Saturday, March 24, 2007

There are mother's days and there are Mother's Days. A day that really goes back to Greek and Roman times, and universally has a lot of relevance, irrespective of religion or culture.

Today, all that is visible and emphasized by the super commercialised society we live in, is the various ways you show your appreciation to your mother; and most of the times, it is restricted to buying gifts, at sales, advertised weeks in advance, or taking your mother out for a great meal. And the retailers and restaurant industry folks go laughing all the way to the bank.

In the midst of all this hoopla, there are some people , who have missed the bus , so to speak, while endeavouring to become mothers. Advanced ages, medical reasons, inability to carry a pregnancy to term, mental unwillingness to considering adoption as an option, abnormal attention to career matters at a younger age, putting child bearing/rearing/family matters etc , very low on the priority list; all these have today forced several couples to seek other avenues to become parents.

There is something to be said for having a child at an age that you are optimally designed to do so. The world over, people in different strata of society, different levels of financial security, and different family situations and conveniences, have children, and bringing a child up , to the best of ones ability, facing problems, attempting to surmount them, teaches one a lot about, existing in set of people, with varying personalities and habits, stress handling, respecting age and privacy, and we become all the richer for it, in people terms, if not dollar terms.

Today, with advances in medical technology, we are now celebrating the teenage of the first test tube baby, and going in for In vitro fertilization (IVF) techniques hs become a common thing.

Another thing that seems to be taking hold is the concept of Surrogate Motherhood. In all the buzz about what is lawful, what is unlawful, should we ban it, should be allow it, is it ethical, is it non ethical, folks seem to be confused about whether the emphasis should be on the "Surrogate" aspect or the "Motherhood" aspect.

Surrogacy itself is not new. Tales of surrogate mothers and intended parents can be found in Roman plays and the Holy Bible. Throughout history there have been many cultures where a relative carrying a child for an infertile relation was not uncommon.

Surrogate Motherhood, as such, came into public prominence with the controversial widely-publicized "Baby M" case in 1986. A lady by the name of Mary Beth Whitehead agreed to carry a baby to term, for a couple, and then waged a custody battle for the same child, unsuccessfully. Mary Beth, was what is termed a "traditional surrogate", or a surrogate mother who is genetically linked to the child.

Since that time, medical advances have now allowed "traditional surrogacy " to be replaced by "gestational surrogacy". In the earlier case the child was related to the mother genetically. In the Gestational case, the surrogate mother is smply the carrier of the child, and the sperm and ova belong to the parents of the child, who may be totally different people.

Being genetically related to the child often results in a lot of psychological problems to the birth mother, the new family, and sometimes , as a result, even to the child, should the problems persist into his/her childhood. Gestational surrogacy, makes things slightly less complicated. Research reveals that the predominant feeling that the Gestational surrogate mothers bear is an altruistic feeling , towards the childless couple. It is their child/embryo, and by carrying it , she is providing a safe, healthy environment , for the growing foetus, that the actual genetic mother cannot provide for various reasons. This has resulted in cordial and sometimes excellent long term relations between families.

Unlike adoption of a child, surrogacy legislation is not so well developed today. Severeal states have their own rules on whether to allow it, and to what extent. its still a fairly unregulated field, and experts say that number of babies born through surrogacy every year could actually go into hundreds.

There are several agencies that have come up that match clients to potential surrogate mothers. These are not fly-by-night spurious things, but proper places, staffed with doctors, lawyers, and mental health professionals. web search indicates at least 80 surrogacy programs or centers functioning across the country.

The main question one may have , is about the cost of surrogacy. What does it cost to have a surrogate mother carry a child to full term? Legal, medical, psychological, and administrative fees to an infertile couple can easily top $50,000. The surrogate mothers need to take hormone injections everyday for four months, for example, and several ultrasound and other tests are routinely required to monitor the progress. The possibility of twins and triplets is high. the commitment of the gestational surrogate mother has to be outstandingly high; today the demand still far outstrips the supply, and the Los Angeles center (Center for Surrogate Parenting and Egg Donation in Los Angeles), has a big waiting list.

Is surrogate parenting being done simply for love and altruism ? The answer is no. The surrogate mother is adequately compensated for her time, effort,dedication, and commitment, and several healthy experienced mothers, who have had early healthy pregnancies have participated in surrogate motherhood activities of the gestational kind. They have put aside a nest egg for the education of their existing children, or used the money for some other important family reason such as someones serious illness etc.

Speaking of waiting lists, can outsourcing be far behind ?

The answer is a resounding NO.

The Nagla family , an Asian family in London found that they were unable to have children. After four years of marriage , Lata the daughter-in-law was unable to get pregnant. All kinds of treatments, medications, etc had absolutely no effect. This whole thing, tended to actually tear the very traditional family apart. A test tube baby was considered, but was finally ruled out by the doctors.

