This paper summarizes the findings of a three-year exploratory qualitative study of teenage childbearing in 20 low-income multigeneration black families. Teenage childbearing in these families is part of an alternative life-course strategy created in response to socioenvironmental constraints. This alternative life-course strategy is characterized by an accelerated family timetable; the separation of reproduction and marriage; an age-condensed generational family structure; and a grandparental child-rearing system. The implications of these patterns for intergenerational family roles are discussed.

Childbearing is an increasingly complicated matter, which has evolved significantly over the past several decades. Treatment options for infertility have expanded. Prenatal testing and treatment have led to an evolution in obstetrical decision-making, wherein the risks and benefits to the fetus and future child are better understood and more strongly considered in medical management of the pregnant woman. Obstetrics appears to be increasingly interventional; one in three babies in the United States is now born by cesarean section. Neonatal intensive (...) care has markedly improved outcomes for premature babies. A pregnant woman may now be presented with many options— obstetrician or midwife, home or hospital delivery, choices among prenatal testing and monitoring, early induction of labor, cesarean delivery. Health care professionals face similar decisions with regard to what they recommend and the boundaries of safe and responsible care they should make available. Preterm Babies, Fetal Patients, and Childbearing Choices, by John D. Lantos and Diane S. Lauderdale, provides an excellent overview of the available information relevant to these questions. (shrink)

Millions of children who were born during the first decade after the Islamic revolution in Iran are now reaching the age of marriage and childbearing. Short spacing between marriage and the birth of the first child has the potential to cause an excessive and costly increase in the growth of population in Iran. Research into the motivations for the birth of first child among newly married couples can create a knowledge base that will enable health centres to help these (...) couples make better decisions about the timing of their first pregnancy. Using a consecutive sampling technique and administering Miller’s Childbearing Questionnaire, data were gathered regarding the childbearing motivations and desires of 300 couples who had been referred to the Shiraz Health Center for premarital counselling. The Childbearing Questionnaire, with some minor modifications, was found to be a valid and reliable instrument for measuring the childbearing motivations of newly married couples of Shiraz County, Fars Province, Iran. The utility of these findings for counselling in health centres is discussed. Based on the results, a longitudinal study is being designed that will allow the development of models for predicting the time of first pregnancy after marriage. (shrink)

Fear of burdening or harming childbearing, migrant women, particularly refugees or others who have experienced war, torture, abuse, or rape, can result in their exclusion from research. This exclusion prohibits health issues and related solutions to be identified for this population. For this reason, while it may be challenging to include these women in studies, it is ethically problematic not to do so. Using ethical guidelines for research involving humans as a framework, and drawing on our research experiences. This (...) discussion article proposes a number of strategies to improve the conditions for childbearing migrant women to participate in health research. What emerged as key for studying this diverse population and ensuring an ethically responsible approach are the use of methods that are adapted to the circumstances of childbearing migrant women and the involvement and support from “migrant-friendly” organizations. Ensuring migrant women are involved in the research process and knowledge produced is also critical. The more researchers working in this field communicate their experiences, the more will be learnt about how best to approach research with migrants. More migration and health research will enable a greater contribution to the knowledge base upon which the needs of this population can be met and their strengths maximized. (shrink)

biological theories of emotion are often used to explain and predict human desires, particularly the desire to reproduce. I propose that these desires are largely socially constructed, but that the naturalization of desires and the normalization of biological theories sustain the pursuit of biological childbearing as a biological need. Foundational metaphysical and epistemological theories have lent both authority and urgency to the idea of a biological need to bear children, which has resulted in a diminished focus on alternative modes (...) of having children.I suggest that a form of biological determinism rests on what philosopher John Dewey calls a misplaced "quest for certainty." This search is a process whereby a... (shrink)

Part graphic novel, part feminist and philosophical analysis, The Pregnancy ≠ Childbearing Project explores how pregnancy can be a meaningful and distinct phenomenon from childbirth and does not equate with childbearing or the production of children.

