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Journal of Education and Health... 2022Surrogacy has become an alternative family formation option for women who are unable to carry a pregnancy. There is no comprehensive care program despite the different...
BACKGROUND
Surrogacy has become an alternative family formation option for women who are unable to carry a pregnancy. There is no comprehensive care program despite the different nature of this pregnancy. The present study aimed to develop a reproductive health-care program for surrogate mothers within the cultural and social context of Iran.
MATERIALS AND METHODS
In the present sequential exploratory mixed methods study, first through a qualitative approach surrogate mothers, care providers, and policy makers of reproductive health services were selected purposefully. Data were collected by using the in-depth semi-structured interviews and analyzed. A care program draft was designed by integrating results of the qualitative study and reviewing the literature and guidelines, then appropriateness of each proposed care was assessed by a two-Rounds Delphi technique (RAM), and the final reproductive health-care program for surrogate mothers was developed.
RESULTS
The surrogate mothers' reproductive health needs were summarized in four main categories: surrogate mothers' extra care, educational training, psychological support, and protecting against surrogacy's social and familial consequences. The reproductive health-care program for surrogate mothers were developed in four sections: prepregnancy health screenings and legal counseling; special care during embryo transfer until pregnancy confirmation; psychological support and prenatal care of surrogacy until delivery and follow-up postpartum care.
CONCLUSION
Women face many challenges in surrogacy and need special care such as legal counseling, reproductive health care, and psychological support. Implementation of this care program seems to help improve the reproductive health of these mothers.
PubMed: 36325217
DOI: 10.4103/jehp.jehp_437_21 -
Journal of Assisted Reproduction and... Nov 2023In the last four decades, the assisted reproductive technology (ART) field has witnessed advances, resulting in improving pregnancy rates and diminishing complications,... (Review)
Review
In the last four decades, the assisted reproductive technology (ART) field has witnessed advances, resulting in improving pregnancy rates and diminishing complications, in particular reduced incidence of multiple births. These improvements are secondary to advanced knowledge on embryonic physiology and metabolism, resulting in the ability to design new and improved culture conditions. Indeed, the incubator represents only a surrogate of the oviduct and uterus, and the culture conditions are only imitating the physiological environment of the female reproductive tract. In vivo, the embryo travels through a dynamic and changing environment from the oviduct to the uterus, while in vitro, the embryo is cultured in a static fashion. Importantly, while culture media play a critical role in optimising embryo development, a large host of additional factors are equally important. Additional potential variables, including but not limited to pH, temperature, osmolality, gas concentrations and light exposure need to be carefully controlled to prevent stress and permit optimal implantation potential. This manuscript will provide an overview of how different current culture conditions may affect oocyte and embryo viability with particular focus on human literature.
Topics: Pregnancy; Humans; Female; Reproductive Techniques, Assisted; Embryo Implantation; Embryonic Development; Embryo, Mammalian; Culture Media; Embryo Culture Techniques; Fertilization in Vitro
PubMed: 37725178
DOI: 10.1007/s10815-023-02934-5 -
MCN. the American Journal of Maternal...Antenatal milk expression is a milk expression intervention beginning at either 36 or 37 weeks of gestation for the purpose of potential colostrum collection and storage...
BACKGROUND
Antenatal milk expression is a milk expression intervention beginning at either 36 or 37 weeks of gestation for the purpose of potential colostrum collection and storage prior to birth for postnatal infant feeding. Research on antenatal milk expression is limited and originates outside the United States.
METHODS
Women who used antenatal milk expression were interviewed about their experiences. A conventional, inductive approach to qualitative content analysis was used to analyze participants' responses.
RESULTS
Three women participated in interviews. They reported learning and performing antenatal milk expression for various postpartum needs including avoidance of formula, milk available for potential infant hypoglycemia, and to support human milk feeding during surrogate mother-infant separation. These mothers obtained education and information on antenatal milk expression primarily on their own.
CLINICAL IMPLICATIONS
Greater awareness and understanding of antenatal milk expression is needed in the professional community caring for childbearing women. Perinatal nurses need to be aware of all breastfeeding practices including antenatal milk expression. Knowledge of the practice and advocacy for more research on antenatal milk expression will improve lactation support and ensure expectant mothers reach their personal breastfeeding goals.