They finally decided on the surrogate mother system, but found the costs in England to be too prohibtive.

Fortunately for them, as is the custom in families in India (from where they hailed), the extended family was able to get the contact of a Clinic and the Doctors where these specialised treatments were conducted. Dr Nayna Patel, who specialsed in these treatments, suggested that someone from the extended family itself, be the gestational surrogate mother. She felt it would be nice for the babies to have someone from the family carry them. The brides mother, after a lot of encouragement from her own family and the grooms family, decided to offer herself as the surrogate mother.

The first attempt at implanting the embryo failed. The second was a success. Grandma carried the grandsons to full term, and delivered two great healthy babies. The genetic mother was overjoyed to have her own mother carry the babies, and her in-laws think that this is a very great and wonderful effort on the maternal grandmothers part. There is an immense amount of respect for the surrogate mother within all the families. Today, the twins are happy and growing up in Ilford England.

Not everyone has such co-operative relatives, but to a lot of women in India, the concept of gestational surrogate motherhood has come as something that can help their families to a better future.

A year ago, a couple flew down from London to this dusty, unremarkable town of Anand in India's Gujarat State, where Dr Patel has her Clinic, to choose a surrogate mother. They were part of a growing number of childless foreigners beating a track to India, drawn here for many of the same reasons that have made India a top destination for medical tourism: low costs, highly-qualified doctors, and a more relaxed legal atmosphere.

The finances, actually tell why these things work. In the US, surrogate mothers are typically paid $15,000, and agencies claim another $30,000. In India, the entire costs range from $2,500 to $6,500. Getting $2800, say, for a surrigate motherhood effort is a big sum by Indian standards.

Despite the urge to shout "Expoiltation!" , this needs to be viewed in non financial terms. It is, for example, not the same as donating a kidney, or an eye. Dr Patel, who runs her Anand Clinic, says "A nine-month pregnancy can never be forced; beyond the commercial angle, having a child is a deeply emotional issue."

The Centre for Family Research at Cambridge University did research on the mental attitude of surrogate mothers post the-baby, and found that British surrogate mothers did not suffer major emotional problems , and the initial natural feelings sort of settled down as time elapsed.

"Many surrogate mothers see this not as 'handing over' the baby, but as 'handing back' the baby, as the baby was never theirs to keep." says Dr Nayan Patel of the Fertility Clinic in Anand.

Each day, dozens of inquiries from India and abroad inundate the clinic. Parents and prospective surrogates are carefully screened and counseled by the clinic, and both parties must sign an elaborate legal contract that signs over the surrogate mother's rights to the baby and underlines the financial terms.

Being a surrogate mother in India is not easy. Moral pressures, and your position in your society need to be considered. Neighbours may not understand, you may be socially boycotted and/or abhorred. Sometimes the mothers move to a different town for the duration of their pregnancy, and come by only for checkups with the clinic.

And its not as if, advanced countries with "advanced" ideas of morality and social behaviour are supportive of surrogate motherhood, whether gestational of traditional. Today, Sweden, Spain, France, and Germany. do not allow it. Other countries such as South Africa, the UK, and Argentina, have ethics committees that look at each case and decide whether to allow it or no.

Critics exist. Armchair and otherwise.

They call it "commoditisation of motherhood" and an "exploitation of the poor by the rich.".

While it is true that the poor benefit financially, and offer what is called by non-sensitive types, as a "rent-a-womb" service, there is a social dimension to all this. Irrespective of whether the surrogate mother is rich or poor, particularly in the cultural, multireligious ethos of India, there is a great empathy for the childless couple's situation, reproduction is viewed as a sacred obligation, and is considered that all the good you do for others in this life , is always rewarded by God.

At the end of the day, irrespective of which country you hail from, a mother is a mother, helping someone else become one.

History is replete with instances of wet-nurses; lactating women functioning as nursing mothers for babies, where the birth mother had no milk, or sometimes, surprisingly, no interest or no time to feed the child, typically in royal households through the ages.

Laws will come, debates will be held, God will possibly be invoked. Oprah might have several programs dedicated to this. Brangelina might even show their support for this in some way by donating maoney . Prominent people will take prominent positions on this. Folks may even invoke Mom and apple pie. In a country where same sex marriages are subjects of legislation, in various states, its a matter of time before surrogacy becomes an issue, and someone flogs the "outsourcing" aspect as a political issue.

In the meanwhile, on the second Sunday in May, while you take your Mom to dinner with the wonderful card from Hallmark and a bouquet of roses, not to speak of the fantastic present you got her, spare a little thought for those surrogate mothers, who give nine months of their time, care and dedication, so that someone , who actually dreamt of children, may now actually have them......

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