camera. in perth, australia, many come together to help a fellow passenger after a man slipped. they managed to push the train up and free his legs and the man was fine. inside story. . >> the new technical and legal frontiers of medicine allow two people to create an embryo and have a third person provide the womb for that new life to grow. it brings joy, but occasionally conflict, accidents and heartbreak along the way. surrogacy is the "inside story."

>> hello, i'm ray suarez. sometimes our ability to do amazing things runs out ahead of our customs, legal boundaries and best practices to deal with it. women who can't carry a fetus to term, who want to be mothers can now have their eggs harvested, fertilized by their partners and have another woman, a third party carry the baby for them. gay men have explored surrogacy as a way to become parents. the story of baby gamy, a biological child of an australian couple born to a young thai woman is just the latest moment where we might pause, think a little bit more about how we manage our miracles and talk about the ethics and economics of surrogate birth. the sorry of baby gamy he wil illustrates the promise and pit false. >> reporter: at seven months gamy appears to be a typical happy baby even as controversy

continues to southwesterly around him. his surrogate mother sat with him in a hospital about 50 miles east of bangkok where he is being treated for a congenital heart condition and lung infection. his story began last year when she said she was offered the equivalent of $15,000 in exchange for acting as a surrogate for an australian couple. she gave birth to twins but she said the parents only came to pick up one child, abandoning gamy who was born with down syndrome. she was kept in the dark about the baby's condition during the pregnancy. >> only the doctors knew he had down syndrome in the fourth month, but they wanted me to terminate the child because he had down syndrome. i said it's already seven months. i can't do it. >> reporter: the australian couple has been identified in the press.

and they did say they offered to take both children. she had two children already and a said she would raise gamy. a fund was started for gamy which has raised support over two weeks. the controversy has gripped politicians. australian prime minister expressed regret over the case saturday. >> it's a very, very sad story, and i hope to think that a child coul--i hate to think that a child could be abandoned like that. >> reporter: surrogacy money

exchange for services is forbidden, so many couples seek the service of thai or indian women and complications surround here in the united states. would-be parents have to navigate a patchwork of laws ranging from those in d.c. which ban surrogacy entirely to california which provides a regulatory structure to support the process. and the expense sends many parents overseas. surrogacy is getting new attention thanks to the high profile of baby gammy. they have considered a lawsuit against gammy's biological parents. >> people who want to take advantage of surrogacy often leave homes where it's banned, looking to places where the laws are more relaxed or, indeed, still being defined. in the united states the 50 states as i mentioned are a patchwork of laws ranging from specific statutes, allowing

surrogate arrangements to outright bans. joining us from our washington, d.c. bureau, kristin travis, owner of world surrogacy and the mother of three surrogate children. and paul an attorney who has handled surrogacy chase cases and naomi khan, professor of law. let me ask you are we still catching u up in the legal code to where we are as people making these arrangements amongst ourselves. >> this is where the technology is outpacing the law. as you've mentioned there is a patchwork of state laws when it comes to surrogacy. it depends on the state in which you live whether or not a contract will be enforcement.

>> paul, do you add a level of complication when you head overseas? >> well, you add a level of risk. along with all the type of complications that you're talking about. this child that you have may end up being raised in horrible conditions. it may be exposed to things you never dreamed your child would be exposed to. because you might not end up taking your kid home. most of the time, though, it works out pretty well. >> but when you have a child in this way, if you come from one country and travel to another to do that, are the contracts you make internationally with the surrogate mother enforceable in her home country? >> oh, that's all over the map more than the united states. there are very few countries that are very good at enforcing those kinds of contracts.

usually you rely upon the agency to twist arms, manipulate people and make sure that it happens oh they can get more business from referrals. >> crystal travis, you've been through the process yourself. you've helped other people through it. it seems to me there are three parties who need to be protected. the mother bearing the child. the parents interested in having that child born and the child themselves. how do you build in a structure to make sure all those interests are met properly? >> we work with attorneys. it depends on which weather country we're working in, whether it be india or mexico so we have lawyers on the ground who facilitate the contracts between the clinics, the surrogate, and the intended parents. we have never had an issue legally with getting children out of either mexico or india. >> what are the kind of bumps along the way that have to be understood, navigated or

prepared for. >> if you're doing surrogacy in a country where it's legal, issues that have arisen with the baby gammy case would never happen in india or mexico because that is open to the contract that if there is an abnormality and the intended parents choose to terminate the pregnancy, then that would be done. >> now mexico doesn't entirely recognize surrogacy. >> the state of tabasco only. >> what problems arise? >> if you work with a doctor who is not in the state of tabasco or an agency that is not making sure that that surrogate gives birth in tabasco, that's a problem. there are agencies and companies coming up, and they're not legit or they're rogue agents, and you could have problems.