In this important book, Jennifer Scuro's lived experience presents a challenge to common ideas and assumptions about motherhood, femininity, and anti-abortion politics, as well as to the familiar content and form of philosophy. It is centered on an intensely personal, 176-page graphic novel that details the vivid aspects of Scuro's own miscarriage. Her experience serves as a philosophical allegory, challenging neoliberal and ableist assumptions that presume normalcy, expect results, and promise the false freedom of choice. Initially fitting the script of (...) "normal" motherhood and femininity, Scuro's experience brought her to the "razor's edge" of her cisgender, white privilege. The cutting truth of her story is that... (shrink)

This article provides some historical perspectives on parental investment and childbearing. Scholars are debating whether parents always loved and nurtured their children. The historical record provides some support for both sides. Parents who abandoned their children often did so with the hope that someone else would be able to raise them. But others, like the ancient Carthagians, sacrificed their own children to appease the gods. Colonial Americans appear to have been particularly solicitous of the well-being of their children. The (...) paper then traces the changes in the role of women in facilitating the process of childbirth in America. Scholars are cautioned not to idealize the childbirth experiences of women in the past as they experienced considerable pain and fear. (shrink)

_The Ethics of Pregnancy, Abortion and Childbirth_ addresses the unique moral questions raised by pregnancy and its intimate bodily nature. From assisted reproduction to abortion and ‘vital conflict’ resolution to more everyday concerns of the pregnant woman, this book argues for pregnancy as a close human relationship with the woman as guardian or custodian. Four approaches to pregnancy are explored: ‘uni-personal’, ‘neighborly’, ‘maternal’ and ‘spousal’. The author challenges not only the view that there is only one moral subject to consider (...) in pregnancy, but also the idea that the location of the fetus lacks all inherent, unique significance. It is argued that the pregnant woman is not a mere ‘neighbor’ or helpful stranger to the fetus but is rather already in a real familial relationship bringing real familial rights and obligations. If the status of the fetus is conclusive for at least some moral questions raised by pregnancy, so too are facts about its bodily relationship with, and presence in, the woman who supports it. This lucid, accessible and original book explores fundamental ethical issues in a rich and often neglected area of philosophy in ways of interest also to those from other disciplines. (shrink)

Preterm birth is defined as any birth that occurs prior to 37 weeks gestation, and is a leading cause of infant mortality, neurological disabilities, breathing, feeding and vision problems, and hea...

Childbearing trans and nonbinary people are confronted with the heteronormative and cisgender frameworks that underpin “maternity” services. We explored the educational needs of 108 perinatal staff in the United Kingdom as related to the needs of trans and nonbinary service users. Participants were most confident in formulating care plans and least confident about the provision of colleagues’ perinatal care in this context. While the majority of participants were positive toward the trans and nonbinary communities, they considered that those communities (...) remain marginalized in perinatal services. Transphobic, anti-trans, and nonbinary attitudes were highlighted by our respondents. Our findings suggest that caregivers witnessed transphobia among colleagues and were apprehensive themselves about providing care to childbearing trans and nonbinary people. They reported a cisheteronormative model of care that lacked awareness of trans and nonbinary issues. The educational needs identified included information about the practicalities of childbearing as a trans or nonbinary person, how to use inclusive language effectively, and creating policies and processes for supporting childbearing trans and nonbinary people. These caregivers’ preferences included hearing from trans and nonbinary people and sharing best practices among themselves, with open discussions about how to be inclusive. (shrink)

The book investigates childbearing ambivalence and the philosophical resources available to overcome it by analyzing the nuances of the contemporary anxiety about having children while focusing on the moral and intellectual shifts that have occurred in how we think of the value and goodness of human life. Peeling back the layers of resistance, What Are Children For? argues that when we make the individual decision whether or not to have children we confront a profound philosophical question, that of the (...) goodness of our form life itself. How can we justify perpetuating human life given the catastrophic harm and suffering of which we are always at once both victims and perpetrators? If we wish to meet this challenge without succumbing to naivete about our predicament, we must, it argues, uncover a capacity to grasp the fundamental goodness of human life—not only theoretically but practically in the actual lives we lead today. (shrink)

SummaryPostponing the start of childbearing raises the question of fertility postponed versus fertility foregone. One of the limitations of previous studies of ‘How late can you wait?’ is that any observed decline in the probability of conception with age could be due to a decline in fecundability with age or due to a decline in coital frequency with age or due to both factors. Using data from a multinational longitudinal study conducted to determine the daily probability of conception among (...) healthy subjects, a discrete-time event history model with long-term survivors is used to study the relationship between age and fecundability for childless women, while controlling for the pattern of intercourse within a menstrual cycle. The findings suggest that women can wait until their early thirties to try for a first birth, providing that they are not already sterile, as the magnitude of the decline in fecundability is very modest and of little practical importance. (shrink)

Testing women of childbearing age for HIV infection and disclosure of HIV status should be examined from three interlocking perspectives— women's personal concerns, the interests of caregivers, and those of the community. In the absence of specific objections, testing for HIV infection should be considered a routine procedure in prenatal care.

