EARNING a meagre 3,000 rupees (S$91) per month as a nurse, Hansha struggles to make ends meet.
After paying half her earnings on rent for a squalid one-room flat with neither electricity nor gas, she has barely enough to keep her 16-year-old son in school.
 
She worries constantly for her husband - a truck driver - who earns 15,000 rupees for long-haul trips transporting goods on India's treacherous highways.

The 39-year-old also has to provide for her sister, 15, and her ailing father, who lost his leg in a railway accident. They live in a tent near train tracks in the dusty town of Nadiad, 22km from Hansha's flat in Anand.

'It's very hard,' Hansha said in her native Gujarati. 'I have to take care of my family and work also.'

She works 14 hours a day, seven days a week, weighing patients, measuring blood pressure and giving injections at Anand's Akanksha Infertility Clinic.

It was through her work at the clinic that she learnt about the financial rewards of being a surrogate.

Hansha became a surrogate mother in December 2007 and delivered twins - a boy and a girl - for an American couple. For that, she earned 250,000 rupees - almost seven years worth of her monthly income.

For many lower-middle class women in India, surrogacy is a chance to escape the sinkhole of low wages and debt. 'This is the fastest route to money,' said Hansha.

Now, she lives in a simple three-room flat complete with gas stoves and ceiling lights. She has paid off all her debts, though her husband still drives trucks to supplement household income.

Owning a home is crucial in India as tenants can be held to ransom by unreasonable landlords. To buy her flat, 33-year-old Deepa, a school caretaker and a mother of two, also became a surrogate mother. In 2007, she rented out her womb to a United States-based Indian couple and delivered a baby boy.

However, the single mother was paid more as she was born into a higher Hindu caste (Brahmin), than Hansha, who is from the Vaishya caste. Such discrimination is common in one of the most rigid class-bound societies in the world.

Many clients, especially those of Indian descent, choose candidates based on caste, said Deepa. 'They do not mind paying more for a higher-caste surrogate. It is a religious thing also,' she added.

Carrying a baby for nine months was not easy, Deepa recalled. Besides enduring labour pangs, she had to hide her swollen belly from friends and relatives. In an intensely conservative society, social stigma is a risk all surrogates face.

'They think very badly of this thing so I don't want to tell,' Deepa said. 'Because of financial reasons, people do this. Otherwise no one will do this.'

But many critics suggest women like Hansha and Deepa are being financially exploited.

They have lambasted Indian legislators and doctors for enabling the outsourcing of wombs on the cheap. In the US, surrogate mothers get US$15,000 (S$21,770) to US$45,000, while their Indian counterparts get an average of just US$6,800.

But Dr Nayna Patel of the Akanksha clinic rejected this. 'America is a popular place for Europeans to find surrogates. Why don't you say Americans are exploiting surrogacy?'

Another criticism of surrogacy is that women like Hansha and Deepa can't help but form a close natural bond with the babies they are carrying, which they are later cruelly wrenched away from.

Mumbai-based lawyer Amit Karkhanis, an expert in medical law, said most surrogate mothers are bound by contract to return the newborn to its intended parents just weeks after delivery.

In the US, surrogates have refused to hand over their babies, citing emotional attachment, resulting in court cases.

Deepa admits she felt a strong bond with her surrogate child: 'When I had to give up the baby, I was heartbroken and I cried. But I told myself that the baby is not mine.'

Such incidents do not occur in Anand, insisted Dr Patel, because she accepts only women, like Hansha and Deepa, who already have children of their own. Also, surrogates have to go through intensive medical check-ups to ensure that they are physically and mentally fit.

Most importantly, she insists on consent from the surrogates' husbands and parents. As a last measure against fraud, the contract she drafts also ensures that the fees to surrogates are paid in instalments upon conception, delivery, then handover of the babies, to deter surrogate mothers from abortion.

Hansha and Deepa said they are happy that they successfully bore their babies and got paid in full. 'I am happy, I benefit and people at the other end benefit also,' Hansha said.

With more clinics vying for customers today, surrogacy fees are set at competitive rates of as low as 200,000 rupees. But despite the alleged price low-balling and exploitation, there is no shortage of womb suppliers.

'This amount could buy me a small house in Mumbai,' said Mangal, 29. As a widow who earns 6,000 rupees a month as a police officer in her native Marath, she struggles to pay her monthly rent of 1,500 rupees.

'A quarter of my salary goes towards rent. If I have my own place to stay, things will be so much easier. But I have not told my employers because if they knew, they would give me the sack.'

Seeking a better life, she, Rajeshri, 24, and Rehka, 27, have all recently signed up to be surrogates.

Rajeshri, a housewife, said: 'I was shocked when our local doctor said that carrying another person's child in my stomach was possible without sleeping with another man other than my husband.

'I told my husband, and initially he said 'no'. But I was able to convince him there is nothing immoral. And we won't be able to earn this kind of money in years.'

Housewife Rehka, whose painter husband brings home only 200 rupees a day, said: 'During the monsoon season, his income is badly affected. If I had a choice or other options to make this kind of money morally, I wouldn't do surrogacy.'

At Akanksha Infertility Clinic, Hansha readies a Taiwanese woman's forearm for an injection to help her ovulate.

She said she would gladly rent out her womb again, despite potential health risks and the prospect of having to live with fresh scars from another Caesarean section.

This time, Hansha wants to buy a house for her sister and father and move them out of their tent.

'If a good couple is willing to pay good money, I am ready to become a surrogate one more time.'

*Surrogate mothers interviewed were willing to give only their first name.

This article was first published in The Straits Times.