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Friday, December 5, 2014

Surrogates find little emotional support

CHENNAI: Dressed in a loose nightgown to conceal her baby bump, Kala, along with three other women, sat expressionless as a doctor explained the process of fertilization to a room full of expectant couples. They had been through this over a dozen times, but for these surrogate mothers, the presentations were little more than a bunch of drawings with a lot of colourful pointers. What they longed for was someone to talk to and an ear to listen.

While legal and medical counselling for surrogate mothers in many fertility clinics entail a couple of rounds of discussions that end in signing a sheaf of papers, salve for their emotional wellbeing often goes ignored. Very few clinics have full-time counsellors and experts say these psychologists often work in the interest of hospitals and commissioning parents.

"Surrogacy is a complicated arrangement, not just legally but emotionally as well," said Deepa Venkatachalam of Sama, a New Delhi-based resource group that works with issues of women and health. A research undertaken by the group in Delhi and Punjab found that none of the medical centres had counsellors. "Counselling was in the form of informal interactions and was directed towards ensuring that the surrogate relinquished the child to the commissioning parents while diligently following the instructions given to her," said Deepa. In Chennai, it is often the doctors who play the role of quasi-counsellors.

Even the ART Bill, which has been pending in Parliament since 2010, provides little in terms of emotional succour for those who rent their wombs. "The draft Bill mentions counselling should be available to patients accessing assisted reproductive technologies on the risks involved, but it doesn't mention anything about counselling for surrogate mothers or the commissioning parents," said Deepa.

Like the intended parents, surrogate mothers undergo emotional upheavals - the turmoil of informing their own children, the fear of becoming emotionally attached to the unborn child, the anxiety over being stigmatized if word got out.

"Many see surrogate mothers as sex workers of sorts, ignoring the altruism behind the act," said Kathiravan Venkatachalam of Start India, which counsels surrogate mothers. He said in most cases money was top priority for surrogate mothers in the beginning. His team explains the possible risks involved in the procedure and ask them to return after a month. "Of the 100 I counsel, only 10 come back. But once they commit themselves they are incredibly strong. The baby gains priority over money," he said.

He admitted that although he sent surrogate mothers to hospitals after counselling, problems arose later. "Sometimes the intended parents treat them as their employees and exercise their authority just because they have paid for their wombs," said Kathiravan. "They insist on tests the surrogates are not comfortable with, make them stick to a diet they dislike," he said.

Commissioning parents need counselling as well. Some couples also send just enough money for the surrogate mothers, ignoring their family. "How can they eat a hearty meal when their children are starving? All these issues need to be addressed through constant counselling - before, during and after delivery," he said. Experts say counsellors should also help the surrogates plan their finances with the money they get.

Doctors at fertility clinics say they rarely feel the absence of a counsellor as they are best placed to know the emotional status of surrogate mothers. "All the mothers who come to us are already mentally prepared. We counsel them every time they come for medical check-up," said Dr Geetha Jeganathan of G G Hospitals.

For many surrogates, their solace is often another surrogate. "When one surrogate mother leaves the hospital after delivery, she advises the other. We believe her because she's the only one who has been through what we have," said Hema (name changed), a surrogate in her second trimester.


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