How has Recent Developments in Technology Changed the Process of Pregnancy

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In recent times, the human race began to battle a question that was once very easy to answer. When exactly does life come to an end? Earlier in the 19th Century, the reply to the question was very obviously and frequently when the heart stops but when technological advancements could allow the heartbeat even after the brain had died or stopped working, it became unclear whether death still occurred when the heart stopped beating or when the brain stopped working. Another discussion has risen and this one does not challenge the end of life but rather the start. About half a century ago, human reproduction was solely based on sexual intercourse, full-term pregnancy, and delivery.

However, technology has disoriented and complicated this idea as concepts like in vitro fertilization (IVF), egg donations, genetic testing, ovulation induction, surrogacy and a plethora of other means of making babies have been introduced. The numerous changes in childbirth technology also include tests and procedures during pregnancy, how the babies' wellbeing is monitored during labor and birth practices. The use of assistive reproductive technology (ART) has had a dramatic increase and a total of 208,786 procedures yearly have been reported with a very high success rate. These advances in technology and research are also changing standards of care for pregnancy, labor, neonatal and postpartum care at an incredibly rapid pace.

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These changes have affected the way we perceive having babies and have been very beneficial to the rapidly changing society as it is now possible to make an infertile couple have a baby of their own and embrace the joy of parenthood which seemed almost impossible years ago. However, on the other side of the fence, technology is evoking a variety of controversies on the legal, ethical and religious sides of some of these reproductive technologies whilst simultaneously making the process of pregnancy overly complicated and not as straight forward as it once was. It is causing women to expect a plethora of high tech treatments throughout their pregnancy journey. Technology is also increasing the possibility of these women developing side effects and risks that would not come with a natural pregnancy like ovarian hyper-stimulation syndrome (OHSS) as well as the chances of the woman having an ectopic pregnancy and multifetal gestations while taking away the value of ‘normal’ pregnancy and the wholesome beauty that complements it. Is technology doing more harm than good?

Are all these procedures morally right? Are we thinking myopically by making these pregnancy ‘alternatives’? Are we misusing our technology? This project will be understanding these ARTs and challenging the subtopics as well as the ethical and legal attitudes tied to them questioning the true moral standards of our society and our principles of right and wrong. IN VITRO FERTILIZATION IVF is a complex series of procedures used to treat fertility or genetic problems and assist with the conception of a child. During IVF, mature eggs are collected from a woman and could be kept in the lab for a certain amount of time (known as gamete preservation) and then fertilized by sperm in a lab, after which it is inserted into the uterus of the same or another woman for normal gestation. In most cases, IVF is used to treat infertility in patients as a result of male factor infertility including decreased sperm count or sperm mortality and in females, blocked fallopian tubes as well as ovulation disorders, premature ovarian failure, and uterine fibroids.

This process of fertilization where an egg is combined with sperm outside of the body involves close monitoring and stimulating of a woman's’ ovulatory process. The first successful IVF was carried out in 1997 and ever since then, it has been an immediate alternative for women with fertility problems. IVF has changed the process of pregnancy and has helped many couples that cannot conceive naturally and have tried all possible ways to no avail realize their dream of parenthood. Approximately 6.5 million babies are born each year using this assistive reproductive technology (ART). IVF is also appropriate for single women and same-sex couples that desire to have children.

The procedure allows couples the option to screen embryos for hereditary disease or chromosomal problems if they wish to do so. Not only has IVF changed the process of pregnancy, but it has also improved it as if a lady or her partner is at risk of passing on any genetic disorder to the child. This process is the most popular and successful assistive reproductive technology as it is relatively easy and has been very successful over the years. Although with IVF, the chances of multiple births increases, not much of a disadvantage tag has been put on this as people do embrace multiple births but the could present a threat. In vitro fertilization offers new promises for women that are willing to spend thousands of dollars and risk the demands of IVF rather than just adopting a child. This demonstrates a strong emotional need for biologic offspring disregarding social pressures. IVF has helped so many infertile couples bare offspring off their own and has been a beneficial injection to the society.

However, In Vitro Fertilisation has its downsides. It has led to the formation of ‘test-tube babies’ and had been a source of moral, ethical and religious controversy since it was developed. This process amounts to the deliberate destruction and killing of millions and millions of human embryos that are not transferred to woman uterus on a daily basis. In these instances, they may also be used for research purposes and further embryonic development is halted. As human life starts at the point of fertilization, human rights should also start at this point and therefore their rights should be recognized. IVF demonstrates the immoral attitude of destroying multiple lives in favour of one. This destruction of embryos not used for implantation devalues the meaning of life and challenges the human standpoint on how much value we attach to this concept of existence.

