Egg Donation and Exotic Beauty

Chapter 3 analyzes constructions of skin color and race in intended parents’ narratives about the experience of selecting an egg donor. This chapter shows how egg donors of different backgrounds are differently valued, bolstering social hierarchies. At the same time, the chapter describes the diversity of ways that intended parents approach race and skin tone when choosing an egg donor. In contrast to dominant assumptions that intended parents seek donors who match their own ethnic backgrounds in order to reproduce whiteness, the process of egg donation represented an opportunity for many intended parents to subvert racial hierarchies by selecting Indian donors with darker skin tones. The chapter argues that such narratives, however, misrecognize donor egg selection as an opening to challenge racial hierarchies; instead, such decisions rely on essentialized notions of race and beauty that exoticize Indian women and reflect new articulations of biological race.

Conclusion

The Conclusion reflects on the various themes discussed in the preceding chapters, elucidating the ways in which transnational surrogacy can be considered a technology of race. By viewing surrogacy as a technology of race and analyzing the ways in which racial reproductive imaginaries work to naturalize and maintain structures of inequality, this book shows how understanding the ways in which inequality becomes taken for granted is key to dismantling those very processes and the structures of which they are a part.

Constrained Agency and Power in Surrogates’ Everyday Lives

Chapter 7 outlines the complexities of agency, constraint, and inequality in the lives of women who become surrogates in India. Women’s personal narratives reveal the global surrogacy industry’s reinforcement of a broader stratification of reproduction. They also show women’s resistance to victimhood. In the context of physician racism and structural inequalities discussed earlier in the book, this chapter analyzes how women challenge racialized constructions of Indian surrogates to create new opportunities for themselves and their families, albeit within larger structures of power. The chapter also examines the roles of women, many of them former surrogates, who act as intermediary agents. The chapter shows how the creation of intermediary positions reinforces the increasingly refined hierarchies inherent in transnational surrogacy. By revealing the many ways in which women exert (limited) power, the chapter highlights the social divisions inherent in transnational surrogacy.

Medicalized Birth and the Construction of Risk

Extending the discussion of physician racism in chapter 5, chapter 6 explores the ways in which doctors provide medical technologies and treatments to surrogate mothers, arguing that doctors racialize women who become surrogate mothers in ways that construct the surrogate mother and her pregnancy as always and already high-risk. This chapter contends that this construction contributes to the justification of excessive medicalization in surrogate pregnancies. The chapter shows how doctors rely on practices of social control and excessive medicalization to control women’s pregnancies, which culminate in soaring rates of cesarean sections among surrogate mothers. This chapter illuminates how gestational surrogacy and cesarean delivery are inextricably intertwined; these interrelated processes stem from practices that racialize this group of women as inherently risky. The chapter concludes with an analysis of the ways in which surrogates understand and negotiate these practices of medicalization and social control, focusing on their views and experiences of cesarean section.

Physician Racism and the Commodification of Intimacy

Chapter 5 offers an in-depth analysis of the key role that doctors play in organizing and facilitating surrogates’ relationships with commissioning parents. By examining how doctors influence the ways in which surrogates themselves understand and negotiate their relationships with commissioning clients, the chapter argues that Indian doctors racialize surrogates in ways that justify their unequal position in surrogacy arrangements. The chapter first addresses the ways in which doctors articulate their own role in transnational surrogacy arrangements, demonstrating how they structure relationships and facilitate communication between clients and surrogates. The chapter then examines surrogates’ narratives regarding their relationships with intended parents, demonstrating how physicians’ practices powerfully shape how surrogates view their own relationships with commissioning clients and fetuses. This chapter shows how physician racism and a racialized labor market shape surrogates’ views of commissioning parents as actors in an economic transaction, rather than as co-collaborators in the creation of babies. Yet while doctors develop racial reproductive imaginaries through which they justify their treatment of surrogates, surrogates simultaneously describe this treatment as problematic and disrespectful, and perceive their inability to communicate directly with clients as a mark of disrespect.

The Making of Citizens and Parents

Chapter 4 examines the ways in which notions of citizenship and nationality intersect with ideas of race and kinship in the context of transnational surrogacy. With increasing numbers of people traveling from other countries to India in order to commission surrogate pregnancies, there have been reports of parents unable to obtain citizenship for their children born in India. This chapter explores what happens when incompatible national legal frameworks, policies about surrogacy, and practices of assigning citizenship intersect in the context of transnational surrogacy in India. The chapter focuses on the process of gaining citizenship in two countries that illustrate the range of approaches to transmission of citizenship: the United States and Norway. In particular, the chapter analyzes how ideas about citizenship and motherhood intersect with racial ideologies (related to blood and genes) to take on new meanings through transnational surrogacy processes. The chapter argues that while assisted reproduction may expand conventional understandings of kinship and family, it also renaturalizes state definitions of citizenship and motherhood.

Making Kinship, Othering Women

Chapter 2 examines how commissioning parents create and make sense of their relations with surrogates, egg donors, and the children born through surrogacy. This chapter asks: How do intended parents narrate their family’s origin stories? Within these narratives, what kinds of racial ideologies do they rely on? The chapter argues that commissioning parents construct boundaries that position the surrogate as racially Other to themselves and their families, in ways that allow them to focus on Indian women alternately as objects of rescue or as shrewd actors involved in economic transactions. The chapter shows how these narratives serve to naturalize inequities between commissioning parents and surrogates in order to justify their participation in unequal economic arrangements.

Public Health and Assisted Reproduction in India

Chapter 1 describes the emergence of India as a global surrogacy destination within a broader discussion of public health, assisted reproduction, and medical tourism. By critically examining the political-economic contexts of transnational reproduction, the chapter considers the practice as a “racialized therapeutic landscape” that illuminates the sociopolitical dynamics within which gestational surrogacy has thrived. The chapter suggests that in order to grasp the contemporary politics of reproduction in India, readers must analyze the foundations of racialized politics of power in transcultural health care settings. The chapter complements this analysis with a description of the range of clinics and surrogacy practices one may encounter in India. While the chapter approaches commercial surrogacy in India through a transnational lens, it also investigates the context of surrogacy “on the ground” in order to demonstrate how the construction of therapeutic landscapes produces and perpetuates certain stereotypes about race.

Introduction

The introductory chapter begins by grounding the reader in Mumbai through a description of various fieldwork encounters that reveal the ways in which surrogate mothers, parents, egg donors, and surrogacy brokers, among other actors, navigate relationships with each other in the process of transnational surrogacy. The chapter situates Indian transnational surrogacy in the context of scholarly debates about assisted reproduction. The chapter then discusses the theoretical foundations of the book, which focus on the concepts of stratified reproduction and racial reproductive imaginaries. Ultimately, the chapter outlines the overarching argument of the book, which holds that reproductive actors rely on racial reproductive imaginaries in order to make sense of the transactional exchanges underlying family formation in the context of ARTs. More broadly, it illustrates the unexpected ways in which processes of racialization in transnational reproduction reflect and reinforce local and global inequalities. Finally, the chapter discusses the methods used in research, as well as the organization of the book.