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to be come surrogate mother

Fri, 2010-03-05 06:22 — rani

i am 25 years old indian living in hyderabad i have 2 children i would like to become surrogate mother

PREMATURE EJACULATIONS AND HOMEOPATHY TREATMENT [PR]

Tue, 2009-12-22 03:33 — homeopathytreatment

It is not very difficult to identify: It usually means that a man reaches the orgasm too soon. According to me if you and your partner think you’re finished too early, then you’re a premature ejaculator.

 Men who suffer from premature ejaculation start dreading sex and eventually it may even affect their overall confidence level.

 But thank God there is homeopathy which has 48 different remedies for premature ejaculation. Each individual case is properly taken and analyzed to select the best remedy for a pericular person. The idea is to make a tailormade prescription which usually has amazing effects with no side effects. The success rate of homeopathic treatment in premature ejaculation is 100% if the remedy is selected diligently by the concerned homeopathic doctor.

 What is Premature Ejaculation (PE)?

 We want to live longer; same is with sex because here also we want to last longer. Ejaculation occurs when a man reaches sexual climax that is orgasm and semen is ejected from his penis. Most men experience premature ejaculation at one time or another. The question is what is the normal time taken to ejaculate after penetration.

 You would be surprised that most men ejaculate within two to six minutes after beginning the intercourse and this according to me is normal. But about 18 to 25 percent of men have trouble delaying ejaculation that long; some ejaculating even before penetrating a woman’s vagina to their embarrasment.

 Premature ejaculation can also be defined as an ejaculation that occurs before the man wishes it to occur or when ejaculation occurs too quickly to sexually satisfy his partner.

 Causes of Premature Ejaculation (PE)

 Psychological: This is the most common cause according to me and constitutes almost 90% of cases; I would like to add that tailormade homeopathy has wonderful remedies for such a situation because the remedies act at the level of the body as well as the mind. Psychological factors that may cause premature ejaculation include:

Concerns about sexual performance.

Lack of sexual experience.

Lack of knowledge of female sexual responses.

Guilt about sex.

Fear of causing a pregnancy.

Communication gap between the partners.

Fear of being caught having sex.

Fear of getting a sexually transmitted disease.

Prostate problems like prostatitis.

Neurological problems (Nervous system related).

Urinary tract infections.

Thyroid related diseases.

Hormonal imbalance.

Medical treatments like beta-adrenergic blockers used to control blood pressure, medicines that increase sexual stimulation and so on.

 Home Remedies for Premature Ejaculation (PE)

 Along with homeopathy remedies, there are a few ways which would help you delay ejaculation during lovemaking. The aim is to improve your ability to recognize when you are about to come and then take steps to delay it.

 Practice makes the man perfect. According to me, irrespective of premature ejaculation one should start having sex more often. Because if there are long gaps between lovemaking sessions, you are more likely to ejaculate early. Secondly, with practice you would better your performance because you learn which posture gives you more control and pleasure and what are your limitations and so on.

Apply the “stop-start” approach. This technique involves stimulating the penis almost to the point of ejaculation, then stopping; stimulating it again, then stopping; and repeating this until you learn to control your ejaculations. This you can do while masturbating or the best is to do with your partner on top during sex. She stops when you ask her to and starts to move again when requested by you.

Squeeze method. It is basically same as “stop-start” method, but includes gently squeezing the base of penis before stopping.

Perform Kegel exercises. Women practice Kegel exercises to strengthen their pelvic muscles after delivery. The same pelvic muscle strengthening exercise that women practice can help men delay ejaculation. It is very easy to to perform Kegel exercises; just contract your buttocks for one second as though you were trying to delay a bowel movement. Do this 15 times in a row, working up to 60 to 75 contractions twice a day. The purpose of Kegels is to strengthen your pelvic muscles so that you can contract or relax as you near orgasm, delaying ejaculation. (An interesting fact is that some men last longer when squeezing the muscles, and others, when relaxing them.)

Do your exercises later. Please do not exercise just before lovemaking. It is because when you exercise the blood is directed towards the group of muscles which are engaged in exercising and the blood is diverted awary from your penis. So, it is not wise to exercise before sex. But I would stress that healthy life style which incorporates yoga and walking is very important to prevent and reverse premature ejaculation.

Woman on top postion. Missionary postion that is man on top is the most common position and you would be surprised that in this postition the men are easily aroused and reach orgasm much faster. So, it is advised that it is better let the woman be on top. That way you can easily control her motion by guiding her hips. When you become too aroused and are about to come you can guide her to slow down or stop her motions and you can last much longer in sex.

Diet for better lovemaking. Premature ejaculation is often due to physical changes occuring in the body due to aging. Men over age 30 may begin to have problems with premature ejaculation even though their sex lives were fine when they were younger. The problem is often an inadequate blood supply in the penis. When the arteries in the penis become partially clogged with fat and cholesterol, maintaining an erection becomes more difficult. When this occurs, your brain tells your body that you’d better ejaculate before you lose your erection, and a pattern for premature ejaculation is developed. So, how to deal with this situation. We should live a healthy lifestyle in order to maintain good arterial health. Your potency will be prolonged if you eat a low-fat, low-cholesterol diet, exercise regularly, don’t smoke or drink and keep your stress managed.

Improved communication. Better interaction with your partner before engaging in sexual activity does a lot for premature ejaculation.

Environment. Having sex in situations that are private and relaxed helps a lot in dealing with early orgasm.

Yoga and meditation. It provides much needed physical and mental relaxation much needed to cure premature ejaculation.