Nevertheless, In the same way, in vitro fertilization has been rendered a source of moral, ethical and religious controversy since its development. The major opposition came from the Roman Catholic Church which issues a statement that opposed this assistive IVF on three grounds: the destruction of human embryos not used for implantation, the possibility of in vitro fertilisation by a donor other than the husband (which removes reproduction from the marital context)and lastly, the dismissal of the essential connection between the conjugal act and procreation. This has caused Christians to frown at this as the grounds are valid and they go against the values of Christianity. SURROGACY Over the last decades, surrogacy has revolutionized infertility problems and made a great impact on the way we go about pregnancy. It has enabled the gestation and birth of a child by another woman referred to as a surrogate mother and the relinquishing of the child after birth to the commissioning parents.

According to Wikipedia, Surrogacy is an agreement, often supported by a legal agreement, whereby a woman agrees to carry and give birth to a child for another person(s) who is or will become the parent(s) of the child. Surrogacy is one of the most popular assistive reproductive technologies(ART) and occurs most times when medical issues arise from either the male or female involved in the reproduction process. It could be that the driver of surrogacy has it medically impossible to carry or birth the child, or a single man or a male couple wish to have a child and other cases of diversity regarding sexual identity and orientation. Surrogacy could occur in two different ways, the first being genetic surrogacy in which the fathers or donors sperm is artificially inseminated into the vagina of the surrogate. This approach leads to an embryo genetically linked to both the surrogate and the father or donor. The second way is the host or gestational surrogacy. In this situation, the embryo implanted shares no genetic link with the surrogate mother. The embryo is made up of the intended parent's gametes, or the intended father's sperm and donor egg, or the donor's sperm and the intended mother's egg. Alternatively, the embryo could have been donated.

The majority of surrogates report that the main incentive and ground on doing this is selflessness and altruism. However, the fact that it comes with great financial benefits should also be a major consideration when weighing the surrogates' incentives. In some countries like England, Australia and a number of states in the United States. paying a surrogate for carrying a baby is legally prohibited as the intention is regarded as altruistic and nothing to do with the financial benefits attached. On the other hand, countries like Sweden, Italy, and Germany do not permit surrogacy as although they have their benefits they also have a number of limitations. Surrogacy has resulted in a major controversy in the 21st Century and has been often been referred to as ‘womb renting’ wherein this bodily service is provided to an individual in commercial situations for a fee.

The controversy surrounding this assistive reproductive technology comes from its implication for women's’ health and general human rights as well as the rights of the children produced and the exploitation of lower-income ladies who sought money desperately. Surrogacy affects a good number of women and their cognitive and emotional health as the woman may be at risk of going through depression during an after the surrogacy process because one may have to face some attachment issues and difficult feelings of grief and loss of a baby and a formed attachment following the delivery. It may also affect other areas of the mother's life like her support system and her close relationships. If she has a spouse, she might have to make sure he completely agrees with this life-changing decision because a lot of consideration has to taken as abstaining from sex and inability to perform to full capacity with work. Although it is a human right to make decisions as one pleases, another reason countries like Sweden disallow such legal arrangements is as a result of the possibility of a breach of contract. In some situations, a surrogate mother could decide to change her mind and keep the child while in other situations, she could breach the contract by breaking some already established agreements like, abstaining from smoking, drinking alcohol or abusing drugs and all these complications amount to a lot of court cases and problems between the surrogate mother and intended parent(s). Ultimately, the intended parents would have to trust the surrogate mother to do everything in the best interest of the unborn child. Another important aspect that births controversy to the practice of surrogacy is the consideration of the rights of the children.

According to the law, a child has the ‘right to know and be cared for by his or her parents…as far as possible’. As the law is not specific about who the parent is- could be the gestational, genetic or the intended parent(s), the child has a right to know all parties involved in their creation and it cannot be decided that the child should be cared for by a particular parent so when of a reasonable age, has every right to decide. Surrogacy also raises interesting questions about when and if the child should be made aware of their manner of birth as well as the identity of their surrogate mother. As the child has a ’right to identity’, they are expected to be made aware of this information in due time in accordance with both the age and maturity of the child. Ethically, surrogacy could be argued to be an altruistic act that one does to help another in need but in the case where this ‘womb renting’ starts to have more commercial than altruistic intentions, it begins to be looked down upon on from a moral dimension. It is very easy for one to say it is the exploitation of women, most especially those that belong to the poorer strata of society as they can earn over 5,000 USD for each pregnancy and this amount could better their standard of living to a very large extent.

