Envisioning relational reproductive justice in surrogacy: Recognising the invisible experiences of intended parents

Abstract

India has become notorious as a multibillion-dollar surrogacy industry. This industry flourished when India allowed commercial surrogacy and attracted many international intended parents to engage with widely available Indian private fertility clinics to achieve parenthood. This industry raised legal, ethical, social, moral and political issues due to cross-border travel for reproduction and the wider socio-economic gap between Indian surrogate mothers and international intended parents. Consequently, Indian surrogacy gained much attention in policy, media and research, which identified surrogacy as a cause of exploitation, commodification and injustice for surrogate mothers and children born via surrogacy. This led to the announcement of ban of commercial surrogacy in India in 2016, which stopped not only internationals but also Indian nationals who engage with commercial surrogacy. In policy discussions and academic research much focus is on surrogate mothers, while a specific focus on Indian intended parents is hardly visible. Given the Indian context, where parenthood and childbearing play important socio-cultural and religious roles, there is a need to understand the surrogacy journeys of Indian intended parents. Further, understanding intended parents’ experiences in the wider socio-cultural context is essential if surrogacy is to be and ethical for the ‘surrogacy triad,’ namely surrogate mother, intended parents and child. This is because surrogacy is a relational and mutual process, where all members of the surrogacy triad are dependent on each other for care and trust. Hence, this thesis moves beyond the exploitation and commodification debates and envisions relational reproductive justice which may include ethics of care as a way forward. This thesis contributes empirically to these broader discussions of relational reproductive justice by exploring Indian intended parents’ representation, experiences, and their struggles in light of wider societal structures such as stigma. The present study is conceptualised using reproductive justice framework, the concept of stigma and Foucauldian power theory. Using a qualitative research methodology, I employ two qualitative research methods, namely discourse analysis of newspaper articles and thematic analysis of in-depth interviews of the intended parents. The results from this analysis are triangulated to gain a holistic understanding of intended parents’ experiences. For the discourse analysis, 196 newspaper articles published on surrogacy from 2002-2017 were selected. A Foucauldian discourse analysis of these newspaper articles allowed my analysis to understand the broader societal framing, representation of intended parents and social context in which intended parents experience their surrogacy journeys. Further, I conducted a thematic analysis of eight in-depth semi-structured interviews of intended parents who I interviewed in India from January to May 2018. A thematic analysis informed by Foucauldian power concepts and stigma theory allowed me to understand the intended parents’ stigma experiences, subjectivities and power relations experienced in the wider society. Collectively these two analyses shed light on factors constraining ethics of care and vision of relational reproductive justice. This thesis primarily argues that stigma and commercialisation constrain the potential for relational reproductive justice. Stigma results in invisibility and secrecy of intended parents’ surrogacy journeys and minimal interaction and interpersonal relationship with the surrogate mothers. Surrogate mothers and their relationship with the child also remain invisible and unrecognised. The invisible and lonely journeys of intended parents worsen when intended parents struggle with a commercialised neoliberal fertility market, experiencing a lack of proper health care, economic constraints and implications of frequent surrogacy policy changes. I suggest stigma and commercialisation affect the caregiving and receiving, and the wellbeing of the surrogacy triad. This thesis concludes by proposing the need to achieve ethics of care for the surrogacy triad and addressing stigma by redefining broader societal discourses about surrogacy. This helps in building interpersonal relations, and practice of care and responsibility between the surrogate mother and intended parents, recognising surrogacy as a relational reproduction process, and furthering a just experience for those involved. Encouraging this potential relational and care perspective can allow children to meet their surrogate mothers or donors, recognising surrogate mother’s role in child’s life and in future extending the definition of families.