spend the money they will earn or had earned. Yet, seeking compensation made the pregnancy and the arrangement more risky for the surrogates than the intended couples. The contract signed by the surrogate laid sole responsibility of protecting the pregnancy and averting risk to the foetus, on them. In that sense, the transaction was completely one-sided. The use of the ambiguous term ‘party’ for intended parents meant that the transaction/arrangement was also understood to be a one-time arrangement, and placed the moral obligation entirely on the surrogate mother than the couple. In the 2006 Hindi language popular film Janani (Mother—directed by Bahl) the pregnant surrogate Akanksha finds herself getting emotionally attached to the unborn child she is carrying for her friends Raj and Urmi. She begins to imagine that the child she is carrying is a rebirth of her recently deceased young son Rahul. After confessing these ambivalent feelings to her husband Tarun, he tries to reason with her about the obligation she owes to her friends, to whom the child belongs. Unable to restrain her hysterical behaviour, Tarun lashes out: ‘Par iss ka baap mein nahin hoon! Rahul mera beta tha!’ [But I am not the father of this child! Rahul was my son.] The role of men within the surrogate pregnancy is a missing part of most analysis. Ragone (1994) mentions the kind of negotiation that the adoptive mother and the surrogate mother undertake to create ambiguities regarding the relationship of the father and the surrogate. Similar ‘enactments’ are seen in the ways in which (p.132) a sister acting as a surrogate for her brother’s child engages with her sister-in-law to denaturalize a tie that has tones of incest (Thompson 2001). Men are implicated in the surrogacy as fathers, but rarely and only in passing is the husband of the surrogate mentioned (Laqueur 2000). The latter is by default a father to the unborn child too—yet his role remains marked by the position that his wife or girlfriend occupies within the arrangement.

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Waiting with the Womb Ignoring the role of men as participants in pregnancies, whether alien or their own, stems from the anthropological tendency of treating pregnancy as a ‘women’s issue’.4 However, research also points towards the male desire to appropriate the pregnancy for themselves (Draper 2003; Middleton 2000). Disembodiment is felt most by intended fathers who seem to be unable to understand or control the embodied pregnancy. Draper notes that ‘men’s transition to fatherhood is “troubled” not only by a cultural ambiguity, arising from the changing status of contemporary fatherhood, but also by a biological ambiguity’ (2003: 744). Such ambiguity is dealt with amongst the Wari’ by insisting on the father’s role in the conception and growth of the foetus through the provision of food for mother and child after birth (Conklin and Morgan 1996), or amongst the Karembola through direct nurturance and caring of sisters’ and wives’ pregnancies (Middleton 2000). In both cases, nurturance over a period of time is privileged over the relatively ‘fleeting’ nine months of pregnancy, thereby creating ‘owner–fathers’. However, in case of the surrogate pregnancy, husbands of surrogate mothers actively want to disassociate themselves from ownership of the pregnancy. They wish to create a discourse that tries to prevent the entry of ambivalence on the part of the surrogate in order to protect the disembodied nature of the pregnancy and the relationships surrounding it. Part religious and part instrumental, the morality with which they confront the pregnancy helps them navigate its alien-ness that comes as a double bind for them. After all, their sanction is necessary for their wives to participate in the surrogacy—which is evident in the contract that (p.133) seeks the husband’s signature. The contract therefore acknowledges that the husband is the ‘owner’ of his wife’s reproductive body. However, it also places the responsibility of the contract on him as well as his wife. Within such a context the morality is embedded in socio-religious identification of obligation, duty, and karma.5 Religion is seen to colour engagements with ARTs across the world in differing cultural contexts (Bharadwaj 2006a). Justification and legitimacy is sought through cultural understandings of modernity seen though reproductive technologies. In India, for instance, the IVF is part of a construct of ‘clinical theodicies’ that try to position biomedicine and biomedical technologies as ‘mythic’ overcoming its otherwise failed and tentative character (Bharadwaj 2006b). Within IVF-surrogacy this form of theodicy is actively used by surrogates and their kin to navigate an alien pregnancy through the ideas of paap-punya or sin–piety. Surrogates and their husbands used local–moral frames of reference to seek social approval, while at the same time surrendering themselves to their fate. ‘Zimmedari’ is in that sense a masculine reclaiming of ‘lost’ manhood through the channelling of some form of ownership over the wife’s ‘illegitimate’ pregnancy.

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Waiting with the Womb The nine months of the surrogate pregnancy are a difficult time for making kin. For the caretakers, the unseen child within the visibly pregnant surrogate evoked ambivalent feelings. Ambivalence, is felt most during the pregnancy, which is already liminal (Turner 1969). Its liminality within the surrogate pregnancy however means that ‘kinship work’ (Thompson 2001) becomes that much more strained and difficult. In India, traditional practices and values intermingle with modern structures and ways of being to oftentimes further strengthen unequal configurations (Bharadwaj 2006b; Ray and Qayum 2010; Van Hollen 2003). Biomedicine strengthens traditional structures (p.134) into a continuum that does not place tradition–modernity at opposite poles. In case of commercial surrogacy this is seen in the way traditional patriarchal structures that govern marriage and kinship retain their essential character wherein the surrogate’s husband negotiates with his wife’s body and the unequal class structures in negotiations with the pregnancy and the pregnant body. The surrogate pregnancy comes to embody the logic of being an ‘auspicious burden’. Van Hollen’s (2003: 79) finds that pregnant mothers are perceived as a burden for her natal kin due to the unending flow of gifts and money that flow out of her parents’ households into that of her conjugal kin (besides the child she is carrying)—symbolic of the asymmetric flow of goods and privileges that has been a characteristic of the north Indian kinship and alliance system (Dumont 1983; Khare 1982).This is further compounded in the emerging consumer culture in neoliberal India—leading to sex-selective abortions of daughters who continue to be seen as ‘burdens’. However, in case of the surrogate her pregnancy becomes the locus of an auspicious burden for the intended parents, her own kin—as well as the agents. Much of this ‘construction’ is fuelled through the rhetoric of ‘distance’ championed by the clinic and agents. Her auspiciousness is, like the dominant notion in Indian culture, embedded within her fertility as much as in her being a married mother. Her husband’s approval is testimony to that. However, the ‘burden’ of her pregnancy creates disembodied relationships that have to be navigated through emotions that are conflicting and ambivalent. Here, biology and substance intermingle in a conflicted narrative that tries to separate the relationship that the intended parents and the surrogate and her kin share with each other—more than with the child. The discomfort of ‘sharing’ substance and kin ties with each other is felt most poignantly in the narratives of the caretakers. They are unable to euphemize the true nature of the arrangement, and reflect their ambivalence through idioms of (p.135) commerce and conflicted kinship. Kinship work is not only difficult here, but fraught with risk.

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Waiting with the Womb

Notes:

(*) This chapter was originally published in Indian Journal of Gender Studies, Vol. 21 No. 2, Copyright 2014 © Centre for Women’s Development Studies, New Delhi. All rights reserved. Reproduced with the permission of the copyright holders and the publishers, Sage Publications India Pvt. Ltd, New Delhi. Parts of this chapter were published in, ‘Recruiting to Give Birth: AgentFacilitators and the Commercial Surrogacy Arrangement in India’. 2017.(with Sarojini N.), in Miranda Davies (Ed.), Babies for Sale? Transnational Surrogacy, Human Rights and the Politics of Reproduction. UK: Zed Books. (1.) In healthcare discourse ‘caregivers’ are identified as those who care for patients and provide nurturance and treatment, such as nurses and relatives. However, here I refer to ‘caretakers’ as those who care for and provide treatment for the surrogate mother as well as the intended parents during the surrogate pregnancy, but they also enact the all-important role of creating/ rejecting relationships formed during the pregnancy. (2.) The ‘alien’ pregnancy is a term being used to refer to the surrogate pregnancy in case of TCGSA and not to an altruistic surrogacy arrangement. (3.) The Human Chorionic Gonadotrophin (hcG) or the pregnancy hormone ‘is produced during pregnancy. It is made by cells that form the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. Levels can first be detected by a blood test about 11 days after conception by a urine test. In general the hcG level will double every 72 hours. The level will reach its peak in the first 8–11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy … Caution must be used in making too much of hcG numbers. A normal pregnancy may have low hcG levels and result in a perfectly healthy baby. The results from an ultrasound after 5–6 weeks gestation are much more accurate than using hcG numbers’ (www.americanpregnancy.org). In her scathing critique of ARTs, Rowland notes that, ‘HCG … [is] often marketed as Pregnyl, to stimulate the release of eggs. HCG also promotes implantation of the embryo, as it is the hormone produced by the developing embryo and later by the placenta. But when administered artificially, it is used to “induce ovulation at a precise time on IVF and related programmes”’ (Rowland 1992: 24, emphasis in original). (4.) Scheper-Hughes (1992) notes how she was chastized by a man whose claims regarding infant illness were dismissed by her on the basis of gender ‘ignorance’ regarding women’s bodies and babies. She found that men are equally knowledgeable about critical interventions in a pregnancy. Often they propose

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Waiting with the Womb divergent advice to women’s received wisdom leading to positive interventions into the pregnancy or childcare. (5.) Islamic ideology on the use of ARTs hierarchizes the different methods within a grid of acceptability and unacceptability (Simpson 2013).

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The Reproductive State

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

The Reproductive State Nations, Citizens, and Kin* Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0005

Abstract and Keywords The birth of the child in transnational commercial surrogacy leads to a protracted process of staking claim. In this chapter, the focus is especially on the national and international laws that are invoked by foreign parents and foreign consulates to grant citizenship to the newborn. The applications for citizenship from their home countries, and the exit visa from India lead to many processes of bureaucratic verification and authentication of the genetic tie between the child and the intended parent(s) and the surrogate mother. Seeking identity here are both the new parents and the newborn. Through the birth certificate and the DNA test paternity is identified, while a parallel process seeks to ascertain maternity through the surrogate mother—who incidentally has rejected her tie to the newborn as part of the contractual requirements! Through the narratives of three foreign nationals navigating the citizenship process—international laws regarding surrogacy, kinship and citizens are analysed. Keywords:   citizenship, statelessness, DNA test, international borders and laws, birth certificate

Vinay stood outside the stately Jaisalmer House in Lutyen’s Delhi sweating profusely. He had begun to lose count of the number of trips he had made with Moshe to this part of Delhi for the citizenship papers. Vinay: I spoke to the Foreigner Regional Registration Office [FRRO] and they said that I will have to go to Jaisalmer House [the headquarters of the

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The Reproductive State Ministry of Home Affairs, Foreign Division (Citizenship Section), Government of India] and get documents for the Exit visa … I have come here to see what all we have to give … What do you want? Whatever documents you want to see we will show you. And then we have to go and show them the documents that will certify our application, including the passport, the birth certificate. I am primarily worried that they want the lady {the surrogate}. That day I got the lady here … she has to sign … I hope that is not required … whatever … if they are satisfied then they will give a letter saying OK … and then with that letter we have to go to FRRO office in RK Puram ... and then take the exit visa and go … But if they think that an inquiry is required then they will conduct it … (p.138) they will bother us more … we are not afraid of an inquiry … we have all the papers and the doctor will support us, but even then if you still want to conduct an inquiry then go ahead. Anindita: So an inquiry means verification? Vinay: Yes ... exactly. Meeting a lot of people … unnecessary conversation {demand for bribes}. That is why I am so tense ... how will he do it {Moshe} … look my parents love the baby a lot but they know that the baby is not theirs … nor is it mine … Everyday you know my mother is getting increasingly attached to the baby. That day you know we were talking about the baby going and she was crying also … (Field Notes, June 2011) As part of this discussion on the final step in the transnational commercial gestational surrogacy arrangement, Moshe and Vinay’s case is demonstrated later in this chapter. The attempt is to see how the state allocates identity to the newborn born from the arrangement. Most of the couples interviewed as part of the ethnography were from outside India, leading to the analysis of the process of getting citizenship for the newborn. Here, the citizenship process comes to enact its own ‘kinship trajectory’ within a transnational–national setting. The child born from the transnational surrogacy arrangement is, no doubt, a special child. The travails of the process of begetting children through the arrangement, as discussed until now, are nothing compared to the joy of holding the child for real. On many occasions, this pleasure was shared with the ethnographer— tentatively holding the newborn while the new parents looked on in apparent pleasure. Yet, while the birth of the child is a welcome end to a lifelong quest (for many) and the removal of the stigma of infertility (despite what many of the naysayers might say)—for many of the respondents this was the beginning of other forms of scrutiny and legitimation.

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The Reproductive State The transnational character of the surrogacy arrangement nonetheless is up against national and international laws that (p.139) are unable to place the child born of such an arrangement within its scope of identity and citizenship. For the child born from the arrangement is an amalgamation, biologically and socially of many combinations of nationalities and ethnicities––in many ways the child defies notions of rootedness––thereby confounding processes of idenitygiving. In this chapter, I examine the kind of ‘dilemma’ that the TCGSA creates for bureaucratic processes of citizenship. The notion of being ‘stateless’ becomes even more acute when coming out of it requires multiple negotiations with many stakeholders. As a parallel, if not completely similar process, transnational adoption undertakes the enterprise of creating ‘new’ citizenry through the ‘kinning’ and transformation of children of foreign birth (Howell 2003)––however none of its conditions seem to extend to TCGSA. The contractual arrangement creates its own problems along with the medical technology that facilitates it. The contribution of ‘genes’ from people beyond the biological–intended parents complicates the script. Not to mention that some of the genetic contribution is anonymous, and the role of the gestate involves relinquishment. The Indian surrogate mother as per the Draft Bill on ARTs and surrogacy maintains her anonymity long after the child is born––and this is to maintain the ‘fiction’ sold by the arrangement that she is a mere ‘carrier’ (Vora 2009) and has effectively relinquished all claims on the child. Legitimacy for the child born of TCGSA involves complicated bureaucratic procedures and paperwork, but essentially the process of gaining citizenship rests on three important elements: the birth certificate, the passport and the exit visa. Each of the three is, however, contingent upon differing country laws and at the international level, upon the sanctification of the notary or Apostille.1 The process of gaining citizenship and the three elements involve an examination of the genetic tie the baby shares with the intended parents and visits to embassies or high commissions, along with approval to exit India from the Indian authorities. (p.140) During this process, the modalities of the commercial surrogacy arrangement are under scrutiny—as it is the reason why the child exists. Thus, the commissioning couple (who are now parents), the surrogate and the infertility clinic are all under intense examination—as much as the child, thereby making way for their analysis. However, the focus is also on the state and the ways in which it comes to influence, impinge, and order the intimate lives of citizens and aliens. In this chapter, the ethnography of the state is seen in the bureaucratic processes of granting identity, and how parents navigated it. The aim is to explore the ways in which the state constructs new subjectivities and invokes old normativities, by influencing ideas regarding kin and family.

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The Reproductive State In the ethnography, of the couples/individuals contracting the arrangement, an overwhelming majority were foreign nationals (see Table 5.1).2 This included persons of Indian origin (PIO), who along with NRIs (non-resident Indians), actively enter the surrogacy arrangement in India. One of them (Puneet Kaur and Rajvir Singh) are mentioned in this chapter––Puneet is a PIO born and raised in the UK, while Rajvir became a UK citizen later. Table 5.1 List of Respondents (Foreign Nationals) Who Had/Were Going to Have Children through the Transnational Commercial Gestational Surrogacy Arrangement during the Fieldwork Couples/

Country

No. of Children Status of Commercial Surrogacy Born in Country of Residence

Xavier

Spain

2

Trent and Philip

Australia 3

Illegal in some states

Chen and Roger

Australia 2

Illegal in some states

Stella and Jacob

Australia 1

Illegal in some states

Macy

Australia 1

Illegal in some states

Puneet Kaur and Rajvir

UK

1

Illegal

Moshe

Israel

1

Transnational surrogacy is not allowed

Saul

Australia 2

Illegal in some states

Michael

UK

Illegal

Daniel and Mike

Australia Entering the surrogacy

Individuals*

1

Illegal

Illegal in some states

process** Stephen and Fred

Australia 2

Illegal in some states

Sebastian

Spain

Illegal

Entering the surrogacy process#

Notes: *All names are pseudonyms. **Status in September 2011.

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The Reproductive State # Status in March 2011. Source: Author. As Table 5.1 shows, many of those interviewed were gay men from Australia— yet, in this chapter, I choose to discuss three cases that do not belong to Australia, but to the peculiarities of the way in which parentage is assigned. Thus, each of the cases deal with narratives of seeking recognition for the child and the parent through particular national laws (UK, Israel, and Spain) which also highlight three different forms of international recognition for commercial surrogacy. Thus, UK allows only altruistic surrogacy, while Spain bans all forms of surrogacy, and Israel promotes surrogacy by funding the arrangement for infertile couples as part of pronatalist policies. However, of importance is the way in which these laws also identify and construct the notion of motherhood and fatherhood, which is what the processes of verification and authentication are all about.

