Thursday, December 30, 2010
From the Wall Street Journal on international baby creation markets:
In a hospital room on the Greek island of Crete with views of a sapphire sea lapping at ancient fortress walls, a Bulgarian woman plans to deliver a baby whose biological mother is an anonymous European egg donor, whose father is Italian, and whose birth is being orchestrated from Los Angeles.
The birth mother is Katia Antonova, a surrogate. She emigrated to Greece from Bulgaria and is a waitress with a husband and three children of her own. She will use the money from her surrogacy to send at least one of her own children to university.
Mr. Rupak is a pioneer in a controversial field at the crossroads of reproductive technology and international adoption. Prospective parents put off by the rigor of traditional adoptions are bypassing that system by producing babies of their own—often using an egg donor from one country, a sperm donor from another, and a surrogate who will deliver in a third country to make what some industry participants call "a world baby."
They turn to PlanetHospital and a handful of other companies. "We take care of all aspects of the process, like a concierge service," says Mr. Rupak, a 41-year-old Canadian.
Clients tend to be people who want children but can't do it themselves: families suffering from infertility; gay male couples. They may also have trouble adopting because of age or other obstacles.
And they're price sensitive. PlanetHospital's services run from $32,000 to around $68,000, versus up to $200,000 for a U.S. surrogate.
Overseas surrogacy has other advantages. Surrogates in some poorer countries have little or no legal right to the baby. In Greece, a surrogate can be prosecuted for trying to keep a child. By contrast, some U.S. surrogates have tried to legally claim the children they've carried.
The process can bring profound dilemmas. In some cases, clinics end up creating more fetuses than a couple needs, forcing a decision over whether to abort one or more pregnancies. Babies carried to term occasionally find themselves temporarily unable to get a passport.
Mr. Rupak is learning to navigate the uncharted nature of his field—the stateless babies, the ethical complexities. His expansion to Greece, a European Union member nation, is specifically intended to lessen the likelihood of the passport problem for European parents-to-be.
Some of his own clients have faced the abortion decision, Mr. Rupak says. "Sometimes they find the money" to pay for more children than they expected, he says. After all, they went to such lengths. And if they decide otherwise, Mr. Rupak says, "We don't judge."
Critics say the business is strewn with pitfalls. "The potential for abuse on many levels is big," says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, discussing the industry in general terms. "You're straddling all these [international] boundaries to buy the ingredients and the equipment." Mr. Caplan calls it the "wild, wild west of medicine."
Laws are vague and can conflict from country to country. In 2008, baby Manji was born to an Indian surrogate just weeks after the divorce of her Japanese parents-to-be. (The family wasn't a PlanetHospital client.) According to a Duke University case study in legal ethics, it led to a tangle of Indian and Japanese law that first prevented the little girl from being issued a birth certificate, and later made it difficult for her father bring her home to Japan. Months went by. To fix the problem, Japan issued a special humanitarian visa.
"This area of law is very unsettled," says Evgenia Terehova, PlanetHospital's lawyer. "There can be all sorts of unforeseen circumstances."
Read the full article here.