INFERTILITY AND ADOPTION GUIDELINES FOR THE REFLECTION PAPER 1 page Single space Prescribed format (can be downloaded from our website, www.famipop.weebly.com) Use at least 10 concepts learned in class when you write your essay. Underline those concepts. One of the challenges that many couples face today is infertility. The desire to have children is a human instinct. Infertility…. the state of being unable to produce offspring; in a woman it is an inability to conceive; in a man it is an inability to impregnate. SOCIAL PRESSURES TO HAVE CHILDREN Our society has a pronatalist bias. Pressure to have children can come from the parents, the family, peers, and relatives and even the society in general. Some societies have negative notions toward women who cannot bear a child. Others will stigmatize men who cannot impregnate women, less masculine. SOCIO-CULTURAL UNDERSTANDING OF INFERTILITY Childless woman may be ostracized. Ghana: One tribe calls infertile woman as Kono which means barrenness, emptiness or worthlessness. Kono is a derogatory term, outcast. INFERTILITY AND DEATH In a tribe in Ghana, when a childless woman dies, they use some local medicine called anya to bury her. Anya is like a leaf which is tied around her waist before burying her. This is done to convey a message that when she is coming back, she should not come back barren. (From an elder) Source: http://uir.unisa.ac.za/bitstream/handle/10500/9829/ ajnm_v10_n1_a3.pdf?sequence=1 CONSEQUENCES OF INFERTILITY Children-Free Adoption Surrogate Motherhood Primary infertility- No history of conception Secondary infertility- Unable to conceive after a successful birth delivery. POSSIBLE CAUSES OF INFERTILITY Female Factors Infections: Vaginitis (see video) & Cervicitis – makes environment hostile to sperm. Cervical Problems – can affect survival or mobility of sperm. Vagina [because of acidity] normally is a hostile environment for sperm. POSSIBLE CAUSES OF INFERTILITY Vaginitis POSSIBLE CAUSES OF INFERTILITY Cervicitis Endometriosis – endometrial tissue grows outside uterine cavity. Male Factors Primary Causes of Male Infertility: Impaired sperm production/mobility/delivery; Testosterone deficiency (hypogonadism). Can be congenital or acquired. Problems in Sperm Production Average # deposited is 70 million/ml in 2-6 ml. Sperm count 20 million or less in 2-6 ml. suggests inadequate production. Causes: Infections - HPV, gonorrhea, chlamydia, epididymitis, testicular inflammation (orchitis) [mumps as adult] High fever from prolonged elevation of scrotal temperature; can cause irreversible infertility if before puberty Diseases; Testicular Cancer Testosterone deficiency - disorder in hypothalamicpituitary-gonadal axis . Men with obesity, diabetes Smoking and drinking and use of some drugs The Sperm Analysis You should get the sample to the lab within 30 minutes. A laboratory specialist must look at the sample within 2 hours of the collection. The earlier the sample is analysed, the more reliable the results. The following things will be evaluated: • • • • • • How the semen thickens into a solid and turns to liquid Fluid thickness, acidity, and sugar content Resistance to flow (viscosity) Movement of the sperm (motility) Number and structure of the sperm Volume of semen Source: http://www.nlm.nih.gov/medlineplus/ency/article/003627.htm Combined Problems [Male/Female] – Sexual technique Sexual Technique/Timing - Provide counseling on: Lay in bed for 10-15 mins. after the intercourse Fertility best if intercourse timed around ovulation. Infrequent intercourse: may lower sperm motility. Frequent: may lower # mature sperm. HOW TO KNOW WHEN YOU ARE OVULATING? Insert Video IMPACTS OF INFERTILITY ON WOMEN (WOMEN’S HEALTH QUEENSLAND WIDE, INC.) May feel angry for not being able to have children Resentment towards other pregnant women Feeling of guilt Infertility as a punishment (career) Previous termination Feeling of inadequacy (dysfunctional self) A diagnosis of infertility will often lead to feelings of grief associated with the loss of control over reproductive capabilities, plans and goals. IMPACTS OF INFERTILITY ON WOMEN (WOMEN’S HEALTH QUEENSLAND WIDE, INC.) Some may feel uneasy when surrounded with children Withdrawal or social isolation IMPACTS OF INFERTILITY ON MEN (WOMEN’S HEALTH QUEENSLAND WIDE, INC.) If the couple’s infertility is a result of sperm dysfunction, the man may feel inadequate and feel that his sense of masculinity is challenged. The strong societal link between fertility and virility causes many men to keep their infertility a secret, in turn increasing