(p.141) Seeking Origins: The Process of Verification and Authentication Citizenship in TCGSA is granted based on the verification and authentication of the child’s identity. In the process, the bureaucracy focuses on ascertaining the authenticity of the genetic tie the child shares with the parent—and verifies the process of social relinquishment. The latter involves a thorough examination of the surrogate pregnancy and its associated terms of engagement. (p.142) As mentioned before, while the process of granting citizenship may differ between countries a standardized procedure could, however, be seen from the interviews given by the respondents. The primary steps involved in getting citizenship included: getting a DNA test at the high commission to prove paternity/maternity, issuing of the passport, and being granted the exit visa from the FRRO, Government of India for the newborn to leave India with its parents. The three steps, ideally, follow in chronological order and begin with the DNA test that is essential to ascertain the genetic tie with the father, or in cases of single women commissioning parents, the mother. The DNA test ensures the nationality of the child through the identification of its genetic parentage. The test itself requires certain documents as a prerequisite, such as: the birth certificate, a notarized surrogacy contract that states that the surrogate has relinquished the child, and studio photographs of the ‘new family’. In conversation with an Australian gay couple, Chen and Roger, the citizenship process was simplified into ‘five easy steps’. ‘We took our babies (a baby boy and a baby girl) back home in five easy steps by: proving descent, getting citizenship, going to the FRRO to get the exit visa, and flying back home!’ In reality, these five steps are far from easy and are represented in Figure 5.1 in

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The Reproductive State the form of three core procedures—which further include five other negotiations with the paperwork, and national and international bureaucracy. Such a convoluted process (which seems simple here, but is not) is similar to the one described by Constable (2003). Transnational marriages between couples of different nationalities, especially brides from the global South such as the infamous ‘mail order Figure 5.1 How to Get Your Baby Back brides’, have to go through Home in ‘3 Easy Steps’ similar processes of Source: Author. bureaucratic scrutiny. In many ways similar to the TCGSA, American men are seen to negotiate with month-long procedural delays to be able to get their Asian wives/fiancées to join them in the US. The process involves long durations of waiting, stress, and anxiety on the part (p.143) of both the husband and wife, as well as their families. Deomampo (2013a) similarly notes that foreigners coming to India to have babies through surrogacy suffer from long periods of immobility and liminality while waiting for their babies’ passports to come through. They are stranded in a foreign country and find navigating this period of uncertainty very difficult. The process of verification and authentication within a transnational context primarily includes a negotiation between ideas of tradition and modernity. Here, cross-cultural ideas must intermingle to give authenticity to a new tie—whether that of marriage or children. Maunaguru (2014) notes that transnational marriages amongst the Sri Lankan Tamil diaspora require the elaborate staging of traditional Hindu marriage rituals that are photographed and produced before visa officers for verification—and authentication. Spouses seeking membership into the partner’s country of residence have to furnish other identificatory documents to gain legitimacy. However, visa officers/bureaucrats reject applications due to questions of authenticity that are defined by notions of tradition—such as the parent-approved arranged marriage, appropriate rituals— and ‘love’, or the lack of it—in keeping with a more (p.144) Western construction of companionship. Legitimacy, therefore, is granted on the basis of ideas that combine multiple cultural values. Procedures involving transnational bureaucracy—such as cross-border brides, transnational adoption, immigration, or TCGSA—are managed at the level of the state, as well as by people, couples, immigrants, and parents. In such situations the state and its bureaucracy are navigated through minor forms of corruption. However, the spatio-temporal processual delays impact the negotiations with Page 6 of 34

The Reproductive State country laws and bureaucracies. In the case of TCGSA the birth certificate and the DNA test become the two important points of collision and combination as they determine the processual narrative of citizenship. The Birth Certificate and the Paternity Test

While conducting this ethnographic research, the Municipal Corporation of Delhi (MCD) was the authorizing body for the birth certificate for the child born of TCGSA. The birth certificate became the most important document that facilitated the other steps within the process of getting citizenship for the child born from surrogacy. The birth certificate as issued by the Indian authorities has a bigger value attached to it, rather than merely record the birth of the child born on Indian soil. The document has value in identifying the parentage of the child born through TCGSA. Initially, the MCD issued a standardized certificate to the child born of surrogacy—not considering them to be in any way ‘special’. This meant that the surrogate’s name was listed under ‘Mother’s Name’, leading to unforeseen problems—as was seen in the cases of the Balaz Twins and Baby Manji. For Baby Manji—the Japanese girl born of the eggs of an unknown Indian donor, and the sperm of her father Ikufumi Yamada—the legal hassles began with the Japanese government refusing to process her citizenship, and an Indian nongovernmental organization (p.145) (NGO) filing a suit on ethical grounds. Manji’s status as a prospective Japanese citizen was hampered due to the ambiguous status surrogacy has in Japan––banned by the Society of Obstetricians and Gynaecologists––but with no legal provision dealing with it. Besides, with the Yamadas divorcing before Manji’s birth, Yuki had relinquished her rights over the unborn child as she had no genetic links to her. This left Ikufumi, the genetic father in a bind as India does not allow single men to adopt children––and a public interest litigation filed by an Indian child rights NGO questioned his motives vis-à-vis the child. The grandmother had to step in as the proxy mother to be able to take the child back to Japan. Besides, Japan relented and gave Manji the passport she needed to be home. In case of the German Balaz Twins (Jan Balaz, the father of the twins was unable to take the children to Germany because the country does not recognize children born from surrogacy as it is illegal there) the recognition of the Indian surrogate as their mother by the High Court of Gujarat (the state where the babies were born) helped the twins get Indian citizenship. However, the Supreme Court of India overturned such an order at the behest of the Indian government when they were reminded that the ‘mother’ had relinquished her rights over the children as part of the surrogacy contract.

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The Reproductive State The dilemma of the ‘motherless’ child adds to the woes of being stateless––yet most couples who were part of the sample insisted that now they had the option of asking the MCD to enter the name of the mother as just ‘surrogate’. For most couples this was an issue of conflict that was related to getting citizenship papers and giving parental identity to a person who had relinquished the same. However, of late, the MCD began to take into cognizance the concerns of the commissioning parents when issuing the birth certificate. ‘The MCD birth certificate which earlier listed “SURROGATE” in place of “Mother’s Name” can now have the intended mother’s name. All one needs to do is point that out (p. 146) before the birth certificate comes in’, confirmed a Delhi-based surrogacy lawyer who facilitated citizenship for TCGSA foreign commissioning parents. Here, the act of removing the surrogate’s name from the birth certificate, both in India, and later by the commissioning parents in their own home countries, has larger implications for citizenship. Thus, the deliberate omission also accompanies parallel processes of invoking the surrogate’s role in the arrangement—especially when she is interviewed many times over by the embassies and Indian authorities. This is to ascertain the legality of the contract and the consensual relinquishment of the child by the surrogate. In many ways documents ‘constitute, authorize and conceal movements’ (Coutin et al. 2002: 823) as well as presenting linear narratives as facades to labyrinthine origin stories. Nowhere is this more evident than in the case of the birth certificate given to the child born through TCGSA. The birth certificate and the passport issued by the parents’ country of birth collude and collide in identifying the stateless child. They are both ‘documents of origin’ (Coutin et al. 2002), but unlike cases of transnational adoptions that however grudgingly acknowledge the ‘origins’ of the child, in case of TCGSA the two documents testify to an altogether different source of personhood that is deeply rooted in the negation of a particular form of biology and genetics. In that sense, Mulla’s (2011) contention that documents are the ‘new kinship technologies’–– resurrecting the interconnections, relatedness, and issues of making and unmaking of kin––could not be more true. The birth certificate extends legitimacy to those who border on the illegitimate–– as Castaneda (2008) finds amongst illegal migrant women in Germany desperate to get their newborn children legitimated through unions with German men. Many of these men may not be the fathers of the children, but were willing to claim paternity in exchange for some compensation. These temporary fathers also known as ‘Imbissvater’ or ‘fast food fathers’ have caught the eye of the German state which is now mulling (p.147) the imposition of a compulsory DNA test to weed out illegitimate cases. The combination of the birth certificate

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The Reproductive State and the DNA test to ascertain the legitimacy of the ‘other’ becomes even more pronounced in TCGSA. Thus, as opposed to the birth certificate most embassies conducted their own DNA tests. The Israeli embassy for instance collected the saliva samples of the baby and the father and sent them to Tel Aviv for testing, as did the Australian embassy. The test results were mailed to the regional consulate. The intricacies of the process of getting and processing DNA got complicated because it seemed that the saliva could be collected and shipped only in special containers/tubes that were sent directly from Israel. Fears of the samples being compromised due to rampant corruption in India was the common view amongst foreign embassy staff. This was further bolstered by cases of malpractice. A legal counsel who was fighting the case for a couple who had a baby through surrogacy recounted the particulars of a case. In a case of medical negligence, a Canadian commissioning couple who had contracted a surrogacy arrangement at a Delhi infertility clinic, found that the child was not theirs in the DNA test. Canada allows surrogacy, but the DNA made the child ineligible for Canadian citizenship. Clearly, the doctors at the clinic mixed up the sperm samples. The child is now stateless––it is a double bind case of medical misconduct and citizenship. (Majumdar 2015: 450) The IVF clinic has an important role in facilitating the citizenship process. They had to make sure that the paperwork on their part was clear and unambiguous–– especially if they had hired the surrogate mother on the couple’s/individual’s behalf. It was the IVF procedure itself that ensured that the DNA test pulled through. But the most important part of assigning citizenship emerges from the DNA test or from the biogenetic identification of paternity. Thus, the importance and legitimacy of the birth certificate was intrinsically linked to the results of what the DNA test revealed. Despite Smerdon’s (2012) plea that all children born of (p.148) TCGSA in India should be immediately granted a birth certificate clarifying the nature of involvement of all the parties concerned, in order to solve the impasse that occurs at the inter-country, inter-governmental level––it is the paternity test that determines the granting of citizenship.

Seeking Identity: The Process of Gaining Legitimacy To gain citizenship for the newborn child, most international couples followed a pre-ordained path. This path may differ from the consulates and embassies of one nation to the other, but as mentioned earlier, in essence involved getting the birth certificate from the Indian government’s registry of births and deaths; the submission of the birth certificate; the surrogacy contract and undergoing the Page 9 of 34

The Reproductive State DNA test at the respective embassy. This was followed by a simultaneous process of registering for the Exit Visa for the newborn with the Indian authorities, by engaging the FRRO and the Ministry of Home Affairs, who conducted verification tests with the couple and the surrogate mother to give their approval for the Exit Visa. Below are three ‘tales of waiting’3 (Constable 2003) that chronicle the experiences of three parents with bureaucratic processes of identity giving. Here, I draw from the ‘emotional content’ of the tales of waiting, marked by ‘increased personal commitment and emotional investment’ (Constable 2003: 175) as well as the frustrations and disappointments entailed in navigating the process. These tales are analysed along with a look at the prevalent legislation in the respective countries to which the respondents belong. ‘I am the Legal Mother’

In a run-down hotel in north-west Delhi, while cradling her newborn, Puneet burst into tears. For some time it was hard to imagine if they were tears of joy or anguish. Then, in between sobbing, she (p.149) exclaimed, ‘I am so tired! This has been going on for so long—I just don’t have the strength in me.’ Puneet’s tryst with pregnancy and childbirth had been going on for the last thirty years—very soon after her marriage and ever since she suffered a miscarriage due to an ectopic pregnancy. The foetus was formed in one of Puneet’s fallopian tubes leading to an abortion and the surgical removal of both her tubes. For Puneet the whole experience was like ‘she almost died’. This, however, led to a lifelong struggle with infertility through multiple IVF cycles and treatments. In June 2011 she was battling rising expenses and the prospect of a long stay in Delhi—far away from her home in north-east London. I met Puneet and Rajveer at Metro IVF through Dr Ruchi and was able to share their journey for a few months before they ‘went off the radar’. While waiting for the birth of their child in a dilapidated hotel in west Delhi in the searing summer heat, both Puneet and Rajveer went through anxiety and extreme stress. Part of this stress had been due to a prolonged period of waiting for the delivery of their newborn son— followed by the equally long wait to get citizenship for him from the UK Home Office. Tracing her roots to Amritsar, Punjab, and to Sialkot in Pakistan, Puneet was born and brought up in the UK. Rajveer was born in Gwalior, India and migrated to UK later. Both had siblings; Puneet had two elder sisters and two elder brothers—all of whom lived in the UK with her parents. Rajveer had three sisters who also lived in the UK, while one brother and one sister lived in Delhi. Both Puneet and Rajveer were the youngest amongst their respective siblings. They had an arranged marriage in the UK.

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The Reproductive State The British government’s requirements from couples seeking citizenship for their children born through surrogacy—especially as commercial surrogacy is not legal in the UK—were very strict and caused Puneet a great deal of anxiety. Puneet and her husband Rajveer negotiated the difficult bureaucratic terrain while grappling with Metro IVF’s alleged inefficiency.4 They had failed to (p. 150) provide Puneet with some important documents in the original—one of which was their case history, a mandatory requirement of the citizenship process in surrogacy. The financial duress felt even more acute as they began to realize that getting citizenship may well exceed the period of a month. Puneet kept referring to a list of steps—provided by a UK-based Indian couple who had a baby through surrogacy from the same clinic only a year back.5 However, the documents continued to pose a problem. The documentary evidence required became roadblocks especially at the level at which Puneet negotiated with them. The necessity of correct documents was further compounded by the contents of the documents. The MCD birth certificate that had already been provided in original to the couple listed the name of the surrogate in the space provided next to MOTHER’S NAME. The entry clearly stated, ‘AYESHA SURROGATE’. Puneet was visibly upset about it. She pointed out the ‘mistake’: The hospital director [not at Metro IVF] told me that this [listing the name of the surrogate in the birth certificate] was mandatory. He said I should be happy that at least my husband’s name was listed there. A similar conflict erupted while filling the MN1 citizenship form—issued by the British Home Office.6 The form had a checklist that had a clause stating the identification of the legal mother being the surrogate mother. Puneet was confused and conflicted about it. ‘The surrogate has relinquished rights and responsibility over the child legally—so I am the legal mother and my name should appear on the form.’ So strong was her desire to list herself as the legal mother in the document that she decided to draft an email to the Home Office in London seeking clarification. A few days later, in a telephone conversation Puneet spoke of having received a reply from the Home Office saying that they did not know of a ‘more suitable entry’. Unaware of the UK law that recognizes the surrogate–birth mother as the legal mother of the (p.151) child, Puneet sought approval and confidence from her friends and family. She noted how they told her that it is her name that should go into the form and on the baby’s passport as she is the legal mother. Puneet’s desire for motherhood extended beyond the struggle with medical technologies, to include legal recognition as one. An earlier attempt to register an adoption with the British Home Office had failed. Puneet and Rajveer had adopted the latter’s elder brother’s son legally in India, but the application for the British citizenship had been turned down thrice due to reasons cited as Page 11 of 34

The Reproductive State ‘mistrust’. It was this word that had, in turn, come to mark Puneet’s relationship with her distant adopted son. Unable to take the boy to the UK, Puneet had come to harbour negative feelings towards the boy. She complained of the amount of money they had spent on his education, which had been wasted as he was a school dropout. For Puneet, this was a form of confirmation of the permanence and superiority of genetic ties, even as she noted, ironically, that her newborn was born through donated eggs and a commercial gestational surrogate. Puneet’s anxiety about her motherhood in relation to her infant son was linked to the ways in which her biology and genetic contribution were mapped, legally and socially. With no genetic contribution to the baby—she lamented how she had donated her healthy eggs to others after she gave up on trying to be pregnant—and her involvement in a surrogacy arrangement, Puneet was in every sense an adoptive mother of her son. However, her recognition as a ‘legal mother’ was fraught with the ways in which her ‘legal’ status was also suspect. The Indian birth certificate refused to identify her as one, while the British High Commission sought the name of the surrogate as the ‘mother’. The UK Human Fertilisation and Embryology Act 2008 (HFE 2008), the law on assisted reproduction (p.152) and surrogacy in the UK, lists an interesting chapter on the meaning of ‘motherhood’. Section 39 Meaning of motherhood. (1)The woman who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child. (2) Subsection (1) does not apply to any child to the extent that the child is treated by virtue of adoption as not being the woman’s child. (3) Subsection (1) applies whether the woman was in the United Kingdom or elsewhere at the time of the placing in her of the embryo or the sperm and eggs. (HFE 2008)7 The woman who gestates the pregnancy is considered to be the mother of the child she is carrying, except in cases where there is another ‘mother’. So in the section on ‘Cases in which woman to be other parent’ the possibility of ‘a woman is not to be treated as the parent of a child whom she is not carrying and has not carried, except where she is so treated …’ (HFE 2008) include the conditions of adoption, and insemination with embryo for another woman. The quoted section also refers to surrogacy arrangements, though it does not explicitly state so. This is in particular reference to assisted reproduction where the anxiety of safeguarding the traditional dyad of the procreative unit of mother–father is seen in its displacement through ARTs (Shore et al. 1992). Thus, surrogacy itself is selectively mediated in the Act: based on the Warnock Committee Report, 1984 commercial surrogacy was banned due to its links with ideas regarding the commoditization of the uterus, and the association of motherhood with an act of Page 12 of 34