Massage. Massage by your own partner is an extremely pleasurable activity and very effective at reducing stress.

 Dr Harshad Raval MD [Homeopathy]
Honorary consultant homeopathy physician to his Excellency Govern.of Gujarat India.
Qualified MD consultant homeopath Physician,

25 years experience in Homeopathy field
Member of nominee advisory committee (Govt. of Gujarat).
International Homeopathy Advisor,
Book writer and Columnist For Gujarat Samachar,
 
ADDRESS:16,floor,white-House| Ellisbridge | Ahmedabad | Gujarat | India

Web site : www.homeopathyonline.in
Blog’s site: www.drharshadraval.com

ALZHEIMER HOMEOPATHY TREATMENT DR HARSHAD RAVAL MD

Tue, 2009-12-22 03:23 — homeopathytreatment

 

Alzheimer Disease is the most common cause of dementia (loss of memory), which is an acquired (not present since birth) intellectual and behavioral impairment of sever intensity to significantly interfere with social and occupational functioning of an individual. The cause of Alzheimer disease is unknown. The existing research on the illness suggests that most cases of Alzheimer disease are caused by converging risk factors that include advancing age, head injury, and lipoprotein E-epsilon 4 genotype among other risk factors that appear to trigger the illness. Treatment of Alzheimer disease is based on developing theories of its cause and on the need to alleviate its cognitive (intellectual) and behavioral manifestations. To date, no interventions have been shown to convincingly prevent Alzheimer disease or slow its progression. Medical treatments for Alzheimer disease include psychotropic medications and behavioral interventions, cholinesterase inhibitors (ChEIs) and the avoidance of centrally acting anticholinergic medications, N-methyl-D-aspartate (NMDA) antagonists, and other and new therapeutic interventions.

Role of Homeopathy in Alzheimer disease:
Homeopathy has a very special advantage over conventional approach in the treatment of this illness. Homeopathy can help restrict the progress of the disease if the treatment is started in the early phase. Nevertheless homeopathy can benefit the person suffering from this illness in reducing the symptom severity. In other sense if not cure homeopathy can definitely give relief in the symptoms without any side effects of the medicine which is usually the case with conventional medicines. Along with homeopathic medicine behavioral therapy may enhance the outcome of the treatment of people suffering from Alzheimer disease.

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ADHD HOMEOPATHY TREATMENT BY DR HARSHAD RAVAL MD

Tue, 2009-12-22 03:20 — homeopathytreatment

ADHD HOMEOPATHY TREATMENT

Attention Deficit Hyperactivity Disorder (ADHD) is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child’s age and development. ADHD affects school performance and interpersonal relationships. Parents of children with ADHD are often exhausted and frustrated. Neuroimaging studies suggest that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and adrenalin) differently from their peers. ADHD is often genetic. Whatever the specific cause may be, it seems to be set in motion early in life as the brain is developing. Depression, sleep deprivation, learning disabilities, tic disorders, and behavior problems may be confused with, or appear along with, ADHD. Every child suspected of having ADHD deserves a careful evaluation to sort out exactly what is contributing to the behaviors causing concern. Attention Deficit Disorder (ADD) is the most commonly diagnosed behavioral disorder of childhood, affecting an estimated 3 – 5% of school aged children. It is diagnosed much more often in boys than in girls. Most children with ADHD also have at least one other developmental or behavioral problem.

The American Academy of Pediatrics has guidelines for treating ADHD:

  • Set specific, appropriate target goals to guide therapy.
  • Medication and behavior therapy should be started.
  • When treatment has not met the target goals, evaluate the original diagnosis, the possible presence of other conditions, and how well the treatment plan has been implemented.
  • Systematic follow-up is important to regularly reassess target goals, results, and any side effects of medications. Information should be gathered from parents, teachers, and the child.

Prognosis of ADHD:
ADHD is a long-term, chronic condition. About half of the children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, adults are often more capable of controlling behavior and masking difficulties. Statistics show that there is an increased incidence in juvenile delinquency and adult encounters with the law among individuals who had ADHD as a child. Every effort should be made to manage symptoms and direct the child’s energy to constructive and educational paths.

Role of Homeopathy in ADHD:
Homeopathy acts deeper in to the person’s life. Effects of homeopathic medicine are more on the life giving energy, the vital force than on the body and its parts. Homeopathy acts on that energy in our body which acts on genes and DNA. Right time of understanding the problem in person’s life and starting the treatment has far greater out come with homeopathy. ADHD child may have genetic cause and there may be functional and structural alteration in the brain of the child to suffer from ADHD, but strength of Homeopathy lies in influencing such illness by virtue of its actions on those channels in our body which directly or indirectly governs the function and structure of our body which is much beyond the level of not only cell but even the genes and DNA and RNA. Because these genes are also powered by the basic life energy. This life giving energy is dynamic and so are the Homeopathic medicines. We can’t see the power but we can experience its presence when we examine a living cell and dead cell. In cases of ADHD significant improvement is observed in the behavioral and intellectual performance of the child. Constitutional homeopathic treatment is the best possible approach which gives satisfactory results in cases of ADHD.

Along with Homeopathic management following care should also be taken

  • Limit distractions in the child’s environment.
  • Provide one-on-one instruction with teacher.
  • Make sure the child gets enough sleep.
  • Make sure the child gets a healthy, varied diet, with plenty of fiber and basic nutrients.
     

FAQ’s for ADHD
 

What is:
1. ADHD – Inattentive type is defined by an individual experiencing at least six of the Attention Deficit Hyperactivity Disorder (ADHD)?
Individuals with ADHD may know what to do, but may not consistently do what they know because of their inability to efficiently stop and think prior to responding, regardless of the setting or task.

