India, the land of contradictions.
In the current issue of Foreign Policy magazine, Anuj Chopra looks at India's rising fertility industry in "The World's Baby Factory." While India has become a well-known destination for fertility tourism and surrogacy, fertility treatments are apparently becoming more and more popular and affordable domestically -- especially among the childless elderly. Treatments are also unregulated, though legislation is in the works. More and more Indian couples in their sixties are seeking fertility treatment and conceiving children, without necessarily understanding the medical risks. Chopra writes:
In India, where fertility treatment is significantly cheaper, regulation weaker, and childlessness is considered a curse, the recent high profile cases have highlighted how women -- even across small towns and villages where health facilities are scarce -- are taking extraordinary risks to conceive babies.
"Medically it is now possible to impregnate a 60-year-old. But medically, it is also possible to impregnate a pre-pubescent girl. Does that mean we should allow it?" says Imrana Qadeer, a retired professor from the Centre of Social Medicine and Community Health at New Delhi's Jawaharlal Nehru University. "The misguided emphasis on genetics -- ‘It has to be my baby, my blood' -- has overshadowed safer and more progressive options such as adoption."
But Dr. Pushpa Bhargava, one of the chief architects of the Assisted Reproductive Technology Bill, says deciding whether an upper age limit should be fixed is a "non-question."
"Procreation is a basic right, and we cannot deny it to anyone," he says, adding that the draft law includes a provision to "discourage" medically unfit women from seeking fertility treatment by requiring clinics to provide professional counseling about its health implications, the low rate of success, the costs involved, and also advice on the possibility of adoption. Bhargava says a fertility counselor's role would be analogous to that of a marriage counselor. "The counselor will offer advice, but in the end, to do or not to do is entirely your decision."
But given the intense social pressure that surrounds childbirth in many parts of India, prospective mothers often don't see it as a choice. Infertility is rarely countenanced as just another random happenstance of birth. A victim of nature's caprice you may well be, but childlessness in many corners around India epitomizes a grave sexual defect, eliciting guilt and shame. "‘No baby? Is something wrong? Is it you or your husband?'" Kisabai Biranje describes it. "That's the general thinking. A married couple must reproduce to be venerable in society."
Although India has seen an increase in domestic adoptions of children in recent years, infant abandonment, especially of girls, is an enduring social problem. Human Rights Watch estimates that 18 million children live and work on the streets of India. Most have little if any contact with family. According to UNICEF, India was home to 25 million orphans in 2007, a figure that likely encompasses both institutionalized children and those on the streets, yet in 2010 Indian domestic and international adoptions combined totaled a mere 6,286.
I was struck by Dr. Bhargava's statement above that "procreation is a basic human right, and cannot be denied to anyone." Adoption, on the other hand, is a different story, especially in India. Just ask Rebecca Morlock.