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Riddle MP. The Role of Religion and Spirituality in Conceptualizing Reproductive Loss: Clinical Implications of the Narratives of Gestational Surrogates in the USA. JOURNAL OF RELIGION AND HEALTH 2021; 60:282-294. [PMID: 32734515 DOI: 10.1007/s10943-020-01076-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- M P Riddle
- Department of Psychology, The Pennsylvania State University, 136 Moore Building, University Park, PA, 16802, USA.
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Ferolino AP, Camposo MAD, Estaño KCL, Tacbobo JMR. Mothers for Others: An Interpretative Phenomenological Analysis of Gestational Surrogates' Child Relinquishment Experiences. J Patient Exp 2021; 7:1336-1340. [PMID: 33457584 PMCID: PMC7786765 DOI: 10.1177/2374373519892415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Previous studies have shown that surrogates reported high satisfaction with the surrogacy process and no psychological difficulties as a result of child relinquishment. However, the experiential dimension of child relinquishment is an understudied area. Objective: This study sought to provide a more detailed portrait of gestational surrogates’ child relinquishment experiences and the meanings they give to this experience. Method: Semistructured interviews were conducted with 3 women who experienced commercial gestational surrogacy for the first time. Interview transcripts were transcribed and analyzed using interpretative phenomenological analysis. Results: Three superordinate themes were generated from the transcripts: (1) undertaking an act of altruism, (2) going through a different kind of motherhood, and (3) promoting a positive body image. Conclusion: Such insights can provide essential knowledge for mental health professionals who are interested in the development of psychological support tailored to promote a smooth emotional transfer of the baby from the surrogate to the intended couple.
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Affiliation(s)
- Austin P Ferolino
- Departmentof Psychology, University of San Carlos, Cebu City, Philippines
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Gracias CS. Reproductive surrogacy in Ireland - an ethical and legal context. Ir J Med Sci 2020; 190:1063-1070. [PMID: 33131030 DOI: 10.1007/s11845-020-02402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
Reproductive surrogacy can be altruistic or commercial, each with complex ethical considerations that are complicated by heterogeneity in governing laws across jurisdictions. Surrogacy in Ireland is relatively new and largely unregulated, so this review aims to elucidate its current regulatory status and associated ethical issues. AIMS: On reproductive surrogacy from an Irish legal perspective, to: 1. Illustrate the lack of established legislation 2. Describe draft statute 3. Demonstrate the inadequacy of current non-statutory regulation 4. Examine European and Irish Constitutional Law 5. Exhibit challenges in case law for parenthood: i. The lack of recognition of intent to conceive compared to non-Irish jurisdictions ii. The lack of recognition of international surrogacy iii. The lack of procedures to transfer legal parenthood iv. The legal/medical/religious/socioeconomic consequences of 5] i, ii, iii On reproductive surrogacy from an Irish ethical perspective, to: 6. Analyse ethical issues in altruistic surrogacy 7. Evaluate ethical issues specific to commercial surrogacy: i. Financial and emotional exploitation ii. Commodification of children and women's bodies iii. Child welfare iv. Healthcare inequality CONCLUSION: Irish reproductive surrogacy exists in a legislative vacuum and is poorly governed by non-statutory regulation. However, Ireland is free to draft laws aligned with modern societal views on reproduction, which is especially relevant given the recent legalisation of same-sex marriage. Ethically, carrying mothers and children are vulnerable, particularly in commercial arrangements, with significant financial disparities between commissioning and surrogate parties. Altruistic arrangements can be a boon to Irish society if supported by public education and appropriate legal frameworks.
