As the mother of two adopted boys, I am for adoption, but now we are seeing couples like Sarah JessicaParker andMatthew Broderick “renting” a womb to obtain their newest child.

What’s wrong with this picture? After all, they give money, and a woman is paid a lot of money to carry their (genetically related) baby to term. End story.

Well, the dirty little secret is that it doesn’t stop there.

For years, Asian children have been legally adopted by those outside the country. Because of abuses, countries like India and China have tightened the laws to prevent “child trafficking”, where children are literally bought by parents, no questions asked.

But now there is a loophole: Child surrogacy.

Since the “father” of the child is the sperm donor, he does have rights to claim the child. Hence the growing but unregulated surrogacy business that is spreading in Asia.

Why Asia?

Because it’s cheaper.  From ABS-CBN:

Der Spiegel magazine, in a September 25, 2008 piece called  “The Life Factory”, estimated that commercial surrogacy in India costs US$10,000, and between US$50,000 to US$80,000 in the US.  (See http://www.spiegel.de/international/world/0,1518,580209-3,00.html)

Here in the Philippines, the price would be higher: about $30,000.

That would be a windfall for a lot of people here,  and because poor people are often desperate for the “pot of gold”. (Half the people in the Philippines live on $2 a day; in Manila, the minimum wage is about $0.50 an hour).

So what’s the problem?

The same as the problems with our “kidney donors”.

Here in the Philippines, buying kidneys is illegal.

So often a middle man finds a poor person who wants to donate the kidney out of the goodness of his heart, and connects the donor with a recipient who will pay all the medical expenses for the donation.  Of course, after the kidney is donated, the grateful recipient gives all of them a nice “thank you” gift.

One: often the donor (or in this case the surrogate mom) won’t get most of that fee, which will be siphoned off by various “middle men”. (for kidney donors, it is less than a quarter of the”thank you gift” from the recipient).

Two: Often the donor (or surrogate mom) won’t be properly screened for health problems.

Three: There won’t be a follow up for health problems caused by the donation.

And in the case of surrogacy, we run into more problems.

Like “private” adoptions, we don’t know if the person receiving the child to care for is psychologically able to do a good job. Is the adoptive parent a user of drugs, are they someone who has serial partners (live in paramours are a major cause of child abuse), or mature enough to raise a child (i.e. not just wanting a child to show off)?

Of course, as Madonna’s adoptions in Malawi show, if you have enough money, you can get poor countries to bend the rules for you, but in this case, it is even more worrisome.

In the ABS-CBN report,  one surrogacy was a European man working in Thailand.As the “sperm donor” he had a “right” to raise the child, but did anyone do a home check to see who would care for the child?

In another report, the child was adopted by a male gay couple. This brings up another problem: Was the sperm donor in this couple checked for HIV, so that the surrogate mom wasn’t put at risk?

And what if the child is found to have a genetic defect? Who cares for the child? And what happens to the child if the requesting parent decides halfway through the pregnancy that they don’t want the kid, and stop paying mom’s expenses?

But the real story is not surrogacy, where the physical risk to the mother is not much more than that of carrying her own child.

But the real risk is to the emotional health of the mom.

From ABS-CBN:

Even in a macho society like the Philippines, some men would apparently agree to their female partners becoming surrogates. “Why not?,” taxi driver Nolan Lopez told Newsbreak when he learned how much it pays. “Anyway there’s no sex involved,” he said.

He was surprised when his partner, Jannylyn Macalincag, objected saying: “If even a mere cellphone becomes precious to me over time, what more a baby that I would carry inside me.”

But in a cold-hearted material world, who cares about mothers who mourn the child of their womb?

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Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket, and she writes medical essays at HeyDoc Xanga Blog.