Characteristics of ADHD have been demonstrated to arise in early childhood for most individuals. This disorder is marked by chronic behaviours lasting at least six months with an onset often before seven years of age. At this time, four subtypes of ADHD have been defined. These include the following characteristics:

Fails to give close attention to details or makes careless mistakes.
Difficulty sustaining attention.
Does not appear to listen.
Struggles to follow through on instructions.
Difficulty with organization.
Avoids or dislikes requiring sustained mental effort.
Often loses things necessary for tasks.
Easily distracted.
Forgetful in daily activities.

2. ADHD – Hyperactive/Impulsive type is defined by an individual experiencing six of the following characteristics:
Fidgets with hands or feet or squirms in seat.
Difficulty remaining seated.
Runs about or climbs excessively (in adults may be limited to subjective feelings of restlessness).
Difficulty engaging in activities quietly.
Acts as if driven by a motor.
Talks excessively.
Blurts out answers before questions have been completed.
Difficulty waiting in turns taking situations.
Interrupts or intrudes upon others

3. ADHD – Combined type is defined by an individual meeting both sets of attention and hyperactive/impulsive criteria.

4. ADHD – Not otherwise specified is defined by an individual who demonstrates some characteristics but an insufficient number of symptoms to reach a full diagnosis.
These symptoms, however, disrupt everyday life. Children and adults who have ADHD exhibit degrees of inattention or hyperactivity/impulsivity that are abnormal for their ages. This can result in serious social problems, or impairment, of family relationships, success at school or work or in other life endeavors.
Children and adults can exhibit other psychiatric disorders, along with their ADHD symptoms. Most commonly, these include oppositional defiant or conduct disorder, along with or separate from internalizing disorders, such as anxiety and depression.

What are the causes of ADHD?
Experts have investigated genetic and environmental causes for ADHD. Some children may inherit a biochemical condition, which influences the expression of ADHD symptoms. Other children may acquire the condition due to abnormal fetal development, which has subtle effects on brain regions that control attention and movement.

Recently, scientists have uncovered research based on brain imaging to localize the brain areas involved in ADHD and have found that areas in the frontal lobe and basal ganglia are reduced by about 10 percent in size and activity in ADHD children.

Recent research based on genetic mechanisms has focused on dopamine as the primary neurotransmitter involved in ADHD. Dopamine pathways in the brain, which link the basal ganglia and frontal cortex, appear to play a major role in ADHD.

How is ADHD diagnosed?
While there is no biological or psychological test that makes a definitive diagnosis of ADHD, a diagnosis can be made based on one’s clinical history of abnormality and impairment.
An evaluation for ADHD will often include assessment of intellectual, academic, social and emotional functioning. Medical examination is also important to rule out low occurring but possible causes of ADHD like symptoms (e.g., adverse reaction to medications, thyroid problems, etc.). The diagnostic process must also include gathering data from teachers as well as other adults who may interact on a routine basis with the individual being evaluated.

It is even more important in the ADHD adult diagnostic process to obtain a careful history of childhood, academic, behavioral and vocational problems. With the increased recognition that ADHD is a disorder presenting throughout the life span, questionnaires and related diagnostic tools for the assessment of adult

ADHD have been standardized and are increasingly available.

ADHD diagnoses are based on a person having three different symptoms. The full syndrome is diagnosed when at least six symptoms from both sets of subtypes (above) are present. Partial syndromes, which are predominantly inattentive or hyperactivity/impulsivity subtypes, are diagnosed when six or more symptoms are present from just one set.

How is ADHD treated?
There are two modalities of treatment that specifically target symptoms of ADHD. One uses medication and the other is a non-medical treatment with psychosocial interventions. The combination of these treatments is called multimodality treatment.

Treating ADHD in children requires a coordinated effort between medical, mental health and educational professionals in conjunction with parents. This combined set of treatments offered by a variety of individuals is referred to as multi-modal intervention. A multi-modal treatment program should include: . Parent training concerning the nature of ADHD as well as effective behavior management strategies . An appropriate educational program . Individual and family counseling, when needed, to minimize the escalation of family problems . Medication when required

Behavior modification techniques have been used to treat the behavioral symptoms of ADHD for more than a quarter of a century. A summary of the literature on trials that have validated the efficacy of this approach shows that, in many cases, behavior modification alone has not been sufficient to address severe symptoms of ADHD.

Classroom success for children with ADHD often requires a range of interventions. Most children with ADHD can be taught in the regular classroom with either minor adjustments in the classroom setting, the addition of support personnel, and/or special education programs provided outside of the classroom. The most severely affected children with ADHD often experience a number of occurring problems and require specialized classrooms.

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INSOMIA HOMEOPATHIC REMEDY AND HOMEOPATHIC TREATMENT

Tue, 2009-12-22 03:09 — homeopathytreatment

Sleep Apnoea is a sleep disorder in which breathing repeatedly stops and starts. We may have sleep apnea if we snore loudly and feel tired even after a full night’s sleep.