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Riddle MP, Jenkins SR. Clinical considerations in the psychological evaluation of gestational surrogates: uses of narrative assessment. HUM FERTIL 2020; 25:176-187. [PMID: 32567407 DOI: 10.1080/14647273.2020.1778802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Potential risks and ethical considerations inherent in surrogacy arrangements place tremendous responsibility on mental health professionals performing the necessary assessments, yet there is little discussion and no consensus on the best testing protocol. In the U.S., the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) are the most common psychological measures used to screen gestational surrogates (GSs), although these self-report symptom inventories reveal tendencies to underreport, deny problems and present positive impressions that may conceal important clinical information. This study examines the utility of a multi-method approach in the psychological evaluation of GS candidates. A total of 43 women cleared to be GSs completed the PAI and an abbreviated protocol of a narrative construction assessment measure (The Thematic Apperception Test (TAT)) as part of the psychological screening process. Findings of the study show that utilising a multi-method approach in the psychological consideration of a GS can address the limitations inherent in a single-measure assessment approach. Including a narrative measure such as the TAT that is less affected by defensiveness found on self-report scales may allow for more subtleties in interpretation, helping assessors to identify women who may have particular psychological vulnerabilities. These might then be addressed through implications counselling.
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Affiliation(s)
- Mary P Riddle
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Sharon R Jenkins
- Department of Psychology, University of North Texas, Denton, TX, USA
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Psychological assessment of gestational carrier candidates: current approaches, challenges, and future considerations. Fertil Steril 2020; 113:897-902. [PMID: 32312559 DOI: 10.1016/j.fertnstert.2020.02.104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 11/23/2022]
Abstract
The role of a mental health professional (MHP) in the psychological assessment of gestational carrier (GC) candidates has evolved over time, with clinical practices well established in the United States. Current ASRM guidelines recommend that all GC candidates undergo a psychosocial consultation and psychological testing (where deemed appropriate). Practice standards are relatively consistent among mental health disciplines, with assessments typically involving a clinical interview and the administration of a single, objective, self-report personality inventory. Although recent studies have established normative data for GCs, there has been little research into which assessment protocols are best suited to answer the referral questions of interest. Current challenges for MHPs placed in a gate-keeping role include providing a thorough screening using measures that typically yield defensive profiles that make them difficult to interpret. Research is emerging that suggests that using a multimethod approach in the psychological assessment of GCs may yield a more comprehensive psychological profile of GC candidates. This could allow MHPs to determine psychological appropriateness with more confidence and contribute additional data to be used in pre-surrogacy counseling. Assessing the psychological appropriateness of a woman to serve as a GC is a complex process, and there are a multitude of factors that must be considered, not the least of which are the psychological well-being of a potential GC, her partner, and her children throughout the process and beyond.
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Igareda González N. Legal and ethical issues in cross-border gestational surrogacy. Fertil Steril 2020; 113:916-919. [PMID: 32327242 DOI: 10.1016/j.fertnstert.2020.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 01/17/2023]
Abstract
This article aims to identify the main legal and ethical issues around international surrogacy. Owing to the legal diversity and ethical background of such a globalized practice, a review of the key existing literature on these two matters has been identified and analyzed. The article also identifies and analyzes the most significant legal solutions provided by supranational jurisdictions when dealing with cases of international surrogacy. The scope of the article includes the efforts to reach a minimum legal framework at the international level, with the aim not to standardize but to provide common legal solutions to those travelling abroad to have a child by means of surrogacy.
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Yee S, Librach CL. Analysis of gestational surrogates' birthing experiences and relationships with intended parents during pregnancy and post-birth. Birth 2019; 46:628-637. [PMID: 31512272 DOI: 10.1111/birt.12450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study investigated the surrogates' birth experiences, their levels of emotional struggle at relinquishment, how often they thought about the surrogacy children, and the surrogate-parent relationship dynamics during pregnancy and post-birth. METHODS Data were collected from 06/2016 to 02/2017 using an anonymous questionnaire. Participants were Canadian gestational surrogates who had completed the process with or without a successful live birth, and who were at various stages of an ongoing surrogacy. For this paper, only a subgroup of cases with a successful live birth was selected for analysis. RESULTS The data set included 131 births involving 90 surrogates who delivered 157 babies (105 singletons and 26 sets of twins). Their mean age at the time of surrogacy was 31.7 ± 5 years (range: 21-47y). More than one-third (37.4%) of the cases were for intended parents who were same-sex male couples and single men. Surrogates assisting Canadian-resident intended parents had an overall better birthing experience compared with those assisting nonresidents. There was none or very little struggle with the relinquishment of the baby in 96.9% of cases. Continued contact with parents after the births was reported in 93.0% of cases. Surrogates were significantly more likely to have frequent post-birth contact with same-sex and single fathers compared with heterosexual parents and single mothers (76.6% vs 54.3%). CONCLUSIONS Same-sex male couples and single men can develop a long-lasting relationship with their surrogates even when no intended female partners are involved. The development of institutional practice guidelines in standardizing surrogacy birth practice is paramount in optimizing surrogates' care.