Drawing on fieldwork and interviews from South India, the author analyzes married women's experiences of stigma when they are childless and their everyday resistance practices. As stigma theory predicts, childless women deviate from the “ordinary and natural” life course and are deeply discredited, but contrary to Goffman's theory, South Indian women cannot “pass” or selectively disclose the “invisible” attribute, and they make serious attempts to destigmatize themselves. Social class and age mediate stigma and resistance processes: Poor village women of (...) class='Hi'>childbearing age are devalued in ways affluent and professional women avoid; differently situated women challenge dominant definitions and ideologies of family in distinctive ways. South Indian women are creating spaces for childless marriages within the gendered margins of families and culturally prevalent definitions of womanhood. The findings contribute to rethinking Western assumptions in Goffman's theory and suggest new directions for research on power and everyday resistance. (shrink)

At what age should children acquire adult rights? To what extent are parents morally permitted to shape the beliefs of their children? How should childbearing rights and resources be distributed? Matthew Clayton provides a controversial set of answers to these and related issues in this pivotal new work.

The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the function of UTx (and what constitutes its ‘success’), as well as the recipient eligibility for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this—the treatment of uterine infertility—explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which (...) both cis‐ and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non‐procreative motivations for uterus acquisition ought to be taken seriously as a matter of non‐discrimination and consistency. (shrink)

Researchers have documented the dominance of intensive mothering ideologies and their impact on mothers and their families. However, the effect of these ideologies on childless women has received little attention. I draw on interview data to examine the parenting ideologies of childless women with electively frozen eggs. I demonstrate that incorporation of and commitment to intensive mothering ideologies affect fertility decision making among these childless women. I find that concerns about the heavy burdens of intensive motherhood, coupled with unsupportive partners (...) and workplaces, produce ambivalence toward childbearing and a strategy of fertility postponement. I extend the literatures on intensive mothering, reproductive decision making, assisted reproductive technologies, and elective egg freezing by identifying egg freezing as an expression of the gendering of fertility risk and as a means of “doing security.” Participants view egg freezing as a means of managing risk in two primary ways: as a means of securing access to biogenetic motherhood by managing biological risks of infertility and fetal genetic abnormality, and as a means of enabling intensive parenting by managing temporal risks inherent in coordinating careers, relationships, and childbearing. (shrink)

There's no doubt that reproductive technologies can transform lives for the better. Infertile couples and single, lesbian, gay, intersex, and transgender people have the potential to form families in ways that would have been inconceivable years ago. Yet we are concerned about the widespread commercialization of certain egg‐freezing programs, the messages they propagate about motherhood, the way they blur the line between care and experimentation, and the manipulative and exaggerated marketing that stretches the truth and inspires false hope in women (...) of various ages. We argue that although reproductive technology, and egg freezing in particular, promise to improve women's care by offering more choices to achieve pregnancy and childbearing, they actually have the potential to be disempowering. First, commercial motives in the fertility industry distort women's medical deliberations, thereby restricting their autonomy; second, having the option to freeze their eggs can change the meaning of women's reproductive choices in a way that is limiting rather than liberating. (shrink)