There are three types of Sleep apnea:

  • Obstructive sleep apnea: this type occurs when throat muscles relax
  • Central sleep apnea: this type occurs when your brain doesn’t send proper signals to the muscles that control breathing
  • Complex sleep apnea: in this type both the above mechanism play a role

Obstructive sleep apnea occurs when the muscles in the back of throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate known as uvula, the tonsils and the tongue. The muscles relax, the airway narrows or closes as we breathe in, and breathing stops for some time. This may lower the level of oxygen in blood. Our brain senses this inability to breathe and briefly rouses us from sleep so that we can reopen airway. This awakening is usually so brief that we don’t remember it. We can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although it is rare. We may make a snorting, choking or gasping sound. This pattern can repeat itself 10 to 40 times or more in an hour, during the whole night. These disturbances decrease the levels of necessary deep sleep, restful phases of sleep. Because of this there is sleepy feeling during day time. People may not be aware that their sleep is interrupted. In fact, many people with this type of sleep apnea think they sleep well during night. Central sleep apnea, which is far less common, occurs when the brain fails to transmit signals to breathing muscles. Person may awaken with shortness of breath or have a difficult time staying asleep. Like obstructive sleep apnea, snoring and daytime sleepiness can occur. The most common cause of central sleep apnea is heart disease, and stroke. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.

People with complex sleep apnea have upper airway obstruction just like those with obstructive sleep apnea, but they also have a problem with the rhythm of breathing and occasional lapses of breathing effort.

The most common signs and symptoms of obstructive and central sleep apneas:

  • Excessive daytime sleepiness
  • Loud snoring, which is usually more prominent in obstructive sleep apnea
  • Observed episodes of breathing cessation during sleep
  • Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
  • Awakening with a dry mouth or sore throat
  • Morning headache
  • Difficulty staying asleep

Following are the leading signs to rule out sleep apnea:

  • Snoring loud enough to disturb the sleep of others or yourself
  • Shortness of breath that awakens you from sleep
  • Intermittent pauses in your breathing during sleep
  • Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving

Following factors may be considered as risk factors for sleep apnea:

  • Excess weight.
  • Neck circumference: A neck circumference greater than 17.5 inches is associated with an increased risk of obstructive sleep apnea.
  • High blood pressure: people with hypertension may suffer from sleep apnea
  • A narrowed airway: this may be a congenital defect
  • Being male: Sleep apnea is more common in male than female.
  • Being older: Sleep apnea is more common in elderly age group
  • Family history: Positive family history is an additional risk factor
  • Heart disorders and stroke or brain tumor: these are related to central sleep apnea

Complications may include:

  • Cardiovascular problems: The more severe your sleep apnea, the greater the risk of high blood pressure. If there’s underlying heart disease, these multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event. Obstructive sleep apnea also increases the risk of stroke, regardless of whether you have high blood pressure
  • Daytime fatigue: severe daytime drowsiness, fatigue and irritability is experienced. Concentration difficulty. Falling asleep at work, while watching TV or even when driving. Irritability, moodiness and depression
  • Sleep-deprivation of others: Loud snoring can disturb sleep of those around you or those who share same room or bed with you
  • Mental state: sleep apnea may also complain of memory problems, mood swings or feelings of depression
  • Urinary and sexual function: a need to get up for urination frequently at night, and impotence
  • Gastrointestinal problems: Gastroesophageal reflux disease (GERD) may be more common in people with sleep apnea

Role of Homeopathy in Sleep Apnea:
Homeopathy reduces the symptom severity of sleep apnea in cases where the illness is not due to some structural obstructions of airway. Homeopathy also helps in reducing the complications of sleep apnea. Homeopathy is safe and effective without causing any side effects. Homeopathy also helps in treating the underlying cause of sleep apn Ankylosing Spondylitis is a form of chronic inflammation of the spine and the sacroiliac (SI) joints. The SI joints are located in the low back at the junction of spine and hip. Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over the period of time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis leads to loss of mobility of the spine. Ankylosing spondylitis is also a systemic rheumatic disease, meaning it can affect other tissues throughout the body. Accordingly, it can cause inflammation in or injury to other joints away from the spine, as well as other organs, such as the eyes, heart, lungs, and kidneys. Ankylosing spondylitis shares many features with several other arthritis conditions, such as Psoriatic Arthritis, Reactive Arthritis, and arthritis associated With Crohn’s Disease and Ulcerative Colitis. Each of these arthritic conditions can cause disease and inflammation in the spine, other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as “Spondyloarthropathies.” The tendency to develop ankylosing spondylitis is believed to be genetically inherited, and the majority (nearly 90%) of patients with ankylosing spondylitis is born with the HLA-B27 gene. Blood tests help to detect the HLA-B27 gene marker. The characteristics of the gene marker HLA-B27 are being further understood. There are now seven different subtypes of HLA-B27 known to be present.

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Stateless babies? And the surrogacy contract. (updated)

Wed, 2009-12-02 07:30 — Peter

Many intended parents are interested in understanding whether the Indian surrogacy contract they enter into is legally enforceable were the surrogate to try and keep the baby. Fortunately, these contracts have not yet been tested. Unfortunately, that means no one really knows how the contracts would hold up in a court of law, if it were ever to get to that point.

There have, however, been two well publicized legal cases around babies born through surrogacy. Both of these cases revolved around the baby’s citizenship, not the legality of the contract. In neither of these cases was the surrogate trying to keep the baby.

What these cases have in common is that the babies are effectively stateless. Neither their intended parents' home country, nor India, recognizes their citizenship. As a result, it is extremely difficult for them to get travel documents to both leave India and enter their destination country.

