Crossmedia Flows of Documentary Images and the Transnational Communicative Figuration Surrounding Gestational Surrogacy in India

Introduction

As anthropologist Marilyn Strathern (2002) argues in her article, the interlocking of technological innovations and societal changes is a question our attention is usually only drawn to after this interrelationship has been made visible by the media or other ‘channels of mediation’. Which means that at the time of its becoming a public matter of comment and discussion, the actual innovation is already something which happened in the past and we as non-experts are literally not able to ‘see that prior process of change’ independently (Strathern, 2002, p. 985).

The bio-technological ¹ innovation definitely marked a watershed moment in the recent history of technologically assisted reproduction. The moment and procedure, which is made visible here in the RT documentary Wombs for Rent in India (2015) is called the intracytoplasmic sperm injection (ICSI). The transvaginal retrieval of oocytes allows for the direct injection of sperm into the ova and hence for a fertilisation outside the body. This procedure exists since 1992 and has since then become the standard procedure of technologically assisted reproduction, thereby developing further and increasingly replacing the conventional in vitro fertilisation in which the egg and sperm are manually combined in a laboratory dish. As a result of this repro-technological innovation, up to five persons can now be involved in the process of creating a new baby. The procedure can be done using the so-called intended mother’s own egg cells and her partner’s sperm. Or it may involve eggs, sperm or embryos from a known or anonymous donor. Moreover, in many cases, a surrogate mother or so-called ‘gestational carrier’ is used, who has an embryo implanted in her uterus. As a consequence, the presence and increasingly important role of the sperm donor and surrogate mother—and since the 1990s also the third figure of the egg donor—for the social reproduction of biological and genetically related families all over the world are now hard to ignore. While the altruistic language and terms such as ‘donors’ and ‘surrogates’ conceal the rapid worldwide commercialisation of gametes, it is important to keep in mind that many different forms of non-commercial actual donations of sperms, eggs as well as gestation and delivery of a baby are currently also increasingly practiced in many parts of the world. ² Besides the growing commercialisation, another important aspect which is concealed by the altruistic language of ‘donation’ is the social inequality and hierarchy which has become a defining moment of technologically assisted reproduction since the beginning of the era of commercial surrogacy in the late 1970s (Bernard, 2014, pp. 278ff.). Over a period of two decades, the ‘surrogate mother’ used to be a woman who agreed to carry her own genetic child for another couple. Since the end of the 1990s, however, the new form of gestational surrogacy, in which the surrogate mother has no genetic relationship to the child that she agrees to carry and deliver for the intended parents, has become more and more prominent. As cultural historian, Andreas Bernard (2014, pp. 278ff.) argues that the social inequality and hierarchy between commissioning parents and surrogate mothers increased significantly from the moment when the surrogate was no longer necessarily genetically related to the baby, and the colour of her skin was hence no longer of relevance to the intending parents.

It is indeed interesting to note the time gap between the beginning of the era of commercial surrogacy around the end of the 1970s, and the enhanced public visibility as well as debate about the repercussions of the repro-technological innovations that have led to a new phenomenon called split mother- and parenthood. This holds especially true for the so-called Global South. Together with Thailand, India came to be known as one of the surrogacy hubs in Asia and for more than 10 years, transnational surrogacy was indeed a thriving business in this country. Despite the legal ban on commercial surrogacy in 2015, it has not been terminated completely according to press reports. ³ The assisted reproduction sector in India has been reported as being worth several hundred million dollars or even more than two billion dollars in recent years, depending upon the source. It is rather difficult to measure the commercial value of an industry that had been legal in India since 2002 but never regulated, in spite of repeated attempts to draft and pass a comprehensive ART legislation.

A number of widely circulated and viewed documentary films—such as Google Baby (Frank, 2009), Can We See the Baby Bump Please? (Sama & Sharma, 2013) or House of Surrogates (Rudge, 2013)—have clearly functioned as a starting and major reference point for the debate about the complex issue of assisted reproductive medicine and transnational surrogacy in India. These films can also be said to have co-created ‘iconic’ images and narratives which were subsequently taken up or developed further in various other formats and media, for instance in documentary theatre, journalistic reportages, fictional films or novels. Despite this observation, little attention has been paid to the existing body of documentary films, particularly with regard to the remarkable intertextual and intermedial references—as well as reiterations—which, as this article would like to show, have added significantly to the establishment of a number of more or less ‘standardised’ stories and visual representations in documentary mediations of the topic. ⁴ The article also argues for the need to pay more attention to the specific political-economic situatedness of documentary films, as these mediations not only make us see and learn, in Strathern’s sense, but to a large extent also shape our quest for more knowledge and deeper understanding of the transnational entanglements in the field of assisted reproductive technologies. A contextualised analysis and comparison of documentary mediations can also shed light on interconnectedness of different media forms, formats and communicative practices, and hence their contribution to an emerging communicative figuration. ⁵ However, it should be mentioned that this applies primarily to transnational communicative spaces and contexts in which commissioning parents from the so-called Global North are involved (who may sometimes also happen to be of Indian origin). But in order to understand how the procedures and societal repercussions of assisted reproductive technologies are mediated to audiences in India, it seems rather obvious that the focus would have to be laid first of all on a number of famous actors or directors and their important role in facilitating an understanding that surrogacy can be seen as a legitimate means of obtaining a child. Most notably, Aamir Khan—the so-called ‘poster boy’ for the surrogacy industry in India (Majumdar, 2014a, p. 120)—and his wife Kiran Rao were one of the first celebrity couples to declare that their son Azad was born through a surrogate mother (see, e.g., India Today, 2013).