Topics: Breast Feeding; Breast Milk Expression; Colostrum; Female; Humans; Infant; Lactation; Milk, Human; Mothers; Postpartum Period; Pregnancy; United States
PubMed: 34398829
DOI: 10.1097/NMC.0000000000000749 -
BMC Pediatrics May 2022The aim of this study was to investigate the effect of kangaroo mother care (KMC) by mother and her surrogate on nutritional behavior and physiological function of... (Randomized Controlled Trial)
Randomized Controlled Trial
KMC by surrogate can have an effect equal to KMC by mother in improving the nutritional behavior and arterial oxygen saturation of the preterm infant: results of a controlled randomized clinical trial.
BACKGROUND
The aim of this study was to investigate the effect of kangaroo mother care (KMC) by mother and her surrogate on nutritional behavior and physiological function of preterm neonates.
METHOD
This study was a randomized, controlled clinical trial conducted on 70 preterm infants admitted to the NICU. For the neonates of the intervention group, KMC was performed (by mother and surrogate) 3 times a day and the neonates of the control group received KMC by the mother 3 times a day for up to 4 days and 60 minutes each time. The primary outcome was to compare the effect of KMC by mother and surrogate on the feeding behavior measured by preterm infant breastfeeding behavior scale (PIBBS), and the secondary outcome was to compare the effect of KMC by mother and surrogate on physiological outcomes.
RESULT
The score of the PIBBS in both groups increased significantly during 4 days, this difference was not significant between the groups. [Adjusted mean difference (95% Confidence interval), 0.66 (- 2.36 to 1.03), P = 0.438]. Within the group, among the physiological functions, only O2 saturation had significantly increased during the study. This increase, however, was not statistically different between the two groups. [Adjusted mean difference (95% Confidence interval), 0.102 (- 0.68 to 0.88), P = 0.761].
CONCLUSION
When the mother is unable to provide this type of care, it can be provided by the surrogate that is as effective as the mother in improving arterial oxygen saturation and the feeding behavior of the preterm neonates.
TRIAL REGISTRATION
IRCT20150424021917N10 . Registered 22/04/ 2020.
Topics: Child; Female; Humans; Infant, Newborn; Infant, Premature; Kangaroo-Mother Care Method; Mothers; Oximetry; Oxygen Saturation
PubMed: 35501762
DOI: 10.1186/s12887-022-03316-z -
The Medico-legal Journal Mar 2022This report focuses on surrogacy in Thailand which is increasingly popular with infertile and childless couples, gay couples, individuals, and even celebrities who want...
This report focuses on surrogacy in Thailand which is increasingly popular with infertile and childless couples, gay couples, individuals, and even celebrities who want children later in life. However, the debate regarding surrogacy continues. It is not widely accepted in various cases, particularly in its commercial form which is banned in many countries. However, such arrangements are still reported to be active irrespective of the ban, and in Thailand in particular. This article proposes that surrogacy legislation needs revision to enforce the current ban on commercial surrogacy.
Topics: Child; Female; Humans; Pregnancy; Surrogate Mothers; Thailand
PubMed: 35156430
DOI: 10.1177/00258172221074246 -
South Dakota Medicine : the Journal of... Feb 2023Gestational surrogacy provides patients with the ability to reproduce in the wake of medical contraindications to pregnancy or an inability to become pregnant. Outcomes...
Gestational surrogacy provides patients with the ability to reproduce in the wake of medical contraindications to pregnancy or an inability to become pregnant. Outcomes of gestational surrogacy are overall positive and are quite similar to those of other assisted reproductive technologies. Gestational surrogacy presents several ethical considerations, including gestational carrier autonomy, procreative liberty, access to care, and cross-border surrogacy. Additionally, its legalities differ between states. Gestational surrogacy continues to be a topic that is worthy of consideration, legislation, and discussion.