 
A very short summary of the cases:
  • Baby Manji. Baby Manji was born  in July 2008 to an Indian gestational surrogate with an unknown egg donor. Unfortunately, the Japanese intended parents got divorced in June 2008; the intended father wanted to raise the baby, but the intended mother walked away. Japanese law recognizes the mother as the woman who gave birth to the baby, so the Japanese embassy would not issue a Japanese passport. Even though he was the genetic father, Indian law required the intended father to adopt the baby. But, Indian law does not allow single men to adopt baby girls. While this was being sorted out, the intended father had to return to Japan, and his mother came to India care for Manji. To further complicate matters, an Indian NGO filed a court petition claiming that Manji was a victim of “child trafficking”. The Indian Supreme court dismissed the NGO’s claims and granted temporary custody to the Japanese maternal grandmother. In early November, 2008, the Indian government ultimately agreed to issue an identity certificate (not a passport) and the Japanese Embassy agreed to issue a one year visa on humanitarian grounds.  Duke's Kenan institute for ethics has written a much more detailed chronology of the baby Manji case.   

  • Jan Balaz. In this case, Jan Balaz and his wife used a gestational surrogate with an egg donor. Twins were born in January, 2008 and in December 2009 the children were still in India. As is typical, the birth certificate issued by the municipality had the names of the intended parents. Unfortunately, German law does not recognize surrogacy so the intended parents were unable to get German passports from their embassy. And although the Indian government had initially issued Indian passports for the babies (which itself is surprising), upon learning of the surrogacy situation it asked for them back. The parents then moved to the U.K, where it would be easier for them to get non-Indian citizenship for the children. It appears that travel documents are not sufficient to get a visa to enter the U.K. or Germany, so Balez is petitioning to get Indian passports for the children.  This would also effectively grant the children Indian citizenship.  As a result, the intended parents (not the gestational surrogate) petitioned the Indian courts to get the Indian passports for their children issued/returned. In December 2009, the issue of granting Indian citizenship, travel documents and/or a German visa to the effectively stateless children was still winding its way through India’s courts, with the children still in India. The Indian Express has written several articles covering the Jan Balez case, as have some other publications (1, 2, 3, 4, 5). 
The main issue tested in these cases was not the legality of the surrogacy contract, but rather whether the babies born to Indian gestational surrogates could receive Indian passports. Because the intended parents could not immediately get citizenship from their home country, they (and not the surrogates) pursued other avenues to prevent their babies from being forever stateless.   

Nevertheless, the outcome of these cases could indirectly affect which names are put on the birth certificate, with each country’s embassy potentially reacting to these changes differently. If and when India's IMCR legislation is passed, there may be more clarity on these issues from the Indian side. But probably not from the intended parent's home country side.

The key lesson in both of these cases is to make sure you contact your embassy or consulate to understand whether they will issue passports and/or citizenship for your children born through surrogacy. And do this before you start the surrogacy process. Each country's embassy has different rules, and every surrogacy situation is unique.

18 Dec Update: The Indian courts (so far) have agreed to issue "travel documents" for the Jan Balez children, but not passports or Indian citizenship.  The travel documents would presumably allow for their departure from India, but don't seem sufficient to get a Visa to enter Germany. As a result, the Indian government is pressing the German government for a "one time special Visa" to allow the babies into Germany.  Additionally, the Indian court asked Balez to file an undertaking, which includes: whether he would use the travel documents only for the purpose of taking the children to Germany, adoption must be carried out in Germany, and produce a document from a suitable agency from Germany certifying that the children were in good condition. 

 
Understandably, the Indian courts are concerned with allowing a baby to leave India's jurisdiction without paternity.  Setting a precedent to allow this could be abused in the future by child traffickers.
 
Several issues and the way they seem to currently fall out:
 
a) Can your baby be stateless?  Yes, your baby is stateless until it is granted a passport and citizenship by a country.  In many (most) cases, you can get a passport and citizenship from your home country through its local consulate or embassy in India.  However, the above shows that in some cases it can be difficult.  Make sure to check with your embassy or consulate regarding your particular situation in order to prevent your baby from becoming the next stateless child story.  
b) Is the surrogacy contract valid?  In both cases, the courts needed to acknowledge the surrogacy contract in order to view the intended parents rather than the gestational carrier as the legal parent.  From this perspective, so far the courts have upheld the validity of the surrogacy contracts.  This issue is sure to come up again. 
c) Can babies born in India through surrogacy get Indian passports (if the intended parents are non-Indian)?  In both cases, "travel documents", rather than a passport and the citizenship it would confer, were granted to the babies.  The Indian government is, understandably, very reluctant to grant Indian passports to babies born through surrogacy.   
d) Can a surrogate mother claim legal custody of a baby she delivers?  Although the court was asked to address the issue of "whether the gestational carrier/surrogate mother will have any parental right to a child so born, even if there is a valid and legally enforceable agreement of surrogacy having contrary stipulations'', it did not issue a specific verdict.  In the Balez case, it does not seem to be moving in the direction of giving the surrogate mother (who hasn't asked for it) legal custody.

Getting the Indian Birth Certificate

Sat, 2009-11-21 04:26 — Peter

I've previously written about getting our baby's exit Visa and also getting his passport. The birth certificate precedes these, and is the step that we found most interesting.

In Indian surrogacy births, the names of the genetic or intended parents are currently put on the Indian birth certificate. There has been some discussion about whether it is legal to put anything other than the gestational carrier's name on the birth certificate, particularly from one of the Mumbai IVF facilities that does not offer surrogacy. While I'm not a lawyer, several things seem certain. First, with the Baby Manji case, India's courts have tacitly acknowledged and accepted surrogacy. Second, the hospitals are putting the genetic/intended parents names on the birth certificates today, and have been for many years. That being said, India is also developing its own legislation on surrogacy, called the ICMR Guidelines. While these haven't been adopted yet (as of Nov 2009), as currently drafted they will explicitly allow the genetic/intended parents names to be put on the birth certificate. Until these are passed, current practice may be a bit of a gray area legally.