Where is rapid economic growth taking us? Why has its spread throughout the world been so limited? What are the causes of the great twentieth century advance in life expectancy? Of the revolution in childbearing that is bringing fertility worldwide to near replacement levels? Have free markets been the source of human improvement? Economics provides a start on these questions, but only a start, argues economist Richard A. Easterlin. To answer them calls for merging economics with concepts and data (...) from other social sciences, and with quantitative and qualitative history. Easterlin demonstrates this approach in seeking answers to these and other questions about world or American experience in the last two centuries, drawing on economics, demography, sociology, history, and psychology. The opening chapter gives an autobiographical account of the evolution of this approach, and why Easterlin is a 'reluctant economist'. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bringing Cancer Care to Those who Don't Have ItLawrence N. ShulmanI have been treating cancer patients in the Harvard Medical School hospitals since 1977, and in those 35 years we have made tremendous progress. Though work still needs to be done, and far too many patients still die of cancer, many are cured. In particular, children and young adults have a high rate of cure from such diseases as (...) Hodgkin's lymphoma, non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and childhood sarcoma. Patients with breast cancer in the US have a greater than 80% chance for long-term survival. The death rate from cervical cancer in the US is very low. These results have been achieved by making diagnoses earlier, in many cases surgical excision, and often systemic therapies such as chemotherapy, hormonal therapy, radiation therapy, and more recently by using so-called "targeted" therapies—those directed at particular molecular characteristics of the cancer cells.Princess Dina Mired has said that the opportunity to survive cancer should not be an accident of geography. In cases where we already have effective and inexpensive tools to cure cancer, these treatments should be considered a basic human right, a life-saving medical service.I met Patty, a young woman living in the U.S. during November of her senior year in high school, after she discovered a small lump above her left collar bone. Though she felt entirely well, she called her primary care doctor who saw her the next day, felt the enlarged lymph node, and referred her to a surgeon, who did a biopsy later that week. Her primary care doctor also called me, and we scheduled a visit when the pathology results were available. The following week the pathologist notified Patty's pediatrician that the biopsy showed Hodgkin's lymphoma. When I met Patty, she was a bright and focused young woman, waiting to hear about her college applications and enjoying her senior year. Her cancer diagnosis was completely out of context with her life as she planned it, but with the support of her family and boyfriend, she seemed prepared to take things one step at a time. A PET CT scan demonstrated a modest mass in the mediastinum (chest), but no other disease. She was in an early stage of the disease with an excellent prognosis. We recommended and administered six months of chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine—four chemotherapy agents that are off-patent, and relatively inexpensive. She lost her hair, not a trivial issue for her, but otherwise felt reasonably well during the treatment. She was determined to graduate with her classmates, and was able continue to attend school and keep up with her work. In June, seven months into her cancer diagnosis and treatment, she graduated with honors, and was on track to enroll in college in September.Like other 18-year-old women with Hodgkin's lymphoma, Patty had an over 80% chance for cure with the potential for a long and productive life ahead of her because we could perform a biopsy, make a diagnosis, and safely and effectively treat her with four inexpensive, off-patent, chemotherapy drugs. She had nearly the same likelihood of living a long and fruitful life as her classmates, and had the same chances for childbearing. In my line of work, with the knowledge we now possess, to allow someone like Patty to die without a chance of curative care is simply unacceptable. Treatment of curable cancers should be considered on par with the right to clean water, adequate nutrition, treatment for infectious disease, and access to maternal and child healthcare services.But in many places in the world, people with cancers we could easily eradicate in Boston have no access to cancer services, and do die unnecessarily. The local healthcare infrastructure has no [End Page E10] capacity to evaluate a patient, perform or process a biopsy, make a diagnosis, or treat the patient with potentially curative surgery, chemotherapy and radiation. I have rounded on the wards of hospitals in developing countries, stopping to talk with numerous patients like Patty: young women, some of whom might have had Hodgkin's lymphoma, but no... (shrink)

It is often acknowledged that public policies can constrain people's procreative opportunities, in some cases even infringing their procreative rights. However, a topic that is not often discussed is how the procreative choices of one generation can affect the procreative opportunities of later generations. In this article, we argue that the demographic fact that childbearing above the replacement fertility level is eventually unsustainable supports two constraints on universal procreation rights: a compossibility constraint and an egalitarian constraint. We explore the (...) implications of these two constraints and suggest that there are reasons to think of procreative opportunity as a finite resource that can be distributed more or less equally across generations. We also briefly discuss possible ways of meeting demands of intergenerational justice with respect to procreative opportunity. (shrink)

