I have been to Bangkok since I was a little girl. I have locked myself in hotel rooms in Bangkok, I’ve been lost in Bangkok markets, I’ve roamed the underbelly of cock-fighting dens and muay thai boxing rings on a bicycle, watched transvestite cabarets, and drank a mountain of roadside coconuts with my college buddies.
Thailand and in particular, Bangkok, thrills me with its amorality, its throbbing insouciant crowds and crawling traffic, the mix of cart vendors, heady smells of chilli and lemongrass and blue-collared workers humbles me in the bright, big, grim street picture of regular Asians struggling to make a living. For all the times I’ve been to Bangkok, I had never, created a map of Bangkok that listed their IVF facilities. It is not something I ever dreamed I would have to do.
On first sight, IVF in Bangkok, like everything else in Thailand, only appears straightforward, but then starts to look a little convoluted, like there’s some backstory you aren’t privy to. As in Singapore, doctors move around from clinic to clinic, when they get successful, they break away and start their own practice with alarming frequency. Different hospitals, offer deeply varying prices. It can feel like you’re buying from a farmer’s market that you don’t quite understand, and that can feel scary.
Even though much has been written up in forums and in truth, many people have sought treatment in Bangkok, there is no real comprehensive guide to the IVF centers and doctors and so few people are willing to share their information, that all research starts to feel like primary research.
Unfortunately, Thai IVF has been getting a bad rep from a surrogacy case gone very wrong. It’s been all over the news, an Australian couple paid a Thai surrogate who fell pregnant with their biological twins. One of the babies had Down Syndrome, which was discovered in the fourth month of the pregnancy and the surrogate refused a requested abortion of that foetus in the seventh month. When it was born, the parents left with just the normal twin and the surrogate, who has adopted the child, has gone public with her story, looking for compassion donations for his treatment and claiming to be unpaid from her surrogacy.
What a horrible situation. I cannot contemplate the parents leaving a child behind. Of course, there are now all kinds of information being dug out, that the father in this couple, had a previous incarceration for child molestation of young girls, which is now causing the surrogate to call for the return of the other (girl) twin. That the couple claim to never have known about the male twin. And of course, the last insult, that the couple used an egg donor and the lady is neither the genetic nor gestational mother. Even without these additional twists, the legalities and complexities of the situation are mind-wrenching and they make me sincerely pray that I would never need a surrogate.
And that, I feel, is wrong. Surrogacy is a wonderful thing and there are many examples and stories of successful and fulfilled surrogates and surrogacy parents. Surrogacy is one of the biggest and most precious gifts in life itself. It is just that when we hear about it, it’s on cases that have gone very astray. It is the legislation and regulation of surrogacy, where these issues become very clouded and entirely confused.
Many things in this story actually don’t stack up. If you consider the very inconsistent statements made, such as that paid surrogacy is not legal in Thailand and that gender selection is not legal nor permissible in Thailand, then I’m certainly not surprised that there has been such a case, rather, I am a little concerned that it spirals, particularly with the military junta, into a situation where IVF clinics are unduly punished and shut down in a reaction based on moral grounds.
First, Thailand does practice PGD or Comprehensive Chromosomal Screening. The test results are binding, that is, the doctor cannot transfer embryos that are clearly abnormal, as this is a risk to both the mother and child. Was it the case that this clinic wasn’t equipped to do PGD, or that the parents did not want to pay extra fees to do so? (This shouldn’t be overlooked, in fact in Singapore, we disallow PGD altogether and do 3-day transfers that anyway are too early for PGD to be assessed). The fact that the child’s condition was only discovered at 4 months, seems to suggest so. The fact that they transferred one male and one female embryo seems to suggest otherwise. Or, and more damningly, did the clinic tell the parents the wrong information, despite having done a PGD screen?
Second, once the embryos are in the surrogate’s womb, to whom does the legality over these embryos belong? Does the surrogate have the right not to terminate, or for that matter, to terminate a pregnancy that the adoptive parents do not wish to care for after birth? To my mind, if you have signed on to be a legal and paid surrogate, you cannot refuse an abortion, any more than you can independantly decide to get an abortion.
