The Role of Religion and Spirituality in Conceptualizing Reproductive Loss: Clinical Implications of the Narratives of Gestational Surrogates in the USA.

Reproductive losses experienced by gestational surrogates, who do not share a genetic connection to the child they are carrying, may not be acknowledged or treated as compassionately as women who lose their "own" pregnancies. In-depth, semi-structured interviews were conducted with 17 gestational surrogates from diverse religious backgrounds. Grounded theory analysis of data included line-by-line coding, and emergent themes were identified. The results suggest that understanding and utilizing the religious/spiritual beliefs of a gestational surrogate may be one way for health professionals to provide implications counseling prior to surrogacy and also as a means to help process and grieve losses that may occur within surrogacy.

Cutting out the surrogate: Caesarean sections in the Mexican surrogacy industry.

Childbirth practices shed light on cultural values, ideologies of gender and motherhood, and social inequalities. Transnational, commercial surrogacy presents a useful lens through which to view the social dynamics that shape childbirth experiences. Surrogacy challenges dominant views on the naturalness and inevitability of maternal-fetal bonds because it involves the separation of gestation from motherhood. What ideologies inform childbirth practices in the consumer-driven context of surrogacy in which the woman giving birth is neither the consumer nor the "mother"? Based on multi-sited ethnographic research between 2014 and 2017 and in-depth interviews with 120 participants in the Mexican surrogacy industry, I argue that doctors draw on normative ideologies of kinship, gender, and maternal-child bonding to justify and normalize the use of Caesarean sections among surrogates. The ideology espoused by these doctors reinforces the notion that maternal-fetal bonding is natural and inevitable, constructs women as irrational and driven by hormones, and presumes that bonding between surrogate mothers and the children they gestate is detrimental to the surrogacy process. Furthermore, the proffered justifications for the Caesarean sections reproduces stereotypes about poor Mexican women as risky patients, contributes to the "disposability" of their labor, and reinforces a hierarchy in which the perceived interests of intended parents and children are elevated above those of surrogate mothers. This article contributes to social science studies of medicine by demonstrating how classist and racist stereotypes, and folk notions of kinship, gender, and maternal-child bonding are biologized in medical practice.

Perceptions of Surrogacy Within the Socio-Cultural Context of Nigeria.

Background: Up until recently, adoption is the most common alternative to recommended to couples struggling to procreate. However, with the advancement in medical technology, it is now possible to procreate through assisted reproductive technology (ART). Debates continue to ensue on the contentious issues emanating from various ART procedures, for instance regarding surrogacy there are concerns that this fragments womanhood, motherhood and parenthood, and there is a dereliction of the sacredness and cultural sanctity of the family system, most especially in an African context. However, as infertility becomes more prevalent among couples trying to have children in Nigeria, it has become important that alternate mediums of reproduction be examined within the socio-cultural milieu of the country. This study set out to examine surrogacy as a panacea to infertility in Nigeria through a qualitative lens. Methods: 15 stakeholders (traditional birth attendants, medical gynaecologists and legal professionals within the social, medico-legal framework of reproductive health) in Nigeria were engaged in an in-depth interview to unravel the challenges surrogacy might or is encountering as an ART in Nigeria. Results: There are various social, traditional, cultural and religious beliefs that police the reproductive sphere of Nigeria, which has grave implications on fertility treatment. These socio-cultural and religious factors do not provide a fertile ground for surrogacy to thrive in Nigeria. Hence, it is important that the socio-cultural framing of reproducing in Nigeria become receptive to modern medical reproductive alternatives and innovations. Conclusions: For surrogacy to permeate the reproductive terrain of the country there is a need to jettison several socio-cultural and religious sentimental beliefs policing reproduction in Nigeria.

La matrona en el escenario de la gestación subrogada / No disponible

No disponible

Effects and outcomes of third-party reproduction: parents.

Third-party reproduction has introduced a host of changing family constellations. Research has shown that children conceived through third-party reproduction are doing well psychologically and developmentally, but what about their parents? How have they coped with the transition to third-party reproduction? Has the experience impacted their marital stability or the quality of their parenting? This review will address parents of children conceived through oocyte donation, parents of children conceived through gestational surrogacy, and gay male parents of children conceived through oocyte donation and gestational surrogacy.

