37
they can make from surrogacy can be life- changing:
it could help them secure their family’s future, start
a business, educate their children, pay medical ex-
penses or build a solid home. Macwan hopes to use
the money to start a small clothing business selling
her own brand. While the majority of surrogates
are poorer women from rural areas, many educated
women have also come to the Akanksha Hospital
amid a startling loss of jobs across India during the
pandemic to act as egg donors or surrogates.
They might be among the last women in India to
be paid for surrogacy. For many years, the country
has been one of the few places—including Russia,
Ukraine and some U.S. states—where commercial
surrogacy is legal. But the ethics of the practice have
been under scrutiny for some time, and now a ban
on all commercial surrogacy is on the horizon. The
ban is part of a new bill that, if enacted, would also
prevent LGBTQ couples and single women from ac-
cessing surrogacy. Activists have criticized these new
restrictions, saying they’re part of Prime Minister
Narendra Modi’s conservative agenda to legally de-
fine “family” in traditional terms. And while law-
makers argue that the industry exploits impover-
ished women, experts fear that the ban would cut
off one of their few paths out of poverty—especially
as COVID-19 continues to batter India’s economy—
and push the market underground.
That could leave these women more vulnerable
than ever. “If they stop commercial surrogacy, it is
not good for poor people like me,” says Savita Vasava,
a 34-year-old mother of three from Dakor, a small
town 21 miles from Akanksha Hospital. She is about
to be a surrogate for the second time in order to save
up for her daughter’s wedding. She’s currently wait-
ing to hear if the embryos recently transferred into
her uterus have resulted in a pregnancy. “It is one
way for us to make a better life. If we work day and
night, we cannot save this kind of money.”It’s hard to mIss the Akanksha Hospital, a shiny
edifice of glass and steel that towers over the banana
field across from it. As you enter, a screen plays a
video on loop showing its charismatic founder,
Dr. Nayana Patel, talking about reproductive health.
Since 2003, her practice has put Anand on the map
as a hub for commercial surrogacy in India. The
new hospital building, inaugurated in 2015, is a
one-stop shop for fertility, offering egg extraction,
in vitro fertilization (IVF), embryo transfer, prenatal
care, delivery of children and neonatal care. In the
reception area is a photo of Oprah Winfrey, whose
endorsement in 2007 led to the clinic’s attracting a
large foreign clientele. A floor-to-ceiling collage of
press clippings touts the hospital’s success, and pic-
tures of smiling babies—many of them white—adorn
the walls. A maze of rooms in the basement of the
building houses surrogates for the duration of their
pregnancy.
Since its legalization nearly two decades ago,
commercial surrogacy has thrived in India, driven
by a lack of bureaucratic red tape, a supply of skilled
English- speaking doctors, low labor costs and a push
to promote medical tourism. At its peak, the indus-
try attracted hundreds of clients a year from wealthy
countries, especially the U.S., Australia and Israel, ac-
cording to Amit Karkhanis, a Mumbai-based lawyer
who specializes in contracts between surrogates and
intended parents. Akanksha Hospital, India’s most fa-
mous clinic, has been praised in international mediaWorld‘I THOUGHT, IF I GO
ONCE, THEN I WILL BE
ABLE TO STAND ON
MY OWN FEET.’
—Pinky Macwan, 24, who turned to surrogacy during the pandemic