Whether a direct link between increasing surrogacy and decreasing adoption can be established or not has also been a matter of debate recently. In any case, there can be no doubt about the fact that celebrity endorsement was especially conducive for the surrogacy industry in India. An article from the Daily Mail which was published in June last year quotes an IVF specialist from Delhi who describes how surrogacy requests from Indian parents have doubled in her clinic since Aamir Khan and Kiran Rao went in for it:

‘The celebrity endorsement of surrogacy has given it an aura of aspiration. Suddenly, surrogacy is not just acceptable—it’s cool. It’s what the rich and famous do,’ said Dr Shivani Sachdev Gour, a Delhi-based IVF Specialist. ‘Interest in this particular assisted reproductive technology shot up soon after Aamir Khan had his surrogate baby. Surrogacy requests from Indian parents have doubled since Aamir Khan went in for it. Couples just land up and say “Aamir Khan ne kiya, hamey bhi karna hai!” (Aamir Khan has done it we also want to do it),’ she added. (Sharma 2016)

Much more controversy surrounded the surrogacy which was commissioned by Shah Rukh Khan and his wife Gauri because of the alleged prenatal sex determination for their third child and second son, AbRam. Interestingly, the coverage and discussion was, once again, very different when actor Tusshar Kapoor became the single father of a son by an Indian surrogate in 2016 (and half a year later, film producer and director Karan Johar became a father of twins through surrogacy), as at least the English-language press reacted with enthusiastic approval lauding the actor’s ‘bold step’ and his ‘new age fatherhood’ repeatedly. In particular, since the incumbent Minister of External Affairs of India, Sushma Swaraj, sharply criticised members of the Hindi film industry for abusing the possibilities of surrogacy—and in the same breath immediately declared that the new surrogacy bill would unequivocally bar couples in live-in relationships, as well as same-sex couples and single parents from accessing the prospectively solely legal form of, so-called altruistic, surrogacy (Daily O, 2016)—the question of who and what family is allowed to be in India has been discussed in a remarkably lively and public manner. ⁶ It might hence appear exceptionally ironic that ever since the proclamation of the ban on commercial surrogacy in India in October 2015, of all things, entirely new ways of thinking and living family and kinship have become as strongly visible in Indian media as hardly ever before. Which is of course precisely what the Indian state had tried to prevent by banning foreign same-sex couples and single parents from obtaining a child through surrogacy in India in 2013 already. Nevertheless, what hardly seems to have changed is the ongoing fundamental invisibility and erasure of the surrogates themselves, as sociologist Anindita Majumdar has called it in her analysis of the coverage on commercial surrogacy in Indian print media (Majumdar, 2014a). And this ‘fazing her out of the narrative altogether’ (Majumdar, 2014a, p. 109) is reiterated every time a celebrity publicly and eloquently thanks the doctors at fertility clinics—or even ‘the universe’, as did Karan Johar on the occasion of his children’s first birthday in February 2017—for their surrogacy-born children, but hardly ever bother to even mention the surrogate and her labour. So even if there were scattered reports on protesting surrogates in the aftermath of the ban, and some of them were occasionally even permitted fleeting appearances on talk shows, the central person of interest for interviewers was always an ‘expert’, or rather the medical director of the respective clinic. Nonetheless, in the course of the current debate, the critical interventions of academics and activists have increased in numbers, with strong appeals for the recognition of surrogacy as labour, in consideration of the long history and various forms of surrogacy. This article is part of a larger research project that investigates the visualisation of different forms of intimate and emotional labour in documentary and fictional films as well as their interrelationship with changing figurations of family. Intimate labour is a concept which was first introduced in a co-edited volume by Eileen Boris and Rhacel Salazar Parreñas who consider various occupations under this category as sharing common attributes that are ‘usually subsumed under the often discretely examined categories of care, domestic, and sex work’:

Each of these labors forges interdependent relations, represents work assumed to be the unpaid responsibility of women, and consequently, is usually considered to be a non-market activity or an activity of low economic value that should be done by lower classes or racial outsiders. (Boris & Parreñas, 2010, p. 3)

The term emotional labour was famously coined by sociologist Arlie Russell Hochschild in her study on gender-typed jobs in the US economy and the specifically required training, professionalisation and constant manipulation of one’s own affects in order to induce particular feelings in the client or customer (Hochschild, 1983). Hochschild’s two well-known case studies for her book centred on flight attendants and debt collectors who were working for the same airlines, but with very different and deeply gendered registers of emotions. She also argued aptly that similar forms of emotional labour would become more and more common with the global expansion of service industries (see also Connell, 2009, p. 83). Alienated relationships based on commercialised affects and gender stereotypes would hence become a defining characteristic of contemporary work worlds, and accordingly, many more examples can be found in seemingly diverse sectors such as call centres, care work, beauty parlours, domestic labour as well as in the field of outsourced reproductive labour. For the analysis of documentary films, it is especially conducive to apply both concepts and to explore how different forms and intersections between emotional and intimate labour are visualised or may be even intentionally used by directors to convey an understanding of the specific labour in focus. As sociologist Amrita Pande convincingly argues in her long-term ethnographic study of commercial surrogacy in India, specifically focusing on Nayana Patel’s famous (and visually much overrepresented) fertility clinic in Anand in Gujarat, the clinic aims at producing so-called ‘perfect mother-workers’. Mother-workers or surrogates constantly have to manipulate and discipline their own emotions and affects, she argues, in order to care for the unborn child as if it was their own. At the same time, they are told repeatedly to think of the baby as the genetic child of others that does not belong to them and to keep the contractual relationship between them and the commissioning parents as well as the clinic constantly in mind. Furthermore, their sense of guilt and obligation towards their own children is also systematically deployed by the clinic as an additional disciplinary tool to shape and produce the targeted perfect mother-workers (Pande, 2014).