The Reproductive State commerce. Thus, the ‘provision of surrogacy services by agencies or individual health professionals should be a criminal offence, but private individuals who entered into surrogacy arrangements should not be liable to criminal prosecution’ (Shore et al. 1992: 297, emphasis in original). As a recommendation the Committee saw surrogacy as demeaning—the traditional tie of mother–child which cannot be compromised in a commercial exchange. The use of ‘payments and reimbursements’ marks the (p.153) clause on surrogacy arrangements in the Act—making it mandatory for non-profit making institutions to undertake the exchange. But in cases where couples come to India seeking surrogacy services—a popular option amongst many British infertile couples—the British state finds itself renegotiating the overseas commercial surrogacy arrangement (Gamble 2009). In its laws on assisted reproductive technologies and surrogacy, the logic of motherhood and fatherhood are established in ways in which the family as a nuclear unit is not threatened. [T]he Warnock Committee approved in vitro fertilization for infertility treatment only in the case of ‘a heterosexual couple living together in a stable relationship’ … Single women wishing to become mothers or women living together rather than in stable heterosexual unions were evidently considered ‘unnatural’ and morally unsuitable for treatment … the idea of women wishing to have children without the normal sexual relations with men that produce them is not only a violation of the ideal of biological fatherhood but also a denial of the nuclear family itself … (Shore et al. 1992: 301, emphasis in original) Fatherhood remains the standard while motherhood is identified as the nurturing role of gestation—deeming the surrogate mother as the mother. In essence, as long as the position of the father remains uncontested, the process of identity giving seems ‘simpler’. Nigel, who with his partner became a father to a baby boy in the summer of 2011 clarified some of the conventions within UK laws on surrogacy. Nigel and his partner discussed the ways in which they saw their sexuality, as a homosexual couple, as posing an impediment to having children—transnational adoption was forbidden, and surrogacy was not allowed to them in the UK. They had been on the lookout for a country where they could have their child through surrogacy and get citizenship as well. The problem regarding the illegal status of commercial surrogacy back home in the UK meant that they had to create fictions regarding the arrangement to be able to process their citizenship faster. (p.154)

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The Reproductive State Nigel (N): The UK needs ... well actually on hindsight you are strongly advised to have a single, widow or divorced surrogate ... basically she would have to be single … that’s the legal advice from the UK. But we had a married surrogate though we were given the impression that we should have a single surrogate but it doesn’t necessarily mean that we should … Anindita (A): Ok ... but why is that impression being given? N: Because the citizenship takes into consideration the father ... if the surrogate is widowed, or single, or divorced and if the biological father of the child is British then the child has automatic citizenship benefits. If the surrogate is married then the genetic father is not regarded as the father as per UK law … it’s actually her husband who is regarded as the father. It is really bizarre but … it’s outdated ... A: So the surrogate is considered as the birth mother? N: Yeah … so the surrogate is treated as the mother, even if it is not her eggs she is identified as the mother, and her husband is the father. So if we are in the UK and I donate my sperm and my wife cannot conceive ... and we have a baby through surrogacy, then as per UK law the surrogate and her husband become the parents of our child … no genetic material to ascertain parenthood. It was all a quick-fix law … years ago and they never anticipated that commercial surrogacy would enter in such a big way ... A: Is there a clause that says that the arrangement should be altruistic and not commercial …? N: It’s not illegal, but it’s not commercial ... you have to show all your expenses … and if you apply for a parental order then you have to show the expenses … so like in the US you pay the surrogate a 1,00,000 US dollars … that would be illegal in the UK … as you cannot show it as ‘reasonable expenses’. And I think that is where the problem in India is ... like I don’t think that the amount of money paid to the Indian surrogate … off the top of my head … is for her circumstances a large amount of money … it’s not life-changing for her, but will be life-improving. Under UK law it would not be a lot of money but the legal advice from UK is ‘be careful, be careful’ cause that amount of money for the surrogate would be, depending on (p. 155) what her background is, would almost seem coerced or exploitative … because the kind of money they might get may not be huge … A: So this is the advice you got from your legal advisor? N: Yes … they are very strong on it. In the UK commercial surrogacy is illegal … they [the authorities] are completely aware what people are

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The Reproductive State paying for commercial surrogacy. So we have to kind of give the impression that we, the client, have paid the expenses … A: So what do you do for that? Do you get documents for that? Saying what? N: You just have to have a folder with all the documents, receipts from hospital–clinic ... the legal advisor suggested that all the expenses should be shown, with at least 70 per cent as medical expenses … The brief description of the ways in which citizenship and identity become an amalgamation of issues of genetic–biological identity, and the euphemization of commercial ties of intimacy points towards the state’s attempts at privileging kinship ties on acceptable parameters of normality. For Nigel it is unfair that his genes would be secondary to the ostensible social fatherhood of the surrogate’s husband. The primacy of marriage in identifying children goes back to what Schneider notes as: ‘the crucial fact; the cultural definitions of kinship and of mother, father, son, daughter, brother, sister et al., all remain the same as they have been for a long, long time ago … these cultural definitions have not changed one iota as a result of the new reproductive technologies, nor will these technologies alone cause them to change in the immediate future …’ (Shore et al. 1992: 308). Yet, these notions have changed in the emergence of families based on transnational adoption, in gay families and in the large number of single parents. However, Schneider’s contention is apt in considering how the state views these changing relationships. In the UK, in the desire to stay faithful to the Euro-American principles of relatedness (p.156) and kin, science is regulated in the service of championing and protecting the norm. Individuals may ‘hide’ and create stories to circumvent their choices by privileging the norm, but the fact that they have to do so means that the idea of family and kin is still understood in terms of the heterosexual married unit. This is why Puneet insists that a ‘professionally taken’ family photograph is an essential requirement for citizenship. The visibility of the triad helps quell the growing anxieties of the state. The squeamishness with transnational surrogacy is felt most in the use of poor women as surrogates. Indian commercial surrogacy proves to be a challenge. So while the surrogate’s fees have to be masked through medical expenses—the fees itself should be adequate to not be seen as a form of ‘exploitation’ of Third World women for their reproductive labour. This paradox is strangely a legacy of the colonial state which has for long been an active participant in the intimate lives of its citizens who came to India as rulers and administrators. Thus, interracial, intercultural unions between European men and Indian women were marked by similar efforts at concealment. The unions itself were ‘tolerated’ by the colonial state (which punished those between Indian men and European women) for the sake of protecting the rights of the father in his children. Page 15 of 34

The Reproductive State However, the Indian mother was ‘hidden’ especially in baptism documents mentioning the birth of the child—or separated from the upbringing of the child when he or she was sent away to England to be brought up as ‘English’ (Ghosh 2006). This invisibility is championed in the birth certificate wherein the surrogate mother is being increasingly identified as the ‘surrogate mother’, and not by her name. Puneet’s anger and feelings of exclusion are being addressed in recent changes in the birth certificate through complete invisibilization, or through selective visibility—as is seen in naming the surrogate mother as merely ‘surrogate’. When faced with the unending citizenship process, Puneet had mentioned how she would have saved more money had she made (p.157) the arrangement back home in the UK, with her family to support her.8 ‘I would have hired a British (Caucasian) surrogate to stay with me for the nine months … one lady had been willing to do it … at that time I thought it was too much money. But now … I have spent more money, time and energy than I thought I would have’. However, here she was in sultry Delhi weather nursing her newborn son and fretting about wanting to breastfeed him, when she knew she could not. ‘But He is My Son! He Looks Like Me!’

Moshe waited in front of the Israeli Embassy in New Delhi on a hot June afternoon. He had come there to process the citizenship papers for his newborn son. Along with his Indian friend and neighbour from Bangkok, Vinay, Moshe was trying to negotiate the complicated process of getting a passport and exit visa out of India for his son. In May 2011, Moshe had a baby boy at Metro IVF in New Delhi. Vinay had helped him arrange the entire surrogacy arrangement. Moshe had come to know of surrogacy in India through friends and the Internet. After many years of wanting to have a child he had finally got his son. At fifty-eight he had decided in favour of surrogacy after he was unable to have children due to his partner’s inability to conceive. His partner though not directly involved in the arrangement had agreed to ‘help’ in the upbringing and care of the child. The long adoption process with additional restrictions on age and residence were among some of the compelling reasons why Moshe had never been keen on it. The other had been the desire to have his ‘own’ child. His son—‘his blood’, as he kept repeating—was like an elixir to his existence. [I came to know of surrogacy] from the Internet and from some other people I know. I heard about the doctor in New Delhi and I came. I would have come even if Vinay had not been there to help. I would (p.158) have come anyway. I needed a baby. Somebody else doesn’t want a baby and [wants to] die old that’s fine for me—but I don’t want to do that. For me— Page 16 of 34

The Reproductive State no. I didn’t want to give up. I am happy to the sky—you don’t know I am dying … I am looking at him [his son] and I want him so much … he is gorgeous. Everywhere I go people go crazy … they say he is beautiful … The fear of dying old and without an heir had been a predominant concern for Moshe. He looked forward to leaving his wealth to his son. Most importantly, his son would inherit his faith. ‘He is already going to be [a Jew] because I am his father … even now when we get the passport he is automatically going to be a Jew …’ Conversion he said is impossible amongst Jews, and a Jew ‘is always born never adopted’. His son would inherit his Jewish faith from him along with his material possessions. Yet, Moshe’s choice of India over Israel (where surrogates are easily available and surrogacy is encouraged)9 had to do with the lax legislation in India that helped a single man like him have a baby more easily. Vinay had been of great help. He had contacted the clinic on Moshe’s behalf, contracted the arrangement for him in New Delhi and taken care of the pregnancy while Moshe waited it out in another part of the world. Since the baby’s birth, Vinay’s mother had been taking care of him while Moshe stayed in a nearby hotel till the citizenship paperwork came through. For Vinay, ‘The baby is very lucky––born from the womb of a poor Dalit woman [erstwhile untouchable castes], the moment he came out my mother, my father, myself, my sister and my friend [Moshe] … we all brought him up together …’ He was worried about his mother’s emotional health after the baby left with Moshe––she would miss him dearly, he said. The process of getting identification papers for the baby to go to Israel was taking too much time and adding to Vinay’s problems. During an earlier conversation, he had spoken of the stress that the citizenship process was bringing on. According to him, (p.159) the DNA check was mandatory—but done in Israel (as he claimed they did not trust the tests to be ‘clear’ in India, primarily stemming from anxieties regarding India’s corrupt bureaucracy). The saliva samples of the baby and the father were taken and sent to Israel. In Moshe’s case, the saliva sample of the baby had been lost in transit to Israel leading to a delay and the resubmission of the sample. The wait had been further extended because the saliva could be collected only in tubes sent in from Israel. Anindita (A): So what do they do in the DNA test? Moshe (M): They take out saliva from the mouth and put it in water. A: And then they put it in a container and ship it to Israel? M: They put the liquid in a tube. But the DNA [tube] broke, so we gave it again … but he is my son! He looks like me! And they can do it in New Delhi, but they are sending it away in my case [in reality as an embassy official told me—all DNA tests are conducted in Tel Aviv] … I don’t know Page 17 of 34

The Reproductive State what’s the problem. The doctor would never do anything to jeopardize me or my baby. He would have to use my sperm very carefully. They cannot make any mistakes—because if they do then the baby stays in India … he is an orphan! (Majumdar 2015: 450) Moshe had complete faith in his doctor regarding the process. The doctor had found a surrogate for him who had immediately got pregnant without going through repeated IVF cycles. ‘I came to New Delhi the first time and Vinay took me [to the clinic] and I gave the sperm and we met the doctor … and everything started real quick. We found a surrogate—and right away she got pregnant—I was very lucky.’ However, Vinay’s opinion of the surrogate was low. He thought she was out to swindle money from them—a stereotypical reaction based on her caste and class identity. Moshe had met the surrogate once, but would now be seeing her with her husband as they both would have to come to the Israeli embassy to officially relinquish (p.160) the child to him. This was mandatory as the Israeli document that recorded the baby’s birth not only gave Moshe’s name as the father of the child but also listed the name of the mother as that of the surrogate. The surrogate’s husband’s name also figured on the document. This was making Moshe a little jittery—he was worried that the surrogate would not relinquish control easily without ‘blackmailing’ him for more money. Besides the husband might also put up resistance, especially since the surrogate was planning to divorce him. Despite her having signed the requisite papers handing the child over to Moshe, Vinay was also nervous about the Indian bureaucratic procedures that were still left to navigate in order to get the exit visa for the baby. Yet, at the end of the day, the sight of the infant was overwhelming for Moshe. He held the baby and cooed to it, sang songs, and constantly remarked on his beauty. He was desperate to be back home with his son—his father and brother were waiting to greet him at the Tel Aviv airport. The desperate desire for his son is evident throughout Moshe’s narrative. He had been able to have his son through many personal trials and attempts, and now faced the final hurdle to ‘claiming’ parenthood. Moshe is amongst a small, but significant group of single men and gay couples who come to clinics in Mumbai, Delhi, and other cities of India to have babies through surrogacy. Because surrogacy and other ARTs are prohibited to single men and gay couples back home in Israel—India has opened up as a possible destination. This policy of exclusion is strange considering Israel is identified as perhaps the only country in the world that is openly supportive of surrogacy (Kahn 2006; Sperling 2010; Teman 2010; Twine 2011). As part of its pronatalist policies that coincide with its religious edicts—ARTs and surrogacy are not only legally Page 18 of 34

The Reproductive State available, but (p.161) state-funded. However, administration, regulation, and access to such treatments and arrangements are heavily regulated by state and Rabbanic laws. Yet, in reference to the ‘extraordinary conceptual and pragmatic flexibility exercised by many rabbis’ in relation to ARTs, Kahn (2006: 470) notes that third-party sperm donation is allowed as long as the donor is ‘non-Jew’. ‘The child conceived in this way would be considered Jewish because Jewishness is conferred through the matriline’ (Kahn 200). This paradox of Jewish inheritance is also the reason why only Jewish women may be surrogates for Jewish heterosexual parents (Teman 2010). ‘[S]urrogacy is permitted by many rabbis, provided that the surrogate like the contracting couple, is Jewish—this to ensure that the womb in which the potential Jewish person is gestated is a Jewish womb, rather than the egg, which is believed by many to be the key determinant of Jewishness’ (Kahn 2006: 470). However, the single man, gay couples and lesbian mother(s) are not allowed to access surrogacy to have children—even though they are allowed to adopt, and lesbian women are allowed to use ARTs. Teman terms this quixotic Israeli law as the ‘last outpost of the nuclear family’ (2010: 14). She finds the exclusionary access to surrogacy as a form of protecting the carrier-intended parent role within the acceptable religious discourse on the family. The conservative approach to the family may be a reaction to the potential confusions raised by surrogacy. The law responds to the challenges surrogacy presents to the concepts of motherhood and family by keeping them neatly defined. The law’s terminology deems the couple the ‘intended parents’ and the surrogate the ‘carrying mother’, specifying that the couple is intended to parent the child and the surrogate is only meant to carry, and thus be an instrument in the nuclear family’s creation. (Teman 2010: 14, emphasis in original) Such a stance is similar to the way in which the British state positions the arrangement. It is this pronatalist, heteronormative mandate that made surrogacy in Israel inaccessible for (p.162) Moshe. Unable to form a viable, legal relationship Moshe sought surrogacy as a single man—but could not contract an arrangement back home due to the religious sanction regarding religion and the matriline. Yet, Moshe was sure that his son would inherit his faith even though the mother was an Indian low-caste Hindu woman. When asked about ‘inheriting the faith’, Moshe denied the link through the mother. Instead, Vinay summed up the ways by which an individual can become a Jew. Vinay (V): I will explain it to you in Hindi. This thing called ‘blood’ (lahoo) … Jews will never accept if it’s someone else’s blood. Jews are the only people who cannot convert. I am Hindu by birth, but then I decide I want to become a Jew … you cannot become! Page 19 of 34

