There is an interesting blog on commercial surrogacy in India in the NYT by Judith Warner. It is best to read the whole piece but here some excerpts:

“…the money [Indian surrogate mothers] were earning for their services — $6,000 to $10,000 – might have been a pittance compared to what surrogates in the United States might earn, but it was still, for their families, the equivalent of 10 to 15 years of normal income.

…Because what’s going on in India – where surrogacy is estimated now to be a $445-million-a-year business — feels like a step toward the kind of insane dehumanization that filled the dystopic fantasies of Aldous Huxley’s “Brave New World” and Margaret Atwood’s “Handmaid’s Tale.” (One “medical tourism” website, PlanetHospital.com, refers to the Indian surrogate mother as a mere “host.”) Images of pregnant women lying in rows, or sitting lined up, belly after belly, for medical exams look like industrial outsourcing pushed to a nightmarish extreme.

…Unlike in France, where commercial surrogacy is banned, or in Italy, where almost every form of assisted reproduction is now illegal, laws in the United States are highly ambivalent on this most drastic use of reproductive technology. Commercial surrogacy is legal in some states, illegal in others and regulated differently everywhere, and little that’s clear and conclusive about where a birth mother’s rights to a baby end and where the fee-paying mother’s rights begin.

…But our rules of decency seem to differ when the women in question are living in abject poverty, half a world away. Then, selling one’s body for money is not degrading but empowering. And the transaction is not outsourcing of the basest nature – not modern-day wet-nursing taken to the nth degree – but a good deal for everyone concerned. “There’s nothing wrong in this,” Priyanka Sharma, another surrogate, concluded the Marketplace segment. “We give them a baby and they give us much-needed money. It’s good for them and for us.”

In its perverse way, surrogacy does seem to bring a measure of empowerment to the poor Indian women who take part in it. Dr. Nayna Patel, the director of a popular clinic that draws dozens of poor rural women as surrogates every year, houses them and provides them with constant monitoring and medical care, told Marie Claire magazine last summer that she takes steps to ensure that each woman who contracts with her as a surrogate keeps control of her money afterwards. “If she wants to buy a house, we’ll hold her money for her until she’s ready. Or if she wants to put it in an account for her children, we’ll go with her to the bank to set up the account in her name,” she said.

Maybe when greater steps are taken toward improving international adoption procedures, maybe when more substantive steps are taken to improve the health, status and education of women world-wide, it’ll be easier to say with a clear conscience that what feels like callous exploitation really is just that.”

She quotes two additional online sources: a report by ABC news and another from marieclaire.com. The ABC report says that the practice has been legal in India since 2002. The report also raises the twin concerns of growing third world baby farms more out of convenience than necessity and compromises on safety to cut costs in a relatively unregulated marketplace:

“…if commercial surrogacy keeps growing, some fear it could change from a medical necessity for infertile women to a convenience for the rich. “You can picture the wealthy couples of the West deciding that pregnancy is just not worth the trouble anymore and the whole industry will be farmed out,” said Lantos.

Or, [Dr. Lantos from Center for Practical Bioethics, Kansas City] said, competition among clinics could lead to compromised safety measures and “the clinic across the street offers it for 20 percent less and one in Bangladesh undercuts that and pretty soon conditions get bad.” The industry is not regulated by the government. Health officials have issued nonbinding ethical guidelines and called for legislation to protect the surrogates and the children.”

The report also says that reliable numbers regarding the extent of the practice are hard to come by though doctors work with surrogates in every major city. For this reason, I am not sure how far the eye-popping number of $445 million, quoted in the Marie Claire report without reference, is reliable.