The Surrogacy (Regulation) Bill, 2016

Salient features of the bill are:

To allow altruistic ethical surrogacy to intending infertile couple between the age of 23–50 years and 26–55 years for female and male, respectively.

Source: Department of Health Research (2016) [emphasis my own, NCS].

Transnational reproduction and especially the three hitherto peripheral figures of the biological family—that is, the sperm donor, the egg cell donor or the surrogate mother—are certainly no longer under-researched or under-represented topics in current academic as well as non-academic debates. Quite on the contrary, there is a growing number of excellent ethnographic studies and elaborate theoretical discussions as well as an abundance of fictional and non-fictional films, TV series, documentary theatre productions or novels that all focus on the complex reconfigurations of family, kinship and parenthood in a global age of increasingly bio-technologised and medicalised bodies. However, precisely the aspect of labour is often neglected or even concealed in this context, especially with regard to surrogate workers. What we encounter instead is the much-overused metaphor of the ‘rented womb’ or ‘womb for rent’ in far too many titles and visualisations, as will be shown further.

Documentary Films as ‘Channels of Mediation’

The body of documentaries on commercial surrogacy in India can be roughly divided into two categories, first of all the largest group of documentary films which were produced for trans/national television networks (mainly in the United States, Russia and Great Britain) and second, a much smaller and less easily accessible group of independently produced documentary films. The latter category can be further divided into a subgroup of films by directors who predominantly live and work in the so-called Global North and those who live and work mostly in India. Examples for the first category would be the aforementioned films Wombs for Rent in India by RT Documentary (2015, 26 min); House of Surrogates by Matt Rudge (BBC 4; 2013, 90 min); Made in India by Rebecca Haimowitz and Vaishali Sinha (PBS/USA; 2010, 95 min) and Google Baby by Zippi Brand Frank (HBO/USA; 2009, 69 min). Examples for the second category would be Ma Na Sapna: A Mother’s Dream by Valerie Gudenus (2013, 86 min); Can We See the Baby Bump Please? by Surabhi Sharma (produced by SAMA: Resource Group for Women and Health in Delhi; 2013, 49 min); Womb on Rent by Ishani Dutta (2013, 49 min) and Mother Anonymous by Rahul Ranadive (as part of Sheela Saravanan’s research on surrogacy in Mumbai; 2011, 10 min).

The documentaries or rather documentary mediations that I will mainly focus on in this article belong mostly to the first category, as they were either commissioned by transnational television channels, by national commercial TV production companies or non-commercial services such as PBS. I consider these documentaries as the internationally most visible and widely circulated films and some of them are also quite often referred to in journalistic articles as well as in discussions in various other media. I would like to distinguish these films, which were all made by professional documentary filmmakers, from a much larger number of reportages that are also sometimes done in a documentary-style format but often involve much less context-related research and generally only very short stays in India. These reportages may also be watched and commented upon by large numbers of viewers on YouTube (such as the number of videos and reports which were produced for VICE). But unlike the documentaries in focus here, they mostly do not seem to travel across the different societal domains of knowledge and debate that Strathern talks about in her aforementioned article and, accordingly, can only be partly considered as ‘channels of mediation’ (Strathern, 2002).

Following James Bennett and Nikki Strange’s elaborate discussion of Television as Digital Media (2011), documentary films can no longer be seen in isolation as they are increasingly embedded in a new, digital (and social) media context (Bennett & Strange, 2011, p. 1). They are hence no longer just ‘televisual or cinematic’, but take on a variety of forms as they move or are distributed across multiple platforms. However, it is important to bear in mind that older forms still co-exist with new forms, and this also pertains to the pluralisation of viewing practices as every service or platform brings its own ‘viewing protocols to bear on the experience of content’ (Bennett & Strange, 2011, p. 1):

Documentary films are still viewed on TV in real time by audiences sitting on their sofas, but they are also viewed on iPads, laptops and phones, downloaded months or even years after their original release and transmission, and interacted with through two-screen programming. (Sorensen, 2013, p. 52)

Translocal Circuits and Connectivities of Technologically Assisted Reproduction: Google Baby (2009)

One of the internationally best-known documentaries about transnational surrogacy and reproductive tourism in India is Google Baby. The film, which was directed by Zippi Brand Frank, a former TV journalist from Israel, is exemplary in the way in which it visualises and contextualises all the new global connectivities, actors and technologies as well as the practices which together bring forth the transnational reproductive market. Google Baby is centred around Doron Mamet, the founder and CEO of Tammuz—a transnational agency catering to intended parents from Israel and providing them with egg cells from donors in the United States, which are then fertilised and taken to India where they are implanted into the womb of a surrogate mother, somewhere ‘in the suburbs of Mumbai or Delhi’ as it says on an older version of the website of the agency, or they are selected ‘from Tammuz’s pool’ and then ‘relocated with their families to accommodation provided in Kathmandu’. The film was produced by Sheila Nevins and Yona Wiesenthal and made its debut in Israel in 2009, it was later purchased by the US American cable network HBO. Google Baby won several awards, among them the first prize at Docaviv (Tel Aviv), the Magnolia Golden Award in Shanghai for best documentary as well as an Emmy Award in the United States in 2011.

