Chandini (27) holds the hand of her six-year-old daughter as she enters an in-vitro fertilisation (IVF) centre in a swanky south Delhi locality for a check-up. “I had to change two buses to make it here,” she says in a whisper, smiling as she wipes the sweat off her forehead with the loose end of her cotton sari. “I live at the other end of the city,” she adds.

Chandini’s eyes, darkened with kohl, scan the waiting room of the clinic. Her feet play nervously with her tattered slippers. Chandini says she decided to become a surrogate mother to earn money for her family. “I want a better life for my  daughters,” she says.

Her husband’s earnings as a daily wage carpenter isn’t enough to support their two daughters, so Chandini works as a housemaid and has become a surrogate. She’s been promised almost $4,500 for carrying and delivering this foetus for a Canadian couple, who couldn’t bear their own child. “This money means a lot to me,” she says.

Hundreds of Indian women rent their wombs to earn money for their families. And the number is growing, as commercial surrogacy is legal.

Ever since India legalised commercial surrogacy in 2002, IVF centres have multiplied, attracting aspiring parents from around the world, says Sanjay Agarwal, chairman of SATYA, an advocacy organisation for surrogate children’s rights.

The low cost of infertility treatment in India — nearly one-quarter of the cost in developed nations — and the modern assisted reproductive techniques available here make India a top choice for infertility treatments, according to the Indian government’s medical tourism website. The Confederation of Indian Industry (CII) predicts that commercial surrogacy will be a $2.3 billion industry by 2012.

Of course, the western Indian state of Gujarat has become the unofficial surrogacy capital of the world. Many aspiring surrogate mothers like Chandini travel to Gujarat from faraway poor states, driven by their desperate socio-economic situations.

Dr Nayna Patel, who became the face of the Indian surrogacy industry when Oprah Winfrey profiled her and her Gujarat clinic, Akanksha Infertility Clinic, in 2007, says the money earned from being a surrogate mother transforms lives.

“It’s only for our financial difficulties that my husband lets me do it,” Chandini says. Another social reality nudges women towards this “work”. Chandini sighs as she says “daughters mean burden” in India. She, of course, refers to the steep dowry that many families must pay their daughters’ husbands when they get married.

But while the money may come handy, Manasi Mishra, head of a surrogacy study at the New Delhi-based Centre for Social Research (CSR), says that surrogate mothers’ lives aren’t improved that much financially. Moreover, surrogacy also raises legal concerns, says Ranjana Kumari, the centre’s director, as there aren’t legal provisions to protect the surrogate mother, child or parents-to-be.

According to CSR’s surrogacy study, the majority of surrogate mothers dislike the way clinics treat them. Women are often coerced into repeated inseminations if the first one fails; they are not allowed to meet the receiving families and they are paid only after relinquishing the baby to the clinic.

SATYA’s Agarwal talks of another danger. He says health care conditions in India also make it a risky process for women, who tend to have children of their own to care for.
“Is it ethical for a country like India, which has one of the worst maternal mortality rates in the world, where a woman dies during childbirth every seven minutes, to promote and allow commercial surrogacy?” he asks, adding, “If the woman dies or suffers long-term serious consequences because of the surrogate pregnancy, then who is going to take care of her own biological dependents?”

Kumari points to the social ramifications of commercial surrogacy. Although Western cultures accept it, traditional Indian values condemn it. “A surrogate mother can face many levels of violence, including social ostracising,” she adds. Chandini confirms that she doesn’t tell people — not even her children — that she’s a surrogate mother.
But Patel disagrees with the critics. She says, “All the reputed IVF clinics have been following many guidelines. Who says that surrogate mothers are exploited?”

As for the social implications and potential pain of giving up one’s baby are concerned, Patel is quick to add, “Akanksha has specialised counselling programmes for the to-be surrogate mother. She is made to meet the commissioning parents, too. And, of course, she is taken good care of.”

The Indian Council of Medical Research has drafted a bill to govern surrogacy. “The bill will take some time to become a law,” says Dr RS Sharma, a member of the drafting committee.

Despite all these measures, Chandini says being a surrogate isn’t easy, but she has few other options. “It takes a heart to give away a baby you feel growing in your womb for nine months,” Chandini says. “It’s what being poor makes you do.”