The Reproductive State Moshe (M): Very difficult. V: You cannot become. M: Only through blood. V: Only through blood. In their convoluted, unclear explanation on Judaism and inheriting a faith, Vinay and Moshe link it to blood, and the patriline. This explanation links up with Moshe’s strange denial of the transferring of the faith through the mother, and his rejection of adoption. How is the father placed within the Jewish ideal of faith and paternity? In her ethnographic study, Kahn (1998) finds a couple negotiating with their identity as parents and Jews in the use of artificial insemination. The husband diagnosed as infertile belongs to the patrilineal Kohen that ‘designates membership in the priestly class, a status which passes from father to son’ (Kahn 1998: 9). Here, the couple decides to use a non-Jew sperm donor and then choose to sex-select so that they may have only girls, who will not be disqualified from following the father’s religious duty. Of course, Kahn adds, ‘so a son conceived with non-Jewish (p.163) donor sperm whose social father is a Kohen, is not a Kohen himself (even though some rabbis have innovatively ruled that in such a case the son could inherit Kohen status from his mother if her father was a Kohen)’ (1998: 9, emphasis mine).10 Moshe’s rendering of his situation in relation to his son took into consideration not only the ways in which Judaism is constructed, but in the ways in which identity giving is successfully manipulated in keeping with the tenets. The Israeli embassy in New Delhi and its consulates in other major cities in India processed citizenship papers of babies born from surrogacy arrangements, based on the validity of the father’s citizenship and faith. This would be applicable even in case of a heterosexual union where the surrogate would be Indian, and a nonJew therefore disqualifying the child from membership into the faith and as citizens of Israel.11 In the reporting of a case of stranded Israeli father, Dan Goldberg, the news report refers to the importance of the DNA test. Golderg, officials said, was relieved [on receiving the Israeli passports of his twin sons] as he was going through tremendous financial hardship after a Jerusalem [where Goldberg belonged] family court initially said that it could not give orders for the mandatory paternity test to initiate the process for Israeli citizenship for the twins. But the hurdles were removed and later … the interior ministry there [in Israel] allowed Goldberg to return with his twins after the DNA paternity established last week that he

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The Reproductive State was indeed the father of the twins … The case highlighted the bias against homosexuals becoming parents in Israel … (Deb Roy 2010a) Fears of the ‘homosexual father’ and the non-normative family loom in the subtext of the above article published in The Times of India. News from the Jerusalem Post makes it clearer: Family Court Judge Philip Marcus, however, refused to approve a paternity test to confirm that Goldberg is Itai’s and Liron’s father, which is required before the babies can be admitted to Israel and be naturalized as citizens. The reason for the decision is the fact that (p.164) Goldberg is gay. Marcus asserted that ‘a child needs to grow up with two parents, not only biologically, but also developmentally …’ He further alluded to the danger that the father may be ‘a pedophile or a serial killer. These are things the state needs to check’. (Jerusalem Post 2010) It was a protest outside the Interior Ministry in Jerusalem by the LGBT community that led to an intervention from the Prime Minister Benjamin Netanyahu to bring Dan and his children home through the facilitation of the DNA test (Vorzimer 2010). The ‘judicial system that can swing from being liberal and open-minded to clerical and orthodox’ was blamed for the above judgment that also placed surrogacy beyond the reach of gay couples in Israel (Coelho, n.d.).12 The Israeli state displays ambivalence towards its assessment of cases of children born through surrogacy in India. Eventually, they may honour the patriarchal tie—rejecting or invisibilizing the tie with the surrogate mother through processes of consent. Here, the flexibility of the faith, as mentioned by Kahn is seen to operate albeit in an ambivalent mode. However, unlike egg donation wherein ideas of a ‘different mixture’ operate in modes that include idealized ‘others’ (such as Jews with European ancestry) and exclude unwanted ‘selves’ (such as Muslims and Palestinians) (Nahman 2006)—in case of TCGSA, this filtering of races is not the prime consideration, as the surrogate is a mere carrier–womb, but it becomes a matter of concern in case of the ‘missing’ adoptive mother. The embassy used the DNA test to ascertain citizenship.13 The child was not excluded from entry into Israel because of the non-Jew surrogate mother, or the single or gay father—yet the anxieties remained. This was reflected in Moshe’s jittery behaviour—the misplaced samples of the DNA test, the surrogate mother’s testimony and her problem with her husband were major issues of concern for him. Moshe’s insistence on the genetic tie through the resemblances he shared with his son were meant to placate worries regarding the ‘other’ (Nahman 2006). Both the surrogate mother and her husband presented a threat to his claiming fatherhood for (p.165) his infant son. That both the Page 21 of 34

The Reproductive State Israeli and Indian state ‘listened’ to the narrative of the ‘other’—the surrogate mother—added to his stress. The DNA test was not only proof of his genetic connection to the child, but was also connected to his son staking a claim for membership into Judaism, and Israeli citizenship. What if the DNA tests came out wrong? Then the child would belong to the surrogate mother and her reluctant estranged husband! The latter posed a serious threat to the choreographed arrangement—for the surrogate’s husband could very well withdraw consent to relinquishing the child, thereby jeopardizing Moshe’s fatherhood and his son’s future. ‘India as a Country and Culture is their Mother’

During our Skype conversation, Xavier spoke of how he knew his quest for a child would be difficult. As a single gay man, living and working as a manager for a theatre in Madrid, 45-year-old Xavier found, to his dismay, that he was exempt from transnational adoption. Even, in Africa, where it was possible for him to adopt a child transnationally, he was at the bottom of the list of potential candidates. That is when transnational surrogacy seemed to be the only viable option available. Due to its prohibitive costs, the United States had to be ruled out, but a friend living in Delhi suggested India as an emerging surrogacy destination. Initial links were established with surrogacy agencies in Mumbai— who turned out to be highly unprofessional—ultimately leading to Delhi as the other destination for surrogacy. Thanks to some timely research, and after establishing links with potential clinics in Delhi, Xavier was ready to begin his journey towards parenthood. Xavier’s efforts came through in 2011, when the 38-year-old surrogate who was carrying his babies, gave birth to twin girls. During the delivery, he found himself bonding with the anxious husband of the surrogate. For Xavier, this moment was crucial to the future of the relationship he shared with the surrogate and her family. He had not been very comfortable of the ways in which commercial (p.166) surrogacy arrangements were carried out, with very little interaction between the surrogate and the potential parents. Xavier did not want his relationship with the surrogate to be reduced to that of a financial transaction. Fuelled by the desire to make the birth of his girls an event that was not marked by the surrogacy contract and the exchange of money, Xavier welcomed his babies to what he referred to as a ‘familial environment’ at his friend’s home. Familial support was an important aspect in surrogacy, according to Xavier, especially for the surrogate. This meant that if a surrogate entered the arrangement under duress and without support—conception and pregnancy would be equally difficult. The surrogate who finally carried Xavier’s daughters was chosen after two failed pregnancies with two different surrogates. The first had been unable to carry the pregnancy due to emotional issues, while the second surrogate had a miscarriage. The conversations with the surrogate’s Page 22 of 34

The Reproductive State family helped him start a dialogue with them, which meant a more sustained relationship with the surrogate. After the babies were born, the citizenship process at the Spanish embassy in New Delhi began in earnest. To get citizenship for his daughters, Xavier also sought permission from the Indian state to relinquish his children. At the Spanish Embassy, the surrogate was identified legally as the ‘mother’—which meant that she had to give her ‘consent’ to Xavier to take the babies out of the country. The embassy viewed her role as a gestate as indicative of her being the mother, and her consent was translated to a relinquishment of rights over the babies. Along with the DNA test results, the surrogate had to provide proof of her marriage to the embassy. Because she had a traditional Hindu ceremonial wedding, the surrogate and her husband had to legally register their wedding for it to be acceptable before the embassy officials. Despite the two differing sets of laws, the two common points were ascertaining paternity and relinquishing maternal rights. At the Spanish Embassy she was legally the mother … she had to ‘allow’ me to take the babies out of the country … she had to (p.167) give permission to the father of the babies to let them travel with him. The exit visa comes from India for which one has to go to the Ministry of External Affairs and the FRRO. Before the stamp on the visa, an inquiry is done—an investigation and verification of the documents. They too meet the surrogate mother and ascertain if she was part of the agreement of her own free will or was she coerced. She is asked to sign—this was the only instance I can remember when she was without her husband. This involved some amount of ‘choreography’ especially in relation to how Xavier presented his relationship status during the process. He was unsure of presenting himself as a gay man in India, so continued to identify himself as ‘single’. However, the clinic knew he was gay and had ostensibly no problems regarding it, but the reception of his sexuality amongst administrative and state officials in India was doubtful. At the time of the pregnancy, Xavier met his French partner who eventually went on to adopt the girls.14 The adoption process was preceded by the deletion of the surrogate’s name from the babies’ birth certificate at the local Spanish tribunal. The replacement of one parent with another was not simple: Xavier had to furnish all the documents that he had produced earlier for the embassy in India. When his twins turned one, Xavier celebrated the event with a big party inviting close family and friends. He also called the surrogate back in India and spoke to her son (as she was not fluent in English). After exchanging news regarding the twins, he learned that the surrogate had used her earnings from the

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The Reproductive State arrangement to help in the education of her son and daughter, and ‘maybe invested in a new house’. On being asked what he would tell his daughters about their birth and conception, Xavier said: ‘I intend to transmit to the girls that to have babies is a question of love but sometimes the way for the conception is different, but behind the decision there is always love. I will explain to them everything and even show them photographs of the surrogate mother pregnant, in hospital, and so on. But I will explain to them that the egg is from an anonymous Indian (p. 168) student. To me it is more important that they understand that India as a country and culture is their mother’ (emphasis mine). Before beginning the citizenship process for his twin daughters, Xavier had undertaken extensive research of the kind of bureaucratic procedures and paperwork that would be involved. For this, he had enlisted the help of a local taxi driver rather than depending upon touts and agents, unlike what many other couples had done.15 The driver had navigated Xavier’s visits to the embassy and state offices, while, at the same, negotiating conversations in Hindi. Yet, in reality, the citizenship process required Xavier to position himself and his children differently—according to the differing demands of the Spanish and Indian state. The liberal stance of the Spanish state extends to spheres of personal law, wherein gay couples, and single men and women are allowed to adopt—unlike many other countries across the world, such as India. Thus, marriage in Spain is governed by a single marriage law that makes no distinction based on sex and sexuality in cases of civil unions (Howell and Marre 2006). After adopting Xavier’s twins, he and his French partner had got married at a civil registry in Spain. The Spanish state seemed to have a very progressive view on aspects of assisted reproduction as well—encouraging the use of ARTs, donor sperm and eggs by lesbian and single women. According to Howell and Marre (2006), the Spanish state is far more liberal than Spanish society itself which is governed by rules and norms established by the Catholic Church. This form of conservatism, however, finds its way into civil law on surrogacy. In the national act governing the use of ARTs in Spain, surrogacy is banned, whether altruistic or commercial. No contract which provides for gestation, with or without payment, by a woman who renounces her maternal bonds in favour of the (p.169) contractor, or of a third party, shall have any legal validity whatsoever. The filiation of children born by substitute gestation will be determined at birth. (Boada, Veiga, and Barri 2003: 272) The role of the mother as gestate is seen to be indissoluble. The law on ARTs prohibits surrogacy based on conventional Spanish procreative and kinship beliefs (Manrique 2009). The birth of a child is an act between man and women, Page 24 of 34

The Reproductive State wherein the woman nurtures the child, while the father passes identity through the act of conception (Manrique 2009). Yet, the Act does recognize the rights of children born through surrogacy, even though it outlaws the practice. This means that there is scope to negotiate with transnational practices surrounding commercial surrogacy, within the law itself. This form of manoeuvrability is evident in the Spanish state’s participation in facilitating the transference of complete parental rights to Xavier and his partner by rescinding the rights of the surrogate as mother. The tacit encouragement of transnational commercial surrogacy by the Spanish state has also meant that a larger number of single men and gay couples are coming to India to have a baby. Akin to Israel, where, surrogacy is allowed and encouraged, but not for gay couples—the primary clientele coming to India are not heterosexual married couples. Reportedly, ‘On an average, we get 10–15 requests for surrogacy in India from Spain …’ confirms a surrogacy agent in a newspaper interview (Jha 2012). Such transnational ‘traffic’ has fuelled anxieties amongst some countries in the European Union, such as Spain, Belgium, Italy, France, and others who outlaw surrogacy, to direct a missive to IVF clinics in Mumbai. This ‘letter’ from the consul-generals of these countries asks clinics and surrogacy agencies to direct their citizens to their respective embassies. ‘The aim of the letter … was to ensure that citizens [of these countries] were aware of the laws of their countries, the legal procedures and the possible delays in returning home with their children’ (Roy 2010a). (p.170) Yet, despite the ‘ban’ and the official letters, embassies have to reconsider citizenship requests for babies born through surrogacy, because of concerns regarding the ‘welfare of the child’. In conversation, a French cultural attaché based in New Delhi, remarked, that they were often forced to reconsider their stance due to pressure from back home. Cases involving stranded parents with stateless babies born through surrogacy garnered much domestic sympathy—as is seen in Israeli Dan Goldberg’s case, or in the case of a Norwegian mother stuck with twins, born through surrogacy in India (Krolokke 2012). The focus, therefore, for the embassy and consuls was always to seek solutions, despite the legal stance against surrogacy back home. In the elaborate machinations of citizenship, the position of the surrogate is the most controversial and conflicted. In case of Xavier’s twins, the Spanish consulate in New Delhi primarily focused on the legal relinquishment of the babies by the surrogate, while at the same time the Indian bureaucracy verified whether her involvement was of ‘free will’. The surrogate’s consent and participation are essential to granting citizenship even though the Spanish state treats her with extreme ambivalence. So, while the embassy seeks proof of her relinquishment of parental rights, it nonetheless recognizes her as the legal mother of the babies. And even though the egg donor is anonymous and escapes Page 25 of 34

The Reproductive State state scrutiny, the surrogate qualifies as the mother due to the importance accorded to the role of the gestate. The surrogate’s recognition as mother is partial, and yet, lingering. The Spanish state must seek her consent to allow Xavier to take his twins out of the country; her name is recorded in the birth certificate; and only its deletion makes way for the acceptance of another parent. In Xavier’s case the deletion and addition of his partner’s name was achieved without much social and personal conflict. However, the recognition of the surrogate as legal mother poses serious problems for the adoptive mother—resurrecting the conflicts between the genetic, social and biological motherhood. In the identification and recognition of parenthood, fatherhood (p.171) emerges as the constant—bolstered by it biological mooring through the DNA test. And even though Xavier seeks a long-lasting relationship with the surrogate and her family, he does not waste time in re-issuing a new parental order that gives legitimacy to his new relationship and family. His daughters must think of India as their ‘mother’—as the country and its culture quickly replace the surrogate as a person. This form of transubstantiation is a common tool used by many of the foreign parents having babies through surrogacy in India. ‘Juam and Mauro [a Spanish gay couple who had twin girls in a clinic in Delhi through surrogacy] wanted their children to retain their Indian roots and hence named them Jaya and Uma. “I love this country for all it has given to me and will keep coming here”, said Mauro’ (Jha 2011). The shifting meanings within TCGSA where parents shift the parentage from the surrogate mother to a country and culture (Deomampo 2013; Vora 2013), is similar to the ways in which transnationally adopted children are ‘kept in touch with their roots’ through the celebration of traditional festivals and root trips to the countries where they were born (Howell 2003). By privileging cultures and nations over biological connectedness with anonymous others, parents of babies born through surrogacy, seek more effective assimilation. It is no wonder then that the promise of future citizenry draws in many of the European countries that otherwise ban surrogacy. And unlike transnational adoption, the creation of physical and racial resemblances is not in question in transnational surrogacy. There is no need to build on a ‘national discourse’ that will help assimilate racially and ethnically different children in TCGSA (Dorow 2006; Howell 2003; Yngvesson 2010). Thus, even though the French cultural attaché insists that: ‘These parents [of children born through surrogacy] are parents of intent, not biological parents. They have a partial genetic link ….’, most of the European countries are granting citizenship to children born via TCGSA by invoking their own standards of biology and genes.

