User:TEreSsAAA/Surrogacy

Surrogacy is an adoption arrangement, often supported by a legal agreement, whereby a woman agrees to childbirth on behalf of another person(s) who will become the child's parent(s) after birth. People pursue surrogacy for a variety of reasons such as infertility, dangers or undesirable factors of pregnancy, or when pregnancy is a medical impossibility.

'''While a surrogacy relationship or legal agreement contains the gestational carrier and the child's parent(s) after birth, the gestational carriers are usually being referred as surrogate mothers. Surrogate mothers are the woman who carries and gives birth to a baby for another person, in such process of surrogacy. Surrogate mothers are usually introduced to parent(s) in need of surrogacy through third-party agencies, or other matching channels. They are usually required to participate in processes of insemination (no matter traditional or IVF), pregnancy, delivery, and newborn feeding early after birth.'''

Embryo
The embryo implanted in gestational surrogacy faces the same risks as anyone using IVF would. Preimplantation risks of the embryo include unintentional epigenetic effects, influence of media which the embryo is cultured on, and undesirable consequences of invasive manipulation of the embryo. Often, multiple embryos are transferred to increase the chance of implantation, and if multiple gestations occur, both the surrogate and the embryos face higher risks of complications.

Children born through singleton IVF surrogacy have been shown to have no physical or mental abnormalities compared to those children born through natural conception. However, children born through multiple gestation in gestational carriers often result in preterm labor and delivery, resulting in prematurity and physical and/or mental anomalies.

Surrogate mothers
Gestational surrogates have a smaller chance of having hypertensive disorder during pregnancy compared to mothers pregnant by oocyte donation. This is possibly because gestational carriers tend to be healthier and more fertile than women who use oocyte donation. Gestational carriers also have low rates of placenta previa / placental abruptions (1.1–7.9%).

'''In most countries, such as China, there exists a huge gap in the legal framework between the legislation and regulation for surrogacy. Due to insufficient authority supervision, surrogacy and the safety of surrogate mothers lack of professional support or reliable operation, the medical conditions cannot be achieved either. All these precarious factors increases the safety risks of artificial surgeries such as egg retrieval and insemination. Moreover, the underground contracts can inflict serious physiological harm on surrogate mothers. Surrogacy agencies ignore surrogate mothers' health risks and deaths: enforced fetal sex selection through forced abortions are very common , and multiple implantations and fetal reduction procedures may also be repeated on the same surrogate mother, causing health hazards such as miscarriage, infertility, and even death.'''

Legal issues
The legality of surrogacy varies around the world. Many countries do not have laws which specifically deal with surrogacy. Some countries ban surrogacy outright, while others ban commercial surrogacy but allow altruistic surrogacy (in which the surrogate is not financially compensated). Some countries allow commercial surrogacy, with few restrictions. Some jurisdictions extend a ban on surrogacy to international surrogacy. In some jurisdictions rules applicable to adoptions apply while others do not regulate the practice.

East Asia
'''In South Korea, Hong Kong, Malaysia, Thailand, and India, surrogacies are all regulated “through national laws that expressly ban it or explicitly set the parameters for its legality”. '''

China
'''Particularly in China, surrogacy operates within a legally gray area. Scholars mostly claim that surrogacy incites social instability both for the Chinese Government and the public, such as civil disputes, gender disproportion, crime, and the spread of disease. However, no law legislation or enforcement has been published against surrogacy, whether it is a surrogate mother or a connecting third agency, despite the state government's attitude to ban such practice.'''

'''Any medical organization involved in surrogacy will be considered as law violation, including any institution that organizes, implements, or facilitates egg retrieval and sale of women. Statistics found more than 400 surrogacy agencies facilitate the birth of more than 10,000 surrogate children every year on average — operating underground with legal prohibitions.'''

'''Due to such blurry legal issues, surrogate mothers have become an underprivileged group facing the oppression of women's reproductive rights and the lack of formal legal restrictions. Many of the conditions they should have, such as emotional caring and social resources, are absent, as research claiming that surrogacy contracts usually blindly meet client needs while ignoring the health and well-being of the surrogate mothers. They are marginalized by society and lack the companionship of their partners and legitimate medical health checkups during the nearly one year of pregnancy.'''

Ethical issues
Numerous ethical questions have been raised with regards to surrogacy. They generally stem from concerns relating to social justice, women's rights, child welfare, bioethics, and societal traditional values.

Chinese Traditional Values
While many people believe that surrogacy exploits women, uses their organs as a tool for making money and objectifies their reproductive rights, the biggest ethical consideration faced by surrogacy in most societies, especially in China, is contradicting traditional Chinese values. This is the most fundamental reason for people’s resistance to surrogacy in social norms.

'''Traditional Chinese values focus on blood ties and family ties. The physical connection between parents and children and the process by which parents give birth to children are considered virtuous ("生恩 shengen"). There is also an ancient Chinese saying that believes that "the body, hair, and skin come from the parents who gave birth to one", and blood relatives should be respected, and one should not harm oneself at will ("身体发肤受之父母 shentifafushoushouzhifumu"). When Chinese people regard blood relations as an important pathway to demonstrate filial piety and family intimacy, these traditional concepts are rooted in the cognitive norm of society. Such emphasis on biological parents and blood relations undoubtedly resulted in conflicts with the practice of surrogacy, which regards childbirth as only a physiological process.'''

'''Correspondingly, this value of kinship relations strongly affects the social status of surrogate mothers. They are easily considered "heartless" or "don't care about their own children" in Chinese society because they are only responsible for the birth process and hand over the children to others and do not participate in the upbringing process. However, there are also opinions that this separation from the children is not voluntary for surrogate mothers, but is forced by third-party agencies or restricted by unfair contracts. They can only give up the right to raise their children and send them away despite suffering great psychological and emotional trauma.'''

Financial aspects
According to the Assisted Human Reproduction Act adopted in 2004, it is prohibited in Canada to compensate a female for acting as a surrogate mother or to advertise the payment of such compensation. However, on October 1, 2016, Health Canada announced its intention to update and strengthen the Assisted Human Reproduction Act to regulate the financial aspects of contracts between intended parents and surrogate mothers. According to research, surrogate mothers are mostly motivated by their low socioeconomic status or family debt ; they are more likely to be forced into surrogacy due to financial pressures. In 2020, Section 12 of the Assisted Human Reproduction Act provides for the reimursement of expenses and monetary compensation to the surrogate mother to alleviate the financial burden associated with surrogacy. According to this proposed regulation, the reimbursement of eligible expenses is not obligatory. Aiming at emphasizing the voluntary nature of the gesture. The proposed regulation provides a non-exhaustive list of different categories of eligible expenses, such as parking fees, travel expenses, caregiver expenses, meals, psychological consultations, etc. Additionally, the surrogate mother can be reimbursed for any lost wages during pregnancy if she obtains written confirmation from a qualified physician that the work posed a risk to the pregnancy.