Births and parenthood

“Come and say hello to your grandson,” my daughter Jika beckoned to me the other day.  She was caressing her distended belly now fully occupied by the six-month-old fetus growing snugly inside her. My wife put her hand on the spot where it moved beneath the skin, and asked me to feel it. “Xavier, this is your Lolo,” Jika said, as I rested the palm of my hand on what could be the unborn child’s head or elbow.

It’s been a while since this youngest daughter of ours, soon to be a mother herself, was born. But like a bolt of recognition, it came rushing back to me: that primal feeling of being swept when you hold a child in your hand for the first time.

Today’s pregnancies are monitored so closely by scanners and testing devices that parents become acquainted with their children long before they are actually born. One of the first things they learn, of course, is whether the fetus is a boy or a girl. Jika’s husband, Brice, e-mails to us every month several photos from the latest ultra sound scan of “bebe.” The condition of the heart, the liver, the spinal column, and even the size of the brain are examined at every visit with the doctor. At six months, the little boy’s features stand out clearly from the grainy black and white film. He has a long face and a broad forehead like his father, and his limbs are fully developed.

At an early stage, it is now possible to determine with great precision if a fetus has any genetic defect, or if it is likely to have a chromosomal condition like Down’s syndrome. In some rare cases, some problems, I understand, may be corrected by surgery even while the baby is in the womb. But in most instances, where serious defects are detected, parents are confronted with the decision whether to proceed or to terminate a pregnancy.

Very early in the pregnancy, Jika and Brice had made up their minds to accept with full gratitude any child they are given, whatever his or her shape or condition might be. Fortunately, their baby is normal and is growing beautifully. They do not need to make the gruesome choice of having to say goodbye to an infant who has yet to see the world, or having to prepare themselves to nurture a child they know will have a difficult life.

But everywhere, the modern scanning of fetuses is throwing up ethical problems that did not exist when detailed information of this kind was not yet available. Many countries have passed laws that make it possible to abort a fetus up to three or four months into a pregnancy, if there is extensive proof that a child may either not survive at birth or suffers from genetic defects that would make its life unbearable. But even with these laws, the moral agony of having to terminate, or, to carry to full term, the life of an unborn defective child does not go away.

Children have always come into the world on a strictly “no return, no exchange” basis. Nature makes sure of that. The emotional and physical bond that develops between a mother and the life she carries within her for nine months is not easily erased. A woman finds herself slipping into the vocation of parenthood well before she becomes fully aware of it. That is why no love is deeper than that of a mother’s for her child.

Nietzsche says, “It is to be compared with an artist’s love for his work.”

Modern technology however is fast altering the landscape of human reproduction. Like consumer products that do not fully meet our expectations, some children are now being “returned” before they are born. In cultures that privilege boys over girls, early determination of the sex of the unborn fetus has contributed immensely to the termination of the life of female fetuses. The increasing popularity of in-vitro fertilization, together with the growing use of surrogate wombs, has made it even more necessary to be on the lookout for possible genetic defects.

A new category of medical malpractice suits has emerged in the wake of the widespread use of fetal scanning: “wrongful births.” If in the past doctors were being charged for “wrongful deaths,” these days they may be made liable as well for not giving sufficient warning to expectant parents about the possibility of defective births.

New reproductive technologies have also “unbundled” the entire reproductive process. A woman’s egg can now be fertilized in vitro using the husband’s or a donor’s sperm, and then attached to another woman’s womb for gestation. Is it possible, under these circumstances, for the owner of the surrogate womb not to develop any attachment to the child she’s carrying? Is a “surrogacy contract” of this nature valid and enforceable?

In his book “Justice,” Michael J. Sandel discusses a case brought before American courts in 1986. William and Elizabeth Stern could not have a baby because of the risk to Elizabeth’s health; she had multiple sclerosis. An infertility center arranged a surrogate pregnancy, in which a surrogate mother, Mary Beth Whitehead, would be inseminated with William’s sperm to produce a baby. A contract provided for the payment of $10,000 to Mary Beth upon delivery of the child. When the baby was born, however, Mary Beth decided to keep the child. William Stern sued to enforce the contract, and a trial judge sustained his right to the child. On appeal, the New Jersey Supreme Court declared the surrogacy contract invalid on the ground that the mother’s consent was not “fully informed.” But, by a Solomonic twist, the same court awarded custody to the Sterns, on the belief that the baby would be better off being raised by the childless couple.

Merry Christmas!

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