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The Reproductive State (p.172) Reclaiming Fatherhood? The anxieties of the father(s) in TCGSA become apparent in the ways in which they find themselves positioned within the arrangement. Interestingly, like the fragmented motherhood, fatherhood too is deeply fragmented. Despite the efforts of the nation-state to locate identity through the father (for the nation is essentially masculine—V. Das 2006)—the experience and emotional negotiations with fatherhood point toward its dislocation from one person to many. Three types of fathers emerge from the arrangement: the one who donates his sperm, the ‘non-bio dad’ (Chapter 2), and the husband of the surrogate mother. The three stand in an interesting, often conflicted relation to each other. In its role as an arbitrator, the state uses the DNA test to decide paternity and grant the same to the genetic father. I suggest that in TCGSA a form of social contract is re-enacted between fathers to give identity to the child born from the arrangement. I suggest that the state(s) tries to gloss over the disrupted fatherhood by creating a singular narrative of fatherhood through DNA testing and the birth certificate. ‘[T]he law was instituted to shape the nation as a masculine nation, so that the social contract became a contract between men conceived as heads of households’ (V. Das 2006: 25, emphasis in original). The surrogate mother and the child born from the arrangement come to embody the ‘abducted person’ just like the one identified by the India–Pakistan Partition in 1946–7. ‘[O]nce the problem of abducted women moved from the order of the family to the order of the state (as in the demand for legislation), it sanctified a sexual contract as the counterpart of the social contract by creating a new legal category of “abducted person” (applicable, however, to only women and children) who came within the regulatory power of the state’ (V. Das 2006: 25). The difference in case of TCGSA is the exchange of women’s reproductive bodies as enacted by patriarchal nation states seeking to bolster depleting citizenry. This is evident in ways in which the state understands the TCGSA contract as that between the intended father(s) and the (p.173) husband of the surrogate mother—both men. ‘National honor’ is negotiable here, especially between the global South and the global North, rather than between warring nations (Das 1995). Xavier protects and nurtures his bond with the surrogate’s family during the period of the pregnancy by maintaining a form of respectful relationship with the husband and son of the surrogate (this is also because direct access to the surrogate is mediated by these two men) post the birth of his daughters without completely ignoring their involvement. Nigel is upset that the surrogate’s husband may have more rights to be the father than he himself––due to a quirk in the law. In addition, Puneet and her husband express their anxieties regarding their surrogate’s husband who though friendly, is a little too close for comfort. The distances and carefully negotiated formal interactions also hide the Page 27 of 34

The Reproductive State anxieties of ‘future claims’ from the surrogate and the husbands—of the child and/or of other material goods in lieu of the child. This fear is a reminder of how despite ‘glossing over’, the ties with the surrogate mother cannot be completely ignored. The ‘non-bio Dad’ remains an important part of the arrangement especially in relation to the gay couple, but also in relation to ‘significant others’. For Moshe, without Vinay the birth of his son, though not impossible, was certainly made that much more possible. Vinay was a second father to Moshe’s son––as Moshe himself declared. Here the perspective of fatherhood is played out in relation to other men––masculinity is endorsed, supported, and bolstered by other men (Chopra et al. 2004). Relations are forged and built on shared parenthood, often in exclusion of those who form an intrinsic part of the birthing process, like the egg donor and surrogate mother. A parallel practice discussed by Simpson (2004) is that of Sri Lankan polyandry involving two men marrying the same woman and rearing their children together in a shared relationship of brotherhood and fatherhood. The fragmentation of fatherhood is conflicting and yet combines the roles of each of the three mentioned above. The fathers privilege a model of procreation that placed their own contribution to the birth as more important than that of others. (p.174) ‘Practical kinship’ may be mobilized for national honour (Das 1995), as much as for giving identity to stateless children belonging to citizens of the global North. For the sake of the child born through TCGSA, kinship and nationality can be engaged into a ‘creation narrative’, similar to the abducted child during the Partition. This narrative is drafted for the benefit of the state and father. In this case, the process of granting citizenship in TCGSA is informed by similar considerations as in the case of placing children born to women abducted from either side of the religious-territorial divide. [H]ow were rights over a child to be distributed between the male and female in terms of their relative contributions to the process of procreation? ... what legal recognition was to be given to children whose parents were not considered to be legally married … was there a contradiction between the legality established by the state and the customary norms of a community regarding the whole question of determining the legitimacy of a child? ... if only one parent was entitled in these cases to transmit filiation as a basis for establishing citizenship, was it the relationship with the mother or the father that was to be considered relevant for creating the necessary credentials for citizenship? (V. Das 2006: 30) The three narratives mentioned in this chapter not only chronicle a difficult journey of identity, kinning, and ownership, but are also ‘creation narratives’— especially those involving Moshe and Xavier. I call them ‘creation narratives’ Page 28 of 34

The Reproductive State because they speak of the father’s quest for fatherhood. They speak of the complicated terrain that ideas regarding procreation and kinship take in the process of commercial gestational surrogacy. In Stefan Helmreich’s (2001) analysis of the Artificial Life laboratories in California, ‘[A] computer program that acts as a model of evolutionary dynamics in populations’ (2001:121) becomes the source of ‘creation stories’ amongst male scientists working on the program. These scientists juxtapose JudeoChristian patriarchal culture that privileges genes and descent through men to create a kind of proxy fatherhood with an information software. Here, masculinity is seen through the eyes of ‘physical fatherhood’—the (p.175) ‘creator’ who plants a ‘seed’, an idea. The physicality of this father is a sign and affirmation of masculinity. [M]ale creation is imagined as fundamentally artificial and female creation as fundamentally natural. Men create artificial life, while women create natural life. There is a curious contradiction here. On one side, females supposedly create naturally and birthing is conflated with reproduction, with feminine contributions regarded as simply supportive. Female birthing is everything at one moment and nothing in the next—so much nothing that reproduction can proceed without women, can even be pristinely transferred to a different vessel … (Helmreich 2001: 124) Fatherhood in such an understanding is portrayed as eternal and not ‘fleeting’, like physical motherhood.16 It is also an attempt to reclaim the primary identity of the father by juxtaposing its essence with a form of physicality which however is a privilege of motherhood. The pater–genitor distinction is a reflection of this lack of physicality. Earlier anthropological explanations were preoccupied with this differential importance given to fatherhood in its examination of physical and social kinship (Barnes 1961). A form of hegemonic biology—that privileges patriarchal ideas regarding blood-genes, marriage, and identity through the father—is what marks the anthropology of kinship in the form of ‘monogenesis’. Monogenesis, according to Carol Delaney (1986), is an extension of Western monotheism that privileges the male role in reproduction relegating female reproduction to a position of receptivity and passivity. She finds that creation myths and ideas of procreation are similarly framed in the Judeo-Christian thinking: especially in the idea of the ‘virgin birth’. The concept of paternity … is exemplified by the Virgin Birth. For regardless of whether conception occurs by seminal word or physical seed, the notion of paternity is the same. It reveals that the origin and identity of a child comes only from one source, it reveals a ‘monogenetic’ theory of creation. This does not mean that women contribute nothing … Instead it Page 29 of 34

The Reproductive State reveals that there is one who creates and transmits (father) and one who receives and nurtures (mother); in this case it is God who creates and transmits, Mary is the medium for the manifestation of this creation … (Delaney 1986: 500) (p.176)

Such an ideology also comes to pervade the way in which the TCGSA is framed in the medical, IVF discourse. The surrogate is treated like a receptacle—and the emergence of multiple motherhoods complicates the earlier understood and defined logic of maternity. In such situations the surrogate is a symbol of the perfect substitute to male creation. Haraway (1992) finds the ‘surrogate’ to be a production of the self—an exercise in ‘sadism’. Against the background of Harry Harlowe’s experiment with the infant Rhesus monkey and a cloth and wire surrogate monkey mother, in 1960s–70s America, Haraway notes: ‘[T]he body of the (real) mother signifies the threat of the powerlessness (castration), and so the image of the mother can arouse anxiety. This dis-ease can be deferred by the production of an ideal image, a fetish, a substitute, a spectacle …’ (1992: 234). However, in reality it is through the continued reference to this ideology that the inherent instability in the notion of fatherhood is overcome. Thus, JudeoChristian mythology and understanding is deeply complicit in the idea of the ‘holy father and son’ (Delaney 2001). Yet, ambiguity in fatherhood remains despite the growing popularity of DNA tests used to prove/disprove the genetic– social link with the father (Fonseca 2009). Thus, the DNA test points towards the importance given to genetic relationships vis-à-vis nurturance, as is evident in the case of TCGSA. However, in the case of gay fathers proving their genetic tie may not be difficult, but leads to official negation of the ‘other’ father—the ‘non-bio Dad’—who does not have a genetic contribution to the baby. It is also a negation of the gay relationship—which is often countered by including the name of the ‘non-bio Dad’ through an adoption/parental order in the home country. Xavier replaces the name of the surrogate mother with that of his partner on his daughters’ birth certificates. Others, like Philip and Trent (discussed in Chapter 2), come back a second time (or third or fourth time, till they are successful) to have children through the ‘non-bio Dad’s’ (p.177) sperm. Creating a shared genetic tie for both fathers involves a mix of legal and biological recognition. The split motherhood that TCGSA leads to bolsters the claim for legitimacy through genetic fatherhood. The DNA test and other identity papers in TCGSA involve a tacit agreement to subdue motherhood (Krolokke 2012). By virtue of seeking compensation for her pregnancy and the mandated relinquishment, the commercial surrogate is not recognized as the ‘Mother’. Due to the dispute in Page 30 of 34

The Reproductive State her identification, the surrogate can not claim ownership of the child, legally. Motherhood and ownership are conflated with nurturance and financialemotional responsibility for the child’s upbringing. The anonymous egg donor further complicates the script with her absence from the citizenship process. Thus, the visible pregnant surrogate is often the one under the scanner during the citizenship process rather than the anonymous ‘fleeting’ egg donor. Yet, as discussed earlier, foreign embassies and the government of India tend to recognize the surrogate as the de jure mother, based primarily on her gestational role of nurturance through the pregnancy. However, the surrogate is not alone—she is accompanied by her husband, who is a co-signatory in the ‘contract of relinquishment’. He, too, must relinquish his claims on the child as a father. This is crucial as he can claim paternity through the tie of marriage with the surrogate. Legally, the marital tie identifies the husband of the mother as the father of her children. Vinay fears that the surrogate’s husband would stake a claim to the child for the sake of money, and Xavier privileges the husband and son of his surrogate to maintain a healthy relationship post the birth of his daughters. These three fathers exemplify the transnational nature of the commercial surrogacy arrangement—and actually point towards a fractured, ambiguous fatherhood. International and national laws seek to identify paternity through the DNA test to overcome the already existent fractured motherhood. This is also because in a majority of the surrogacy cases, the father (along with the adoptive-genetic mother) forms the commissioning couple funding the (p.178) arrangement. The multiplicity of parental roles and identity that the nature of the arrangement invokes come forth in attempts by the national/international laws to situate the parents as per predefined notions of biology and the nurturing aspects of parenthood. While TCGSA panders to the idea of identity through the father––for those countries in which surrogacy is allowed have no hesitation in extending citizenship to the child based on the proven genetic connectedness of the father––all of a sudden motherhood, the once uncontestable truth of biological ties through procreation, is now very much under the scanner (Melhuus 2012). In addition, fatherhood has emerged as the connecting link in the gestational surrogacy arrangement. To place origins and grant new identities, some form of a stable ‘root’ has to be identified. In such a situation, the biologically traceable Father is perfect. It also helps countries to reclaim children as their own, to deny difference. The underlying ‘fear’ that the ‘other’, here the surrogate mother, may seek ownership and membership in the country of the child she carried also drives the desire to ‘invisibilize’ her. In seeking the surrogate’s renunciation of the child are practical ideas of identification and traceability. In a situation of Page 31 of 34

The Reproductive State multiple mothers, where one is anonymous and the other non-existent (if the couple is gay), the surrogate mother emerges as the only biologically and physically traceable entity—just like the father.

Notes:

(*) Parts of this chapter have been previously published in ‘In No-man’s Land: Citizens and Kin in Transnational Commercial Surrogacy in India’, Contemporary South Asia 23(4): 442–55 and ‘Surrogate Mothers and Gay Fathers: Navigating the Commercial Surrogacy Arrangement in India’, in Adi Moreno and Susanne Hofmann (eds), Intimate Economies: Bodies, Emotions and Sexualities on the Global Market (pp. 213–31). UK: Palgrave Series on Globalization, 2016. (1.) According to the Apostille Treaty drafted by the Hague Conference on Private International Law a document issued in one of the signatory countries can be ratified for legal purposes in all other signatory countries. The Apostille (French: certification) acts as international notarization of documents used amongst signatory countries such as India. (2.) Indian couples seeking to have children also enter the arrangement––but the skewed representation in this ethnography suggests aspects of stigma and lack of financial capability as important factors to consider regarding its popularity amongst Indians. (3.) ‘Tales of waiting are … sad, reflecting the difficulty of separation … or the frustration of communicating at a distance, to being hopeful and full of promise …’ (Constable 2003: 176). (4.) The dispute between the clinic and Puneet became evident a few weeks before the delivery of the baby. As the due date passed by without any sign of labour and delivery, Puneet and Rajveer became increasingly tense accusing the clinic of delaying labour to make more money from them. After the birth of the child, both mentioned how the clinic had extracted more money from them before releasing the newborn from the hospital. Puneet mentioned how the clinic’s lawyer had made them pay Rs 25,000 for processing affidavits for the citizenship, far more than the standard payment of Rs 10,000. (5.) Seeing the long-drawn out process Puneet had enlisted the help of a fellow Sikh at the British High Commission in Delhi to process her paperwork faster. Another British couple who were navigating the citizenship process for their baby at around the same time said that the British High Commission in New Delhi was ‘nothing more than a post office … they deliver our papers to the

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The Reproductive State Home Office and cannot take any decisions on individual cases. That power lies with the home secretary in London’. (6.) The MN1 form is issued by the UK Border Agency and the Home Office to register a child under 18 years of age as a British citizen. (7.) Quotations taken from Act website—full bibliographic details in the bibliography. (8.) Elly Teman notes, ‘The U.K. regulations specifically prohibit payment to the surrogate and encourage intrafamilial and altruistic surrogacy arrangements. In actuality, however, U.K. surrogates often receive remuneration, labelled “compensation”, equivalent to the fees paid to U.S. and Israeli surrogates’ (2010: 11). (9.) Israel’s pronatalist policy sponsors IVF and surrogacy for infertile heterosexual couples. Over the past few years many gay single men and couples were stranded in India with their babies born through surrogacy due to the reluctance of the Israeli state to process passports for the babies (Deb Roy 2010a). (10.) An Israeli expatriate living in India, whose wife is Indian, noted that his two sons are considered to be Jews through him. He noted that the Bar-mitzvah (initiation ritual) would incorporate them into the Jewish community. (11.) I did not encounter any cases of Jewish heterosexual couples coming to India to have babies through surrogacy, perhaps because the practice is legal and state-endorsed in Israel. (12.) During the devastating Nepal Earthquake in 2015, the Israeli government sent a rescue team to bring back Israeli citizens stranded in Nepal. Many of these citizens were gay men with newborns who had gone to Kathmandu during the delivery of their babies through a commercial surrogacy arrangement contracted in India. Because India had outlawed homosexual foreign couples from contracting an arrangement in India, many had contracted arrangements with Indian clinics that facilitated the pregnancy and delivery of the baby through Indian surrogates in Nepal. Nepal had also passed legislation outlawing domestic surrogacy, but allowing for foreign surrogates to deliver on its soil. (13.) The Israeli consulate in Mumbai refused to reply to questions regarding the processual requirements for citizenship of children born through surrogacy, except that they collect the required paperwork and the DNA sample to be sent to Tel Aviv. (14.) He had met and married his French partner in Spain where, as per law, any two individuals could get married—not limiting it to gender, sexuality, or race.

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The Reproductive State (15.) All three cases discussed in this chapter include the experiences of couples, and single parents who processed the citizenship papers themselves, and not through touts. (16.) The seed and earth symbolism that is commonly used across different cultural contexts to describe the gendered aspect of procreation (Delaney 1986; Dube 2001) places the woman in a dormant passive position. Nurturance through gestation and breast milk maybe visible physically, but are nonetheless ‘not forever’. As Delaney remarks on procreation beliefs from a Turkish village: ‘Women’s nurturant capacity is valued, but it must also be remarked that the substance they provide ultimately derives from men, since men are thought to engender both males and females. The substance women contribute pertains only to this world––it is temporal and perishable and does not carry the eternal identity of a person’ (1986: 497).

