Surrogacy Bill should address health safeguards: Sonali Kusum, Ph.D Research Scholar NLSIU Bangalore.
Maternal mortality of surrogate mother and lack of reproductive health safeguards in Surrogacy Bill, Economic Times, ETHealthWorld | June 27, 2017, 06:19 IST available at http://health.economictimes.indiatimes.com/news/policy/surrogacy-bill-should-address-health-safeguards-sonali-kusum/59329910
The proposed surrogacy (regulation) bill 2016 emphasizes on controlling exploitation of surrogate mother but lacks reproductive or maternal health safeguards for surrogate mother. This assume greater significance following landmark judicial pronouncement in Laxmi Mandal vs Deen Dayal Harinagar Hospital ( 2008) declaring maternal or reproductive health as facet of right to life under article 21, read with directive principles of state policy ( article 42 ) imposing obligation on state to uphold safe motherhood under Indian constitution.
Unlike normal pregnancy, surrogate pregnancy involves hormonal treatment, in vitro fertilization (IVF) technique accordingly carries aggravated health risks as negative hormonal drug reaction, nausea, vomiting, stomach pains, swelling, shortness of breath, ovarian hyper stimulation syndrome (OHSS) leading to maternal mortality among others. There have been a few reported cases of death of surrogate mother Easwari (30) died of excessive bleeding after giving birth to surrogate baby at a surrogacy clinic in Coimbatore Tamil Nadu in 2009yr. Another surrogate mother Premila Vaghela (36) died in eight month of her pregnancy following a similar condition as pre-eclampsia while giving birth to a premature surrogate child in Gujarat. A Jharkhand based women, Ranjeeta Lal (29) was forced to be surrogate for her sister-in-law’s baby by her husband and in-laws, she died of a massive heart attack while giving birth to a boy at Ranchi.. These cases further worsens the maternal mortality rate ( MMR) of India which is highest in the world.
The surrogacy bill 2016 provides for insurance of surrogate mother only. The Surrogacy bill lacks post delivery care for surrogate mother. The surrogacy bill does not prescribe permissible number of embryo transfer , cycles of IVF, these are left to be prescribed under the rules subsequently. Nor does the surrogacy bill refer to performing of multiple pregnancy, foetal reduction.
It may be noted that the surrogacy bill 2016 appears retrograde as compared to the earlier Assisted Reproductive Technology (ART) Bill 2014 which provides for life of surrogate mother to be protected over the life of unborn child in life threatening situation [ART Bill 2014 Section 60 (30)]. Imposing liability on clinic in case of death or disability of the surrogate mother, it shall be presumed to have been caused by the negligence of the assisted reproductive technology clinic unless proven otherwise [Section 60 (34) (a) ART bill 2014]..This generates accountability on the ART clinic towards surrogate mother and checks scope for medical malpractices or misuse of technology. Additional compensation in case of death of surrogate mother for the surviving children and family of surrogate mother. [ ART Bill 2014 Section 60 (29) ]. This is particularly relevant in case of surrogate mothers who is single parent as widow or divorcee, as her child runs the risk of being orphaned.
There is no provision in the surrogacy bill 2016 on registration of woman in the hospital as acting surrogate mother for the concerned couple and ART treatment performed, medication administered to surrogate mother. Though the earlier ART Bill 2014 provided for similar provision. Consequently there is no record on total number of MMR in case of surrogate pregnancy annually in India.
Though the surrogacy bill 2016 provides for conduct of abortion or medical termination of pregnancy which is a statutory right of every Indian women as per the prescribed conditions in Medical termination of Pregnancy (MTP) Act but this surrogacy bill makes abortion conditional upon obtaining authorisation from the appropriate authority before performing abortion. This is unjustified abridgment of the statutory reproductive health right of women and unnecessarily procedural. Besides, obtaining such authorisation may impede urgent medical intervention to save the life of surrogate mother thus may act against the interest of surrogate mother.
In light of above, the condition of surrogate mother remains vulnerable to health exploitation, therefore surrogacy bill needs reconsideration and effective measures to curb the same.