Surrogacy Under Scrutiny

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With its soft pink background and the picture of a happy, healthy baby, at first sight, Ymdaiyun.com looks no different from any other website that caters to the needs of expecting mothers.
But the website doesn’t sell nappies, or formula milk, strollers or any of the other products usually associated with motherhood. Rather a cursory skim of its text reveals that it is in fact a surrogacy intermediary website.
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. At present, doctors in China are banned from performing surrogacy procedures, according to a 2001 regulation on assisted reproductive technology released by the Ministry of Health.
The regulation also prohibits the trading of any human gamete, zygote or embryo.
Despite this regulation, an illegal surrogacy black market continues to thrive in China. At the end of 2011, surrogacy was brought to the public’s attention by a wealthy couple in south China’s Guangdong Province, who had surrogate mothers give birth to five of their eight children.
The rich couple had failed to conceive a baby after years of marriage, so they turned to assisted reproductive technology. Eight embryos were cultivated in test tubes, and they all survived. So the couple, opting to keep all of them, had five carried by two surrogate mothers and three by the wife.
The story of these babies born in the fall of 2010 was leaked by a photography studio in late 2011.
“The case of the eight babies in Guangdong shows the extent to which humanassisted reproductive technology can be abused,” said Dong Yuzheng, an ethicist and Secretary General of the Guangdong Family Planning Association (GFPA).
A service for the rich
The Guangdong surrogacy case is only the tip of the iceberg. The website Aa69.com operated by Lu Jinfeng, the self-proclaimed “Father of Surrogacy in China,” said that since Lu’s agency began to recruit “volunteer” surrogate mothers in January 2004, it had overseen more than 6,000 successful surrogate births.
There are approximately 500 surrogate agencies of various sizes across China, and about 50 of these are located in Guangzhou, capital of Guangdong, according to the Shanghai-based Xinmin Weekly. Since 2004, many of these agencies have been recruiting surrogate mothers and reaching intended parents online.
Some prospective parents also search for surrogate mothers through online instant messaging platforms such as QQ. The Guangzhou-based Southern Daily recently found more than 180 QQ groups dedicated to surrogacy, and estimated that these groups have approximately 30,000 members, the majority of whom are looking for surrogate mothers.
An infertility report released by the China Population Association in 2010 said that one out of eight Chinese couples of childbearing age had difficulty conceiving, the rate is four to five times higher than that reported 20 years ago.
While some women chose surrogacy for health reasons as they cannot carry babies for the term of their pregnancy, successful women are increasingly seeing surrogacy as an option so that their careers and figures will not be affected by pregnancy. Some couples also use surrogacy to dodge the one-child policy. China adopted the policy since the mid-1970s to slow population growth, which allows most urban couples to have only one child.
Currently, the cost of surrogate birth is high in China. The wealthy couple in Guangdong Province reportedly spent nearly 1 million yuan($158,692) on two surrogate moth
ers and related medical procedures for their eight babies.
The surrogate plans offered by Ymdaiyun. com cost from 280,000 yuan ($44,434) to 550,000 yuan ($87,281).
A plan listed on the website says the intended parents should pay the surrogate agency 14,000 yuan ($2,222) for introducing them to a surrogate mother, and 35,000 yuan ($5,554) for introducing them to doctors who will
perform required medical procedures.
These medical procedures cost about 40,000-70,000 yuan ($6,348-11,108) and the living expenses and remuneration for the surrogate mother add up to about 191,500 yuan($30,390).
The website says that the net pay to a surrogate mother is 80,000 yuan ($12,695) to 100,000 yuan ($15,869).
A reporter with the Guangzhou-based Information Times has made undercover visits to the residences of surrogate mothers hired by Lu’s agency. She found that the women who chose to be surrogate mothers did so because they needed money to improve their lives.
Of the three surrogate mothers the reporter talked to, two were divorced and have their own children, and wanted to make some money to raise their own children; while one woman was single and wanted to use her earning as surrogate mother to build a house for herself and then find her Mr. Right.
Legal void
Although the Ministry of Health bans medical institutions and personnel from performing surrogacy procedures, Lu said the ministry does not have the power to prevent the emergence of a private surrogacy market outside the formal medical system.
Dong of GFPA said that the regulation on assisted reproductive technology is an administrative rule rather than a law, and since there are ambiguities about the rule’s enforcement, some people have taken advantage of this loophole to engage in commercial surrogacy.
After the story of the Guangzhou couple’s octuplets was published, the Department of Health of Guangdong Province set up a special group to investigate the case, and said that those who violate existing regulations governing surrogacy would be seriously punished.
But the punishments currently stipulated in the regulations have been blamed for being insufficient to deter a medical institution from performing surrogacy procedures.
Those found to have violated existing regulations governing surrogacy will be given a warning, a fine of 30,000 yuan($4,761) and administrative sanctions by relevant provincial health authorities.
Given the high profitability of surrogacy, the fine does not serve as a strong deterrent. The Southern Daily newspaper found that in a surrogacy procedure priced at 280,000 yuan ($44,444), hospitals make 60,000 yuan($9,522) in operation and medicine costs.
The paper said that doctors performing surrogate procedures in Guangzhou usually receive as much as 60,000 yuan to 120,000 yuan ($19,044) for each baby.
Given the high financial rewards, some doctors, especially those in private hospitals, are prepared to perform the procedures under table.
Moreover, to circumvent the regulations entirely, some big surrogate agencies even send surrogate mothers they hire in China to get embryos implanted in foreign countries like India and Thailand where surrogacy is legal, said Lu.
Surrogacy involves many risks, such as possible birth defects, abortion, the safety of the surrogate mother and the possible divorce, or death of the intended parents during the surrogate mothers’ pregnancy. Currently, the liabilities and compensations regarding any legal dispute are spelled out in contracts between surrogate agencies, surrogate mothers and intended parents.
For instance, the contract between Lu’s agency and its surrogate mothers says that if a surrogate mother dies in the contract period, and policy authorities determine that the intended parents are liable, then the intended parents are liable to pay the surrogate mother’s family an indemnity of 100,000 yuan($15,873).
“But surrogacy contracts are invalid as commercial surrogacy procedures are illegal in China. So if one party breaches the contract, it is very difficult for the other party to receive legal protection,” said Wan Xin, a director of the China Health Law Society.
The parent-child relationship in surrogate births is another legal and moral concern. If a surrogate mother decides to keep the baby, it is also difficult for the intended parents to take legal action.
Wan said that China’s marriage law and inheritance law regard the woman delivering the baby as the legal mother.
Wan said that the government should actively make laws governing surrogacy. He suggested that surrogacy should be permitted only for couples of childbearing age who cannot conceive and deliver their baby through other means and who conform to the family planning policy.
Zhang Lizhu, a professor at the Beijing Medical University (now Peking University Health Science Campus) who cultivated the first test-tube baby on the Chinese mainland in 1988, is also on record saying that the government should strictly regulate surrogacy rather than simply outlawing it.
Zhang said that if a law permitting surrogacy is introduced, the Ministry of Health would be able to authorize a small number of qualified hospitals to perform surrogacy procedures and require such procedures to be approved by designated agencies and an ethical committee.
She said that in this regulated environment, surrogacy will not be abused and the technology will allow couples who cannot conceive naturally to realize their dreams of having children.
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