I actually know a little something about this issue. When we were doing IVF, the hospital made us sign legal forms that the embryos created belonged to my husband and I. Both of us had to sign consent, and in the case of either of our deaths, they would belong to the survivor. Much the same as a house, or any other kind of property. Of course one quirk of this, meant that in theory, I could be pregnant with our child long after he had passed on, or even after we had divorced and that he could in theory, find a surrogate, in the opposite instance.
However, once an embryo implants in a womb, they become the sole property of the person carrying them. That is to say that under Singapore law, if I became pregnant, the decision to have an abortion (or not have one) would be mine and mine alone. If the sperm donor was my husband, then he would have some legal right to the resultant child. If the sperm donor wasn’t my husband, then in theory, the birth mother assumes full ‘ownership’ and right of consent. In the US, I believe there is a case of a B-grade celebrity who was involved in IVF with an ex-girlfriend who is now claiming his rights to be equivalent only to those of a random sperm donor.
The laws to govern the legal parentage and status of children born through assisted reproductive technologies (ART) were proposed in Singapore in 2011 and were called “The Status of Children (Assisted Reproduction Technology) Bill 2011”, they are clearly drafted on the premise that a child conceived through ART should only have a single set of parents, that is, a legal mother and legal father. They confer legal motherhood on the woman who carries or has carried the child as a result of ART, known as the gestational mother. If the couple is married and the husband’s sperm is used, he will be treated as the legal father. Where donor sperm is used, then the husband will be the legal father if he has consented to the treatment or he accepts the child as ‘a child of the marriage’.
Where the woman is unmarried, her partner (defined in the Bill ‘as a man with whom the gestational mother was living in a relationship as if he was her spouse’) may apply to court for a declaration of legal parenthood, if his sperm was used or he consented to the child being a child of the relationship
This works the same in reverse, an embryo created from an egg donor belongs legally, both to the donor and the sperm donor (whether related or otherwise) but the egg donor relinquishes her right to consent and ownership to both the embryo and the resultant child, once the embryo implants in the birth mother. Therein lies the crux, if you cannot conceive, it is still much easier and simpler if you can carry a pregnancy. Once you are the birth mother, there is no legal contest that the child belongs to you.
Of course, these same issues are prevalent in adoption, it’s just that unlike adoption, these issues are fought over sexless eggs and sperm, or nascent embryos. There is a bigger question of intent and mal-intent. Of course, if the embryos had not implanted, which is the more common outcome and means they would not be nurtured into life, then there would be no contest.
The other issues which are doubtful to me, are why it took until the seventh month for an abortion to be requested. Did the couple not know about the presence of twins, or was the communication from the surrogate clinic or agency fraught with language barriers and deliberate face-saving miscommunication? Is it possible that the clinic utilised the defective embryos to create the second pregnancy — unlikely since the couple actually do have a daughter of similar age, but still, begs the question, how do you know what results of potentially valid embryos that are left in a clinic’s care? In this particular case, the fact that the surrogate is soliciting donations, questioning the legal parent rights of the Australian couple over the normal twin and claiming that the surrogacy clinic withheld payments, does suggest some measure of illegality, indignance or possibly, greed.
To me, the scrutiny should be not just on surrogacy but in holding the doctors, nurses and hospital owners, in what may be a lucrative and corrupt system, accountable to consistent protocol and policies. It is something that not just extreme IVF cases would be wary of, but even regular IVF patients may fall prey to, because they become the pool for traded embryos. It is important to restore trust and accountability to the system.
However, I can also understand the other side of it. This is a means by which people, who are desperate to become parents, turn to for an answer, or a possibility. It is one of the few places where each of these practices can be afforded so cheaply and quickly. To infertile parents, it is not entrapment, it is a Godsend. How does legislation get around the fact that it is all ‘alternative’? If a clampdown made it the case that Thai surrogacy could only be considered by a heterosexual, married couple, via a blood relative, we could basically strike out anybody who was foreign, single or gay from having options and we might as well shutter most of the industry.
In essence, they would become, like Singapore.