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Affiliation(s)
| | - Clifford L Librach
- CReATe Fertility Centre, Toronto, ON, Canada.,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.,Department of Obstetrics and Reproductive Endocrinology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Obstetrics and Gynecology, Women's College Hospital, Toronto, ON, Canada
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Yee S, Goodman CV, Librach CL. Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases. Reprod Biomed Online 2019; 39:249-261. [DOI: 10.1016/j.rbmo.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/15/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022]
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Yee S, Hemalal S, Librach CL. "Not my child to give away": A qualitative analysis of gestational surrogates' experiences. Women Birth 2019; 33:e256-e265. [PMID: 30824376 DOI: 10.1016/j.wombi.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/17/2019] [Accepted: 02/11/2019] [Indexed: 11/26/2022]
Abstract
PROBLEM/BACKGROUND Limited empirical data are available on the experiences of women who have been a gestational surrogate. QUESTION What are the experiences of gestational surrogates along the surrogacy pathway? METHODS An anonymous study-specific cross-sectional survey was used to evaluate participants' experience of being a surrogate. A total of 184 Canadian women who were recruited from Canadian surrogacy agencies and the Internet completed the online survey; 9446 words were collected from 110 participants who entered comments to one or more questions. The qualitative data were analyzed through thematic analysis. FINDINGS Seven main themes, and eighteen interrelated sub-themes grouped under the pre-, during, and post-surrogacy stages were identified. Many surrogates viewed surrogacy as a positive experience and as something meaningful and impactful to other people's lives. Most surrogates had harmonious relationships with their intended parents and maintained on-going contact with the surrogacy family post birth. DISCUSSION Surrogacy involves deliberate efforts to establish a trustful surrogate-parent partnership through relationship building, boundary negotiation, and management of expectations. The compatibility between surrogate and intended parents, regarding aspects such as communication and pregnancy management styles, was an important contributing factor to a positive experience. CONCLUSION Our findings provide a deeper understanding of participants' reasons for and motivation to be a surrogate, the relationship dynamics with their intended parents and the gestated fetus during surrogacy, and their satisfaction on personal and relationship levels post surrogacy. The findings would be useful to mental health professionals in preparing new surrogates for the potential challenges along the surrogacy pathway.
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Affiliation(s)
| | - Shilini Hemalal
- CReATe Fertility Centre, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Clifford L Librach
- CReATe Fertility Centre, Canada; Institute of Medical Science, University of Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Canada; Department of Obstetrics and Reproductive Endocrinology, Sunnybrook Health Sciences Centre, Canada; Department of Obstetrics and Gynecology, Women's College Hospital, Canada; Department of Physiology, University of Toronto, Canada
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Rumpik D, Rumpikova T, Pohanka M, Ventruba P, Belaskova S. Gestational surrogacy in the Czech Republic. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 163:155-160. [PMID: 30238935 DOI: 10.5507/bp.2018.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Gestational surrogacy, is a treatment option for women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. The aim of our study was to review, evaluate and share our experience and outcomes over the last 13 years of the largest surrogacy program in the Czech republic. METHODS A total of 75 intended mothers and 82 surrogate mothers participated in this study. A retrospective cohort study was performed. Anonymized data were collected on 130 cycles of gestational surrogate (2004-2017) directly from the Clinic database. RESULTS We performed 130 in vitro fertilization cycles with gestational surrogacy which involved 73 fresh embryo transfers and 57 frozen embryo transfers. We achieved 57 (43.9%) pregnancies and 42 (32.3%) live births. The rate of multiple pregnancies was only 2.3 %. The most common indication for using was an absent or damaged uterus (65%), followed by medical conditions precluding pregnancy (23%) and repeated in vitro fertilization cycles or pregnancy failure (12%). CONCLUSION In the 14 years of our experience, we have shown that treatment of young women with specific indications for gestational surrogacy is beneficial, successful and relatively free of complications. However, it is imperative to follow the medical indications for this treatment and specialist recommendations.