The film, produced and directed by the Tel Aviv filmmaker Zippi Brand Frank, examines the ways in which globalization has further complicated and diffused the fertility industry. ‘Google Baby’, though, is also the chronicle of an idea, one belonging to an Israeli entrepreneur named Doron, who gets into the business of using egg donors in the United States and gestational carriers in India to provide for the childless of the Western world. Logistically, this involves freezing multiple donor embryos and shipping them to a surrogacy center in Anand, India, packaged in liquid nitrogen. Emotionally, it requires an enormous amount of fortitude on the part of childbearers in a culture where some regard surrogacy as a kind of prostitution. (…) What could easily be rendered as straight-out horrid exploitation is given an amazingly neutral hand as Ms. Brand Frank deftly avoids the clichés that typically materialize in any journalistic look at atypical reproduction. (Bellafante, 2010)

The film is also available on YouTube in several different versions and has been clicked or watched more than 100,000 times online (Figure 1). Many press reviews mention, with some amazement, the ‘striking neutrality’ of the documentary which never seems to judge the practices that it illuminates or to take a definite stand against commercial surrogacy and split parenthood. The film’s openness to diverse readings is also clearly confirmed by some of the highly contrasting comments posted by viewers on YouTube, ranging from pro-surrogacy statements and sympathetic remarks towards the commissioning parents to expressions of puzzlement or outright shock and disgust about the outsourcing pregnancies. For instance, user Sarah Godoy posted a comment in 2017 in which she said: ‘This is one of the most depressing things I’ve ever seen in my life’, whereas user Calandra posted a very different comment in December 2017:

I’m watching this documentary for my bioethics class and I must say it’s very detailed and good to watch. Surrogacy is helping a lot of people with health concerns become parents. I would go to this same route if I can never have a successful pregnancy. Thumbs up for this documentary. ⁷

OPEN IN VIEWER

Figure 1.

Source: Retrieved from https://www.imdb.com/title/tt1490675/mediaviewer/rm763922688

Likewise, comments on widely shared documentaries show that these films may not only serve as a starting point for critical debate and introspection but sometimes also primarily as a source of information for potential intending parents, as one comment posted by ‘r person’ (posted in 2013) indicates:

My partner and I watched this documentary (i.e., Google Baby)—and—decided to go this route. (…) We are due in April. THANK YOU for drawing so much attention to this. It’s one thing to fly under the radar, it’s another to become the gay parent capitol of the world! Had things remained contained, I would not be panicking as to what I will do now that singles and gays are barred, care to donate some funds to help? (ibid.)

Director Zippi Brand Frank confirmed in press interviews that she does not condemn the practices of sperm, egg donation and commercial surrogacy entirely, but she clearly expressed hopes for her film to support demands for a regulation to avoid the exploitation or surrogate workers and babies as mere commodities (Leichman, 2011).

As mentioned earlier in this article, even before the Indian government announced in October 2015 that it would ban foreigners from seeking surrogacy in India, non-heterosexual couples, non-married couples and singles had already been excluded from the group of foreign nationals that could apply for a ‘Medical Visa’. However, this was not the case in Nepal so that agencies like Tammuz could use the existing legal loopholes, hire a surrogate mother in India and ‘relocate’ her across the border. This cross-border business became only visible in the Indian and international news media when Israel evacuated babies from Nepal after the earthquake in April 2015, while the surrogates who had carried and delivered these babies had been left behind and most of them were actually from India (Green, 2015; Gross, 2015). In the wake of the negative coverage and massive critique, the government in Nepal announced shortly afterwards that it would ban foreigners from seeking surrogacy in the country, as Thailand and India had already announced earlier in the same year. As a consequence, Tammuz is now offering surrogacy programmes or ‘donors’ in the United States, Ukraine and Albania only, and no longer in Asia, for the time being at least (see tammuz.com, last accessed Jan 04, 2019).

After the successive bans in Thailand, India and Nepal, many experts expected that Cambodia (and eventually Laos, too) would become the next surrogacy hub in the region. Facing losses in what had developed into an extremely lucrative trade, Indian clinics quickly began moving out to Cambodia, a country with an equally unregulated surrogacy market and a visa-on-arrival facility for Indian nationals. According to a report which was published by Aljazeera in June 2016 (Bhowmick, 2016) more than a dozen Thai and Indian clinics were already operating from Cambodia at that time, and it was expected that they would primarily hire Indian surrogates, because they are ‘cheaper’. In view of this, many experts in India, including women’s rights and reproductive health advocacy organisations like SAMA, argued that the ban and criminalisation of commercial surrogacy was not really about the protection of poor women but in fact made them even more vulnerable as the industry would simply go underground. In their view, the long-awaited strict regulation of the surrogacy market in India would thus have been better than the partial ban (Vora, 2017). However, to the surprise of many, the government of Cambodia also announced a permanent ban of commercial surrogacy in the country in November 2016, while the debate about the draft Surrogacy Regulation Bill in India is still ongoing.

