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They’ve been called “baby factories,” conjuring up images of poor, illiterate women packed into bunks and forced by their husbands to bear surrogate children for Westerners. And they make up a vital industry in India—since 2002, when surrogacy was legalized in the country, a U.N.-backed study estimates that the surrogacy business has raked in more than $400 million a year.

More than 3,000 fertility clinics operate across India, and some can be quite flashy. Dr. Nanya Patel —who once appeared on Oprah and has been dubbed the country’s “mother of surrogacy”—says she plans to open a huge clinic that will house hundreds of Indian women, along with delivery rooms, an in-vitro fertilization department, even restaurants and a gift shop. With couples paying an average of $25,000 to $30,000 for the entire procedure, and Patel paying her surrogates around 400,000 rupees ($6,500), it’s safe to say that she’s earning a pretty penny. Since 2004, she has delivered more than 650 babies. She says she’s a feminist and her work involves “one woman helping another.”

Patel’s critics are not...