The evolving world of ART: who are the intended parents and how are their children doing?

Treatment advances in assisted reproductive technology (ART) such as oocyte donation and gestational surrogacy have introduced a new cohort of intended parents and new family constellations. Who these parents are and how their children are doing is the focus of this paper. Special emphasis will be paid to the impact of delayed parenthood on oocyte donation, the increasing numbers of gestational surrogacy participants (intended parents and surrogates), and the growing numbers of gay male couples seeking fatherhood through ART. While it appears that children of these new family constellations are doing well, research is limited and longitudinal studies of their health and well being are needed.

Is there such a thing as Latin bioethics?

This paper reflects on the presumption that there are distinct ethical differences between the supposedly 'Anglo-Saxon liberal' and 'Latin (Southern European) paternalist' ethical traditions. The predominance of the bioethical paradigm (principalism) is measured by a comparative analysis of regional moral opinion reflected in nation-state health laws. By looking at the way the ethico-legal concept figures into various national ordinances, we attempt to ascertain the extent and nature of variation (if any) between localities by exploring the understanding and application of principalism's keystone: patient autonomy.

Normal infant by a gestational carrier for a phenylketonuria mother: alternative therapy.

The consequences of pregnancies in untreated phenylketonuria (PKU) mothers are a high incidence of spontaneous abortion, intrauterine growth retardation with microcephaly, congenital malformations, and abnormal intellectual development. PKU fathers, on the other hand, produce normal children. Obviously children of PKU women and men are at least heterozygous, proving that the abnormalities produced by the PKU mothers are not genetic but "intrauterinely environmental." Exposure to the mother's metabolic abnormalities affects the fetus during the entire pregnancy. A PKU mother can produce a healthy infant if she maintains a very restricted and controlled diet before and during pregnancy. However, even the most recent reports describe a very high incidence of congenitally abnormal children of PKU mothers, hence dietary compliance is not working in all cases. A 26-year-old PKU patient with proven fertility underwent standard ovarian stimulation in preparation for oocyte retrieval. Following conventional co-incubation of the oocytes and her husband's sperm, two embryos were transferred to the gestational carrier's uterine cavity, resulting in a single intrauterine pregnancy. Birth was induced at 39 weeks of gestation. The male infant weighed 3486 g. Head circumference was 36 cm and length 50.5 cm; there was no evidence of any abnormality and/or malformation. At 1 year of age, the child's growth measurements and development assessments were normal. This describes the first reported successful term pregnancy of an untreated PKU mother with the help of a gestational carrier (GC), producing a normal infant. This is an alternative method that should be offered to PKU women who are unable and/or unwilling to maintain a well controlled diet before and during pregnancy.

Bioethics and culture: an African perspective.

The project of Bioethics seems to me to require paying attention to the cultural realities and assumptive frame of reference of different peoples. I assume that this must be one of the views of the organizers of this conference too and that this is why the idea of country reports is taken seriously. If I am right about this, then it makes sense for me to start my discussion with a very brief discussion of some aspects of the cultural realities of Africa with particular reference to the Yoruba of Nigeria. Then I will discuss how this world view raises issues for bioethics. Two aspects of people's worldview relevant to bioethical issues are their conception of the human person and their conception of cause. What they consider themselves to be, and what they consider to be the principles of causation will normally influence their attitudes to health and illness and their choices regarding health care. I will briefly discuss these issues with regard to the Yoruba worldview.

Gestational carrier--a reproductive haven for offspring of mothers with phenylketonuria (PKU): an alternative therapy for maternal PKU.

Maternal phenylketonuria, PKU, has a detrimental effect on embryogenesis. Infant pathology is independent of fetal genotype, but is directly correlated with excessive phenylalaninaemia throughout pregnancy. Although normal children have been delivered by affected mothers who either had benign hyperphenylalaninaemia or in whom strict diet has apparently maintained maternal phenylalaninaemia in the low normal range from before conception, more abnormal than normal births have been reported. In addition, attempts at dietary management are often unsuccessful; most reported cases documented various severe pathological consequences of maternal PKU. Currently available methods provide viable alternative treatment. In vitro fertilization using the parental gametes, followed by implantation of the pre-embryo in a surrogate mother, would avoid a metabolic environment impairing normal development, and therefore should be recommended as alternative therapy for potential mothers with PKU.