From Slate, August 23:

Reproductive tourism in India is now a half-a-billion-dollar-a-year industry, with surrogacy services offered in 350 clinics across the country since it was legalized in 2002.

The primary appeal of India is that it is cheap, hardly regulated, and relatively safe. Surrogacy can cost up to $100,000 in the US, while many Indian clinics charge $22,000 or less. Very few questions are asked. Same-sex couples, single parents and even busy women who just don’t have time to give birth are welcomed by doctors. As a bonus, many Indians speak English and Indian surrogate mothers are less likely to use illegal drugs. Plus medical standards in private hospitals are very high….

The surrogates, many of whom are cooped up in “surrogacy homes” away from their families for the duration of the pregnancy, are often in dire financial straits….

In another disturbing case, an upper-class Indian woman hired a surrogate to carry her child and invited her to live in her home…. The client accused the surrogate mother of stealing and not only kicked her out of the house but coolly informed her that she didn’t want her services anymore and that she should terminate the pregnancy. Surrogates get paid only on delivery of the baby, so this kind of situation is economically devastating for a surrogate. It can also severely compromise the ethical and religious beliefs of surrogates who may not wish to undergo an abortion….

Meanwhile, from New America Media, August 31:

On a recent day in this Los Angeles suburb, Maya Jagdeesh, 35, was being wheeled out of a room at the Fertility Institutes after undergoing an $18,000 procedure to ensure she gets a boy.

Jagdeesh… had flown in from Vancouver, BC, with her husband to Dr. Jeffrey Steinberg’s clinic after seeing his online ad that characterizes his pre-implantation genetic diagnosis service as “the world’s largest and most successful 100% sex-selection program.”

Jagdeesh said that in her Indian community, most people would assume that her husband or in-laws had forced her to have the procedure. But she insisted she had sought out the clinic herself….

But not all the women who come to his fertility clinic or others in the US that offer PGD are brought there by happy reasons. Especially for those with roots in Asia, Africa, and the Middle East, sex selection is often not freely chosen. Women are frequently coerced, overtly or subtly, to guarantee the prize their husbands desire above all else – a son….

A 2008 analysis of Census data by 2 Columbia University economists found that among US children born to Indian, Chinese and Korean parents, the ratio of boys to girls was skewed. For eldest children, the ratio was similar to the general population – 1.05 boys for every girl.

But when the first baby was a girl, the odds of the 2nd being a boy rose to 1.17 to 1. And after the birth of 2 girls, the likelihood of the 3rd being a son jumped to 1.51 to 1.

This is clear “evidence of sex selection, most likely at the prenatal stage,” the authors wrote.

So strong is the hunger for a male child in some communities in India, and so intense is the pressure on women to produce a son, that female infants are frequently murdered, sometimes by the frightened mothers themselves.

The deep-rooted cultural bias against daughters has noticeably skewed the female-to-male ratio in some states in India, particularly in Punjab, Himachal Pradesh, Rajasthan, Uttar Pradesh and Bihar, where an estimated 160,000 baby girls are reportedly killed every year. In 2001, males in India outnumbered females by about 35 million.

Part of the imbalance comes from abortions. Ultrasound results often lead to terminated pregnancies, which is why the Indian government banned the use of the technology to determine gender in 1994.

Even so, sex-selective abortions have resulted in 10 million “missing” female fetuses over the past 20 years, according to a 2006 report in The Lancet.

Steinberg… denied that his clinic is perpetuating a cultural preference for boys….

Still, support groups for South Asian victims of domestic violence talk of gender preference as being, in Jesudasan’s words, “part of the life cycle of violence against women.”

“I have talked to severely abused South Asian women in fertility clinics,” said Dr. Sunita Puri, a medical student at UC San Francisco who has been researching sex-selection among South Asians in and outside the US….