Intermedial References and Intertextual Borrowings: House of Surrogates (2013)

As briefly indicated earlier in this article, it is particularly interesting to observe that documentary films create images and tell stories which are often taken up and developed further in various other documentary or fictional formats. Two recent examples shall serve to illustrate this observation in the following section. The first example is a novel by British–Indian actress, comedian, screenwriter and novelist Meera Syal which was published in June 2015, titled The House of Hidden Mothers. The novel was well received by critics and audiences, especially in the UK. Syal was also willing to play her role as an ‘insider’ and ‘authentic expert’ and hence spoke engagingly in television interviews about the perils of the surrogacy industry in India. This is of course a phenomenon which has been apparent particularly in the ‘packaging’ and marketing of documentary and fictional films for quite some time now: In view of the competitive and profoundly changing nature of national and transnational television production, it is becoming crucial to raise interest in essential issues through credible testimonials, such as ‘authentic’ actors or other ‘experts’, and to communicate relevant stories which inform and engage audiences in an equally entertaining and instructive manner. Against this background, the question regarding the role of the production and knowledge transfer through and ‘around’ the broadcasting of such films (or in this case, the publication of a novel by a well-known TV actress, comedian and screenwriter) seems justified. Regarding the transnational communicative figuration which has formed around the theme of reproductive tourism, split parenthood and commercial surrogacy in India, I found two aspects in the newspaper articles about the novel quite telling. First, that some authors expected the novel to be adapted for a feature film very soon and also mentioned the fact that Syal already had an eye on the film rights when her book was published (Elkin, 2015). Second, Syal also mentioned in one interview that it was in fact a BBC documentary which inspired her to write the book (2015); after watching this documentary, she says that she knew immediately what her third novel would be about, and there can be hardly any doubt that Syal was referring to the BBC documentary House of Surrogates made by director Matt Rudge in 2013.

Like numerous other documentaries and TV reports, Rudge’s film House of Surrogates (2013) features fertility specialist Dr Nayana Patel very prominently. Patel is surrounded in the aforementioned picture by ‘her surrogates’, as she likes to call them in interviews. The total number of interviews and documentaries which have been made about Dr Patel and her clinic would be very difficult to estimate. She became instantly famous all over the world after the screening of Lisa Ling’s report about her clinic on the Oprah Winfrey Show in 2007 and was subsequently treated like a spokesperson of the Indian surrogacy industry by international media. So quite naturally, ever since the Indian government announced that it would ban foreign couples from seeking surrogacy in India in October 2015, Nayana Patel is once again in the focus of international media and she was also at the forefront of a protest campaign in India, advocating for strict regulation of commercial surrogacy instead of a ban and criminalisation of the industry.

One striking feature of this body of documentaries and TV reports is that there are a lot of borrowings and intertextual references between the different films and formats which add to the establishment and reiteration of more or less ‘standardised’ stories and framings. The ‘visual overrepresentation’ of Dr Nayana Patel and her Akanksha fertility clinic in Anand is of course the most obvious evidence for this. In the context of the discussion of the ban on commercial surrogacy in India, her rhetorical recourse to the language of ‘humanitarianism’ and ‘human rights’ is particularly interesting to note. Patel repeatedly and very effectively raised the question across media platforms: ‘Why take away the basic human right to have a baby?’ (Doshi, 2016; Dr Patel, personal communication, 3 February, 2016). Financially speaking, there is probably much at stake for her, especially since the opening of a new and much bigger ‘state-of-the art hospital’ in December 2015.

It is not difficult at all to imagine who the model for the renowned fertility specialist in Meera Syal’s novel must have been:

Then there’s Dr Passi, the internationally respected doctor who convinces herself, and half convinces the reader, that she is providing a service which overseas couples want while giving Indian women the chance to improve their lot and educate their children—as she funds her own Western lifestyle and puts her own three children through medical school. Is it advantageous for all concerned or is she simply an unscrupulous exploiter? ([Emphasis added]; Elkin, 2015)

Nayana Patel’s Akanksha infertility clinic has also become the central visual symbol of a permanent surveillance of surrogate mothers in the so-called surrogacy hostels in Anand where they have to spend a large part of their pregnancy. This also leads to the second interesting example which serves to illustrate the role of documentary films in the emerging communicative figuration on transnational reproduction and surrogacy.

Living and Labouring Under a Panoptic Gaze

In an article published in August 2017 in The Guardian, the author Ellen E. Jones ponders about the question why infertility, parenthood and surrogacy have become such prominent features in a number of highly successful TV productions recently, most notably Jane Campion’s Top of the Lake: The China Girl and a series based on Margaret Atwood’s novel The Handmaid’s Tale (1985) which was adapted for television under the same title in 2017 (Jones, 2017). ⁸