their feeling of isolation. IMPACTS OF INFERTILITY ON MARITAL RELATIONSHIP (WOMEN’S HEALTH QUEENSLAND WIDE, INC.) Infertility can place great strain on a relationship, particularly where the diagnosis relates to only one partner. The infertile partner may fear being left for another (fertile) person, while the fertile partner may blame or feel anger towards their partner. IMPACTS OF INFERTILITY ON MARITAL RELATIONSHIP (WOMEN’S HEALTH QUEENSLAND WIDE, INC.) Differing levels of enthusiasm for pursuing treatment can occur, particularly in couples where one partner already has children. Agreeing on what fertility tests to perform, which treatment options to pursue and when to stop treatment can all cause conflict. If one partner does not want to begin or continue with treatment, the other partner may feel they are being denied the chance to have a child and become resentful. COMING INTO TERMS WITH INFERTILITY While some couples may not consider treatment, others may spend years pursuing treatment to have a child. Infertility treatment is emotionally and financially demanding. It is therefore important to come to an agreement, preferably before treatment will start, on the types of treatments, number of attempts, overall length of time and amount of money they will commit towards having a child. (Women’s Health Queensland Wide, Inc.) For couples who can afford, the option is in-vitro fertilization. Step 1. Stimulation or super ovulation (fertility drug) Step 2. Egg Retrieval (Follicular aspiration, a minor surgery)..If cannot produce, donation is the option. For couples who can afford, the option is in vetro infertilization. Step 3. Insemination and Fertilization---intracytoplasmic sperm injection (ICSI) Step 4. Embryo Culture (when the egg divides) Step 5. Embryo Transfer- Embryos are placed into the woman’s womb 3 - 5 days after egg retrieval and fertilization…The doctor inserts a thin tube containing the embryos into the woman’s vagina, through the cervix, and up into the womb. COST In the United States, a cycle of in vitro fertilization costs approximately $10,000 to $15,000. INSERT VIDEO IVF “The idea behind the underwear is that tests of men with fertility problems tend to "be naturally warmer by an average of over one degree Celsius". That little number adds up to a big difference and by lowering temperature in the precious area can improve the motility of the sperm.” “The Snowballs underwear is made from organic cotton and cools with freezable gel packs in a wedge shape made of Carboxymethyl Cellulose Sodium.” Source: http://sploid.gizmodo.com/this-tingly-cold-pair-of-underwear-will-makeyour-sperm-1497544777 CULTURAL PRACTICES (OTHER REMEDIES) OTHER REMEDIES Herbal Medicine Spiritual means if they think infertility is caused by evil spirits. Massage (Lingam Massage for Erectile Dysfunction)…a sensual massage Acupuncture Yoga ADOPTION This is an alternative to infertility treatment. By definition (DWSD), “this refers the socio-legal process of providing a permanent family to a child whose parents have voluntarily or involuntarily relinquished parental authority over the child.” WHO USUALLY ADOPTS? Homosexual Parents parents who cannot produce offspring Parents who just want to have children but do not want to engage in sexual relationships Altruistic reasons JASON HANNA AND JOE RIGGS, TEXAS GAY FATHERS, DENIED LEGAL PARENTHOOD OF TWIN SONS “In order to grant a second-parent adoption it has to be between two married people,” Jason explained. “And so, considering we’re not legally married in the eyes of Texas, they don’t have to grant that secondparent adoption because they don’t recognize our marriage…It’s up to the judge’s discretion on whether or not to grant it.” ADOPTION IS A PROCESS Adoption Adoption is not time bound. involves people, the adoptees, the adoptive parents, and the birth parents. TYPES OF ADOPTION Public Adoption: An adoption that occurs through licensed public agencies (DSWD) Private Adoption: An adoption arranged directly between adoptive parents an the biological birth mother, usually with the assistance of an attorney Transracial Adoptions Single-Parent Adoptions Adoptions by Gays and Lesbians International Adoptions ADOPTIONS Closed Adoption: An adoption where identifying information is sealed and unavailable to all parties Open Adoption: A type of adoption that involves direct contact between the biological and adoptive parents INTERNATIONAL ADOPTIONS (U.S.) About 18,000 adoptions in 2000 were of children from outside the country. 