Abstract
Transnational surrogacy has captured the attention of social scientists interested in the thorny ethical dimensions of globalization. India has been the epicenter of the transnational surrogacy industry and the focus of social science studies on the topic. In her book, Discounted Life: The Price of Global Surrogacy in India, Sharmila Rudrappa provides fresh insights into the tensions between the unequal exchange inherent in this particular “market in life” on one hand, and the fact that the Indian women whom she studied opt to become surrogate mothers repeatedly and some claim that it enhances their social worth, even though they are acutely aware of the ways in which their lives as surrogates are “discounted.” For Rudrappa, the key to understanding this apparent contradiction lies in appreciating the broader reproductive, political, economic, and cultural context of working-class women’s lives in the South Indian city of Bangalore where she carried out most of her research.
Rudrappa’s ethnographic approach to studying transnational surrogacy allows us to appreciate this phenomenon primarily from the perspective of Indian surrogate mothers themselves and, to some extent, from the parents using the surrogate services. This helps to debunk two dominant narratives about transnational surrogacy. First, she refutes the simplistic mainstream media narrative that transnational surrogacy is an unabashed form of exploitation by privileged White men and women from the global north over desperate destitute ignorant women of color in the global south who have no control over their destinies and are duped and forced to engage in the highly stigmatizing practice of surrogacy. Contrary to these Orientalist representations, Rudrappa’s nuanced account sheds light on the agency of surrogate mothers as they carefully consider their options before entering into this new labor opportunity. At the same time, she also considers how the severe social stigma of childlessness and its resulting discrimination, compels infertile and gay couples from around the world to consider affordable, legal, and technologically advanced surrogacy arrangements in India. Second, Rudrappa challenges the marketing narrative of the surrogacy agencies which are repeated by most commissioning parents that this is a win–win relationship. Indeed, she is clear throughout that she considers this to be an unequal relationship and shows that even surrogate mothers who have reasons for entering into a surrogacy contract, do not consider this to be a fair exchange. They are aware that they are not getting the better end of the stick; some are even trying to rectify this by establishing their own surrogacy cooperatives. Nevertheless, they consider surrogacy to be beneficial to them and to the future of their families when considered in the context of other options available to them.
A self-described “feminist labor sociologist,” Rudrappa situates this emergent form of labor within the context of other forms of gendered labor that are otherwise available to working-class women in Bangalore. This makes her work distinctive. Her research reveals that contrary to global media assumptions, surrogate mothers are not recruited from destitute populations living in abject poverty in India, because the bodies of extremely poor women would be physically compromised and would not be well suited for the job of carrying out gestation services. Rather, the vast majority of surrogate mothers in Bangalore come from working-class communities. They have previously worked in or were planning to work in the globalized garment industry that supplies clothing for companies such as the Gap, Levi’s, and Abercrombie and Fitch. As they weigh their options between work in the garment industry versus work in the transnational surrogacy industry, these women often conclude that the latter is the better deal.
To appreciate this evaluation, Rudrappa articulates women’s long list of critiques of the garment work. They report that work in the garment industry is physically exhausting, repetitive, back-breaking labor for which they are paid less than men and are often forced to work overtime without remuneration. They feel that work in the garment industry severely imperils their health, and they are also expected to perform the second shift of unpaid labor for their households when they return home from work. They complain that in the garment industry they face unremitting sexual harassment by their male superiors, only to return home to be harassed by husbands and in-laws who accuse them of promiscuity, particularly when they work overtime but have no pay to show for it. They do not take much pride in the parts of clothing they are producing and do not feel that their labor in the garment industry significantly improves their social worth.
By contrast, women argue that their work as surrogate mothers enhances their social worth because, although it is stigmatizing, they feel that they are producing something of great value and that, as women, they are uniquely capable of this labor. Although they are very aware that the labor they perform through surrogacy takes a major toll on their bodies and health (not only because of the pregnancies but also because of the hormone treatments and the mandatory cesarean sections), they consider it to be physically less demanding than the garment work, particularly given the fact that they stay in surrogacy dormitories where they are provided with nutritious food and lots of rest.
Rudrappa adds an important contribution to the literature on surrogacy in India by also pointing out that the bodies of lower and working-class women in India have long been the object of reproductive health medical interventions through government and transnational NGO population control initiatives, which have compelled women to undergo sterilizations. These programs have used monetary incentives and punishments to meet birth control quotas in the name of reproductive choice. These longstanding practices have normalized the assumptions that women’s reproductive bodies are easily available to medical interventions such as surrogacy. Surrogate mothers themselves sometimes naturalize such assumptions and consider the medical interventions through surrogacy to be another way to manipulate their reproductive bodies for the greater good of society. The surrogacy agencies in India typically only give contracts to women who have had children and have been sterilized. Most working-class women in Bangalore meet these criteria.
Furthermore, the surrogate women Rudrappa interviewed take pride in the lump sum of cash (usually US$4000) that they can earn from their work, an amount that the men in their families are not able to earn. They do not feel as though this income is as life-changing as the commissioning parents and surrogacy agencies who subscribe to the win–win discourse make it out to be. It is money that helps them and their families to have a modicum of economic security in the context of economic precarity. It is not that surrogate mothers feel as though this is unequivocally dignified and empowering work. For example, they condemn the fact that they are not allowed to breastfeed the newborns but are forced to use machines to pump their milk for the babies every 2 hours like cattle. And they know that the US$4000 they earn does not represent the full value of their work. Nevertheless, in weighing their options, they often conclude that it is a wise decision.
Rudrappa’s ethnographic representations of parents from around the world who engage the services of Indian surrogate women also add to our understanding of what motivates people to engage in transnational surrogacy, despite the negative media representations of them. In some cases, however, these examples are culled from blogs of commissions parents. We are, therefore, not able to fully appreciate the broader sociocultural contexts of their lives that drive them to make this decision with the same kind of sensitivity that Rudrappa has shown when discussing Indian women’s comparisons between garment work and surrogate work. Furthermore, although she reflexively considers the ethics of conducting her research with the surrogate mothers, we do not find the same kind of reflexivity when it comes to her use of quotes from blogs and emails of commissioning parents which would have been helpful.
Overall, Rudrappa’s book provides highly respectful and sensitive insights into the social-cultural context of the decision-making practices of surrogate mothers and others engaged in transnational surrogacy. Her approach leads her to aptly conclude that the discourse of reproductive justice with its emphasis on the need to address and transform structural constraints offers a better framework of analysis of transnational surrogacy than the discourse of reproductive rights with its emphasis on leveraging and celebrating individual choice. While the theoretical and philosophical distinction between justice versus rights could have been fleshed out more clearly and deeply, it is made evident through the compelling ethnographic examples provided throughout the book. Discounted Life is clearly written and is appropriate reading for both undergraduate and graduate courses. It makes an important contribution to the social science of reproduction, medicine, and gendered labor in the context of globalization and should be required reading for anyone involved in transnational surrogacy services and policy.