Topics: Pregnancy; Female; Humans; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 36898073
DOI: No ID Found -
American Journal of Obstetrics and... Sep 2021Gestational surrogacy in the United States has quadrupled since 1999, but to date, only a few states explicitly permit compensated gestational surrogacy. Current legal... (Review)
Review
Gestational surrogacy in the United States has quadrupled since 1999, but to date, only a few states explicitly permit compensated gestational surrogacy. Current legal prohibitions are often influenced by outdated and stereotyped understandings of surrogacy. It is increasingly important to understand the current literature about the medical and mental health impacts of surrogacy and how state legislatures have addressed compensated gestational surrogacy in recent years. Based on this review, we found no evidence of substantial adverse medical or psychological outcomes among women who are gestational carriers or among the children they give birth to. The literature suggests that gestational surrogacy is a safe and increasingly popular option for families as long as rigorous screening and medical, psychological, and social supports are equitably provided. As states move to responsibly legalize and regulate gestational surrogacy, there is a continued need for further longitudinal studies on the health and psychological outcomes of gestational surrogacy.
Topics: Female; Humans; Parent-Child Relations; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 33839094
DOI: 10.1016/j.ajog.2021.04.213 -
Frontiers in Pharmacology 2023Prescription drug use is prevalent during pregnancy, yet there is limited knowledge about maternal-fetal safety and efficacy of this drug use because pregnant... (Review)
Review
Prescription drug use is prevalent during pregnancy, yet there is limited knowledge about maternal-fetal safety and efficacy of this drug use because pregnant individuals have historically been excluded from clinical trials. Underrepresentation has resulted in a lack of data available to estimate or predict fetal drug exposure. Approaches to study fetal drug pharmacology are limited and must be evaluated for feasibility and accuracy. Anatomic and physiological changes throughout pregnancy fluctuate based on gestational age and can affect drug pharmacokinetics (PK) for both mother and fetus. Drug concentrations have been studied throughout different stages of gestation and at or following delivery in tissue and fluid biospecimens. Sampling amniotic fluid, umbilical cord blood, placental tissue, meconium, umbilical cord tissue, and neonatal hair present surrogate options to quantify and characterize fetal drug exposure. These sampling methods can be applied to all therapeutics including small molecule drugs, large molecule drugs, conjugated nanoparticles, and chemical exposures. Alternative approaches to determine PK have been explored, including physiologically based PK modeling, methods, and traditional animal models. These alternative approaches along with convenience sampling of tissue or fluid biospecimens can address challenges in studying maternal-fetal pharmacology. In this narrative review, we 1) present an overview of the current understanding of maternal-fetal drug exposure; 2) discuss biospecimen-guided sampling design and methods for measuring fetal drug concentrations throughout gestation; and 3) propose methods for advancing pharmacology research in the maternal-fetal population.
PubMed: 37033628
DOI: 10.3389/fphar.2023.1111601 -
Gynecologie, Obstetrique, Fertilite &... Jun 2024
Topics: Humans; France; Surrogate Mothers; Female; Pregnancy; Altruism
PubMed: 38340981
DOI: 10.1016/j.gofs.2024.02.001 -
Fertility and Sterility May 2020Surrogacy raises a number of concerns about the psychological adjustment of the surrogate, the parents, and the child. Despite surrogacy becoming more common, research... (Review)
Review
Surrogacy raises a number of concerns about the psychological adjustment of the surrogate, the parents, and the child. Despite surrogacy becoming more common, research into the postdelivery psychological adjustment of the individuals involved has lagged far behind. This review examines research on the psychological adjustment of surrogates and their children. It then presents findings from studies assessing parents' psychological health and parent-child relationships, and children's adjustment within families formed through surrogacy. Finally, it examines how children born through surrogacy feel about their birth and toward their surrogate. Overall, studies have shown good psychological outcomes for surrogates, parents, and children, but research is still very limited, particularly in relation to the geographical location of the research, the ages of the children studied, and the lack of longitudinal projects. Different forms of surrogacy now exist under the umbrella term of "surrogacy." There is now greater diversity in terms of who is using surrogacy, their motivations for using it, whose gametes are used for the pregnancy, and how a surrogacy arrangement is managed. There is therefore a need for future studies to examine the consequences of these different forms of surrogacy on the postdelivery psychological health of surrogates, surrogacy parents, and their children.
Topics: Adaptation, Psychological; Fathers; Female; Humans; Interpersonal Relations; Live Birth; Mother-Child Relations; Mothers; Pregnancy; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 32312560
DOI: 10.1016/j.fertnstert.2020.03.010