Background: Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles. Research aim: The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research (...) project. Research design: Template analysis was chosen for this part of the action research. Template analysis is a design that tests theory against empirical data, which requires pre-set codes. Participants and context: A priori codes that represent midwifery-led care were generated by a stakeholder consultative group of nine childbearing women using nominal group technique, collected in Perth, Western Australia. The a priori codes were applied to a predesigned template with four domains of care ethics. Ethical considerations: Ethics approval was granted by the Edith Cowan University research ethics committee REMS no. 2019-00296-Buchanan. Findings: The participants generated eight a priori codes representing ethical midwifery care, such as: 1.1 Relationship with Midwife; 1.2 Woman-centred care; 2.1 Trust women’s bodies and abilities; 2.2. Protect normal physiological birth; 3.1. Information provision; 3.2. Respect autonomy; 4.1. Birth culture of fear (midwifery-led care counter-cultural) and 4.2. Recognition of rite of passage. The a priori codes were mapped to the care ethics template. The template analysis found that midwifery-led care does indeed demonstrate care ethics. Discussion: Care ethics takes into consideration what principle-based bioethics have previously overlooked: relationship, context and power. Conclusion: Midwifery-led care has been determined in this study to demonstrate care ethics, which suggest that further research is defensible with the view that it could be incorporated into the ethical codes and conduct for the midwifery profession. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Women and Health Research:A Report from the Institute of MedicineAnna C. Mastroianni (bio), Ruth Faden (bio), and Daniel Federman (bio)In recent years, claims have been made by segments of the research community and by women's health advocacy groups that clinical research practices and policies have not benefitted women's health to the same extent as men's health. Central to these claims has been an assertion that women have been inadequately (...) represented as subjects of clinical studies and that as a result neither health conditions unique to women—e.g., menopause—nor women's manifestations of health problems affecting both sexes—e.g., heart disease—have been investigated sufficiently.The scientific community, including federal agencies that sponsor and regulate clinical studies, is increasingly responsive to these claims and is taking steps to raise the level of women's participation in clinical studies. Controversy and concern have surrounded these actions, however. Two of the claims that have been made are: (1) that women are more difficult to study than men because of their cyclical hormonal changes; and (2) that conducting gender-specific subgroup analyses would increase the size of study populations, raise the cost of studies, and thereby reduce the number of studies that could be performed with the limited resources available. In addition, controversy over the inclusion of women of childbearing potential and pregnant women has been particularly salient. Concerns have been expressed about avoiding potential harm to existing or potential fetuses and about the possible legal and financial ramifications of such harm. A further concern involves the perceived difficulties in enrolling women in studies and retaining them for the duration of the studies.Against this backdrop, the Office of Research on Women's Health at the National Institutes of Health (NIH) asked the Institute of Medicine (IOM) in October 1992 to establish the Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies. The Committee's charge was to: (1) consider the ethical and legal implications of including women, particularly pregnant women and women of childbearing potential, in clinical studies; (2) examine known instances of litigation regarding injuries to research subjects [End Page 55] and describe existing legal liabilities and protections; and (3) provide practical advice on these issues for consideration by NIH, institutional review boards (IRBs), and clinical investigators.The 16 Committee members came from diverse backgrounds: bioethics, law, epidemiology and biostatistics, public health policy, obstetrics and gynecology, clinical research, pharmaceutical development, social and behavioral sciences, and clinical evaluative sciences.1 Chaired by two of the authors of this article, Ruth Faden and Daniel Federman, and coordinated by the third, IOM Study Director Anna Mastroianni, the Committee met five times over a fourteen-month period, convened a one-and-one-half day invitational workshop, and commissioned several background papers. The Committee's deliberations were complicated by the announcement of new federal policies late in its term. Specifically, the Food and Drug Administration (FDA) issued guidelines (FDA 1993) to replace its 1977 guidelines, which prohibited the inclusion of women of childbearing potential in early phases of most clinical drug trials. In addition, Congress passed the NIH Revitalization Act of 1993 (P.L. 103-43), which contains provisions mandating the inclusion of women and racial and ethnic minorities in NIH-sponsored clinical research. In February 1994, the IOM Committee publicly issued its final report and recommendations, Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies, publishing the workshop presentations and commissioned papers in a separate volume.Deliberations of the CommitteeA number of issues arose at the outset as the Committee considered its charge. A few members initially believed that verification of the underrepresentation of women relative to men in clinical studies as a whole was a prerequisite to providing policy recommendations. Others believed that such an examination would be an important contribution to the knowledge base, but that it was not necessary for addressing the Committee's charge. As summarized in the Committee's report, the Committee's research indicated that firm conclusions about the relative underrepresentation of women could not be drawn from the available data because of the lack of systematic information... (shrink)

