A care ethical perspective on surrogacy - with Priya Sharma
Episode 18 of Careful Thinking
The eighteenth episode of the Careful Thinking podcast - and the first episode of 2025 - features my conversation with Priya Sharma, in which we discuss her research on surrogacy, which brings a care ethical perspective to bear on this controversial topic, and offers a critique of the way surrogacy is currently regulated in India.
Priya recently took up a position as an Assistant Professor in the Humanities and Social Science at T A Pai Management Institute, on the Bengalaru Campus of Manipal Academy of Higher Education. She studied for a PhD at the Indian Institute of Technology in Mumbai, where she was until recently a postdoctoral fellow. Building on her doctoral thesis, Priya has published an article, with her supervisor Amrita Banerjee, on care ethics and Indian surrogacy policy, in the journal Hypatia, and she has contributed a chapter on similar issues to the forthcoming Routledge Companion to Gender and Reproduction. A member of the Critical Midwifery Studies Collective, Priya is the India Project Lead for Birth Futures, a multi-country initiative which is working towards ‘a human-centred ecosystem of birth care by creating spaces for social dreaming’.
Over the past year, I’ve interviewed writers and researchers for the podcast from the UK, France, the Netherlands, the Czech Republic, North America and Australasia. However, although the podcast has attracted a loyal Indian audience, and recent episodes have featured one or two guests with South Asian roots, this was the first actual link-up with India.
The episode takes up the theme of reproductive care from the previous one, in which I talked with Inge van Nistelrooij about her work around obstetric violence and reproductive justice, and interestingly Priya has connections, via the Critical Midwifery Studies Collective, with some of Inge's co-researchers in the Netherlands. I should also add that Priya shares an academic mentor, in Amrita Banerjee, with another previous podcast guest, Ira Chadha-Sridhar (see Episode 15), who similarly credits Professor Banerjee with introducing her to feminist care ethics.
Priya Sharma
We began our conversation in this episode by exploring Priya’s academic background and her journey to researching surrogacy and reproductive care. Priya then provided some background to current debates around surrogacy, explaining the differences between traditional and gestational, and commercial and altruistic surrogacy. This led on to a discussion of the historical context of surrogacy in India, and recent attempts to regulate the field, which were the main focus of Priya’s PhD research. Priya outlined her criticisms of the law, based on her interviews with surrogate mothers, and on her reading of feminist care ethics, and specifically its emphasis on care as labour. We discussed radical feminist critiques of surrogacy, aspects of which Priya agrees with, though she takes issue with the contention that surrogacy severs a natural bond between mother and child.
In the final part of the episode, we moved on to talking about Priya’s involvement with the international Critical Midwifery Studies Collective, and with the Birth Futures initiative, including her recent research with women in her home village in the Himalayas about their experiences of pregnancy and childbirth.
The work of Birth Futures, with its use of immersive, arts-based methods to encourage women to explore their hopes for better birth care, is fascinating, and I recommend exploring their website, which includes a page about Priya’s research in Adhog, Himachal Pradesh, as well as details of the organisation’s parallel projects in Peru and the Netherlands.
As I mentioned during the episode, I’ve found engaging with Priya’s work both inspiring, and at the same challenging to some of my personal preconceptions. I prefer not to express my own opinions on the podcast, as I don’t like to detract from my guests’ presentation of their ideas. But perhaps I can allow myself space here to say that, speaking personally, I have some sympathy with what Priya describes as the radical feminist critique of surrogacy (see, for example, this recent Substack post by Julie Bindel), though one doesn’t have to be a radical feminist to share that critique. I wonder whether there might be an alternative and more sceptical care ethical response to surrogacy, one that voices concern about the way surrogacy removes the relational element from pregnancy and childbirth, reducing it to a somewhat mechanistic medical process. In the course of our conversation on the podcast, Priya cited the work of the communist feminist scholar Sophie Lewis, who explicitly promotes surrogacy as a tool for abolishing the family, which made me think of what Elissa Strauss (my guest in Episode 16) writes in When You Care, about ‘radical, utopian political texts that degrade or completely ignore family life, in favour of impersonal visions that focus on cooperation among members of society at large’. Elissa makes the argument that support for intimate family bonds and for women’s rights and social progress are interdependent, rather than mutually exclusive, and I tend to agree.