Of course, you need the baby's name for the birth certificate. Because our baby was born 5 weeks early, we hadn't selected a name yet. The passport is dependent on having a birth certificate. And the exit visa is dependent on having a passport. So, every days delay in getting the birth certificate, is a days delay in going home.

In the week we were deciding on a name, we also investigated how to get the birth certificate quickly. Getting the baby's birth certificate from the BMC in Mumbai is supposed to take 21 days. Except that it's India, so sometimes the 21 days is reputed to stretch longer - we heard numbers like six weeks. Unfortunately, there is no official "expedited" service. Since it's India, the expedited services are unofficial and seem to require paying "chai pani", which is literally translated as "tea money", but more realistically described as a facilitating payment or bribe.

The Birth Certificate is issued once the local municipality receives the registration of the baby's birth from the hospital. In Mumbai, birth certificates are issued by the the Municipal Corporation of Greater Mumbai, also known as the Brihanmumbai Municipal Corporation, or BMC. At Hirinandani, on the day the baby is born, you will be asked to fill out a form in a giant book. This is the form submitted to the BMC for the birth certificate. Fill it out in capital letters and clearly - anything that causes confusion will delay the birth certificate. It is useful to get or make a copy of the form in case the BMC makes a mistake and you need to get the birth certificate corrected.

At the hospital, I had a conversation with one of the Indian women who had recently given birth and explained that, in our situation, we really wanted to get the birth certificate more quickly than the documented 21 days. We talked about the Indian concept of "chai pani". I asked her if you can just directly ask someone "So, how much chai pani do I have to pay in order to get this accelerated?" She laughed and said this would be far too direct, offend the person you were speaking to, and likely ruin any chances to get the document accelerated. Apparently, the correct approach is to ask "is there anything we can do to make this go faster" and listen for an opening that would suggest a small payment would help. Without having dealt with the BMC specifically, but with knowledge of Indian culture, she thought a typical accelerating payment for a birth certificate would be 100 or 500 Rupees. Although she did agree that a foreigner might be asked for more.

Most intended parents don’t go to the BMC directly, but rather work through a facilitator. We spoke to the public affairs department at the Hirinandani hospital, who can also arrange for a speedier birth certificate. They unofficially work through a third party agent, who charges 5,000 Rupees. He doesn't guarantee a delivery date and the public affairs folks said they were just passing along his charges. When asked whether we could get a receipt, the public affairs officer said we could not. (It's quite unclear who actually receives various cuts of this payment).

Our other choice was to work with Dilip, who has worked with other surrogate couples to facilitate the birth certificate process. He quoted us 3,000 Rupees and also 1 week to get the birth certificate.

So, we found that our choices to get a birth certificate came down to:

1. Go through the public relations officer at the hospital. At Hirinandani, the public relations office was working with through a service that charged 5,000 Rupees (Aug 2009). No guarantee on how long it would take to get the birth certificate (maybe a week), but quicker than doing it manually.

2. Go through a service/person who knows the process. Many have used Dilip, who was recently (August) charging 3,000 Rupees.

3. Go to the local municipal office (in Mumbai, the BMC) and go through the process yourself, either waiting the 21 days (or longer) or attempting to pay “chai pani” oneself.

For both options 1 and 2, we were requested to write a letter to the BMC requesting an accelerated birth certificate. The hospital’s public relations office provided us the template to follow.

We chose option 2 - Dilip - since it was cheaper, the hospitals relationship with their service provider was "unofficial", and other folks we knew had also worked with Dilip. We gave him the letter on a Tuesday, saying we'd need the paperwork by the following Tuesday for our Wednesday meeting at the consulate. He said a week was "no problem" and thought he might have the birth certificates as early as Friday.

Being India, Dilip called the following Tuesday telling us the birth certificates weren't ready, and that we should go to the consulate Wednesday anyway, and drop them off later. This, of course, pretty much defeats the purpose of going to the consulate. In our case, we had already delayed our meeting with the consulate for another couple days, so late delivery of the birth certificates wasn't a problem. Dilip delivered the birth certificates the next day, which was eight days from our original request.

Our advice:
1) Make sure you write all information very clearly on the hospital birth registration form and on the letter to the BMC so that the birth certificate is not printed incorrectly. It's an even bigger bureaucratic hassle to get it fixed.
2) Make copies of the hospital registration form and the letter you send so that if there is an error, you can prove it wasn't yours.
3) Don't ever base your plans on when you expect to get the birth certificate. Our experience is that India has not yet learned to “under-promise and over-deliver”, rather you are more likely to get “over-promised and under-delivered”. Leave some buffer time, you may need it.

(A version of this post, retitled The Indian Birth Certificate, is included as part of the India Surrogacy Guide at GlobalDoctorOptions.com.  Please leave comments if there is more to learn based on your experience.)

Surrogacy Abroad

Tue, 2009-10-27 08:00 — surrogacyabroad

 

Surrogacy Abroad, Inc. is an International Surrogacy agency based in
Chicago. We specialize in Surrogacy in India, we deal with surrogate
Moms, egg donors (Caucasian & Indian donors). We are a “one-stop” agency
For any intended parent (GLBT friendly) and can accommodate every aspect of
The journey to parenthood through surrogacy. Although the total cost for
Surrogacy in India is roughly a third of the typical cost as compared to
Most surrogacy agencies in the United States, we at Surrogacy Abroad, Inc.
Believe that cost alone should not be the deciding factor in selecting our
Agency to service your fertility needs; our partner clinic has one of the
Highest rates of IVF success achieved in any ART clinic around the world.
 