The field of reproductive medicine witnessed a breakthrough in September 2014 with the first successful live birth post uterine transplantation. This success represents the culmination of decades' worth of research on infertility and reproductive medicine. This subject of infertility gathers special attention in the Middle East, as childbearing is given paramount importance in the family unit. And as with any new medical advancement, Middle Eastern people look to their religious authorities for guidance. This paper describes the various ethical quandaries (...) related to uterine transplantation, from a perspective of the religious and societal factors that are unique to the Middle East, and embeds them within the conversation of its alternative solutions. (shrink)

This chapter argues that there is a collective responsibility to have enough children in order to ensure that people will not, in the future, suffer great harm due to depopulation. Moreover, if people stopped having children voluntarily, it could be legitimate for states to incentivize and maybe even coerce individuals to bear and rear children. Various arguments against the enforceability of an individual duty to bear and rear children are examined. Coercing people to have children would come at significant moral (...) cost; however, none of the arguments against enforceability seem decisive. The existence of a collective responsibility to have children bears on the question of whether parents and non-parents ought to shoulder the costs of childbearing and child rearing together. (shrink)

The views on in vitro fertilization within Russian Orthodox Christian society are diverse. One reason for that variation is the ambiguity found in “The Basis of the Social Concept,” the document issued in 2000 by the Russian Orthodox Church and considered to be the primary guidelines for determining the Church’s stance on bioethics. This essay explores how the treatment of infertility reconciles with the Orthodox Christian faith and what methods of medical assistance for infertility may be appropriate for Orthodox Christians. (...) The focus here is on IVF because it is among the most widely used methods to overcome childlessness, and the permissibility of IVF is the object of disagreement among Orthodox. The article defines criteria that can help to discern what is absolutely wrong and must be avoided from what only falls short of the mark, but not very far, for Orthodox Christians. If treatment of the underlying causes of infertility has failed or promises no hope and a husband and a wife do not feel able to carry the Cross of infertility, then from pastoral dispensation they might be blessed to use ethically acceptable variants of IVF. IVF has many variants that are different in their spiritual influence on a person. Orthodox Christians pursuing IVF should seek spiritual guidance and a blessing to pursue IVF. They must not form more embryos than will be transferred in the same cycle. Freezing, discarding, or reduction of embryos is forbidden. Infertile couples ought to use only their reproductive cells. The use of donor gametes is unacceptable. Any embryo formed ought to be transferred into the wife’s womb, and the use of surrogates is impermissible. Only a husband and wife who are able to maintain their marital union and where the wife is still of childbearing age should be blessed to use IVF. (shrink)

Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation.Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the (...) State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory.Results: Almost half of the sample declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation.Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation. (shrink)

The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed childbearing is usually discussed in the context of reproductive justice, and in relationship to ethical issues associated with the use and risk of assisted reproductive technologies. We aim to go beyond these more “traditional” ways in which reproductive ethics is framed by revisiting ethics itself through the lens of the figure of the so-called “older” mother. For this purpose, we start by exploring (...) some of the deep seated socio-cultural discourses in the context of procreation: ageism, ableism and the widespread bias towards geneticism and pronatalism. Afterwards, we provide a critical overview of the key arguments against or in support of advanced motherhood. We then briefly discuss how entrenchment by both sides has produced an impasse in the debate on the ethics of advanced motherhood and proceed by arguing that it is fundamental to bring about a change in this narrative. For this purpose, we will revisit the feminist usage of the concept of vulnerability which will allow us both to criticize culturally prescribed norms about motherhood and to address the painful reality of age-related fertility decline. In the last section, we argue that instead of defining “older” motherhood as an ethical problem, we should problematize the fact that female reproductive ageing is an understudied and ill-sourced topic. We believe that allocating resources to research to better understand female reproductive ageing is not only ethically permissible, but might even be ethically desirable. (shrink)

