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Surrogate mother – praiseworthy or stigmatized: a qualitative study on perceptions of surrogacy in Assam, India
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård och migration/Essén)ORCID iD: 0000-0003-0811-9922
Department of Women's Studies, Gauhati University, Guwahati, India.
Faculty of Health and Society, Malmö University, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård och migration/Essén)ORCID iD: 0000-0002-2900-2849
2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, article id 1328890Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Surrogacy is a reproductive practice that has been strongly marketed in India as a solution for childless couples. As a result, the number of surrogacy clinics is increasing. Meanwhile, a global discourse on surrogacy, originating from a Western perspective, has characterized surrogacy as being exploitative of women in low-income settings, where poverty drives them to become surrogate mothers.

OBJECTIVE: This study explored perspectives on surrogacy from men and women in Assam, an Indian state known to be a low-income setting. Surrogacy arrangements in Assam are still uncommon. It can be expected that the dominant global discourses on surrogacy will be unfamiliar to the general population, and the objective was also to position the results within the divergent global discourses of surrogacy.

METHODS:  In order to explore local views on surrogacy, we conducted individual interviews and focus group discussions with people from various socioeconomic groups in Assam.

RESULTS: Our findings reveal that people in Assam perceive surrogacy as a good option for a childless couple, as it would result in a child who is a 'blood' relation - something highly desirable for sociocultural reasons. However, the part played by the surrogate mother complicates local views on surrogacy. Most people consider payment to the surrogate mother contrary to societal norms. A surrogate mother is also often judged in a moral light, either as a 'bad mother' for selling her child, or as a 'noble woman' who has helped a childless couple and deserves payment for her services.

CONCLUSIONS: In order to decrease the stigmatization of women, a regulatory policy is needed that will take into account the complex understandings of surrogacy and perceptions of surrogate mothers in Indian society. In policy, the possible effect of the dominant exploitation discourse needs to be modulated by local understandings of this reproduction method.

Place, publisher, year, edition, pages
2017. Vol. 10, no 1, article id 1328890
Keywords [en]
Childlessness, in-vitro fertilization (IVF) surrogacy, low-income setting, motherhood, stigmatization, surrogate mother
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-327390DOI: 10.1080/16549716.2017.1328890ISI: 000403498600001PubMedID: 28604252OAI: oai:DiVA.org:uu-327390DiVA, id: diva2:1130514
Available from: 2017-08-10 Created: 2017-08-10 Last updated: 2019-06-19Bibliographically approved
In thesis
1. Challenges of transnational parenthood: Exploring different perspectives of surrogacy in Sweden and India
Open this publication in new window or tab >>Challenges of transnational parenthood: Exploring different perspectives of surrogacy in Sweden and India
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Transnational surrogacy challenges traditional norms of parenthood, especially motherhood; additionally, it is viewed as the exploitation of poor women. The overall aim of this thesis was to shed light on the consequences of an unregulated situation on surrogacy in the Swedish and Indian contexts, and to give different perspectives on surrogacy and the surrogate. The experiences of using transnational surrogacy and the consequences of using this reproductive method in a context of a largely unregulated situation had rarely been explored at the start of the study. Between 2012 and 2015, qualitative interviews were conducted with commissioning parents in Sweden who used transnational surrogacy mainly in India, as well as with social workers in Sweden, who have handled cases regarding the legal recognition of parenthood. To capture a non-western perspective on surrogacy, the views of women and men in different social strata in Assam, India were explored through individual interviews and focus group discussions. At the start of the project, India was the most common country to turn to for surrogacy. The results reveal that both commissioning parents and social workers needed to navigate inadequate parental legislation, with the result that commissioning parents felt questioned as parents. Social workers tried to balance the protection of the surrogate’s rights with the child’s best interest. The ethical aspects made the users of surrogacy ambivalent, and, for social workers, it resulted in further reluctance to handle legal parenthood cases. However, from an Assamese point of view, no ethical considerations were expressed; instead, the surrogate would either be stigmatized for her act and seen as though she was “selling her child,” or seen as a woman doing a noble act, helping a childless couple. All the informants demonstrated a pragmatic view of legal parenthood, but the current legal situation in Sweden limits the scope to act as parents in relation to society, because of the length of time it takes to be recognized as legal parents. This comes with a risk for children. From the perspective of reproductive justice, a clearer regulation on surrogacy, and kinship rules that are more adjusted to the current family practice, are needed. Additionally, to limit the risks for all parties involved in the surrogacy process, a more transparent surrogacy process is needed.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 118
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1580
Keywords
Transnational surrogacy, Surrogacy, Assisted reproduction, Commissioning parents, Legal parenthood, Social workers, Exploitation, Surrogate, Motherhood, Kinship, Social constructionism, Reproductive Justice, Sweden, India, Assam
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-385699 (URN)978-91-513-0690-2 (ISBN)
Public defence
2019-09-27, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2019-09-06 Created: 2019-06-19 Last updated: 2019-09-17

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