More glimpses of the realities of surrogacy in India

J goes to Hiranandani hospital for her routine OB-GYN checkups. I went with her for her very first checkup, and it was an intensely disconcerting experience. There are about maybe 12 surrogates gathering and waiting for anywhere between 1-3 hours. The OB-GYN's assistant shows up, and starts seeing this procession of women. They get a doppler check and their blood pressure and weight read, all while the next 3 patients are queuing up on the other side of the curtain while the first patient is in the bed. My mom likened it to the situation in the poorest, most strapped municipal hospitals, where she worked briefly as an intern

After that first painful experience where I waited over 3 hours for a 15-min cursory check complete with an ancient-looking doppler, I never went again, and instead only go with J to the wonderful, detailed ultrasounds that are run at the Mediscan testing center by the very capable Dr. Bhansal.

This past Wednesday marked 28 weeks, and J went for her checkup at Hiranandani. I contemplated going, but I decided to just trust the system and sent her off with all the reports and expected her to get both the Rhogam shot and much discussed mandatory steroid shot. Too many times where I decide to just trust the system here, it has turned out to be a Bad Idea. But that is a topic for another post.

I talked to J after the appointment and find that no injections were given. I then try to find out what happened. If you go to an agency like Surrogacy India, they have this system where all the reports are scanned and uploaded and are available online for the parents immediately. Here, with the Malpani Clinic, there is no such centralization. I've spent 3 days waiting to find out what exactly was done at that visit. The surrogate handler claims that she gave the report to the receptionist at the clinic, who then claims to have emailed it to me. No such email was received. The handler claims she reminded the receptionist of it again one day later, and that she apparently mailed me. No mail was received. I've asked the doctor what was happening, and have received no word. I am SO very glad that I have to deal with this system only for another 10 or so weeks.

But here is the deal: they don't give the steroid injection at the hospital, they only write the prescription for it, and expect that some local nurse or some local doctor will give it. In the case of the Malpani clinic, the person who gives the shots is no trained nurse, but the handler herself.  A little background on the handler: This is a woman who has gone through surrogacy herself, comes from the same socio-economic class as the surrogate, and is partially literate, but at best studied till high school. In general, these are not people who are professional and impartial: they may not above lying for the surrogate (remember the story I posted about the handler who helped a 42 year old surrogate propagate a lie that she was 28?). 

In this case, the handler will give the shot at her home.I have to pray that the she is atleast trained in sterile techniques. I asked my RE about this, but as with most situations, I got resounding silence.

Here is the other thing: J told me that Dr. Malpani thinks that the Rhogam shot at 28 weeks is not necessary. He has not bothered communicating this directly with me, and nor has the OB-Gyn.

The person who did seem to think it necessary is Dr. Bhansal. She is a fetal metal specialist who works with high-risk pregnancies. She is also the go-to person for detecting fetal anemia, and is also the go-to person to give transfusions in the situations where it does develop. I'll have to talk to her about the necessity of this again. I totally hear you guys about the many places that do not give this prophylactically at 28 weeks. The one reason why I'd be more concerned here is because this is a surrogacy, and J may not be as prompt as required if something goes wrong (if she falls, etc).

But, in happier news, we have crossed the 28-week mark. This is the point after which the complication rate falls considerably. I was supposed to go in for an ultrasound tomorrow, but my mother will not be in town. A while ago, my friend M told me to always take my mother with me to the ultrasounds, because she is my lucky charm. I take that advice very seriously: she has come for every appointment, and I'm far too chicken to go in without her now. The next ultrasound should happen in the middle of next week.  

Also, I want to celebrate the surprise (to me anyway, I had NO idea) pregnancies of 2 bloggers who are very close to my heart, who have stopped actively blogging. I think it is rather cool that two such very wise women who I thought were actually quite similar (in their outlook on things and their utter sensibility)  are so synchronized with their pregnancies; they both just crossed 24 weeks. Adele and Arohanui, so very happy for the both of you!