The author assumes that the implicit equation of surrogacy and prostitution in Jane Campion’s Top of the Lake: The China Girl is rather controversial, but ‘very much in keeping with TV’s awareness of the global politics of fertility’ (Jones, 2017). Jones describes in her article how the show’s images of ‘young women waiting out their forty weeks in the tense boredom of dormitory-style rooms’ is reminiscent of the documentary House of Surrogates and the ‘Akanksha Infertility Clinic in small-town India, patronized mostly by couples from the UK, the US and Canada, and run by the glamorous matriarch-meets-entrepreneur, Dr Nayana Patel’ (Jones, 2017). This resemblance prompted her to interview director Matt Rudge for her article. So in spite of the fact that the article explores television’s most recent ‘obsession with surrogate mothers’ and talks primarily about two fictional TV shows which were both screened in 2017, a longer section of it is actually about the reception and long-lasting impact of the before mentioned documentary from 2013. Rudge says in the same interview that when he first visited Dr Patel’s fertility clinic in Anand, he thought that viewers would have impulsive reactions: ‘But what I knew the film would do, is slowly take viewers deeper, to meet those involved, so that their presumptions would ultimately be turned on their head’. And Jones agrees that House of Surrogates depiction of a vast global wealth gap, as well as the careless way the bonds of baby and birth mother were severed, remained upsetting. However, she goes on to explain that Rudge himself believes that our culture’s fascination with surrogacy has less to do with the sci-fi strangeness of the procedure and more to do with the emotions involved. As Rudge puts it: ‘Hope, disappointment, separation, love, loss, family; in that sense, it’s a story that goes to the heart of being human. The themes are universal’ (Jones, 2017).

Although this does not apply to all the contexts and cities in India where surrogate mothers sometimes stay at home during their pregnancy, the first association and indeed a standard visual representation of surrogate mothers in documentaries—as well as in feature films—is the dormitory of the surrogacy hostels. ⁹ The constant surveillance and immobilisation of surrogate mothers who are separated from their own families and children for a long time has been the focus of much critique in the academic discussions as well as in public debates. ¹⁰ However, this narrative is also sometimes complicated by surrogates themselves who talk about the strong bonds of friendship and solidarity between women who share a lot of similar experiences, or about the little subversive acts they perform together to undermine the medical control over their bodies (Pande, 2010). Ma Na Sapna: A Mother’s Dream (2013) by Austrian director Valerie Gudenus has several interesting scenes in this regard in which we see and hear, on the one hand, how interpersonal conflicts between surrogates may erupt in the claustrophobic and barrack-like atmosphere of the surrogacy hostel. On the other hand, we listen to personal stories such as Champa’s (33:18 min) who, four days after the embryo transfer into her womb, tells the director’s team and interpreter Reshma Jain how much she hopes that the results will be positive (i.e., that she will be pregnant), not least because she is visibly enjoying the company of her two roommates whom she likes a lot. Also, by hearing Champa comment on how much cooler the house (hostel) is during the hot season, we may be inclined to believe that despite the constant surveillance, (self-)disciplining and immobilisation, at least for some surrogates, this could indeed be a welcome break from their strenuous and demanding everyday lives. Interestingly but perhaps not surprisingly, this ambivalent trope of a ‘welcome holiday’ for the surrogates whose lives outside the hostel might be so much tougher than inside the clinic is also taken up in fictional firms. Notably when the doctor in charge explains to a (usually) Western intending couple that the months-long separation of the surrogates from their families and especially—as is generally suggested in post-Nirbhaya visualisations of gender relations for German television screens—often from a very violent husband is assumed to be a preferable condition, not only presented as a better option for the surrogacy-born baby but also for the surrogate mother herself. A rather clichéd and deeply orientalist visualisation of this ever-recurring trope of the victimised Southern woman who is ‘saved’ from her husband, at least temporarily, by a medical authority and the commissioning couple from Germany that selects her as ‘their’ surrogate mother can for instance be found in the TV melodrama Monsoon Baby (Andreas Kleinert, Director), which was released in 2014 and since then successfully screened several times on German public broadcasting channel ARD.

Another very problematic aspect is the camera’s gaze onto the labouring bodies of surrogate mothers during childbirth, an ethically questionable visualisation of surrogacy which has nevertheless rarely been discussed nor problematised. Their faces covered with sweat and sometimes tears, the surrogates usually do not speak. In the many documentary films which were shot in Dr Nayana Patel’s clinic in Anand, it is once again the doctor in charge or other ‘observing medical experts’ who speak for her, interpret and comment on the situation. It is of course a golden opportunity for the filmmaker: an extremely versatile doctor performing a routine C-section while responding to a phone call and saying a few friendly words towards the surrogate mother as well as the camera. Then, very matter-of-factly, Dr Patel announces ‘Now we send the baby out to the mother’ (Google Baby, 4:35 min). What better opportunity could there be for a filmmaker than this moment of twofold delivery in order to convey the complexities of split motherhood and the commodification of bodies and babies.

Framing Surrogacy as Labour Versus a Prevalent Rhetoric of ‘Rented Wombs’

