Pregnancy without Borders: Reproductive Tourism's Global Reach

Posted by Marcy Darnovsky on September 28th, 2010 Tao

Because reproductive tourism is not tracked or monitored - let alone regulated - there is little reliable information about the numbers of babies, surrogates, contracting parents, or dollars involved. But recent media coverage and two upcoming conferences suggest that it has become a global growth sector. Commercial surrogacy is apparently seen as a business opportunity in many locales where public policy is lax and contract pregnancy comes cheap.


With many hundreds of fertility clinics offering fertility services to people from other countries, India remains the global capital of reproductive tourism. And the competition is encouraging innovation. According to the Times of India, clinics in the Gujarati city of Ahmedabad now offer mail-order surrogates.

Aspiring parents no longer need to show up except to take delivery of a child. Instead, they can use either their own or purchased gametes to have embryos produced in a clinic near home, and send them by courier to an Indian facility where they are transferred into a surrogate. The Times explains that "[b]usy childless couples and even singles who cannot afford to take extended leaves are now shipping their children-in-the-making to state clinics to be implanted in the wombs of surrogates."

A recent article on the Indian surrogacy industry in Slate emphasizes the class and cultural divide between intended parents and the surrogates they hire. The surrogates are typically "cash-strapped [women] from rural India [who] travel to metropolitan centers to offer their services as a last-ditch effort to get money." Some see this as an exercise of women's agency and choice. Slate reporter Amana Fontanella-Khan differs:

To exercise one's freedom meaningfully requires information and education, and many surrogates are deeply ignorant about what the procedure entails. It is not uncommon for surrogates to authorize contracts with a thumbprint as opposed to a signature because they are illiterate. Even those who are literate often aren't able to read the contracts, which tend to be written in English.
A three-part series in RH Reality Check [1, 2, 3] makes a similar point:
[T]he contexts of poverty and gender inequality in which [reproductive tourism is] taking place underscore the troubling elements of international surrogacy as a family-building strategy.

Another critical perspective on India's booming reproductive tourism industry is offered by Memorial University Faculty of Medicine Professor Shree Mulay on Radio Canada International.

While women's health advocates tend to focus their concern on the well-being of surrogates, many media accounts (1, 2, 3) have centered on the plight of contracting parents from countries that prohibit or restrict commercial surrogacy, and who therefore ran into problems getting their home countries to grant citizenship to their newborns. In July, the consul generals of eight European countries sent letters to a number of Indian IVF clinics that cater to Europeans, asking them to desist from initiating any surrogacy pregnancies for citizens of these countries who had not previously conferred with their consulates about the laws in their home countries.

Other destinations for reproductive tourism

As Biopolitical Times noted in June, RH Reality Check has reported on the emergence of reproductive tourism in Guatemala. Surrogacy contracts there are being arranged by some of the same people formerly implicated in Guatemala's highly troubling international adoption practices, which according to one child rights advocate amounted in some cases to children being "manufactured" to supply the system. And the "labor force" - the women who relinquish babies they have borne - will be drawn from the same impoverished communities in a country that the UN recognizes as having the greatest gender inequality in the Western hemisphere.

Other destinations for commercial surrogacy reported in the news stories include Argentina and Spain. Fertility Argentina holds "patient conferences" in New York City, and advertises "affordable egg donation" in Argentina. Its website also offers a "Personal Concierge [who] will assist you in all of your needs and requirements with specific solutions, before, during and after your stay."

And in China, commercial surrogacy has taken on the trappings of fertility tourism within the country. According to an article in the English-language Xinhuanet, "Most would-be surrogates come from small or medium-sized cities or rural areas and almost all have financial problems."

Upcoming conferences

The thriving business of surrogacy is reflected in two upcoming conferences. Both prefer to call their topic not "reproductive tourism" or "fertility tourism" but "cross-border reproductive care."

On November 24, the UK organization Progress Educational Trust (PET) is  holding its annual conference, this year titled "Passport to Parenthood: The Evidence and Ethics Behind Cross-Border Reproductive Care." The event is supported by Merck Serono, a division of the pharmaceutical giant. According to Lobbywatch, PET "was established to promote the benefits of reproductive and genetic science" and "is very closely linked with the pharmaceutical industry."

And this coming March 24-27 in Florence, the new trade group Society of Cross-Border Reproductive Care is holding its second annual congress, "An International Conference on the Global Quest for a Baby." Topics include "Cross-border gestational surrogacy: providing opportunity or exploitation of the poor?" and "Worldwide gamete donation: fulfilling an undeniable need or a form of organ trafficking?"

Those are good questions. Let's hope that those running fertility businesses and groups closely linked to the pharmaceutical industry aren't the only ones providing answers.

Previously on Biopolitical Times:

Posted in Assisted Reproduction, Global Governance, Marcy Darnovsky's Blog Posts, Reproductive Justice, Health & Rights, Surrogacy


Comments are now closed for this item.

  1. Comment by Sandy Starr, Oct 4th, 2010 7:05am

    Thank you for mentioning the Progress Educational Trust (PET)'s forthcoming conference 'Passport to Parenthood: The Evidence and Ethics Behind Cross-Border Reproductive Care'. I just wanted to correct the misleading quotation from the Lobbywatch website concerning PET's objectives and funding.

    PET's fundamental objective - as set out on our website at - is to create an environment in which ethically sound research and practice in genetics, assisted conception, embryo/stem cell research and related areas will thrive. PET's Patron, Baroness Mary Warnock, is in fact the person who (in 1984) pioneered the framework via which fertilisation and embryology are regulated in the UK.

    While it is true, as mentioned in this piece, that PET's forthcoming conference has received (welcome) financial support from Merck Serono, PET does not have especially close links with the pharmaceutical industry. In fact, PET has received little or no funding from the pharmaceutical sector in recent years.

    PET's actual sources of funding are easy to discover. Not only is PET obliged, as a registered charity, to make its annual reports and accounts available available via the website of the UK Charity Commission at but in the interests of transparency these annual reports and accounts are also available in full on the PET website. See:

    Sandy Starr
    Communications Officer, Progress Educational Trust

  2. Comment by Robert Dingwall, Oct 1st, 2010 1:26am

    Isn't it time we stopped using the pejorative label 'reproductive tourism'? This is a very loaded term that obscures the great variety of motives for which women, and their partners, cross national boundaries in search of assistance with conception. Some of these motives may, indeed, be trivial, but, for many, this is also an act of desperation in escaping oppressive regulators in their own countries, like the HFEA in the UK. Should we necessarily expect a global agreement on regulation and isn't it better to have different countries offering a variety of regimes that recognize and respect the diversity of human needs. While this should not stop us from criticizing overt exploitation, as in the case of surrogacy and oocyte sales in some poor countries, should we not resist the attempts to globalize national jurisdictions, where citizens are fleeing from their results? In what other field do we argue that people should be imprisoned within their national borders when faced with a legal regime that they find intolerable but others do not? Within the EU, for example, free movement of citizens is a fundamental principle. Should this be compromised because of national differences in approach to regulation? UK citizens traveling to Spain in search of anonymous gametes, for example, cannot well be characterized as 'tourists' and it is absurd for the HFEA to engage in black propaganda that suggest Spanish health care is generally inferior to that offered in the UK.



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