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Re: Outsourcing surrogacy?!?
Hmm let me see how to order all my thoughts and try to keep this as short as possible. When I get started talking about surrogacy, I can write volumes!!
First off, some background. When a couple reaches the conclusion that they are in need of a surrogate, the vast majority of time the IM (Intended Mother) is of an "advanced age" for childbearing--meaning past 35. They have almost always tried every other option available to them, and most likely suffered multiple pregnancy losses, failed IVF treatments, often even failed adoptions in some cases. I am saying this for several reasons, which I will explain in more detail.
1) Since the eggs will be coming from an IM of "advanced maternal age", the pregnancy is very often considered a higher risk.
2) Since IVF is used as part of surrogacy, the incidence of multiples is much higher than in the general population--again, a high risk pregnancy from the outset, requiring specialized care, and the coordination of perinatologists with RE's (reproductive endocrinologists) as well as the OB/GYN.
3) IVF pregnancies are more fragile than naturally achieved pregnancies, meaning much more frequent monitoring along the way--meaning that the carrier must have regular access to specific types of medical personnel past the routine OB/GYNs you would find in most suburban locales even in the US.
4) Surrogacy and the entire set of medical procedures leading up to it is SCARY. You have tons of questions throughout the process, and as an IM I can tell you firsthand that you're stressed out enough if you're just at home. I simply honestly cannot imagine what it would be like to have to travel to India for these procedures (which take weeks from start to finish, so you have to stay there), deal with a potential language barrier and cultural issues, and of course, deal with medical practices that may be operating under less than optimal conditions. Along these lines, I was downright HORRIFIED at the part in the article about some guy in a t-shirt just wandering in and jabbing the woman with a needle during the interview. WTF?!
4) Many IVF babies, and especially twins or higher multiples, are born prematurely. While India may have "pretty advanced medical care" according to the article, it's still largely a developing nation, and I personally would find it terrifying and traumatic for my newborn preemie babies to struggle for their lives in an environment where I was not 100% confident that they were being given the best possible medical care around the clock. Remember: parents who are pursuing surrogacy have often suffered NUMEROUS losses (eight in my own case), and peace of mind is invaluable at a time like this.
5) I don't have to remind anyone here that nutrition and proper levels of exercise and rest are of paramount importance when a woman is pregnant. The surrogate carriers in the article are basically portrayed as women from the very poorest segments of society, meaning that they often are malnourished in the first place, and pregnancy can very realistically endanger their health (and, of course, that of the baby or babies!). In addition, a large portion of the Indian nation is vegetarian, which poses some unique challenges during pregnancy (not insurmountable, but nonetheless an issue to be considered). Obviously as a prospective parent, I would also be very concerned about the safety of my child/children, in an instance where the surrogate has to struggle on a regular basis just for subsistence level needs like food, clean water, etc., how in the world could her body take on the stress of medical procedures and a pregnancy?? Not only that, but parasites from contaminated food or water, along with insect-borne diseases, are quite common in developing nations. Does not sound like the healthiest environment for your growing baby.
These are some of the medical issues that I personally see as huge obstacles. I won't even get into the potentially exploitative nature of this type of practice in underserved portions of the population. In the United States, reputable surrogacy agencies specifically will NOT work with the poorer potential surrogates for a multitude of reasons, not the least of which is the fact that if you NEED the money, that's the wrong motivation for offering your body as a surrogate. Don't forget: any pregnancy carries with it the risk of the carrier losing her own fertility permanently, as well as even possible death in the most extreme instances. It's a complicated, emotional, and risky process for everyone involved.
I personally feel entering into a foreign surrogacy solely for the reason of "saving money" on the process (and the article offers NO other reason for prospective parents to choose this option) is utterly repugnant and morally suspect. Babies, and surrogates, are NOT merchandise, to be gotten "on sale". If I were bound and determined to help change lives in India or elsewhere, I could think of much better ways to use $5,000, $12,000, even $50,000 (which is still just a small fraction of the cost of a surrogacy in the states, by the way) to accomplish that goal and reach a vastly greater number of people in a more meaningful way.
Last but not least, but I will cut this short so as not to totally bore anyone: There are also the very practical considerations such as immigration issues, issuance of passports, medical clearances for the babies, traveling issues (how to get your newborn(s) home safely and easily?), and on and on. Heck, our surrogate is only 500 miles away from us, and we're already worried about the logistics of traveling and transporting our babies when they come!!
I honestly hope that my comments do not offend anyone. They are meant to enlighten others about the surrogacy process as well as offer some realistic challenges to the idea of "outsourcing" surrogacy to a developing nation. I tried hard not to be judgmental even though I do realize that I was not entirely successful at it! These are just my personal opinions and concerns, as someone who is about as familiar with surrogacy as you can get.
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Come see my babies! 
