Is womb rental morally/socially acceptable?

How surrogacy came to be so popular in the choking backwater of Anand, a dairy community with a population of 150,000 in India's western state of Gujarat, is a long story.

The short answer is Dr. Nayna Patel, 47, the clinic's director. A charismatic woman with flowing hair and a toothpaste-commercial smile, Patel single-handedly put Anand on the map when, in 2003, she orchestrated the surrogacy of a local woman who wanted to "lend" her womb to her U.K.-based daughter. The woman gave birth to test-tube twins — her own genetic grandchildren — and the event made headlines worldwide. Afterward, Patel was inundated with requests for surrogacy.

She now has 45 surrogate mothers on her books, mostly impoverished women from nearby villages. Twenty-seven of them are currently pregnant, and each will be paid between $5000 and $7000 — the equivalent to upwards of 10 years' salary for rural Indians. More than 50 babies have been born at the clinic in the past three years, half to Westerners or Indians living overseas.

Another example of third-world exploitation? Globalization gone mad? The system certainly lends itself to the criticism that foreign women unwilling or unable to pay high Western fees happily exploit poor women at a 10th of the price it would cost back home.

The system also avoids the legal red tape and ill-defined surrogacy laws women face in the U.S. (Not to mention that India, unlike some developing countries, has a fairly advanced medical system and doctors who speak English.) Or is it a mutually beneficial relationship? By some estimates, Indian surrogacy is already a $445-million-a-year business.