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Conclusion

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

Conclusion Conflicted Kinship and Commercial Surrogacy Anindita Majumdar

DOI:10.1093/oso/9780199474363.003.0006

Abstract and Keywords The concluding chapter sums up the findings of the book and presents the theoretical idea of conflicted kinship to understand the ways in which the process of commercial surrogacy makes and unmakes kin. More importantly the chapter looks at the issues of reproduction, the state, and the procreative tourism to understand the ways in which kinship may never be the same again. Keywords:   conflicted kinship, nature, nurture, parents, biology, kinship

Figure 6.1 Philip and Trent’s Children (reproduced with permission)

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Conclusion (p.182) Figure 6.1 is an image Source: Author, with the kind permission from November 2013 of the of the parents of the children. respondents Philip and Trent’s three children born through commercial gestational surrogacy in India. The girls (left and right), aged four years were born in 2009 in a clinic in Mumbai. They had an Indian surrogate and an Indian anonymous egg donor. The boy (centre), aged three years was born in 2010 in a clinic in Delhi—again from an Indian egg donor and an Indian surrogate mother. I had the pleasure of seeing him, aged three days, sleeping peacefully inside an incubator at the clinic in Delhi. Though not discussed openly, the girls were born from one father, and the boy, presumably, from the other. Philip and Trent are very active on social networking websites back home in Australia advocating for same-sex marriage legislation, surrogacy in India, and gay rights across the world. They have been very open about the decision regarding surrogacy and the birth of their children—appearing on television news features and news reports across the world. In February this year, when the girls started school, Philip and Trent were unable to hold back their tears of joy—in many ways they have been an inspiration behind this book. At first sight it’s a picture like any other—yet within it is the story of their extraordinary birth, and the desire of their parents to have them. The image of the children invokes many of the ideas that this thesis has been exploring: of procreation, sexuality, marriage, and of course kinship. Through the multiple— some fleeting, other permanent—relationships forged through their birth a kind of ‘post-modern family’ emerges (Stacey 2006). How does kinship grapple with this? How does one understand this ‘brave new world’? As I noted in Chapter 1, one needs to go back to the very core of classical kinship—the notion and understanding of biology/blood amongst kin. Relationships in anthropology and in practice may exist in various forms, but are always compared to an idealized notion of kin (Miller n.d.). This is why the conflict that emerges from the interface between the various elements that form a relationship is (p.183) also symbolic of the negotiations involved in recognizing intimate relationships as kinship. However, kinship as anthropologists define it is, to a large extent, different from the way people, processes and institutions understand them. Thus, ethnographic engagements help us make meaning from the meanings created through practice. Despite the varied practices and understandings of kin and kin relationships, the examination of conflicted kinship emerges from the separation of the biological from the social domain of kinship. Here, Strathern’s (1999a) understanding of ‘domainization’ is an important way of engaging with kinship. Thus, pre-existing cultural contexts help in creating ‘domains’ that are then used to understand emerging practices—such as new reproductive technologies and their impact on kinship. This involves a process of ‘making explicit’ practices within an order of Page 2 of 14

Conclusion ideas, such as assisted reproduction in the context of procreation. However, contextualization is a complex mechanism that is undertaken at one level by people and practices; and at another level by anthropologists. And that is how ‘kinship as a tool’ of analysis engages with ‘kinship as theory’. One began this research by trying to understand the way ‘biology’ is configured in intimate, interpersonal relationships through a case study of transnational commercial gestational surrogacy. In theoretical formulations regarding biology, the notion is deeply conflicted. This is drawn, to a large extent, from the ethnographic engagement with genetic, reproductive technologies spurred by, and in turn influencing the critique and reformulation of kinship as a discipline. In the study of TCGSA these same conflicts are embarked upon. By engaging different tools of kinship—such as the processual analysis of kinship and relatedness—the idea of biology in its conflicted versions is mapped. What is the point of such an exercise? It is in the back and forth over kinship identity, over shared substance, shared resemblance and shared pasts, presents and futures that the relationships between biology and kinship become more (p.184) nuanced. Edwards (2006) calls this the ‘trafficking of concepts’ as found in the ‘oscillation between biological and social conceptualization of kinship’ (2006: 133). Most importantly, she notes: ‘[W]hat Europeans include either as biological or as social cannot necessarily be predicted … The question remains how we, as analysts, knew what belonged to the realm of the biological and the social? Presented with a matrix of kinship, we seemed to be able, readily and with alacrity, to categorize some aspects of relatedness, for example as biological and others as social’ (2006: 134). Therefore, the idea here was to utilize theoretical ideas and concepts to see whether one is able to explain the ways in which kinship can explain kinship. The processual analysis of kinship engages with ideas regarding the formation of relatedness over a period of time, such as is seen in the case of ‘kinship in practice’ (Bock and Rao 2000; V. Das 1995). It encapsulates ideas of practical, plural kinship that can be applicable in cross-cultural contexts. It also engages with ideas of kin-making through ‘substances’ going beyond ‘biology’—and including food, locality, memories, and space within its ambit. However, what it also focuses on is an idea of kinship as ‘conflicted’. In the analysis of kinship through the processual mode, the conflicts in understanding kinship come to the fore. This occurs both on the part of the respondents as well as the investigator (through the act of analysis and writing the emic). Here, Bourdieu’s formulation of the diachronic approach to the analysis of social practice and structures becomes an interesting conceptual tool. Such a perspective places an exchange, for instance, in its dynamic practice—and not in the realm of symbolic, synchronic representation.

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Conclusion The mapping of the TCGSA in its processual, dynamic representation leads to the emergence of certain ideas regarding kin and kinship. From the choice of the arrangement, to the pregnancy and finally to the birth of the child—the surrogacy process is mapped in broad stages, which encapsulate within them other related-conflicted processes. Through the mapping of these stages, (p. 185) the idea was to engage the ways in which relationships ‘unravel’ and may be made sense of through kinship as a tool of analysis.

Conflicted Kinship The first predominant conflict occurs in the identification of biology, or to be more precise, in the assignment of ties of parent and child. The notion of biology and its identification become enmeshed within socio-legal, genetic, and nurturing roles. Such a conflict has been analysed in the new kinship studies (Edwards and Salazar 2009; Franklin and McKinnon 2001)—especially in relation to the use of anonymous sperm/oocyte donors (Becker 2002) and to some extent in the case of surrogacy (Ragone 1996; Thompson 2001). Yet, in this analysis ‘biology’ is caught in its social and biological roles—just as the ‘social’ is implicated in its biological and nurturing role. The resolution of this conflict is ‘easily achieved’ by identifying the intended parents/commissioning couples as the parents of the foetus being carried by the surrogate mother—and that is what the contract, the doctors, agents, and the surrogate mothers try to fulfil. However, the transnational nature of the surrogacy arrangement brings with it its own set of peculiarities and contradictions that make the process of making and unmaking of kin that much more difficult. Thus, no single model of identified kinship can operate here, even though the biomedical and Euro-American forms of kinship tend to predominate. Other forms of relatedness that borrow from South Asian, Indo-Aryan notions of kinship also become important conceptual categories in understanding surrogacy and kinship. In anthropological analysis, Marshall Sahlins’ recent two-part essay on ‘What Kinship is?’ (Parts One and Two) (2011a; 2011b) finds that ‘conflicting kinship’ emerges due to the contingencies of ‘mutuality of being’ (2011b: 235). His assertion that kinship binds people and relationships together in varied cultural contexts in ties of ‘consubstantiality’ (2011b: 232), or of shared bodies through (p.186) shared substances (through sexual relationship, food) is challenged by opposing ties of shared biology. Thus, the ‘intermingling’ of bodily substance seen in case of siblings born of the same woman, or breastfed by the same woman (Carsten 1991); and in the case of husband and wife through sexual procreation—becomes the source of conflicting kinship. To elaborate on the above point, in Veena Das’ (1976) analysis this ‘conflict’ is played out in the relationships that emerge from ‘biological ties’. In the case of Punjabi kinship, the mother–child bond is rendered immutable due to the shared Page 4 of 14

Conclusion nurturance that the mother provides through her body during the pregnancy and after birth through her breast milk. However, this ‘natural’ tie clashes with another tie akin to nature—that of sexual relations between husband and wife. The relationship with the wife and the mother are both constructed on a biological axis—but are placed at two extremes vis-à-vis social and cultural codes of kinship. So, while, the relationship with the mother cannot be replaced due to the ‘strong natural bond with her children which … cannot be obliterated’ (V. Das 1976: 202) one wife can always be replaced by another. And while ‘shared sexuality is considered to create strong natural bonds which are extremely difficult to resist’ (V. Das 1976: 205) they are nonetheless ‘socially’ inferior to the tie of blood. Both biology and social kinship are conflicted and deployed through diverse mechanisms of ‘masks and faces’ (V. Das 1976). Though Das insists that the ‘backstage’ (drawing from Goffman’s dramaturgical approach) belonging to ‘instinctive behaviour’ arising out of biological kinship is managed by the ‘frontstage’ of social kinship (learned etiquette of honour and social codes) yet, in case of surrogacy deploying the social and the biological in neat and separate categories is difficult. The biological tie of the mother–child itself becomes deeply contested. Other relationships of code, conduct become enmeshed and are impacted by the way in which biology is constructed within TCGSA. (p.187) However, how are these enmeshed, entangled codes and forms of conduct dealt with, and understood? Relationships of code are based on cultural ideologies that often privilege ‘natural substance’ over other forms of relationship. According to Ostor et al. (1983) it is precisely the predominance of the ideological primacy of the natural tie, as seen in Schneider’s formulation of kinship as cultural symbolism, that helps facilitate cross-cultural analysis. Here, we are back to the question of ‘domains’: for while Ostor et al. (1983) reject, like Schneider, the ‘universal assumption’ of genealogy, descent, and filiation—they nonetheless believe that the domain of culturally defined relationships as prevalent in different cultures is ‘susceptible to analysis in cultural terms…[but] the burden of the proof in each case is on the anthropologist to present an analysis in cultural terms using symbols that differentiate between domains and express concepts underlying relationships among the units of indigenous domains’ (Ostor et al. 1983: 4). And it was while fulfilling this particular mandate within kinship, that Weismantel (1995) finds that the Zumbagua of Ecuador think of ‘biology’ very differently from that configured in Euro-American analysis of kinship; as do Conklin and Morgan (1996) amongst the Wari’; and Carsten in Pulau Langkawi (1995). In these studies, indigenous notions of relatedness are seen to be in conflict with Euro-American understandings leading to the query: what happens

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Conclusion to the idea of relationships when two conflicting ideologies come together in one particular cultural setting? South Asian kinship studies have been influenced to a large extent by EuroAmerican theoretical ideas (Uberoi 1994). How different is ‘Kinship Studies in India’ (Uberoi 1994: 3) when it replicates the study of Indian kinship within Euro-American paradigms of analysis—whether structural or symbolic? Does TCGSA really represent the conflicting–conflicted notions of ‘biology’ as found in the cross-cultural exchange of different kinship ideologies and practices? The ethnography in this book suggests that in a transnational setting governed by the use of technology and its (p.188) representation as an ‘ideology’ (Habermas 2008), the biomedical identification of kinship draws from a Euro-American ideology, but is based in a cultural setting that is marked by differing, contesting, and evolving practices of South Asian kinship. In this enterprise not only are emerging engagements with Euro-American kinship looked at, but a more dynamic reading of South Asian kinship ideologies is also embarked upon. TCGSA is ‘fertile ground’ for the ‘playing out’ and analysis of such cultural ideologies in the making and unmaking of people, persons, and relationships. The variety of cultural engagements and kinship ideologies do inform the process—in the way doctors, intended parents, surrogate mothers, agents, and others try to position biology. To be able to make the connections is an essential part of the preoccupation with biogenetic ties. In order to do so effectively, some connections have to be privileged over others, or some have to be ignored and made subservient in relation to others. In the sections that follow the idea of conflicted and ambivalent kinship is explored through three themes, each representing the four core fieldwork chapters, that in turn represent the three important stages within TCGSA. Between Choice and Kinship

Thus, we begin with the strongest counter to kinship as understood in its biological foundation—in the idea of ‘choice’. Chapters 2 and 3 try to identify ‘intention’ through the formulation of choice and kinship. This is explored through two primary ideas—one that engages with the contract and the medicolegal identification of intention within the surrogacy arrangement; and the other is through the negotiations that participants themselves undertake in the choice of the arrangement. Is intention mapped through an idea of ‘choice’ that is carefully constructed through the neoliberal markets in ARTs? Considering the kind of tacit support that surrogacy as an industry has got through the ICMR’s legal guidelines on ARTs, the contract mirrors the agenda of the (p.189) ARTs industry in identifying intention in relation to the commissioning couple, the surrogate mother and the IVF clinic. Thus, the locus of ownership and parenthood lie with the commissioning couple—while the responsibility of executing the arrangement is with the surrogate mother. The medical staff Page 6 of 14

Conclusion administers the arrangement without any specific responsibilities, except to create a child for those who commission the surrogacy. Here, intention and commission sharply intertwine to show that ‘choice’ is manufactured, designed to create a form of ‘organic solidarity’ where the division of labour signifies mutual participation, but is actually lopsided. The contract identifies the ‘parent’, but does that through the relinquishment of the child by the surrogate mother. The displacement of intention is clearly laid out—the intention to parent is judged not only on the basis of funding the arrangement and providing the necessary ‘bodily donations’—but also through the intention to birth and relinquish rights to parenthood emerging from another bodily connection. In such identification choice comes to be embedded within a medical notion of biology and is not a rejection of the same. This is also analysed from the perspective of the IVF specialists who identify biological connections through the relationship that the womb and egg share with the foetus. In the process of ‘“matchmaking’ genes cross-cultural notions of avoidance amongst close and distant kin and relationships converge with that of genes (Edwards 2009a), and socio-economic profiles of surrogate mothers and egg donors comes to delineate their suitability (thus, the appearance of the egg donor may be more important than that of the surrogate mother). However, what is interesting is the way IVF specialists create competing narratives regarding the biological contribution of the egg and womb to the child through the conflicting, ambivalent identification of the egg donor and surrogate mother. Akin to the process of matrimonial matchmaking, doctors and agents combine new forms of technology with traditional notions of eligibility and suitability (Kaur 2014). (p.190) The back and forth over the identification of biological ties is seen as ambivalent in the three narratives that map the notion of motivations and choice in the surrogacy arrangement. Here, the surrogate mother, adoptive mothers and gay fathers articulate their notion of kin and kinship through their choice of surrogacy. Thus, the surrogate mother simultaneously asserts her agency and identifies her constrained ‘choice’ in becoming a commercial gestate. She positions herself as ‘majboor’ or ‘desperate’ to protect her intimate relationships, which are nonetheless compromised during the impersonal and intrusive delivery process. However, she is willing, and able to negotiate her bodily rights and conjugal duties in ways in which both may be protected. In that sense, the surrogate mother and the adoptive mother are similarly positioned in the TCGSA. They are both navigating the eulogized roles of wife and mother, which are resurrected in idealized forms within the arrangement. For the adoptive mother in the surrogacy arrangement, being ‘infertile’ also draws into focus the procreative marital tie (Bharadwaj 2003; Franklin 1997; Franklin and Roberts 2006) and how children form part of the normativizing element of the heterosexual marriage tie (Butler 2002). In many ways the norm of the family born of the marital tie is found in some or the other permutation in Page 7 of 14

Conclusion different cultures. Yet, the ways in which the norm exercises its influence is felt through situations that threaten it. Thus, while the adoptive mother tries to protect her allegiance to the norm—gay fathers try to reposition it by seeking to enter it. The tie of marriage comes into conflict in such an identification. The adoptive mother feels the exclusion, especially if she has not contributed her eggs to the pregnancy. The official ‘slight’ of her identity as a mother brings into question not only her ties to the child, but also to her husband. The desire for children is linked to the performance of the heterosexual marriage norm that is seemingly ‘jeopardized’ in the wake of homosexual couples ‘replicating’ the tie of procreating through surrogacy. Gay men are an (p.191) important community that benefits through TCGSA in India. The ability to claim genetic and social fatherhood has led to gay couples seeking the marital tie. In this case, having children together as a couple is an important way to seek legitimacy and social approval. It is also a necessary condition which seems to protect an intimate relationship from disintegrating. That is amply clear in the ways in which the adoptive mother tries to explain her choice of surrogacy as a viable method of having children. The shared tie between husband and wife replicated through the procreative relationships can be mimicked through ARTs, in essence, even with the participation of a ‘third party’. However, the kind of negotiations that are involved require the navigation of other relationships and the socially relational understanding of genetic, biological contribution. The anxieties of the adoptive mother are an important lens by which the marital tie itself is understood. Here, social norms are reconstructed through scientific interventions, marriages ‘saved’, and intimacy and identity restored. In an extension of the above debate the choice of surrogacy amongst gay fathers is becoming a strong rallying cry to demand for equal marriage rights. To be able to ‘birth’ children is now seen as an important reason to demand legitimacy through the social tie of marriage. Here, the heterosexual marriage and family norm (Butler 2002; Tellis 2014) is both being challenged and endorsed. By invoking the procreative ideal of marriage, gay couples are also repositioning it within an idea of choice and non-biology. How, one may ask? In the narrative of Vincent and John, the element of choice as suggested by Weston (1991) seems to be overwhelmingly usurped by the negotiations regarding physical resemblances and the desire for genetic connections. However, while genetic ties come to define the quest for a child amongst gay couples who choose surrogacy it is also because of the restrictions to parentage as such. So, adoption, fosterage, and coparenting with lesbian couples seems restrictive and distant primarily because they define (p.192) the ideal parenting couple within a heterosexual paradigm (except in case of lesbian co-parenting where incidentally the biological–physical bond of pregnancy seems to take privilege over the rights of the gay fathers). In such a situation, the choice of surrogacy involves an overturning of the dominant Page 8 of 14

Conclusion biological exclusions supported by adoption, fosterage, and co-parenting. Instead of providing or exercising an oppositional alternative, as seen in Weston’s analysis, gay couples are usurping the predominance of biological kin to redefine it in more inclusive terms. That truly is revolutionary. Here, one would disagree with Schneider (1997), Butler (2002), and Tellis (2014) when they say that gay couples re-enact the heterosexual paradigm. Gay couples, I believe are in fact reinventing it—bringing choice and individualism back into the domain of kinship and pointing towards the need to start focusing on the family as a more dynamic area of analysis and enquiry. Between Nature and Nurture

