Ugandan women rent wombs

By Carol Natukunda

IT was a miracle when a virgin bore a baby and later gave birth to Jesus, on what is commemorated by Christians as Christmas day.

Today, there is technology that allows a woman to bear a child without having sexual intercourse. And that technology is here in Uganda. Last October, Claire gave birth to a baby she had to immediately hand over to its biological parents. They could not have a baby so they rented her womb for sh6m - a considerable amount for a single mother who runs a telecom shop in the city.

“I have two children of my own,” says Claire, who withheld her second name. “That couple had none, yet they have been together for ten years.”

The childless couple lives in Buziga in Kampala. Claire was their close friend since childhood. When they learnt of the rent-a-womb phenomenon, they asked her to carry the child for them. Three Ugandan women have given birth by this method in the last two years, according to Dr. Tamale Ssali, a gynaecologist and director of the Bukoto based Women’s International and Fertility Centre. This process is called surrogate motherhood – where in case a woman can’t conceive normally because her womb or uterus either has an infection or has been removed, she can use the alternative.

She can have her eggs artificially fertilised with her husband’s sperms in a test tube, after which she seeks a volunteer (surrogate) to carry the fertilised egg in her womb. Usually, the surrogate mother is advised to sign a contract.

Ssali says four babies have been born through surrogacy since the hospital was set up. In 2006, the first surrogate mother gave birth to twin boys. The 29-year-old was hired at sh4.5m. Ssali, however, acknowledges that on average, they receive about five inquiries every week on surrogacy, although many of them never come back.

While the hospital helps couples to look for a surrogate mother, some come with their friends or relatives, who offer to do it voluntarily, according to Ssali.“Some surrogates are paid between sh4m and sh6m, but for some couples it is just a token of appreciation to the surrogate mother,” he explains.

Hiring a womb arises from a number of problems, Ssali observes. Some women may have overgrown fibroids in the uterus which cannot allow them to conceive, others may have lost their uterus as a result of excessive bleeding during previous childbirth or a serious infection, which may have caused the uterus to rapture. Another common illness is endometriosis, a condition in which the uterus gets inflammed. “A uterus is like a ground for growing. If the lining has scars, nothing can grow in it,” Ssali says. “The woman may have the eggs, but if there is something wrong with the housing, then the embryo cannot grow.”

With such tales, surrogacy is the only resort – if not adoption - after years of emotionally and physically painful treatments and years of waiting. But it is not easy getting a surrogate mother, given the stigma that comes along with it.

Claire, for instance, confides that she had to take her two children – one aged nine and another 13 - to her mother’s home in Mityana, about 70km from Kampala, so that they would not keep asking her where the pregnancy came from. With the money she earned, she was able to reunite with her children but had to shift from her two-bedroomed house in Kyengera because neighbours would also ask about the baby. “What do you tell your neighbours who have seen you pregnant? Where do you say you put the child?” she explains. Dr. Ssali concurs: “surrogacy is a new phenomenon in Uganda. People are curious and this is a bit disturbing to the women.”

It is also expensive. Not only would the couple have to cater for the expenses of the antenatal care and gynaecology tests of the surrogate mother, they also have to meet the cost of the in-vitro fertilisation, which could be as high as sh6m. This implies that one could actually spend over sh14m.

In developed countries where surrogacy is a common phenomenon, new emotional challenges have also been identified.

There are stories of surrogate mothers developing an emotional bond with the babies they are carrying and after delivery, they do not want to let go of the child. Ssali says such cases have not arisen and states that to avoid the attachment, the baby is taken away immediately after delivery. The egg owner brings the surrogate mother for antenatal visits. But as soon as she gives birth, she is not allowed to see the baby. “She can’t even breastfeed. Besides, she is counselled and fully prepared before she signs the contract,” Ssali says.

Claire says although she was worried about what other people would say, she did not have any emotion for the child. She thinks it is because she had been psychologically prepared to appreciate that the child was not hers. “I did it for money, but now I am proud to have rendered such a service to a woman who lost her womb to cancer at the age of 22,” she says. Claire adds that renting her womb did not give her any complications. “It wasn’t different from my previous pregnancies,” she said. “My feet swelled, my moods swung and I got morning sickness.”

But it is not as easy as it happened with Claire. Without giving details, Ssali says the process of in-vitro-fertilisation (IVF) is sometimes “a complicated one. Sometimes it fails.”

While this is welcome technology to barren women, there are problems with legal guidelines in Uganda on the issue.

We do not have any law about surrogate motherhood. India is set to draft new laws to police surrogate pregnancies amid fears that the country’s booming rent-a-womb industry is running out of control.

With many women willing to offer their wombs, exploitation has set in. Surrogate mothers are willing in spite of the cheap medical care. Absence of legal controls has allegedly made India the world leader in commercial surrogacy, attracting foreigners, many of them British.

Employing a surrogate and medical fees in India costs as little as 500,000 rupees (£6,000), compared to about £35,000 in the US. By contrast, in the UK, offering money to somebody to carry a child – or even advertising for one – is illegal. This points to the ease with which relatively rich foreigners are able to rent the wombs of poor people, creating a potential for exploitation. internationally, there is a default legal assumption that the woman giving birth to a child is that child’s legal mother. As such, she may have a right to visit it when she wants to. In some jurisdictions, intended parents may be recognised as the legal parents from birth.

Many states issue pre-birth orders through court, placing names of the intended parents on birth certificate. In others, surrogacy is either not recognised, or is prohibited.