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Affiliation(s)
- David Rumpik
- Clinic of Reproductive Medicine and Gynecology Zlin, Zlin, Czech Republic.,Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Masaryk University Brno, Brno, Czech Republic
| | - Tatana Rumpikova
- Clinic of Reproductive Medicine and Gynecology Zlin, Zlin, Czech Republic.,Faculty of Humanities, Bata University Zlin, Zlin, Czech Republic
| | - Michal Pohanka
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Masaryk University Brno, Brno, Czech Republic
| | - Pavel Ventruba
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Masaryk University Brno, Brno, Czech Republic
| | - Silvie Belaskova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic Corresponding author: David Rumpik, e-mail
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Italian gay fathers' experiences of transnational surrogacy and their relationship with the surrogate pre- and post-birth. Reprod Biomed Online 2017; 34:181-190. [DOI: 10.1016/j.rbmo.2016.10.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 11/20/2022]
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Bromfield NF. “Surrogacy Has Been One of the Most Rewarding Experiences in My Life”: A Content Analysis of Blogs by U.S. Commercial Gestational Surrogates. INTERNATIONAL JOURNAL OF FEMINIST APPROACHES TO BIOETHICS 2016. [DOI: 10.3138/ijfab.9.1.192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Commercial gestational surrogacy has increased significantly over the past decade, and many people are speaking out against it as dehumanization, commodification, baby selling, and exploitation. Surrogacy has been banned in much of the world, despite only a small number of empirical studies on surrogates' experiences and attitudes. The United States is a popular global surrogacy destination, where surrogacy remains legal. U.S. surrogates are not an invisible group but are active users of internet forums and blogs. This article describes the framing of the experiences by gestational surrogates who keep blogs, using those blogs as data.
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Söderström-Anttila V, Wennerholm UB, Loft A, Pinborg A, Aittomäki K, Romundstad LB, Bergh C. Surrogacy: outcomes for surrogate mothers, children and the resulting families—a systematic review. Hum Reprod Update 2015; 22:260-76. [DOI: 10.1093/humupd/dmv046] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/21/2015] [Indexed: 11/13/2022] Open
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Saravanan S. Global justice, capabilities approach and commercial surrogacy in India. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2015; 18:295-307. [PMID: 25894236 DOI: 10.1007/s11019-015-9640-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Inequalities, ineffective governance, unclear surrogacy regulations and unethical practices make India an ideal environment for global injustice in the process of commercial surrogacy. This article aims to apply the 'capabilities approach' to find possibilities of global justice through human fellowship in the context of commercial surrogacy. I draw primarily on my research findings supplemented by other relevant empirical research and documentary films on surrogacy. The paper reveals inequalities and inadequate basic entitlements among surrogate mothers as a consequence of which they are engaged in unjust contracts. Their limited entitlements also limit their opportunities to engage in enriching goals. It is the role of the state to provide all its citizens with basic entitlements and protect their basic human rights. Individuals in India evading their basic duty also contribute to the existing inequalities. Individual responsibilities of the medical practitioners and the intended parents are in question here as they are more inclined towards self-interest rather than commitment towards human fellowship. At the global level, the injustice in transnational commercial surrogacy practices in developing countries calls for an international declaration of women and child rights in third party reproduction with a normative vision of mutual fellowship and human dignity.