we're starting to see this happen in nepal right now with the situation in thailand. it was never legal to pursue surrogacy in the first place. now you have agents running to nepal and setting up new forumsish the same thing will happen in nepal with doctors that is happening on the ground in thailand. >> now occasionally a mother changes her mind. could you give birth in tabasco and simply head to so sonora, yukatan and never have to surrender that child? >> that would never happen. in order to be a surrogate you're not genetically related to that baby you're carrying. basically we are renting parent--parents are really renting your uterus. you have no legal rights. your name is not on the birth

certificate. unlike thailand that's a problem. the surrogate as nate i name is on the certificate. in india, the surrogate's name is not on the legal birth certificate. >> paul is it as clear to you that you have no parental rights when a child emerges from your womb? >> well, no. because sometimes you do have some rights. but for example, that hypothetical girl that is having the baby in that state in mexico. nobody is holding her prisoner. somewhere during the pregnancy if she decides to get on a bus and decide to go to another state, she's gone, and the baby is gone. and nobody is going to go find that child. but american couple that have their baby in that country somewhere, they live forever with the knowledge that that child is being raised in a

manner that is wholly unacceptable to them. it's not that clearcut. it usually works out, but it is hazardous. >> naomi, it usually works out. there has to be a certain level of good will involved, too, doesn't there? along with the legal arrangements along with the parties promising each other things there has to be a certain intention to follow through. >> absolutely. it's interesting most of the surrogacy arrangements do follow through and there is a child who is given to the intended parents. it is important that there be good will, there be trust, cooperation among everyone involved. then as crystal mentioned it is important to have a contract so people have in writing exactly what their expectations are with

respect to the surrogacy arrangement. but in addition to the written word you absolutely need good trust. i would imagine crystal would agree that there needs to be screening of the surrogates as well to make sure that the surrogates are fully prepared to deal with what happens at the end of the pregnancy. >> kristin travis is there an element of people wanting to give this gift, want to go help make it happen, who may think, oh, i don't want a contract. it's like making it an intended spouse sign a pre-nup. let's arrange this on our own. is there a down side to that? >> well, there could be, but the reality is if you're pursuing surrogacy in an international country you have to sign a contract in whether it be india or mexico with the clinic you're working with any way. that's standard operating procedures in this business. >> what about here in the states? are you still advised not to try

to handle it on your own. >> i would advise people not to handle it on their own, but the reality is a the majority of people do handle it on their owner and they get themselves oftentimes in trouble. what's happening in thailand if you probably did go through an agency or facilitator you're probably not going to get your money back. having that person that has a relationship with the doctors, they can get your money back when a country decides to shut down surrogacy. >> we're going to take a short break. when we return we'll talk about the possible pitfalls and couples who are seeking this kind of service, what they should have in mind before they do. this is "inside story." stay with us.

>> you're watching "inside story" on al jazeera america. i'm ray suarez. hiring a woman to have a baby for you is banned in some places, and loud in others and in united states only a married couple consisting of a man and woman with move forward with a legally binding surrogacy contract. some couples have spent a lot of money, traveled extensively and ended up with no child and no recourse. paul, your buzzer on your desk buzzes. the receptionist says there is a

couple waiting in the outer office, and they're interested in surrogacy. what do you need to know from them and what do they need to hear from you? >> well, they're about to start on a long-term adventure. it's not something that is going to be accomplished in two, three, even four months. in texas they're going to have to find the surrogate, and they're going to have to go through a home study in the nature of what we would do for an adoption, and then it's got to be validated in court with a proceeding before the pregnancy occurs. if any of that doesn't happen, it's a void contract. and essentially you're relying upon the carrier of the child to allow you to adopt that baby. and then for a court to permit it to happen. >> are things easier if they are coming in already with a woman who is ready to embark on the

surrogacy with them? >> oh, yes, at least they don't have to go through the search process. but they still have to go through a significant process to verify that these are the kinds of people that we want to be having children, which is one of the reasons why people slip into other countries because they might not pass that background check. they may have things in their background similar to this gentleman in australia that would preclude a judge from being willing to validate the contract. this can be a mess or it can be a blessing. >> crystal travis, if you're advising people, are there places in the united states where it's easier or harder where you might tell them to go ahead and do it, or might tell them to look elsewhere? >> well, it depends on people's pocketbooks. so generally the clients that come to me generally cannot afford to pursue surrogacy here

in the u.s. or the reality is that most of the people by the time they do surrogacy internationally they've exhausted their funds here. they generally have spent $100,000 or 200,000 here. and in international countries that's their last hope, and that's why they want to pursue surrogacy internationally. >> naomi, to make this different and separate and ethically less problematic than straight out baby selling, what protections do we have to build in? >> there are a series of protections that some states have built into the process. in illinois both surrogate and intending parents have to have legal representation. having lawyers involved can help in terms of protecting the interest of all those who are involved. screening is incredibly