 
Our all inclusive surrogacy package:
 
1.       Psychological screening for Surrogate
2.       Criminal history inquiry for Surrogate
3.       Surrogate(s) mother medications and all necessary tests prior to Embryo transfer
4.       All necessary medications for Surrogate(s) mother after Embryo transfer
5.       Surrogate compensation
6.       Surrogate food and boarding in the clinic premises (for 1 year)
7.       Invasive Procedures Compensation without any exclusions
8.       Monthly expense allowance {non-accountable}
9.       Maternity clothing allowance
10.   Egg donor medical consultations (including pre-arrival in India), shots, scans, and all necessary medical procedures
11.   Egg retrieval (hospital facility &/or medical clinic, doctors, surgeons, specialist, nurses, products and medications etc.)
12.   Egg donor post operative care
13.   Sperm donor medical consultations, tests, medications
14.   Sperm washing and analysis for IVF (hospital facility &/or medical clinic, doctors, specialist, nurses and products etc.)
15.   Embryo tests and embryo processing
16.   Embryo freezing & storage (6 months)
17.   IVF procedure (hospital facility &/or medical clinic, doctors, surgeons, specialist, nurses, products and medications etc.)
18.   Multiple (4) ET (embryo transfer) procedures
19.   Surrogate post ET care
20.   FR (fetal reduction) as considered appropriate and necessary (hospital facility &/or medical clinic, doctors, surgeons, specialist, nurses, products and medications etc.)
21.   Surrogate post FR care
22.   Fetus abnormality tests and testing (as considered appropriate)
23.   Child delivery (hospital facility, doctors, surgeons, nurses, products and medications)
24.   Cesarean section
25.   .   Surrogate post delivery care (hospital facility, doctors, surgeons, nurses, products and medications etc.)
27.   Child (ren) post delivery care (hospital facility, doctors, surgeons, nurses, products and medications etc.)
28.   Administration and All Medical Reports (as necessary)
29.   Legal Contracts
30.   Legal Documents File for Child(ren):
1.       Birth certificate(s) and all birth related documents
2.       Paternity/DNA test(s)
3.       Exit documents from India
4.       Travel documents/visa
31.   Surrogate 24/7 access to doctors
32.   Indian Donor compensation
     
 
 The cost for the above package including Indian Egg donor is $39,850.00. We can customize the package according to your needs and adjust the cost.

Selecting the surrogate

Fri, 2009-10-02 20:24 — Peter

Because we'd like our new baby to have a sibling, so we're looking at another round of surrogacy.  Having finally gone through a successful round, we're re-thinking the criteria for selecting a surrogate. 

Many of the clinics, including Rotunda who we've worked with, will either email you surrogate profiles or, if you are in Mumbai, provide a book of profiles to look through.  The information in the profiles themselves are rather limited and include age, religion, education, number of children and a photo.

Having gone through a round of this already, this is what we think of the different criteria one can consider and the ones that are important to us:

1) Successful pregnancies.  To us, more is better.  Both her own and also through surrogacy.  Successful pregnancies show that the surrogate can carry a baby to term and has experience doing so.

2) No unsuccessful pregnancies or complications in pregnancies.  During our pregnancy, our surrogate had gestational diabetes, high amniotic fluid levels, and low T4 levels (related to the thyroid).  It is our understanding that she had not exhibited any of these signs in four previous pregnancies.  So, on the one hand, successful previous pregnancies are a good sign.  On the other hand, they don't guarantee a trouble free pregnancy.  One possibility is to speak with the gynecologist that handled the surrogates previous pregnancies to understand if there were any complications with those pregnancies.

3) Vegetarian/diet.  India has a high percentage of vegetarians.  Our understanding is that this can lead to low iodine levels which may have caused the low T4 levels in our surrogate.  While this can be overcome with vitamins, we may consider a non-vegetarian surrogate for our next round.

4) Education level.  We have mixed feelings on this.  On the one hand, the education level one attains is really based on how one did in the lottery of birth.  If you're born in the U.S., you probably got an education.  If you are a woman born in the Indian countryside, you may not have had the good fortune of access to formal education.  From that perspective, education is irrelevant.  On the other hand, a higher education level may impart more knowledge that would help ensure a safe and successful pregnancy.  But trumping that is whether the surrogate has had past successful pregnancies.  So, overall, education is a non-issue for us.

5) Previous transfers.  Some of the surrogates have had multiple previous unsuccessful transfer attempts.  It's valuable to ask how many unsuccessful transfer attempts a particular surrogate has had.  Medical science doesn't understand everything, and certainly doesn't understand what does and doesn't cause a successful transfer.

6) Religion.  Aside from any diet restrictions that religion imposes, religion is a non-issue for us.

7) Age.  For us, age is secondary to successful pregnancies and limited unsuccessful transfers.  However, age in the mid to late 20s are probably in the sweet spot. 

8) Medical tests.  Clearly, standard medical tests to check for any diseases should be undertaken.  Most of the reputable clinics seem to do this.

9) Height/weight/etc.  Some Indian women are more petite and some IPs may have genes that could result in bigger babies.  While not a factor for us, some couples may want to pursue a "bigger" surrogate.  It would seem that a big baby in a little woman could increase risks during delivery, much as the larger babies caused by gestational diabetes can increase risks during delivery.