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Affiliation(s)
- Sheela Saravanan
- Cluster of Excellence, Asia and Europe in a Global Context, Karl Jaspers Centre for Advanced Transcultural Studies, Heidelberg University, Germany,
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Jadva V, Imrie S, Golombok S. Surrogate mothers 10 years on: a longitudinal study of psychological well-being and relationships with the parents and child. Hum Reprod 2014; 30:373-9. [DOI: 10.1093/humrep/deu339] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Imrie S, Jadva V. The long-term experiences of surrogates: relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reprod Biomed Online 2014; 29:424-35. [DOI: 10.1016/j.rbmo.2014.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 06/11/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
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Gay men seeking surrogacy to achieve parenthood. Reprod Biomed Online 2013; 27:271-9. [DOI: 10.1016/j.rbmo.2013.03.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/01/2013] [Accepted: 03/26/2013] [Indexed: 11/23/2022]
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Baslington H. The social organization of surrogacy: relinquishing a baby and the role of payment in the psychological detachment process. J Health Psychol 2012; 7:57-71. [PMID: 22114227 DOI: 10.1177/1359105302007001652] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article presents the 'maternal-foetal detachment' theory providing a framework for understanding how some women relinquish a baby in the context of paid surrogacy. It is postulated that attitude towards payment becomes part of a psychological detachment process in which surrogate mothers emotionally distance themselves from the growing foetus. Important are the subcultural influences engendered by the social organization of surrogacy. Some surrogate mothers appear to learn not to attach to the unborn child or, if feelings emerge, they deal with these by deflecting emotions towards the couple. The discussion considers what can be learned about the concepts of maternal-foetal attachment and maternal instinct. The surrogacy case offers conflicting evidence in favour of, and in opposition to, the concept of maternal instinct.
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Purewal S, Crawshaw M, van den Akker O. Completing the surrogate motherhood process: parental order reporters' attitudes towards surrogacy arrangements, role ambiguity and role conflict. HUM FERTIL 2012; 15:94-9. [PMID: 22458916 DOI: 10.3109/14647273.2012.668746] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study investigated the attitudes of parental order reporters (PORs) towards their work with surrogacy arrangements and their experiences of role conflict and role ambiguity. A questionnaire was used to assess PORs' perceptions of their role in parental order [PO] applications, attitudes towards surrogacy arrangements and the legal process and the influence of role ambiguity or conflict. Questionnaires were distributed to all PORs employed by the Children and Family Court Advisory and Support Service in England. Thirty-three PORs participated (response rate 46%) who, on average, had each completed five PO applications (range 1-40). Positive attitudes towards surrogacy and the child's needs for openness about origins were found. Concerns about the inadequacy of preparation and assessment arrangements, overseas arrangements and non-regulation of surrogacy agencies were evident. PORs with high-role ambiguity were more likely to report less positive attitudes towards the emotional consequence of surrogacy on offspring. High scores on role ambiguity and role conflict were reflected in less positive attitudes towards the parties' preparation towards parenthood. These results have implications for training, policy and practice in this area.
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Horowitz JE. Non-traditional Family Building Planning. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2011; 732:115-30. [DOI: 10.1007/978-94-007-2492-1_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Bergman K, Rubio RJ, Green RJ, Padrón E. Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood. JOURNAL OF GLBT FAMILY STUDIES 2010; 6:111-141. [PMID: 0 DOI: 10.1080/15504281003704942] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Teman E. The social construction of surrogacy research: An anthropological critique of the psychosocial scholarship on surrogate motherhood. Soc Sci Med 2008; 67:1104-12. [DOI: 10.1016/j.socscimed.2008.05.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Indexed: 10/21/2022]
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van den Akker OBA. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod 2007; 22:2287-95. [PMID: 17635845 DOI: 10.1093/humrep/dem155] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Personality differences between surrogate mothers (SMs) who gestate and relinquish and intended mothers (IMs) who commission a genetically related or unrelated baby have been unexplored in the UK. Furthermore, the psychological effects of the arrangement have not been determined in a prospective longitudinal study, making this the first quantitative report of psychological functioning in SMs and IMs. METHODS SMs and IMs (n = 81: 61 surrogate, 20 intended) undergoing genetic or gestational surrogacy (4 groups) were assessed by postal questionnaire during the first, second and third trimesters of pregnancy. Those with a positive outcome were assessed again in the first week, at 6 weeks and 6 months post-delivery of the surrogate baby. RESULTS There were no significant differences between or within SM and IM groups on personality characteristics. Social support, marital harmony and state anxiety differed significantly (to P < 0.01) between SMs and IMs at different stages of the arrangement. Differences in attitudes towards the pregnancy and the baby were also observed between groups during pregnancy (to P < 0.001), but there was no evidence of post-natal depression amongst the groups studied. CONCLUSIONS These results are important because they demonstrate psychological effects of the surrogate arrangement are notable and occur over an extended period of time. It also shows that psychological screening and support prior to, during and following surrogacy is indicated.
