The World’s Baby Factory: It’s already the world’s second-most populous country. So why is India turning 75 year old grandmothers into mothers?

February 12, 2012

Foreign Policy:

Four years ago, when she was expecting her first baby, Kisabai Biranje wanted desperately to be invisible. She tried for as long as she could to keep her pregnancy hidden behind the crumpled pleats of her floral printed cotton saris. But as the months passed, it became impossible to keep her bulging belly a secret.

Becoming a mother was Kisabai’s greatest joy. But pregnancy in the sixth decade of her life was also her greatest shame.

As her stomach began to show, it set off a trail of tarnishing gossip and innuendo in this agrarian town in India’s western sugar belt: How did she get pregnant in her post-menopausal years? Was the egg her own? Was the sperm her husband’s? Why would she want to become a mother at the age of a grandmother?

But her unremitting quest for motherhood, however risky — or risqué — at her age, kept her going. “We had nearly given up after more than two decades of marriage,” explains Kisabai, who does not have a birth certificate, but says she was born just after British colonial rule in India ended in 1947. “We went to doctors, shamans, god men — nothing worked.”

“Then we discovered a clinic that made childbearing at our age a reality,” chimes in her husband Mahadev Biranje, a 68-year-old sugarcane farmer. “When we told the doctor we were thinking about adoption, he said, ‘Why do you want to raise someone else’s child when you can have your own?’ We looked at him incredulously and said, ‘Can we really do that at our age?’”

The Biranjes discovered that in vitro fertilization (IVF) — a procreation technique that involves harvesting a woman’s egg from the ovary and fertilizing it artificially with a healthy sperm — could circumvent, if not undo, the deleterious influences of aging on female fecundity, making pregnancy possible even at an advanced reproductive age. For Mahadev, the procedure was akin to being plopped on a biological time machine that miraculously rolled back the years.

In recent years, thousands of fertility clinics have cropped up around India, spawning a new industry of “fertility tourism” for reproductively challenged couples from around the world. They are the medical equivalent of dollar stores, offering IVF treatment at a fraction of the cost in developed economies, and often without the strict regulations and waiting periods that elsewhere make the procedure a logistical nightmare. IVF — along with other reproductive specialties like surrogacy (the world-famous “womb-for-rent” business), hormone therapy, and gamete (egg or sperm) donation — are part of India’s flourishing fertility treatment business, on track to blossom into a $2.3 billion enterprise in 2012 according to the lobby group Confederation of Indian Industry. The sector, described as a “pot of gold” in a report by the Indian Law Commission, has earned India the dubious reputation of being the world’s baby factory.

Fertility clinics aren’t just serving the international market, they’re increasingly serving the domestic market as well. And regulation has not kept pace with the proliferation of clinics as India emerges as the Wild West of fertility. In recent years, facilities have been accused of a litany of shocking abuses — from exploiting impoverished women who became surrogate mothers to prescribing unapproved fertility drugs to delivering “stateless babies” who are refused citizenship by both their mother’s country and their Indian birthplace.

The Indian government is gearing up to pass a new law to regulate the fertility business, prepared by a 12-member committee of the Indian Council of Medical Research and expected to be tabled in parliament in the coming months. It mandates that all fertility clinics be registered with the government; spells out specific guidelines for the sourcing, purchase and storage of gametes; and also explicitly enumerates the health and legal rights of surrogate mothers and babies delivered by them.

But one pressing issue has remained beyond the purview of regulation: How old is too old to get pregnant?

In 2008, Rajo Devi Lohan, an Indian woman from a tiny village in the northern state of Haryana, became the world’s oldest mother at the age of 70.  About a year and a half later, Bhateri Devi, a 66-year-old from the same state, became the world’s oldest woman to give birth to triplets.

In India, as in many other countries, medically assisted procreation techniques have long been the preserve of the upper-class elite. But in recent years, with proliferating clinics hawking cheap treatment, it is fast becoming the trend du jour among middle- and working-middle class couples, including the elderly. Bearing children at an old age is considered anathema to cultural norms in India, as the Biranjes have learned, but it often does not overshadow the social pressure to reproduce.

After about five decades of a childless marriage, both of the Haryana women were impregnated by fertilized eggs implanted to their post-menopausal uteruses by Dr. Anurag Bishnoi, who runs a private fertility clinic in the city of Hisar. Lohan’s health rapidly deteriorated after her caesarean delivery and she suffered internal bleeding. In various media interviews, she said she is still surviving on pain killers and wasn’t forewarned by Bishnoi about the dangers of giving birth at her age…

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