Perhaps you heard about the fire in a garment factory in Karachi, Pakistan last month. Faulty wiring, dangerous chemicals, even locked doors: a chilling example of what happens when workers have no power and the responsibility for safety is deeded over to a group that is paid by the factories themselves.
It seems that Pakistan today is where the U.S. was about 100 years ago, when (in 1911) the Triangle Shirtwaist factory fire claimed about 150 lives (of about 500 total employees) and led to the ascendance of the International Ladies’ Garment Workers’ Union (“ILGWU”) and to the emergence of somewhat better safety regulations. (I know a bit about this. My grandmother was a member of the ILGWU, and did “piece work” for decades. The conditions remained horrible by modern standards but were a huge improvement over the previous status quo.)
What does this have to do with fetuses (feti?), you may be wondering….
When I heard about the Karachi fire, I found myself thinking about another exploited class of women: gestational surrogates in India. By referring to the practice as “biological colonialism,” some have tried to silence all debate about this practice, which involves rich Westerners renting poor women’s wombs at relatively bargain-basement prices. (For example, $12,000 instead of the $70,000 it might cost in the U.S.)
In both cases, the problem is simple to diagnose, and easy to rail against — but way harder to address seriously. Factory workers in Pakistan are willing to put up with the conditions because their economic choices are terrible. And Indian women are willing to become surrogates for complex reasons, but mostly because the money they can earn (less than 1/2 of the $12,000 the Western couple pays) is enough to provide a good start toward better life for their kids. Read these stories and then report back:
Vohra has no job but helps her husband in his scrap-metal business, for which they earn 50 to 60 rupees ($1.20 to $1.45) a day. If her pregnancy is successful, the $5,500 she receives will, as she puts it, “give my children a future.”
Growing up, Vohra worked in the wheat fields; she had little education. After her parents married her off at 16, she moved with her husband into a one-room mud house that erodes every year during the monsoon season. She plans to divide her surrogacy windfall three ways: buying a brick house, investing in her husband’s business, and paying for her children’s education. “My daughter wants to be a teacher,” she says. “I’ll do anything to give her that opportunity.
[Another surrogate] has five children of her own, a husband who’s a lazy drunk, and a job crushing glass that’s used in making (of all things) fortified kite string, for which she earns $25 a month.
“I’ll be glad when this is over,” she says, as [the doctor] places a stethoscope on her ballooning brown stomach. “It’s exhausting being pregnant again.” Then, in case her complaints are misunderstood, she quickly adds, “This is not exploitation. Crushing glass for 15 hours a day is exploitation.” (emphasis added)
What should we say about this?
We can take the absolutist view: All surrogacies are wrong. In the U.S., the law regulating the practice of one woman carrying the child destined to be parented by another is a ridiculous patchwork that ranges from the permissive, to the qualified (no paying the surrogate, for example) to the outright illegal. We can and should continue to debate which of these approaches is best.
But I’m not sure surrogacy is any worse just because Indian women are willing to provide the service at a lower cost. The article quoted above was originally from Marie Claire magazine, and the clinic featured in the story is run by a middle-aged, female doctor who seems to have the best interest and safety of all parties in mind. (But, sigh!, no same-sex couples are permitted…I don’t feel like getting into that right now. Focus, man!) Whatever the situation in that clinic, though, the practice is unregulated and there are surely enough horror stories of women who have been killed in the process. Here’s one such story.
The Indian government likes the financial lift the country gets from medical tourism, and this is — in one sense, at least — just one more example of that phenomenon. For now, it’s easy to criticize the practice because of the safety issues — just as we can and should call for better safety regulation of garment factories in neighboring Pakistan.
But what should we say to these women if there were better regulation protecting their safety? That they’re better off crushing glass for 12 hours a day, with no prospect of bequeathing a better life to their kids? That the world will — any day now — make a commitment to global health that will lift all ships?
Are we concerned about women’s health? Their autonomy? And what are the best ways of expressing that concern?