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Abstract
This review addresses the psychosocial research carried out on surrogacy triads (surrogate mothers, commissioning mothers and offspring) and shows that research has focused on a number of specific issues: attachment and disclosure to surrogate offspring; experiences, characteristics and motivations of surrogate mothers; and changes in profiles of the commissioning/intended mothers. Virtually all studies have used highly selected samples making generalizations difficult. There have been a notable lack of theory, no interventions and only a handful of longitudinal studies or studies comparing different populations. Few studies have specifically questioned the meaning of and need for a family or the influence and impact that professionals, treatment availability and financial factors have on the choices made for surrogate and intended mothers. Societal attitudes have changed somewhat; however, according to public opinion, women giving up babies still fall outside the acceptable remit. Surrogate and intended mothers appear to reconcile their unusual choice through a process of cognitive restructuring, and the success or failure of this cognitive appraisal affects people's willingness to be open and honest about their choices. Normal population surveys, on the contrary, are less accepting of third party reproduction; they have no personal need to reconsider and hence maintain their original normative cognitively consonant state.
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Ciccarelli JC, Beckman LJ. Navigating rough waters: an overview of psychological aspects of surrogacy. THE JOURNAL OF SOCIAL ISSUES 2005; 61:21-43. [PMID: 17073022 DOI: 10.1111/j.0022-4537.2005.00392.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This article provides an overview of the social and psychological aspects surrounding the surrogacy process including attitudes about surrogacy, perceptions and problems of surrogate mothers and intended/social parents, and questions concerning children resulting from contractual parenting. Review of the literature on contractual parenting reveals a wealth of discussion about the ethical, moral, legal, and psychological implications, but limited empirical data on the psychological and social aspects. Future research can provide empirical evidence as a foundation for counseling at all phases of the surrogacy process.
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Affiliation(s)
- Eric Blyth
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
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Kleinpeter CH, Hohman MM. Surrogate motherhood: personality traits and satisfaction with service providers. Psychol Rep 2000; 87:957-70. [PMID: 11191413 DOI: 10.2466/pr0.2000.87.3.957] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study explored the personality traits of 15 women who served as surrogate mothers in a California-based surrogacy program. Their satisfaction with their service providers, i.e., the program director, psychologist, and medical doctor, were explored. All had given birth to one or more children, and five had been a surrogate more than once. 13 used in vitro fertilization, with only two choosing artificial insemination. 15 subjects were given the NEO-R Personality Inventory, a global measure of normal personality traits. Analysis indicated that surrogates overall were very pleased with their experiences, and they differed from the general population on nine personality traits.
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Affiliation(s)
- C H Kleinpeter
- Department of Social Work, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840-0902, USA
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KLEINPETER CHRISTINEHAGAN. SURROGATE MOTHERHOOD: PERSONALITY TRAITS AND SATISFACTION WITH SERVICE PROVIDERS. Psychol Rep 2000. [DOI: 10.2466/pr0.87.7.957-970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
In considering the interrelated ethical, legal and social aspects of surrogacy we acknowledge that society has long accepted the delegation of various parenteral functions and explore the role of a surrogate in relationship to this as well as alluding to commoner comparisons with prostitution and adultery. In particular, the "birth mother" rule, the public antipathy to "commercial" surrogacy and restrictive legislation are explored and found to be inappropriate. It is concluded that the regulation, surveillance and assessment needed to ensure the best outcome for all concerned would perhaps be easiest achieved in programmes that are formally licensed under permissive legislation and adequately funded by "commercial" means.
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Affiliation(s)
- D R Bromham
- Academic Division of Obstetrics and Gynaecology, St. James's University Hospital, Leeds, United Kingdom
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Biyth E. ‘Not a primrose path’: Commissioning parents' experiences of surrogacy arrangements in Britain. J Reprod Infant Psychol 1995. [DOI: 10.1080/02646839508403248] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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