Inside the Dark Realities of the International Surrogacy Industry

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Photo: Benjamin Lanpher and Ryan Nethery/VICE/HBO

In the latest Vice for HBO documentary, Outsourcing Embryos, correspondent Gianna Toboni traveled to India to report on the booming gestational-surrogacy industry. Commissioning couples from the U.S. and Europe use Indian surrogacy agencies because they’re as much as six times cheaper than Western alternatives. Surrogacy companies claim to offer opportunities for women to escape poverty, promoting international surrogacy as a win-win for everyone involved.

But, Toboni and her team quickly expose the dark underside of an unregulated and dangerous industry. Women are routinely recruited from slums, made to sign contracts they can’t read, before spending a year living in a facility. Once the baby is born — via cesarean section so that doctors can maximize births per day — the surrogate is sent home, often without the full compensation she was promised. We spoke to Toboni about the lives of surrogate women, how the industry can improve, and the emerging black market for “extra” babies.  

Do you think the American and European commissioning couples that use these Indian surrogacy agencies really don’t know what’s going on?
There are cases where American couples feel a little strange about what is happening, and the ethics of it, but turn a blind eye because they don’t want to pay the higher rates in the States. Many couples don’t want to know what’s behind the scenes, they want their baby fast, and they want it done cheaply. At the same time, there are couples who have an ongoing relationship with the surrogate and are very involved in making sure she’s making a choice and not simply being exploited.

At one point you go undercover to explore the extremely cheap and rather questionable surrogacy organizations. I couldn’t tell if you were able to find these agencies because of your team’s investigative skills or if they’re regularly being used by American couples.
That’s something I was wondering initially myself. So when we got to these seedy agencies with poor practices, I’d say something like, “I’m a little bit nervous, do Americans use your organization?” And they said yes. There was one guy, who ended up in the episode, and not only did he say yes, but he pulled up their profiles on Facebook and showed us the babies that had been gestated by his surrogates. It wasn’t like they were just boasting about their business; they had social-media proof. If you’re an American, you want to pay a cheap price, unfortunately, and you can find these places. We just showed up at the door and knocked.

Photo: Benjamin Lanpher and Ryan Nethery/VICE/HBO

There’s such dramatic income disparities and power dynamics at play with international surrogacy. To me, it seems inherently problematic, but do you think there’s a way it could be done right?
I do think there’s a way to do it right. The Indian government just hasn’t passed regulations that would allow this to be a safe industry. More regulations and increased effort by couples would help. It’s the responsibility of the couple to really research and see what kind of pressure their surrogate is under. I asked one woman when she was on the delivery table about to give birth if she was ever afraid she could die during childbirth. She said, “Yeah, I know that’s a real possibility.” The surrogates understand what the situation is medically for them, but it doesn’t seem like the commissioning couples do. The medical facility is good and clean, but at the same time, these women are risking their lives.

Right now, the surrogacy industry is anything goes, which is really scary. There was legislation proposed in India in 2010, it just hasn’t been passed. We didn’t see anyone receive poor medical service at the clinics we were able to visit. At the same time, there’s no limit to how many embryos can be implanted. Doctors have been known to insert more than one or two embryos to increase the chances that the woman will get pregnant without losing time or money. The commissioning couple may only want one baby, so sometimes, when more than one baby is born, the couple isn’t told, even though it’s their genetic offspring. As you can see in the documentary, I was offered one of these babies from the black market.

Were you surprised by the black-market industry surrounding these “extra” babies?
I wasn’t surprised that it existed, but I was surprised by how easily we were able to find it. We did a lot of research and spoke to a number of experts before we went, and we’d heard rumors that there are extra babies and orphanages of white babies in India. We didn’t find any orphanages, but then, when a couple offered me a baby for sale over dinner, it was shocking.

Photo: Gianna Toboni/VICE

Do you find it difficult to maintain the journalistic remove required to do a job like this?
That situation in particular, when I was undercover and offered that baby, was the most heartbreaking experience I’ve ever been a part of. It was terrifying how aggressively they were pushing this baby on us. They even offered to let us make a down payment so we could take it home in a few days. I’m sitting there thinking, I’m sure I could find someone to raise this baby. But it’s also highly illegal and you just can’t. Vice doesn’t require the colder, more removed affect we’ve come to expect from investigative work. You can sit there and say, “This is really fucked-up and I want to take this baby so it’s safe.” To not be able to authentically react to what I’m seeing would do a disservice to the content. I’m a journalist, but I’m a human being first.

One thing that often happens with these internationally reported stories is that journalists go in, do the investigative work, interview people on the ground, and then produce something that those people never see. Do you make an effort to show participants, like the surrogate women, the role they have in exposing this story?
For sure, when people give us their time and tell their story, which is often taking them away from their family or their work, it's important we show them the final product.

We definitely create links and in some cases export DVDs to people overseas. Not everyone has access to HBO.

This interview has been edited and condensed.