One standardised narrative which was first introduced to a global audience by the Oprah Winfrey Show in 2007 and has been reiterated since then in many documentary films and countless other media is the metaphor of the ‘womb for rent’ or ‘rented womb’ of the surrogate mother. Specifically with regard to the coverage in Indian news media, Anindita Majumdar notes an important shift taking place between 2007 and 2014 in the way surrogacy was perceived vis-à-vis the infertile couple and their individual ‘drama of childlessness’, which ultimately led to an almost complete erasure of the surrogate mother from the picture (Majumdar, 2014a). She argues that the exploitative business of surrogacy, the missing legal regulation and the many risks involved for surrogate mothers were now increasingly couched in a language of altruism and philanthropy and framed as a ‘win–win situation’ or an act of solidarity between two women—one woman whose longing for a genetic child would be fulfilled and the other woman whose hopes for a better future for her children would finally become real. However, this ‘rhetoric of the womb’ is by no means limited to the framing and coverage in Indian news media, but can equally be regarded as a key metaphor which is used transnationally in the context of almost every media-related discussion of commercial surrogacy in India and other countries in the so-called Global South. In view of this erasure of the surrogate mother from the media coverage, the increasing use of a rhetoric of the womb as well as a general shift of attention to the plight of the childless couple, it is particularly relevant to find out that how far documentary filmmakers are motivated and able to ‘step in’ and assume the function of investigative journalism or if they help enhance the visibility and give voice to the surrogate workers through their films. There can perhaps be no straightforward answer to these questions, but there is most certainly a noticeable difference between the group of documentary films which are made by international filmmakers and those made by Indian filmmakers, that is, who primarily address Indian audiences. For instance, I was told by one Indian researcher who tried several times to interview Nayana Patel that it was next to impossible to meet her, while it was obviously much easier for Western filmmakers to get access to Dr Patel, or that was at least her impression. So it is perhaps no coincidence at all that we see documentary explorations of other places, fertility clinics as well as homes of surrogates workers in this smaller body of films, whereas Patel and her clinic very clearly dominate the visual production of filmmakers who are located in Western countries, as has already been pointed out. In these documentaries, however, the surrogates can only be interviewed inside the fertility clinic or inside the surrogacy hostels, and it is hence no surprise that they often display a deep gratitude towards the clinic and especially the doctor in charge. They also tend to reproduce the same rhetoric of altruism and of surrogacy being a ‘life changing opportunity’ for them which, as the audience is often made to believe, will allow them to buy a house or invest the money they earn for a better education of their children. However, it is interesting how a film like Ma Na Sapna brings this into question, rather subtly. On the one hand, there can be no doubt that in many scenes in this film, Nayana Patel once again knows how to make use of a documentary film for her tried and tested mode of self-representation. But Ma Na Sapna also manages to qualify some of the statements which had been made in previous documentaries on the Akanksha fertility clinic and commercial surrogacy in India in general, such as the assertion that surrogate mothers will be able to buy a house for their family from the money they earn for their physical and emotional labour. Some dialogues in Valerie Gudenus’ film make it very clear, however, that the prices for houses have gone up very quickly in all the surrounding localities, while the wage Dr Patel’s clinic is willing to pay to the surrogate mothers has not been increased correspondingly during the last couple of years. Another example would be the satirical comments made by surrogates on the qualification of the lady who is supposed to teach them some basic knowledge of the English language. It is an essential element of Nayana Patel’s self-representation as a ‘feminist entrepreneur’ that she wants ‘her’ surrogates to ‘learn something’, that is, acquire skills, such as embroidery, which would enable them to earn a living after leaving the clinic or gaining a basic mastery of the English language that would enable them to communicate with ‘their’ commissioning parents directly, but also to negotiate with them about a higher ‘compensation’ for their labour.

OPEN IN VIEWER

Figure 2.

Source: Berglund, 2015.

In the context of her own ethnographic research, Pande is cautious not to overinterpret the ‘everyday resistances’ by surrogates in Anand as something which could really pose a ‘threat to the fundamentally exploitative structure of transnational surrogacy’. What they do represent to her, however, ‘is a constant process of negotiation and strategizing at the local level’ (Pande, 2010, 2014, pp. 10–11). Despite these ambivalences and the fact that visualisations of the dormitories have become a standardised or even stereotypical form of representation of commercial surrogacy in India, it can be argued that precisely this kind of visual representation of the surrogacy hostels and dormitories is still crucial as it enables us, the viewers, to see and immediately understand why the rhetoric of rented wombs is so deeply problematic. Not only because it serves to further erase the surrogate from the picture but also because it suggests that no active labour is involved in the whole process, as the surrogate seemingly only ‘rents out’ a body part, her uterus and is hence not seen as a worker who is, accordingly, also entitled to labour rights and social security. Exactly, this is the reason why reproductive health and women’s rights organisations like SAMA have been advocating for a strict regulation of commercial surrogacy in India for many years and calling for a recognition of surrogacy as labour, but not a legal ban.

Regarding, more specifically, the academic discussion on the two concepts of intimate and emotional labour, Pande’s study as well as many of the documentaries on reproductive tourism and commercial surrogacy in India indeed help us understand that surrogate workers engage in both. They are thus also refuting the notion brought forward by Eileen Boris and Rhacel Salazar Parreñas that ‘surrogate mothers do not engage in emotional labor, though their jobs may involve emotional labor that would occur in private and not public spaces’:

However, emotional labor is not a prerequisite or requirement in intimate labor. In many cases, intimate laborers need not regulate their emotions. Sperm donors, (…) and surrogate mothers do not engage in emotional labor. (Boris & Parreñas, 2010, p. 7)

It is questionable whether the public–private binary can be applied either to the peculiar space of the surrogacy hostel or to the mediated communicative space in which face-to-face labour is indeed involved and surrogate workers have to display certain emotions to induce a particular feeling in the client or customer, in this case, the commissioning parents. This is, for instance, aptly illustrated in the opening scene from Surabhi Sharma’s 2013 documentary Can We See the Baby Bump Please? We get introduced to the mediated kinning practices of a commissioning couple from the United States who through their routine Skype calls try hard to ‘connect’ with the unborn child and also to engage in some small talk with the surrogate mother Haseena. She does not speak or understand English, hence the help of an ever-smiling interpreter is required not only to translate words but also to provide a connection between the two distant lifeworlds. Nevertheless, it is Haseena who is expected to ‘perform’ a happy and healthy pregnancy in front of the computer screen to show her growing belly and also to display an interest in the commissioning parents’ favourite music that they would like her—or rather, the baby inside her belly—to listen to. In short, Haseena’s labour goes far beyond providing a body part and caring for herself as well as for the unborn baby in her womb.