The resurgence of interest in the meaning of citizenship has encouraged debate on its gendered character, especially the relationship between public and private. Informed by such analyses, this article considers the political organizations, in this case in Australia, formed to reclaim maternity care from medical dominance and to promote women's choices as childbearers. As activists, mothers have carved out a new form of politics, transforming their ‘private’ experiences into issues of public contention. Challenging established categories, they have sought to improve (...) their social rights through educating the public and changing professional and institutional practices – for example, asserting their ‘right’ to birth at home and breastfeed in public places. I argue that neither this project, nor that of feminism's emphasis on achieving equality in the public sphere, has been adequate, for gender equity requires intermeshed social, economic and political rights. By conceptualizing mothers as a political collectivity with distinctive, though not homogeneous, interests and needs, the article indicates ways to extend current theoretical frameworks, including postmodernist feminist debates on gender-justice and the politics of differentiated citizenship. (shrink)

Reproductive autonomy is central to women’s welfare both because childbearing takes place in women’s bodies and because they are generally expected to take primary responsibility for child rearing. In 2005, the factors that influence their autonomy most strongly are poverty and belief systems that devalue such autonomy. Unfortunately, such autonomy is a low priority for most societies, or is anathema to their belief systems altogether. This situation is doubly sad because women’s reproductive autonomy is intrinsically valuable for women and (...) also instrumentally valuable for the welfare of humankind. This paper takes for granted the moral and practical necessity of such autonomy and digs deeper into the question of what such a commitment might entail, focusing on the mid-level policy making that, at least in the US and Canada, plays a significant role in shaping women’s options. This paper examines a large teaching hospital’s policy on reduction of multifetal pregnancies. The policy permits reduction of triplets to twins, but not twins to a singleton. As there is no morally relevant difference between these two types of reduction, it is evident that inappropriate medicalisation can still limit women’s autonomy in undesirable ways. (shrink)

In Western countries, a social trend toward delaying childbearing has been observed in women of reproductive age for the last two decades. This delay is due to different factors related to lifestyle, such as the development of a professional career or the absence of the right partner. As a consequence, women who defer childbearing may find themselves affected by age-related infertility when they decide to conceive. Fertility preservation techniques are, therefore, proposed as a solution for these women. Among (...) all possible solutions, social freezing is an alternative strongly discussed from a scientific, social and ethical point of view.A survey among 930 female students at the University of Padova (Italy) investigated their knowledge and attitudes on social egg freezing and their potential intentions regarding this procedure. To our knowledge, this is the first study to examine the level of awareness of age-related infertility in Italian young women and their attitudes regarding acceptable indications for elective oocyte freezing, their potential personal use, the circumstances in which they would then decide to use cryopreserved eggs, and their attitudes towards cost coverage and oocyte donation.Data collected in this study revealed some important points about young women and their knowledge about social oocyte freezing in Italy as compared to other European countries and the United States.Overall, 34.3% of the students reported having heard about the possibility of oocyte cryopreservation for non-medical reasons and being aware of the meaning of this procedure; only 19.5% were in favour of social egg freezing and 48.4% thought that the cost for this procedure should be borne entirely by the woman herself. Regarding egg donation, the majority of students (64.9%) would not accept donating their eggs to a known woman or couple and 42.5% would instead accept donating to a biobank.Our study shows that young Italian women are significantly less aware of age-related decline in fertility and the possibility of using social egg freezing compared to their similarly situated counterparts in other Western countries. (shrink)

Fetal ultrasonography has made women's and men's relationship to the fetus more equal. Drawing on information obtained from multiple conjoint interviews with 62 childbearing couples, I suggest that although women and men are both advantaged by fetal ultrasonography, expectant fathers' experience of the fetus is always enhanced, whereas pregnant women's experience may also be attenuated. For men, fetal ultrasonography is like a prosthetic device: an enabling mechanism that permits them access to a female world from which they have been (...) excluded because of their limited biological role in reproduction. For women, fetal ultrasonography is enabling, but it may also be a disabling mechanism that disrupts their privileged access to the fetus. (shrink)

Most discussions of population control focus on how many children people should have, but ignore issues to do with the timing, so there is little discussion of the value of delaying childbearing. Once we recognize that delaying childbearing can have a significant impact on the size of the population, and, therefore, on CO2e emissions, our perspective on egg freezing changes significantly. In this article, I argue that, if we focus on future generations in general, rather than focusing only (...) on the children who would be conceived using frozen eggs, policies permitting or encouraging the freezing of eggs may reduce potential harms to future generations. This, I argue, may block the objections to egg freezing for non-medical reasons which focus on the potential risks to the child. (shrink)