important, the surrogate as well as screening of the intending parents so they know precisely what they're getting into. screening independent representation and counseling can help everyone involved and deal with the consequences. >> i'm interested in the idea of both the couple that desires a child and the intended surrogate having separate representation. they have different interests at state. >> they have very different interests at stake although the intending parents want a child, and the surrogate, of course, there is a meeting of the minds, and everybody wants a child to be produced. but the process of what happens if for example a child, a what happens if there are severe

brain difficulties or halt problemhealth problems. the intending parents and surrogates may have different interests in what happens to that child. the contracts generally specify the activities the surrogate is permitted to participate in so there may be different interests when it comes to that as well. >> can you specify along with the surrogate's behavior that you will or won't take children on board at the end of the legacy with certain problems or challenges or the normal anomalies that plague the human race? >> are you suggesting that it might be permissible to buy your way into this, and then if you have buyer's remorse because the child is not developing appropriately, you can walk away

and say hey, that's not my problem? >> not what i ordered. >> not in any jurisdiction in the united states, no. >> simple at that. >> no, absolutely an as simple as that. >> can you order a select difficult reduction if in the fertization process an intended surrogate ends up carrying more babies than you had asked for? >> well, you know, that's a real interesting question. i don't think in our country those are going to be enforc enforceable. but i think probably they should be. the law in this area is just about 25 years old, and in terms of law that's very young, we're still sorting out the details. people with creative imaginations like yours stretch legislators to come up with

something to fit the problem. >> crystal travis, perhaps you have insight on this or want to be heard on this. selective reduction, that is aborting when someone ends up carrying four children than the two or one you may have wanted. what happens then? >> speaking from experience my older son was a twin. one died early in gestation. our twins and triplets because in india if you have multiple children they will reduce to twins for the safety of the surrogate and the safety of the remaining fetuses. >> what about in the united states? i would imagine that the idea of demanding or even requesting a selective reduction gets very complicated here in america. >> i don't think it really gets that complicated. i think what happens is that four intended parents if their surrogate were to carry

triplets, that they have that in the contract that they'll reduce if that's not what they want. >> we're going to take a short break. when we come back we'll talk about the ways that society is changing that's both demanding us get used to this idea, and also build in some local protections to build a framework around it. this is inside story. stay with us.

>> welcome back to inside story. on al jazeera america. i'm ray suarez. new local and medical frontiers of surrogacy over time have best practices emerge to protect the rights and interests of both the people who want a child and the people who agree to bear those children. will we over time develop a body of law to handle the problems that arise from time to time? crystal, you're in this business with world of surrogacy. perhaps when this all began it

was just infertile couples. is there a new--as society changes, as gay marriage comes online in more places are there new constituencies coming forward and saying we can take advantage of this as well? >> certainly, i think what happened was when india started the whole process with surrogacy it was not just infertile couples. a lot of couples were people who were older and their eggs have aged out, such as myself. and a lot of gay and single people were opting for this option of surrogacy because it was, frankly, a lot easier than going the adoption route. at least it was better to have some of your genetics than no genetics. as part of modernity, this is not going to stop. pandora's box has opened and we have to figure out guidelines and laws to be put in place to

remedy some of these situations like this situation, like baby gammy. >> paul, now that the box is open, will the world of legislation catch up quickly, or might this be a social change that takes some time? >> well, right now we're in a position where our legislation is reactive. every time we have a bad situation we make mothe another law to make sure that that bad situation doesn't occur. now we're going to get to proactive legislation where we anticipate how to best organize this with the rest of our society. it's going to happen. we're going to have standardizations worldwide where we have enforceability worldwide. you know, 30-35 years ago if somebody took your child across into another country and got some kind of a child order there

you couldn't go get your child back. this is going to catch up, too. >> naomi. we now live in a world where a woman can give birth to a child to whom she is not related. have we not only legally not caught up, i is you teach family law, is there still part of the human software that needs to catch up. >> there is part of the human software that needs to catch up. this can be done through counseling and advising, and part of this can be done as the law becomes more clear about precisely what the expectations are. but there is still a significant portion of americans, in fact, a significant portion of countries that ban surrogacy because they don't like the idea that a woman, the woman who gives birth is then not going to be identified as the legal mother.

>> naomi, crystal, paul, great to talk to you all. that brink u brings us to the end of this edition of "inside story." today's program may be over but the conversation continues. we want to hear what you think about this or any day's show. we are located on facebook or twitter, you can reach me directly @ray suarez news. in washington, i'm ray suarez. build