It is in extension of this reinvention of biology as understood by kinship, Chapter 4 investigates the ways in which the surrogate pregnancy leads to ‘disembodied relationships’. The ‘alien’ pregnancy which unfolds in another’s body and is claimed by someone else requires negotiations between kin and kinning. The liminality of the pregnant surrogate makes her the focus amongst different participants within the arrangement. Thus, the chapter analyses the narratives of ‘significant others’ who are implicated in the arrangement—such as the agent, the mother-in-law of the adoptive mother, and the surrogate’s husband. All three are involved in the arrangement as ‘caretakers’ who have an important role to play in relation to creating meaning regarding the pregnancy. However, one finds that the ‘strategic naturalizing’ that clinics undertake to reassign biology within IVF, surrogacy arrangements involving donors (Thompson 2001)—fails in case of the TCGSA. The creation of meaning through kinning is confronted with two ideas (p.193) of kin and pregnancy: the biomedical view that privileges genes, and the view that places pregnancy as the source of identity and personmaking in South Asian kinship. In this chapter, motherhood becomes fractured, contested and deeply ambivalent in its relation to pregnancy. The understanding of disembodied relationships is influenced by discussions by Sharp (2006) and Heinemann (2011) regarding the shared bodily ties between donor kin and organ recipients in organ donations. The performance and understanding of kinship is through the negotiations that people undertake to reclaim relationships lost through death by displacing the same in some measure on others who share bodily aspects (such as organs) with the deceased kin. In case of the surrogacy arrangement there is resistance in creating shared bodily connection between the pregnant surrogate and the intended parents. This is seen in the resistance articulated by the surrogate’s husband and the relatives of the intended parents—as well as by the agent. However, paradoxically some form of attachment has to be nurtured by the surrogate for the foetus in order to facilitate a smooth delivery of a healthy baby. The narrative of separation and embodiment comes undone in creating viable linkages between biology and nurturance—and between the foetus and the pregnant surrogate. Agents clash with IVF specialists to create viable meanings of kinning through pregnancy; intended parents and their relatives recreate the class idiom in the apparent Page 9 of 14

Conclusion socio-economic differences between them and the surrogates by distancing themselves from the surrogate as the ‘other’; and surrogates’ husbands try to create an understanding of the arrangement through a moral positioning of their role in the arrangement. Pande (2010a) finds the creation of a viable moral universe as an essential step towards combating the stigma that arises from participating in the surrogacy arrangement as a ‘hired womb’. I find this form of ‘combative disassociation’ undertaken by the surrogate’s husband in claiming the surrogate pregnancy as a job and ‘responsibility’ (as it is constructed in the contract (p.194) through the joint signatures of the husband and his promise of sexual abstinence); or on the overt focus on the compensation being earned through the arrangement. Both mechanisms help the surrogate and her husband to distance themselves from the pregnancy, thereby rejecting any form of kinship ties with the foetus. This is more pronounced in the case of the surrogate’s husband as he tries to cope with his wife’s ‘alien’ pregnancy. Within such a context the immediate focus is on motherhood—its role, performance, and ideology become muddled in the surrogate pregnancy, in the signing of the contract, and also after the birth of the child—in the process of granting citizenship. Here, the surrogate mother comes to represent the nurturing role for nine months of the pregnancy, which is, however, positioned as secondary to the genetic contribution of the adoptive mother by the IVF specialist, agents, the surrogate’s husband, the intended parents, as well as the surrogate mother herself. In case of gay couples as intended parents, the surrogate mother occupies an important position, which is nonetheless held to be subordinate to that of the anonymous egg donor. Yet, gay intended parents see the surrogate mother as an important element in their child’s birth because of their links with her—they resurrect her in images of India as the mother of the children (Deomampo 2013a). Between Parents and Others

In Chapter 5, these navigations of kin and kin identity are seen after the birth of the child and through the state’s intervention in the intimate lives of citizens. Through the analysis of three journeys of couples and single fathers, the process of acquiring citizenship is charted. Here, international laws collide in identifying children born through surrogacy in India to foreign parents. However, the different laws and practices lay testimony to the ways in which the state and society come to understand parentage and biological citizenship. (p.195) The chapter follows the ‘creation’ of the child, again, through the bureaucratic processes of identity giving. Different forms of cultural ambivalence are seen through the narratives of parents seeking citizenship for their child(ren) in the UK (having a middle stance on surrogacy); Israel (with a liberal, pronatalist stance on surrogacy); and Spain (which deems surrogacy as illegal).

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Conclusion The transnational becomes a contested terrain in the negotiation between national laws and boundaries. Belonging to a nation involves the authentication and verification of not only the surrogacy contract—but also the ties of kinship that are made through the arrangement. Thus, bureaucratic processes are invoked through cumbersome paperwork and the anxieties of ‘waiting’ to get the citizenship and exit visa out of India. Thus, elements of this process—the birth certificate and the DNA test—become important artefacts of identity making and negotiation. Just like transnational adoption, the child (Posocco 2011; Yngvesson and Coutin 2006) has to be re-made as per bureaucratic and state apparatus to fit into a suitable identity and claim membership to a nation. However, unlike adoption where states come together to create fictions around the child’s origins and future parents (Dorow 2006; Howell 2003), the complicated nature of the surrogacy arrangement along with its overt monetary element create problems for a smooth negotiation of citizenship. The shared genetic ties with the surrogate and the anonymous egg donor, and the illegal status that surrogacy occupies in many countries in Europe and elsewhere positions the child in a state of flux and transition. The child born of the surrogacy arrangement in India becomes a ‘stateless commodity’ judged on the basis of the contractual birth agreement and its complicated parentage. Such an ideology is in keeping with bureaucratic requirements of identifying the surrogate mother as the mother of the child before granting citizenship. In the birth certificate, in seeking her official relinquishment or permission to ‘release’ the child into the care of the intended parents—usually the father—the state (p. 196) recognizes that tie which was till now constructed merely as one of facilitating the birth of the child. The citizenship process brings the role of the surrogate mother in the arrangement to a full circle; reversing her status as a non-claimant in the medical process, to seeking her approval before granting ‘legitimacy’ to the children. The state in its role as ‘identity-giver’ through the recognition of biogenetic parentage is unable to reconcile the manifold conflicts and contradictions that emerge from the arrangement. Each act of authentication and verification of identity through the birth certificate, DNA tests, passport, and exit visa are opposed to each other, and yet incomplete without the other. The birth certificate is countered by authenticating the tie of ‘genes’ through the DNA test —and by ignoring the surrogate mother whose ‘mention’ is found in the document. A ‘valid’ DNA test proving paternity leads to the granting of the passport, but only if the surrogate, anonymous in the birth certificate, is willing to validate the tie of paternity. Again, the child’s exit from India depends upon the surrogate ‘mother’s’ relinquishment of the baby. International laws collide and collude to validate, deny papers and petitions of relationships (Mody 2008).

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Conclusion In the exercise of identifying parents, fatherhood comes under scrutiny. However, the state’s privileging of the paternal role (ostensibly due to the multiple mothers) hides deeper anxieties regarding the fractured position of the father within TCGSA. Three types of fathers emerge in the arrangement: the ‘genetic’ father, who has to prove his connections to the baby through the DNA test; the ‘non-bio Dad’, or the partner in a gay relationship who has no genetic connections to the baby and has to claim parental rights through court injunctions allowing adoption; and the ‘other’ father, or the surrogate’s husband who has to relinquish his rights over the baby to be able to facilitate citizenship of the child. What the chapter points towards is the way in which supposedly immutable ties of biology, of parentage as recognized by the state and international laws are now conflicted. The recognition (p.197) of these ties is based on the scrutiny and judgement of ‘others’. Here, the notion of nurturance, upbringing, and socialization enter the discourse in subtle ways, but are overwhelmed by larger narratives on parenthood, marriage, family, and community/state/national membership. The ‘other’ (state, clinic, relations) become an important axis to knowing ‘one’s own’. This book attempts to look at these other relationships through the vantage point of parenthood and biology—thereby also focusing on the multiple fissures and cleavages that interpersonal relationships have always had—yet are being brought forth through the use of ARTs.

A Brave New World? At the core of biological kinship is the notion of information. This information about kin, kinship and relationships has been a favourite preoccupation of anthropologists. Strathern (1999a) notes that the process, desire of ‘knowing’ has led to both connections and disconnections through technologies that disrupt biology (such as ARTs), and at the same time seek their verification (such as the DNA test). In such a scenario the knowledge that ‘kinship makes children part of the bodies/persons of their parents’ (Strathern 1999a: 66) comes undone—thereby impacting ‘kinship knowledge’ (Carsten 2007). In the Euro-American context the disruption of kinship knowledge, and by extension, of the self, the person has led to legal interventions in the way in which kinship information/ knowledge is regulated. However, legal regulation has had consequences for kinship and interpersonal relationships, and how we think about them, especially since countries like the UK have begun deliberating on the need to make information about anonymous sperm and egg donors public (Strathern 1999a).1 Thus, a child born of donated gametes may seek information regarding the donor. This form of ‘knowledge’ has consequences for intimate relationships as is seen in the case of adopted children seeking (p.198) their birth parents (Carsten 2000a). Ultimately, however, ‘kinship knowledge, by itself, does not create kinship …

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Conclusion whilst knowledge of a person … is crucial to being close to them … knowledge must also be activated in relationships’ (Carsten 2007: 422). However, in case of the ICMR ARTs Draft Regulation Bill, 2014 any information regarding the identity of the anonymous gamete donors and the surrogate mother has to be kept anonymous. These records are not to be made public except in case of medical emergencies and through a legal order. Such an idea privileges ties of nurturance of kinship through familial networks it privileges a different idea of kinship information, closer to that of indigenous, South Asian forms of relatedness that emphasize the growth and fulfilment of relationships over time. The transnational commercial gestational surrogacy arrangement brings to the fore the collision of different folk understandings of kinship and relationships. The South Asian notion of kinship information affirms other notions of personhood and kinship, contrary to the ‘search for roots’ that EuroAmerican kinship feels is necessary to complete a person. The idea of kinship knowledge or kinship information is invoked at the end of this book to make way for new questions that are emerging from the practice of TCGSA. One in particular, will become increasingly relevant as children born through surrogacy in India—such as Philip and Trent’s children—begin to grow up. Will they be told the circumstances of their birth? Will they come seeking their surrogate mothers and egg donors? Will they want a relationship with them? During an online chat, Trent mentions to me: I think most people are surprised that for the most part we celebrate the heritage of our children and I find others use my term that the children are ‘of India and of us’. That being said our children are born stateless and not recognised by the Indian state as being half-Indian. Australia has had to reconcile its past with a stolen generation and I believe 100 per cent India will have the same issue (p.199) with surro-kids who want to wander back to India to find that half they seek to understand. They will want more information on surrogates and egg donors. Maybe linking the needs of the children we can link back the needs of the surrogates, albeit late. Knowing us, do you think our daughters and son will be any less activists [sic] on issues that affect them, and you are going to be one of the first people these three will look up … (dated 11 November 2013) To classify the ethnographer–anthropologist as ‘record keeper’ means that the kind of kinship information being sought is more like information, and less like a relationship. However, in reality, as this thesis has tried to do in combining different forms of kinship ideology, whether Euro-American or South Asian, relationships are forged and broken at levels of practice and intimacy. Here, kinship information may be revealing but not necessarily disruptive of relationships forged and nurtured over many years. At the core of the anthropology of kinship is thus the maintenance and privileging of nurturance, Page 13 of 14

Conclusion lived and shared relationships and not just their coding and identification that becomes the source of conflict and ambivalence. In that sense, this book will never be complete. As the children of Trent and Philip and all the other couples in this ethnography, grow our jobs as chroniclers will become even more important. Notes:

(1.) In another context, that of organ donation, anonymity of organ donors and their kin is strictly maintained (Sharp 2006).

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Bibliography

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

(p.200) Bibliography Anindita Majumdar

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Bibliography Van Hollen, C. 2006. Birth on the Threshold: Childbirth and Modernity in South India. New Delhi: Zubaan. Van Maanen, J. 2011. Tales of the Field: On Writing Ethnography. Chicago: University of Chicago Press. Vatuk, S. 1975. ‘Gifts and Affines in North India’, Contributions to Indian Sociology 9(2): 155–96. Vora, K. 2009. ‘Indian Transnational Surrogacy and the Disaggregation of Mothering Work’, Anthropology News 50(2): 9–12. (p.225) Vora, K. 2010/11. ‘Medicine, Markets and the Pregnant Body: Indian Commercial Surrogacy and Reproductive Labor in a Transnational Frame’, The Scholar and Feminist Online, Double Issue 9.1–9.2: Fall 2010/Spring 2011. Retrieved from www.barnard.edu/sfonline ———. 2013. ‘Potential, Risk and Return in Transnational Indian Gestational Surrogacy’, Current Anthropology 54(7): S97–S106. ———. 2014. ‘Experimental Sociality and Gestational Surrogacy in the Indian ART Clinic’, Ethnos 79(1): 63–83. Vorzimer, A. 2010. ‘Dan Goldberg Returning Home to Israel with Twins from India’, The Spin Doctor. Retrieved on 4 October 2013 from http:// www.eggdonor.com/blog/2010/05/25/dan-goldberg-returning-home-to-israelwith-twins-from-india/ Waldby, C. 2008. ‘Oocyte Markets: Women’s Reproductive Work in Embryonic Stem Cell Research’, New Genetics and Society 27(1): 19–31. Weiner, A. 1976. Women of Value, Men of Renown: New Perspectives in Trobriand Exchange. Austin: University of Texas Press. Weismantel, M. 1995. ‘Making Kin: Kinship Theory and Zumbagua Adoption’, American Ethnologist 22(4): 685–704. Weston, K. 1991. Families We Choose: Lesbians, Gays, Kinship. New York: Columbia University Press. Widge, A. 2002. ‘Sociocultural Attitudes Towards Infertility and Assisted Reproduction in India’, in E. Vayena, P.J. Rowe, and P.D. Griffin (eds), Current Practices and Controversies in Assisted Reproduction (pp. 60–74). Geneva: World Health Organization. Williams, L. 2010. Global Marriage: Cross-border Marriage Migration in Global Context. UK: Palgrave Macmillan.

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Index

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

(p.227) Index abortions 43, 100, 134, 149 absentia, study on 3 adoption process 157 adoptive–genetic mother 63 adoptive mother 14–16, 190 negotiation of relationship with father 17 advertisements 35 matrimonial, for brides wanted 88 for surrogate mothers and egg donors 5, 89 agency(ies) 36–7 role in surrogate pregnancy 113–14 agent–facilitators 107 alien pregnancy 110–11 dealing with the pregnant mother 118–21 pregnant mother 111–13 unwanted pregnancy 127–9 All India Democratic Women’s Association (AIDWA) 79n1 altruistic gestational surrogacy 93 altruistic surrogacy 140 arrangements 90–1 ambivalence in surrogate pregnancy 133 anonymous donors 8–9, 23, 42, 65, 73, 77, 81 anonymous egg donors 43, 65, 95, 98, 125, 177, 182, 194–5 anonymous gamete donors 36, 82, 84, 86–9, 198 antagonism 17, 126 Apostille Treaty 139, 179n1 artificial/assisted reproduction 81 artificial insemination 72, 75, 129, 162 artificial life laboratories in California 174 artificial pregnancy 113–14 asexual act 114 Page 1 of 13

Index assisted reproductive technologies (ARTs) 2–3, 6, 11, 33n4, 34n8, 47, 65–6, 78, 81–2, 197 banks 24 disrupted fatherhood role 17 in India, low cost 24 (p.228) intention to commissioning couple 189 mutating characteristics 12 transnational clinic 20 attention deficit hyperactivity disorder (ADHD) 74 auto-immune (AI) strain 57, 60 baby back home in 3 easy steps 143 Baby Manji case 144–45 barrenness, notion of 64 Beta hcG test 111 biocommerce 101 biocrossings 33n6, 95 biogenetic facts 82 biogenetic parentage 196 biogenetic substances 109 biological connectedness 73, 98, 171 biological essentialism 55 biological kin / kinship 7–8, 197 biological links 113 biological tie of mother–child 186 biologization 114 of pregnancy 122 biology(ies) 6–13, 31, 47, 63, 72–3, 84–7, 95, 107, 146, 151, 171, 178, 183–5, 187–9, 192, 196–7 configured in intimate relationships 9 definition of 77 in Euro-American kinship 83 failed 19 hegemonic 175 metanarrative of 7 shared 186 surrogates parturient 45 birth certificate 32, 69, 90, 139, 142, 144–8, 150–1, 156, 167, 170, 172, 176, 195 birth intermingle 31 blood–biology–gene–DNA 8 bodily donations 189 body boundaries 108 breast milk 127, 180n16, 186 British High Commission 151 caregivers 135n1 caretakers 110–11, 114, 133–4, 135n1 Catholic Church 168 child identity/membership 141 claiming of 32 gaining legitimacy process 148–51 Page 2 of 13