However, I should add that when I expressed some of these reservations about surrogacy in conversation with my wife, after recording the interview with Priya, she made the valid points that having a child via a surrogate may be the only way that, for medical or other reasons, some women are able to become mothers, and some men become fathers, and that in most cases children born via surrogacy will be loved and cherished by their parents. There are obviously powerful arguments and deeply felt opinions, on all sides of this debate, and I hope this episode of the podcast will prompt further discussion. Feel free to add your own views in the comments below.
From the 'Birth Futures' website
Here are a few quotations by Priya from the podcast episode:
The most frequent form of surrogacy which was there in India, for which people used to come, was commercial gestational surrogacy. So the commercial bit here meant that you paid a woman...to carry a child for you...As someone who's intending to have a child through surrogacy, you anyways paid for necessary medical and legal expenses. But when you also paid the woman who's going to carry your baby for her services, that's when it was called commercial surrogacy. Now that is something that India has recently banned through a law, and that was the main point of contention in my research. So the point was that it was because of the commercial nature of surrogacy industry in India that there was a lot of exploitation, especially of the women acting as surrogates.
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So when I started my research...my first thing, because I am a trained anthropologist and sociologist, was to just go and speak with these women...What are their demands? Are they the ones asking for a ban on commercial surrogacy? Do they think that is the main source of exploitation, the money that is paid to them, or is it something else? That was my primary question...when I started reaching out to people…It was not easy to get into the field. But then when I entered, my major question was around the potential ban. And I was astonished…they were very, very clear that what they are doing is labour and they have to be paid for it...they were very vocal about the fact...‘not paying us would be more exploitative for us because at the end of the day we're doing it for our existing children’.
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I was very happy when I found ethics of care and...how it kind of helped me in my own surrogacy research, was...when I...started reading about how care was understood in...feminist ethics of care...So...a lot of times...the association is with something which is rooted in affect...rooted in emotion. And there's this dichotomy between body and mind and emotion and rationality...and that was totally shaken up by care ethics...be it Joan Tronto’s idea of care as not just disposition but also a practice...Also when I started thinking about surrogacy, when I started thinking about what surrogates were doing and…in anthropological literature, sociological literature, feminist literature from these disciplinary fields, it has been established for many years now that surrogacy is a form of care-based labour...So I could see that there was a very essentialised idea of care that was being given to surrogacy, when it was said that women will be willing to do it without taking any money. At the end of the day they're helping someone and you don't take money for birthing a child. It's a care-based thing, caring for them. And you don't put monetary value to care. So what I realised was that care was being seen as still very much...essentialised here. And the labour bit of it...that was being sidelined. And that's where feminist care ethics helped me to question...how care is featured in this debate of surrogacy...So I was trying to see that...the surrogate is giving care, care giving...but she also is the one who should receive care. And a surrogate is trying to tell us, ‘I want to be paid for my labour. So you're not caring for me...not listening to what I want.’
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I'm from a very remote village in the Himalayas...we had road connectivity, but then the twin forces of climate change and faulty development practice led to it being blocked…So I thought, let me just go there and speak with women there…they could tell me a lot about their experiences of birthing children in public healthcare hospitals, living in a remote village like that, where you have to climb up the hill to reach the road and how difficult it is as women in labour to do that. And then we...used some AI generated images...with some elements of like, there is an example an ambulance that has come right to the village and there are birthing cubicles right in the village, so how different would that be? So...also we figured out by doing one part in the Netherlands, another in Peru and one in India, that a future for some would be the present for someone already. And…we could see...how for some…the future could be very sci-fi. But here, what they're looking for, a just future is... ‘we want a motorable road, we want the health services to come here...I want to go to…a delivery board which has an attached washroom and only I am the person, I don't want to share my bed with anyone.’ Or ‘I want my traditional birth attendant also with me along with the doctor. I want to be heard’...We are trying to give them some probes on, what if you have all the technology in the world and all the resources in the world, what do you think you would want to do?
You can listen to the whole episode here, or wherever you get your podcasts.
You can download a transcript of the episode here:
The header image is the painting ‘Resting’ (1940) by the Indian-Hungarian artist Amrita Sher-Gil (1913-41), in the National Gallery of Modern Art, New Delhi.