10) Choice of surrogates.  Even with the above, if the clinic has very limited choice, you're going to get what is available.  We wanted to have some choice, or have a sense that the clinic did some filtering based on the criteria that was important to us.   

11) Colostrum/Breast Milk.  Colostrum is the initial milk produced for newborns and helps jump-start the baby's immune system.  If you would like the surogate to express colostrum or breast milk for some period of time, consider including this as part of the selection process and also include it in the contract with the surrogate.  Asking any time after the transfer leaves you at greater risk of the surrogate declining. 

Of course, you have to trust that the clinic and surrogate are giving you accurate information.  We worked with Rotunda, where we did observe a conversation about "no longer working with a surrogate that had complications in a transfer".  From that, it would appear that Rotunda has a high enough supply of surrogate candidates that it can be selective about which it offers for intended parents to work with. 

Also important is how the surrogates health and progress will be monitored during the pregnancy.  Some of the clinics have housing for the surrogates (Rotunda is one), some find or rent housing, some provide a caretaker to periodically visit the surrogate during her pregnancy, and some do none of the above.  For us, it was important that the surrogate have housing where her pregnancy could be monitored more frequently.

So, top issues for us are medical tests, history of previous pregnancies, history of previous transfers, diet and willingness to express colostrum.

[This post was slightly edited and added to the Surrogacy India Guide.]

Please add your criteria in the comment section.  

To meet the surrogate?

Sat, 2009-09-12 01:23 — Peter

Meeting the surrogate is an intensely personal choice which sometimes brings out the clash between the intended parents emotional need to be involved in the pregnancy and the surrogate’s (and often her family’s) financial want for more money.   Remember, the surrogate’s aren’t doing this for emotional fulfilment, they’re doing it for the financial reward. It’s labor that they are getting paid for. 

There are three phases at which one can choose to meet the surrogate:
  • Before the surrogate is selected, as part of the surrogate selection process
  • After the surrogate is carrying the child, but before she has delivered
  • After the surrogate has delivered the baby
From an emotional perspective, the intended parents are often interested in understanding everything about their child, including the woman that will be carrying the child and everything about her and her family. Some areas of interest are related to the child, especially with regard to food and nutrition. Some are related to the family environment, especially with regard to safety. Others are more personal, with the surrogate even becoming like an aunt. If the clinic or agency you are working with is unproven or cannot reassure you about the surrogates living conditions, then there is more reason to consider meeting the surrogate and understanding her living conditions.
 
From a commercial perspective, the surrogate and her family are seeing an immense amount of money from this transaction, and are some will wonder if they can get more. After all, if the intended parents can afford the costs of surrogacy, can’t they provide the surrogate just a bit more money?  A choice to make multiple international trips to visit the surrogate during the pregnancy is also an indication of wealth, and also an indication that maybe the surrogate can make more money.
 
Remember – Indian’s grow up in a culture with more bargaining and negotiation (and less fixed prices) than westerners are used to. In India, even overseas Indians who visit Mumbai get over-charged for taxi rides.   And more similar to the Chinese culture than the American culture, a signed contract is more like the start of the negotiating process rather than the end of the negotiating process.  So, you may get new requests during the surrogates pregnancy.   
 
Cases we’ve seen and heard of include:
  • The surrogate and family that were still calling the intended parents two years after the childs birth requesting money for things like their childrens school fees. 
  • The surrogate’s sister who called the intended parents in the hotel after the birth and requested an additional monetary payment for the surrogate.
  • The surrogate and her husband who threatened to abort one of the twins in a multiple pregnancy unless they were compensated more money (it’s unclear if the original contract already provided more funds)
We did meet our surrogate in the hospital after she had given birth as she was being discharged.  She seemed very nice.  We ran into her another day in the hospital and invited her to visit the baby in our hospital room.  Because we both had appointments, several hours passed before she was able to visit our room.  By then her brother and brother's wife had joined her, and her brother asked for more money so that she could have her own room (to build and extra room for their house).  He also asked for more money for her post-pregnancy medication, although Rotunda pays for this for six weeks and the doctor told us she wouldn't need anything beyond routine vitamins.  Admitedly, our surrogate seemed a bit embarassed about what her brother was doing, but in the more male dominated society, she may not have had much choice.  We were considering giving her some extra money or a piece of jewelry, but it's always difficult to know if it would actually get delivered to her, so we chose not to.  We were also considering seeing her again to take some pictures, let her see the baby again, and give her a piece of jewelry.  But because of her brother's request, we were unsure if she would come alone and what other requests she might make.  So we chose not to meet her again. 
 
It is/was a commercial arrangement, and both parties fulfilled their obligations.
 
My recommendations:
  • If you want to meet the surrogate, do so after the baby is born and in your hands. This is the point at which the surrogate and her family have no negotiating leverage. While they still have the baby, they have negotiating leverage, should they choose to use it.
  • Do not get involved in any negotiations. Refer all requests to your agency and/or doctor. 
  • Do not give the surrogate your contact information. If she and her family can’t contact you, she can’t make additional requests or demands. 
  • Don’t appear to be rich. This will be difficult, because as a westerner, and by being able to pay for the surrogacy process, you already appear richer than anyone the surrogate may know. But if you invite the surrogate and her family to an expensive restaurant or make multiple plane trips to visit her during her pregnancy, you’ll appear even more rich. Which makes you a more inviting target.
  • If you do plan on meeting with your surrogate, coordinate closely with your clinic to understand what they might add to the above comments. 

[This post was slightly edited and then also added to the Surrogacy India Guide.]

If you have a story, or know a story, please post it or link to it in the comments section.