Index non-disclosure of 43 primary 44 through father 175 childlessness 36–7, 64, 79n3 choice(s), notion of 8, 36–7, 188–92 (see also intention) conscious 27 as intention 47–8 lifestyle 57 reproductive 37, 55 surrogate mother 39 Chori Chori Chupke Chupke 14–15 citizenship bureaucratic processes of 139 process in Spanish embassy in New Delhi 166 class(es) 6, 9, 47, 72, 84, 87, 109, 123 identity 159 and poverty 123 surrogates from lower background 22, 34n9, 121 cultural-biologicals 7–8 colonial India 86, 126–7 combative disassociation 193 (p.229) commercial gestational surrogacy 6, 26, 65, 77, 90 contract agreement 38–40 components of 41–2 living repositories 27 commercial surrogacy industry 27 ban on 2 burgeoning 1 package, cost of 23 taken-for granted nature 3 commissioning couples / individual 4–5, 9–10, 29–30, 32n1, 40, 51, 81, 85–7, 90, 96, 140, 147, 177–8, 185, 189 Communist Party of India-Marxist (CPI-M) 79n1 communities of substance 108 Confederation of Indian Industries (CII) 24 conflicted kinship 183, 185 conned surrogacy 116 constitutive knowledge 83 contractual birth agreement 195 contractual professionalism 124 contractual relationship 109 contractual surrogacy 26, 90, 116, 124 co-parenting 69, 73, 75–6, 191–2 corporate clinics 22–3 cultural engagements 188 cyborg fantasy 114 de-biologization 114 Delhi, surrogacy arrangement in 126 desire to parent 37 Page 3 of 13

Index disability 1 disembodied relationships 31, 107, 192–3 disembodiment 107 DNA test 7, 17, 32, 83, 142, 195–6 doctors role, in surrogate pregnancy 113 donors 64, 68, 104, 192 (see also egg donors; sperm donors) anonymous 23, 42, 65, 81 Hispanic 71 identity of 82 Indian 144 kin 109, 193 matching 85 profile 98 semen 91 Doosri Dulhan 14 Down’s Syndrome 32n1 early miscarriage 113 egg(s) / oocyte 9, 19, 63, 100 (see also sperm) donation 91 donors 4, 9, 22, 25, 43, 49, 65, 67–72, 77–8, 81, 85, 88, 97–9, 197–8 reproductive bioeconomy of 26 embryologists 22, 31, 92, 101–2 embryos 65, 90, 98, 100, 113 access and use by scientific community 101 fertilized 43 frozen 25 genetic connections 102 grading 101 to grow 129 inseminating by anonymous donor eggs 42 stem cell research, use in 102–3 in surrogacy arrangement 101 embryo transfer (ET) 96 enforced employment 84 ethnographer–anthropologist as record keeper 199 (p.230) ethnography 5, 10, 33n4, 65, 74, 95, 110, 124, 130, 138, 140, 179n2, 187, 199 intention 38 of reproductive tourism 27 role of others 31 Euro American kinship 82–4, 188, 198 Euro-American principles 155 exit visa 32, 139, 142,148, 157, 160, 195–6 experimental sociality, notion of 20 failed pregnancies 115, 166 failed surrogacy 116 faithful retainer 123 fallopian tubes 149 father/fatherhood biological 17 Page 4 of 13

Index intended 16 missing third party 18 multiple 16 within surrogacy arrangement 13 types of 196 female feticide 100 fertility 20, 38, 60, 96, 119 clinics 31 tourism 5 fictive kin 109 Filhaal 15 foetus 13, 15–17, 25–26, 31, 46, 59–61, 63, 65–6, 87, 108 images of 124 nurturance 122 separation of surrogate with 90 foreign couples 1–2, 10, 84, 96, 99, 115, 123, 125 demand for commercial surrogacy 4 homosexual 180n12 incubated in Indian wombs 9 and IVF 115 rely on IVF doctors and agent 115 third world surrogates 127 Foreigner Regional Registration Office (FRRO) 137, 142, 148 friendship 7–8, 15 gay 196 couples 10, 32n1, 36–7, 63, 160–1, 168–9, 173, 178, 191 dads/fathers 3, 47–8, 69–70, 72–4, 77, 164, 190 families 155 intended parents 194 male/men 16, 75, 140, 165, 167, 180n12, 190–1 parents 73 rights 182 gene(s) 7–9, 13–14, 31, 36, 63, 71, 73, 87, 95, 103, 109, 112, 139, 155, 171, 174, 196 intention and ideas, analysis of 78 naturalizing tie of 66 shared 61, 77, 82 social identification of 70 gene sutra 92 genetic–biological contribution 191 identity 155 standard 13 genetic embryo testing method 60 genetic father 67, 145, 154, 172, 177, 196 genetic parentage/parents/parenthood 38, 59, 90, 121, 142, 196 genetic surrogacy 6 features of 8–9 mother 9–10 (p.231) Page 5 of 13

Index German Balaz Twins 144–5 gestational surrogate mother 126 ghatak (matchmaker) 86 gift relationship, ideology of 26 globalization 20–1, 27 global reproductive assemblages 5–6 granting citizenship process 142, 170–1, 174, 194–5 Hague Conference 179n1 heterosexual couple/parents 161 use of donated gametes 81 heterosexual couples 8, 10, 38, 153, 169, 179n9 heterosexual marriage/married unit 156, 190 heterosexual unions 153, 163 High Court of Gujarat 145 Hindi films on surrogacy 14, 33n7 homosexual couples 9, 73, 76, 81, 153, 163, 190 father 163 men 75 parents 77 homosexuality 74–5 Human Chorionic Gonadotrophin (hcG) 135n3 identity(ies) 83–4, 87, 108, 127, 138–40, 174–5 class 159 of donors and surrogate mothers 81–2 of gamete donor 85 -giver 196 giving 195 husband genetic 62 making 195 parental 145 racial 84 unborn child 100 Imbissvater 146 Indian Council of Medical Research (ICMR) 1–2, 24, 40, 103 ART's Draft Regulation Bill 2010 2–3, 24, 39, 45, 81, 84, 88, 93, 139, 188–9, 198 Indian Society of Assisted Reproduction (ISAR) 24 infant, breastfeeding of 126 infertile heterosexual union 71 infertile Indian women 47 infertility 36, 38, 118, 138, 140 biomedical identification of 37 in-built mechanism to tackle, Indian culture 2 clinics 22–3, 33n8, 96, 101 male 17 for married women as symbol of incomplete conjugality 64 medicine 19 narratives 47 private players in market 21 Page 6 of 13

Index specialist 43 through multiple IVF cycles 149 treatments 61–3, 103, 153 types of 25 use ICMR ART Bill 2010 38 information about kinship, notion of 80–2 new 83 through IVF specialists 85 informed choice 87 insemination/embryo transfer 114 instinctive behaviour 186 intended parents (IPs) 41–2, 103, 195 aspects of 36 (p.232) to become parents 37 bestowers of gifts for poor women 46 gay 194 intention/intentionality, notion of 28, 36–7 as choice 30–31, 47–8 combinations of interrelationships 38 as a form of eligibility 37–8 owners with entitlements 41 for surrogacy contract 38–40 in vitro fertilization (IVF) 3–5, 10, 18–19, 31, 33n4, 34n8, 42–3 (see also surrogacy; surrogate) in India cost in surrogacy arrangement 24–5 fertility and surrogacy clinic, requirement 20 medical service and treatment, commercialization of 19–20 surrogacy clinic 20–1, 43 intracystoplasmic sperm injection (IVF/ICSI) costs 23, 33n4 specialist-administered treatment 28, 39 specialist and agents 86, 95–6, 189 act as matchmakers 103 invoke folk genetics 103 Israeli Dan Goldberg’s case 170 Israeli documentation of surrogacy 160 Janani 15, 131 jeopardized surrogacy 116 Jewish inheritance 161 Judeo-Christian mythology 176 Khan, Aamir 79n3 kin / kinning / kinship 18–19, 113, 188–92 as anthropologists 183 anthropology of 199 biological 82 biology role in study of 8 biomedical identification of 188 classical 82–3, 182 conflicted 32, 185–8 Page 7 of 13

Index examination of 183 constructed biology 8 dilemmas 95 Euro-American 13, 82–3 ideas of 82 identity 183, 194 Indo-Aryan ideology 85 information 198–9 knowledge 83, 197–8 matching 90–5 anonymous 97–103 negotiation 106 processual analysis of 12, 184 Schneider’s study in American society 7 sexual procreation 13 South Asian studies on 187 stages of 28 ties of 80–1 as a tool 183 trajectory 138 lesbian 168 co-parenting 192 couples 69, 72–3, 75–6, 161, 191 mother 161 LGBT community 164 Spanish State 168 lower class surrogate 121 (p.233) Made in India documentary (2010) 9 mail order brides 142 making kin, practice of 8 marriage(s), notion of 6–7, 14, 16, 42, 79n3, 92, 190 conditions for baby boy 56–60 gay 74 infertile 64 market 87 traditional matchmaking in Indian 86 matchmaking genes 85–90 matrimonial matchmaking 189 websites 87 medical doctors as matchmakers 85–90 medical perceptions 98 medical tourism industry in India 34n10 men and surrogate pregnancy 131–2 Metro IVF 5, 91, 149–50, 157 middle class carer 120 Ministry of Health 24 Ministry of Home Affairs 2, 148 Miracle Babies 21, 40, 62, 64, 111 Page 8 of 13

Index miracle births 91 miscarriages 29, 43, 65, 113, 115, 125, 149, 166 money earned in surrogacy 130–1 monogenesis 175 mother and gestate, identification of 122 mother–child bond 126 mother / motherhood 56, 79n3 (see also surrogacy) biological given-ness of 13 focus within surrogacy 16 identity of 9 intended 92 missing third party 18 role of 16 surrogacy relation with, biological–social tie 13 motivation(s), notion of 36, 38, 47, 55, 190 Municipal Corporation of Delhi (MCD) 144 national honor 173 negotiation(s) 12, 14, 17, 27, 29, 66, 72–3, 134, 139, 142–4, 188, 191–3 conflicted 8 interpersonal 106 of kinship dilemmas 19 with opposing emotions 111 Nepal Earthquake, in 2015 180n12 Netanyahu, B. 164 non-bio Dad 196 nonbiological children 47 non-commercial surrogacy arrangements 95 non-governmental organization (NGO) 144–5 non-resident Indian (NRI) 118 NRTs 27, 33n4, 47 nurture / nurturing / nurturance 30, 44, 58, 60, 84, 176–8, 180n16, 185–6, 192–4 alien pregnancy 110–35 of foetus 107 motherhood role 17 of non-biological children 47 pregnancy 106 role of gestation 153 obligation 6–7, 26, 53, 63, 124, 131, 133 organ donation 109, 193, 199n1 (p.234) donors 199n1 transplantation 34n10, 109 other father 176, 196 ownership 14, 22, 28, 41, 46, 77, 98, 113 parent(s) / parenting / parenthood 3, 109–10, 117, 154, 160, 165, 170, 178, 189, 197 achievement, ways of 37 biological 37 cross-cultural engagement with 13 ideal couple 192 Page 9 of 13

Index intentionality, idea of 37 joint 76 mutual 70 non-genetic 38 order 75 shared 75, 173 social 37–8 unplanned 37 Patel, Nayna 1 pater–genitor distinction 175 paternity test 144–8 patron–client relationship 124 personhood 82, 84, 108, 146, 198 persons of Indian origin (PIO) 140 philanthropy 46, 127 physical labor 122 post-conception pregnancy 106 practical kinship 12, 174 pregnant(s)/pregnancy 5, 8, 14, 18, 28, 49, 57, 151, 159, 190 adoptive mother 66 alien 192, 194 biological role 14 body 31, 108 house surrogates 24 Indian surrogate mothers 85 married mother 61 mother 111–18 dealing with 118–27 natural attachment among women during 15 unwanted 127–135 visible surrogate 13, 177 pregnancy–motherhood–nurturance difficult 121–2 Pregnyl 135n3 premature birth / delivery 119–20 Private International Law 179n1 processual–relational system 108 procreative universe 12 prostitution 27, 50, 52 Rabbanic laws 161 Rajan, Kaushik Sunder 25 Rao, Kiran 79n3 regulative knowledge 82 religion and surrogate pregnancy 133 reproductive aspirations 62 reproductive tourism 24, 27 agency 10 retaining, pregnancy 106 rhetoric of love 123–4 same-sex marriage 182 Page 10 of 13

Index sentimentality 109 sex 6–13 sexual intercourse 6 sexual procreation 72, 85 sexual reproduction 38 shared biological tie 124 shared sexuality 186 shifting body metaphors 124 single fathers 17, 63, 126 single gay fathers / men 36, 74, 77, 165, 194 single parents 155 single unmarried girl 96 (p.235) single woman / man 9, 97, 142, 145, 153, 161, 168–9 Skype conversation 165 social distance 6 social networking websites 125 Society of Obstetricians and Gynaecologists 145 sonography images of foetus 125 sororate marriage, practice of 94 sperm 8, 19 anonymous 83, 197 donors 3, 16, 81, 85, 88, 98, 162 to embryo, contribution 98 Stanadhayini 127 strategic naturalizing process 87–8, 192 Supreme Court of India 145 surrogacy agent 85 arrangements 2–4, 16–19, 192 average expenditure in commissioning 23 combinations 91 cost of 24–5 as a hired womb 193 surrogates and egg donors, recruitment of 88 contract authentication and verification 141–4, 195 declaration of intent 30 as form of relationship 40–47 forms of 6 in India child as stateless commodity 195 Delhi as hub 22 mothers popular representation 14–16 male gay couple seeking 16 market 4 surrogacy agents–facilitators 114 surrogate(s) / surrogate mothers 31, 36, 38–9, 79, 81, 88, 91, 106 act 109 classification of 97 Page 11 of 13

Index commercial-prostitute-turned-surrogate 15 conflict between adoptive and 14 father 17 genetic mother 16 husband 193 in India husbands rationalization of wife involvement 18 scrutiny of reproductive choices 37 marriage age 38 narratives of 47–78 personal identification 90 potential parents contract with 18–19 tests 95 as volunteered as egg donors 99 Tel Aviv airport 160 saliva testing in 147 Thai surrogate Pattaramon Chanbua courted much controversy (2014) 32n1 third-party affiliate or administrators (TPAs) definition of 21–2 working pattern of 22 third-party reproduction 81 Third World surrogate 127 women 46, 156 (p.236) Times of India, The 163 trafficking of concepts 184 transnational 195 adoption 11, 85, 195 bureaucracy, procedures in 144 care work 11 commercial gestational surrogacy 11, 84, 138 feminism 27 marriages 11, 142–3 national setting 138 relationships 11 Transnational Commercial Gestational Surrogacy Arrangement (TCGSA) 6, 10–11, 13, 19, 21, 27, 38, 48, 78, 87, 97, 103, 183, 186, 188 anthropological traditions 36–7 birth certificate and the paternity test 144–8 child citizenship process 139 children through 141 citizenship in 141–2 fatherhood 172–8 gaining legitimacy 148 gametes use from anonymous donors 81 gay men community contribution 190–1 legal mother 148–51 Page 12 of 13

Index mapping of 184 nature of 64 planned course of action 36 stages of 28–9 verification and authentication 141–4 UK Border Agency 179n1 UK Human Fertilisation and Embryology Act 2008 151 ultrasounds 111, 125, 135n3 United Kingdom, surrogacy practice in 140 unwanted pregnancy 127–35 upbringing, child 177, 197 upper class genetic parents 121 venereal disease research laboratory (VDRL) 104n5 vernacularization process 11 vicissitudes 110 wait with the womb 110 Warnock Committee Report 152 wet nurse 127 wife-givers (WG) transfer women 93–4 wife-takers (WT) 94 woman body, commodification of 25 wombs, women ban in hiring by foreigners 2 eligible 93 hired 193 ineligible 93 trade in 19–27 waiting with 107 Xavier’s case 165–71, 173–4, 176–7 zamindar (landlord) patrons 127

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About the Author

Transnational Commercial Surrogacy and the (Un)Making of Kin in India Anindita Majumdar

Print publication date: 2018 Print ISBN-13: 9780199474363 Published to Oxford Scholarship Online: April 2018 DOI: 10.1093/oso/9780199474363.001.0001

(p.237) About the Author Anindita Majumdar

Anindita Majumdar is Assistant Professor, Department of Liberal Arts, Indian Institute of Technology Hyderabad, India. The research for this book was awarded the ‘Distinction in Doctoral Research Award’ by the Indian Institute of Technology Delhi for the year 2015–16. She has previously published her work in the Indian Journal of Gender Studies, Contemporary South Asia, Gender, Technology and Development, and Economic and Political Weekly. She has taught at University of Delhi, Manipal University, and IIT, Delhi.

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