The use of women's’ bodies commercially generates worrisome questions making the human race wonder; Are the privileged exploiting those that are less privileged? Could we call this exploitation of women? Is this human trafficking? Or the commodification and devaluing of human life? These are the few concerns that cause these countries to ban this practice. However, surrogacy is a rewarding gift especially to a lot of individuals that see a reason to give back and enjoy the feeling of satisfaction and pride that comes with it. In as much as there are many emotional, physical and cognitive demands from a surrogate mother for the pregnancy, it is arguable that surrogates get a fair enough compensation as it is a very unique experience and one enjoys a sense of community and the joys and wonders of pregnancy as well as their cost-effective profitable earnings which leave us questioning if at the end of all the practice, it is worthwhile. GENETIC TESTING Genetic Testing is a type of medical examination that identifies a mutation in chromosomes, genes or proteins. The results of the test could identify a suspected genetic condition to doctors as well as determine the tested person chances of developing or passing on a particular disorder. In the specific case of pregnancy, this blood test screens the fetus for some disorders and is done most times between weeks 10-12 of the pregnancy. During this prenatal test, doctors remove a small piece of the placenta and screen for any genetic problems.

The cost of genetic testing range from slightly under $100 to approximately $2000 depending on the complexity and type of test and the test could reveal if one has a suspected disorder. This ART(Assistive Reproductive Technology) has made a noticeable impact on the pregnancy process and is one of the most recommended tests for expecting mothers. Doctors recommend this test for different reasons like; If the pregnant woman is over the age of 34, as at that age, the likeliness of the woman having a child with a chromosomal problem, if the normal prenatal test is done and the result is abnormal, a parent that has one child with a serious birth defect as it is possible same would happen for the next child, a woman that has had 2 or more miscarriages and lastly, if a mother has delivered a child with distinctive physical and genetic problems. These different situations make genetic testing advisable so something can be done about a problem (if possible) as soon as possible.

Progress has been made and has improved how illnesses are diagnosed and treated. However, genetic tests are not always able to determine how the gene will affect the person that carries it. It is one thing to identify a mutated gene/protein and another to be able to treat and prevent some of these diseases and illnesses that could be caused by it. a chance that the test results may also return as inconclusive or uncertain exists and this may increase stress and anxiety levels for the expecting mothers and instead of benefiting her on the long run could stress her out emotionally over the course of the pregnancy as well as weigh heavily on the minds of her loved ones but most obstetrician-gynecologists encourage these tests are done. Dr. Andrea Greiner, a maternal and fetal medicine specialist reminds women that, “it is optional, but not required.’. She goes on to say that,’Every woman wants to believe that her pregnancy is normal and uncomplicated’ and then proceeds to respond to the argument that considers the emotional and mental state of the mother being unnecessarily stressed out if after a positive result not much can be done about it to change fix or treat the embryos mutation by saying, “no one likes a surprise”, as the knowledge of positive results in advance really helps and gives expectant parents ample time to plan and prepare themselves and home for a baby who’s has a possibility of special needs.

Risks are also very much involved in the genetic test itself as the procedures for this prenatal test require a sample of the amniotic fluid from the amniotic sac or surrounding tissues and any slight mishap such as the excessive amount of force or an attempt to retrieve the fluid from the wrong tissues could lead to a miscarriage. Another physical risk possible is an infection being passed to the embryo or the surrounding tissues as the insemination of unclean utensils( although a rare occurrence) is very much possible and could pass on bacteria that the embryos underdeveloped white blood cells are unable to fight off which could lead to infections killing the unborn baby as a result of its weak immune system or causing deformities and illness for the embryo. This could also affect the expecting mothers' uterus and reproductive tract (where utensils are inserted) and could cause infections disrupting the growth of the baby or in extreme cases, causing her to miscarry. EUGENIC ABORTION After tests have been run, the expecting mother experiences a long and unending 2-4 weeks wait. In some cases, negative results are recovered and the mother lifts this heavyweight off her chest. However, it is also possible for these results to be wrong and would not reflect any abnormalities until discovered after birth. On the other hand, if the results come out positive and demonstrate signs of disease, illness or deformity of the embryo, the unpleasant news nudges these women to think and decide what the next step to take in the pregnancy will be.

As a result of these birth defects, a few mothers often go with the option of late-term abortions as they cannot handle these fetal anomalies and an avenue for controversy is leased. Aborting a baby as a result of birth defects could be understood, especially in a situation where the child has very little or no chance of living. From the parental perspective, imagine a young expectant couple about to birth their first child and the shock they experience on discovering that the unborn child faces a serious or fetal birth defect. Following the shock, they are cued to as soon as possible, make a prompt decision on the fate of the unborn baby. One that will affect the rest of their lives. They either face the rest of their lives looking for

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