Wombs in Labor is an absorbing and meticulously researched work. Amrita Pande fruitfully scrutinises the minutiae of interactions among surrogates and the community of a clinic for their underlying meaning, writes Marion Koob

Koob, Marion

LSE Research Online

16/02/2015Book Review: Wombs in Labor: Transnational CommercialSurrogacy in India by Amrita Pandeblogs.lse.ac.uk /lsereviewofbooks/2015/02/16/book-review-wombs-in-labor-transnational-commercial-surrogacy-in-india-by-amrita-pande/Wombs in Labor is an absorbing and meticulously researched work. Amrita Pande fruitfully scrutinises theminutiae of interactions among surrogates and the community of a clinic for their underlying meaning, writes MarionKoob.Wombs in Labor: Transnational Commercial Surrogacy in India.Amrita Pande. Columbia University Press. 2014.Find this book:Parvati is a nurse. She wanted to be a teacher but did not finishmiddle school. One day, a doctor at the hospital where she workstold her about surrogacy – carrying another couple’s child throughpregnancy. She went to a fertility clinic, where a couple from NewZealand was willing to pay $5,000 for her to bear their child, anamount worth approximately 50 times her household’s monthlyincome. She and her husband had hesitations, namely about thehealth risks involved and the social stigma which surrogacy stillrelays – but they agreed to go ahead. The money will help save on acrippling monthly rent and pay in part for building a house.In recent years, the business of surrogacy has boomed in India, inthe fold of a huge growth in medical tourism.  Many foreigners aredrawn to the country for surrogacy due to the lack of regulation in thisdomain. Yet, its ethical ramifications have sparked an on-goingdebate in the media. Surrogates are typically required to live indormitories for the duration of the pregnancy, under a strict regimeand the careful watch of doctors and nurses. This conjures visionsreminiscent of the world of dystopian fiction, of Margaret Atwood’sThe Handmaid’s Tale, or of Lois Lowry’s The Giver.Wombs in Labor: Transnational Commercial Surrogacy in India by Amrita Pande is an ethnography of one of thecountry’s very first fertility clinics. Made up of interviews of “fifty-two surrogates, their husbands and in-laws, twelveintending parents, three doctors, three surrogacy brokers, three hostel matrons, and several nurses” andcomplimented by participant observation, the study is an intimate analysis of the lives sustained by this trade. AmritaPande discusses its subtleties of power; the use of divinity as a rationale for surrogacy; the absurdity of a prosperingfertility business in a historically anti-natal state.Armaan Clinic (a pseudonym) manages pregnancies to the minutest detail in order to ensure their success. InChapter 4, “Manufacturing the Perfect Mother-Worker”, Pande shows how this control is exercised on surrogates. The perfect surrogate is formed through the creation of two conflicting identities. The first, ‘mother-producer’encourages surrogates to behave with care and nurturing towards the baby they carry.Good ‘mother-producers’ stay in clinic hostels, although this means living far away from their own family. There, theyparticipate in scheduled activities such as classes in English and computing, which facilitates communication with1/3clients about the pregnancy. But most crucially, ‘mother-producers’ must be selfless, and thus not negotiate paymentwith clients.The contrasting ‘worker-producer’ identity incites surrogates to work to contract and give the baby up at birth withoutprotest. Breastfeeding is not allowed in order to prevent attachment to the child. The disposability and transience ofthe surrogates’ role is stressed. “They are just wombs,” comments a clinic employee.The interplay of these two is repressive, Pande argues. At recruitment, the clinic accents ‘mother-worker’ ideals.Women are persuaded to sign up by means of their fear of being a ‘bad mother’ by not providing adequately for theirown children. Because mothers are also selfless, they are expected to accept whatever payment is offered to them.This has resulted in a wide disparity in how women are remunerated. At the time of study, rewards ranged from$2,000 to $8,000. Discouraging bargaining is also a stark choice when, as of December 2011, the clinic had awaiting list of two hundred parents.This chapter’s only limitation is the specificity of its evidence. Pande extrapolates some of her arguments from thetestimonies of two or three clinic employees or associates, and here the reader is left wondering whether differentcharacters would translate to wholly distinct realities in comparable clinics.Surrogates make efforts to resist the inordinate amount of control exercised on their bodies during their pregnancy.This is within the context of the Indian Government’s anti-natal policy, whose rules governed their experiences ofreproduction prior to Armaan. Chapter 6, “Embodied Labour and Neo-Eugenics”shows that surrogates do reclaimpower over their bodies, but ultimately in meaningless ways. Pande argues that despite small victories, the balanceof control does not alter.The Indian Government’s anti-natal policy advocates controlling women’s fertility for the sake of modernity andrationality, promoting birth control as a means to enhanced health, rather than women’s greater autonomy. Part ofthe programme is a ‘two-child’ norm, which presses women to use a permanent contraception method after theirsecond child. Tied into this are subsidies, educational benefits, and consumer products. Women with more than twochildren are banned from running in some elections, and the provision of some health benefits is linked tosterilisation. The policy communicates to women that their fertility is wasteful, and the source of their poverty.Surrogates resist this pressure by directing their capacity to bear children towards productive means.Yet the underlying dynamic remains the same. While surrogates derive financial value from having children, they arereducing their own fertility to the advantage of someone else’s.Pande cites the example of Naseem, a surrogate who had difficulty conceiving a second child. When she eventuallydid become pregnant, her husband lost his job, causing a financial distress which led her to having an abortion, andthen becoming a surrogate. Several women Pande interviews interrupted their own pregnancies to carry surrogaciesinstead. Others deliberately chose not to try to conceive in order to do the same.Pande contends that this results in a stratified reproduction system, in which low-income or poor women are drivento have children for the wealthy, instead of for themselves. And while the Indian government champions fertilitytreatments as part of medical tourism, they push those poorer to permanent sterilisation, and small families. Theauthor qualifies this as neo-eugenics. This chapter is haunting and persuasive. Pande uses a wealth of resourcesand perspectives to support its case. It could only have been improved by further interviews with clients, who wouldhave added an interesting voice within the neo-eugenics argument.Wombs in Labor is an absorbing and meticulously researched work. Pande fruitfully scrutinises the minutiae ofinteractions among surrogates and the community of the clinic for their underlying meaning. Her findings areanchored within a wide range of literature: the sociology of labour, body and divinity, and she expands on existingtheory while making connections to comparable cases. Unlike many academic writing, this enhances rather thanhinders the flow of the book.2/3In addition, Pande comments on recently proposed legislation in India on surrogacy. She advocates for a greaterprotection of surrogates’ rights, envisaging an international model of fair-trade surrogacy.Wombs in Labor is recommended to anyone interested in the subject of surrogacy and will please all readers.Marion Koob has a BSc in Government and Economics at the LSE and and MPhil in International Relations at theUniversity of Cambridge. She has worked in Polis, the LSE’s journalism think-tank, and is now at the British FilmInstitute. Read more reviews by Marion.Copyright 2013 LSE Review of Books3/3

Book review: wombs in labor: transnational commercial surrogacy in India by Amrita Pande

Abstract

Similar works

Full text

Available Versions

LSE Research Online