Outlook

Journalistic and academic articles have so far mostly addressed documentary films on transnational reproduction and commercial surrogacy in India as individual texts, generally focusing more on the content than on the form of the films and hence, sometimes also neglecting the origin(s) and itineraries of certain images, tropes or recurring visual representations. This article was based on the assumption that it is not only interesting but also academically relevant to trace some of these image itineraries to understand how they might contribute to emerging global imaginaries (Brosius & Wenzlhuemer, 2011) as well as to a translocal communicative figuration around the topic of transnational reproduction and commercial surrogacy in India. Looking at a number of very successful documentaries that were made primarily for transnational audiences between 2009 and 2013 and by filmmakers who are mostly located outside India, it sought to shed light specifically on three images and tropes that it considers central for this communicative figuration: (a) the medical authority-cum-media actor (i.e., internationally well-known fertility expert and doctor in charge, Dr Nayana Patel), (b) the image of the surrogacy hostels and dormitories in Anand, Gujarat (i.e., the deeply ambivalent trope of a ‘welcome holiday’ for the surrogates versus ‘panoptic surveillance and control’ of their bodies, actions and thoughts) and (c) the contested notion of ‘rented wombs’ (i.e., the passive provision of a body part) versus surrogacy as labour (including very demanding and complex intimate as well as emotional labour). The article showed that the flows of these images and tropes are by no means restricted to intertextual references between the documentaries in focus here, but that they travel across a wide variety of different media, contexts and formats, including for instance, television dramas, talk shows, newspaper interviews, documentary theatre, journalistic travel photography and novels. It can thus be argued that conceptualisations of individual media as decisive ‘channels’ of a successful mediation and subsequent societal debate about technological innovations and related changes of practices of social reproduction and ‘doing family’ need to be complemented by approaches which focus more on the ‘patterns of processes of communicative interweaving that exist across various media and have a thematic framing that orients communicative action (Hasebrink & Hepp, 2013, p. 10 as cited in Radde-Antweiler, 2018, pp. 210–211)’.

In addition to focusing on the emergence of transmedial communicative figurations and thematic framings that actually define ‘the topic’, however, it is also important to identify and illuminate the critical absences within these communicative spaces. One such critical aspect is the underrepresentation of Indian intending parents in documentary films on surrogacy which adds to the notion that most commissioning parents are from the Global North or Western countries. This is—or at least before the ban on surrogacy in India was—not the case, as Sarojini Nadimpally and Deepa Venkatachalam from the SAMA: Resource Group for Women and Health in Delhi point out. According to their research, there is an ‘equally large number of Indians who are “consumers” of ARTs and surrogacy’ (Nadimpally & Venkatachalam, 2016, p. 91). But while foreign clients usually access clinics in the metropolitan and bigger cities in India, clinics in small towns and cities are primarily frequented by so-called local consumers. Documentaries (both international as well as by Indian filmmakers) which do not focus on Anand are mostly shot in Mumbai or Delhi, however, so that the dominance of urban-centred representations may have added to the wrong perception that commercial surrogacy and split parenthood are largely an urban or metropolitan phenomenon in India. As documentaries are an important reference for academic articles and sometimes also an inspiration for future research projects, this also means that in addition to an already rich theoretical discussion about North–South inequalities and India as an exemplary ‘labor market primarily for the reproduction of the biological and affective life of other places’ (Vora, 2015, p. 7; emphasis my own), a theoretical inquiry into the socio-spatial dynamics within the ‘same places’ is required.

What many documentaries and subsequent discussions also fail to address is the biopolitical aspect and specific class politics of a state-supported market of pronatal technologies which caters primarily to the needs of upper-middle-class families, while the antinatal policies of the Indian state continue to be directed at the poorer sections of society. A lot of attention is given to the interconnected problems of technologically assisted reproduction, changing family and kinning practices as well as the ethical boundaries and legal definitions of what can or should be regarded and accepted as labour. In comparison, the persistence of antinatal technologies such as statesponsored mass sterilisation of women receives much less attention and was only scandalised in the wake of massive suffering and fatalities caused by botched surgeries in mobile sterilisation camps in Bihar and Chhatisgarh. ¹¹ In her ethnographic study on reproductive choices and family practices among middle-class families in South India, anthropologist Minna Saavala (2010, p. 32) found that:

[T]he unfortunate, even socially disastrous, situation in which a couple is unable to conceive at all creates particular complications for middle-class couples; they will struggle with this aspect of controlled procreation to the full and if they are unable to succeed even with the help of New Reproductive Technologies (which only very few can afford), they generally find it very difficult to accept the situation. (Emphasis added)

Even if she refers primarily to (lower) middle-class families, Saavala’s quote also indicates that many more people than the privileged few who are usually represented in public discussions and media articles may be faced with involuntary childlessness and would like to have access to IVF methods and fertility treatments, including an increasing number of poor married couples. ¹²

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author received no financial support for the research, authorship and/or publication of this article.