48% of all children who have been adopted from overseas by American parents were from Asia, 33% percent from Latin America, and 11% from Europe. UK ADOPTION TODAY In the UK today there are 4 main areas of adoption: Adoption of step-children Babies and children with disabilities Children who have been removed from their families Babies and young children from overseas COMPONENTS OF ADOPTION (DSWD) The following are components of adoption: Recruitment of potential adoptive families who may provide a home to a child; Development of adoptive applicants as parents to a particular child in need of a home; Selection of a family who can best contribute to the total development of a particular child; Preparation of the child and family prior to placement to insure acceptance and readiness for the new relationship; COMPONENTS OF ADOPTION (DSWD) The following are components of adoption: Supervision of trial custody for at least six months to facilitate the child’s adjustment in the family prior to the completion of adoption; Preparation for removal of the child from the adoptive home if the placement disrupts while alternative plans are being worked out; Finalization of adoption and termination of service with issuance of the final decree of adoption and amended birth certificate; Organization of groups of adoptive parents as part of support system; and Post-legal adoption counselling when adoptive family and adoptee need further counselling related to information about adoptee’s background and search for his/her biological parents. HOMOSEXUAL ADOPTIVE PARENTS Do children under homosexual families grow differently? A study by Farr, Forssell, and Patterson (2010) reveals that gender orientation is not really significant to cause children’s adjustment. What matters most according to them is parental relationship, parenting, and parenting stress. IMPACTS OF ADOPTION ON BIRTH PARENTS ( CHILD WELFARE INFORMATION GATEWAY , 2013) It is a traumatic experience Thinking about the child Guilt and shame Identity issues Effect on other relationships INSERT VIDEO Beautiful Woman LEGAL INSTRUMENT Republic Act 8552 Domestic Adoption Act of 1998 Republic Act 8043 Inter-Country Adoption Act of 1995. RA 8552 [1] Birth certificates, marriage certificate, proof of financial capacity (like ITR, bank deposit, etc), clearances (barangay, police, NBI, fiscal, court), and others as proof of good moral character, good health, etc. [2] Upon payment of the filing or docket fee, the petition is raffled to a Family Court (of the city nearest the place where the petitioner resides). [3] Newspaper Publication RA 8552 [4] Before the initial hearing, the social worker conducts a case study and home visit. The social worker submits his investigation report and recommendations to the court before the initial hearing. [5] On the date of the initial hearing, the petitioner and the prospective adoptee must be present. The lawyer presents what are known as the jurisdictional facts (petition, proof of publication in newspaper, notice to the Office of the Solicitor General, etc). [6] If there is no opposition to the petition for adoption by any party, then the lawyer asks the court permission for an ex-parte presentation of evidence, done before only the court stenographer and the court appointed commissioner (the branch clerk of court). The court however can require presentation of evidence in open court. All in all, the case could take up to about a year to finish. [7] If the court decision is favorable and there is no appeal by any party, then the court issues a Certificate of Finality. The lawyer then coordinates with the Local Civil Registrar (of the town or city where the court is located, and the adoptee’s birthplace) and the National Statistics Office for the issuance of a new birth certificate bearing the petitioner’s surname. ADOPTION REUNIONS This is the process/time when the adoptee and his/her biological parents meet. This could be a negative or positive experience on the child and the couples (biological and adoptive parents). SURROGACY Hagar (mother of Ishmael) Abraham-Sarah-Hagar triad is a type of blended family, only that this is not a result of divorce or death or separation. Latin surrogātus, assimilated variant of subrogātus; see subrogate…meaning substitute for another Surrogacy: The act of giving birth to a child for another person or a couple who then adopts or takes legal custody of the child Traditional Surrogacy: A type of surrogacy where the man’s sperm is implanted in the surrogate through artificial insemination TYPES OF SURROGACY Traditional Surrogacy The mother is both a biological parent and the carrying mother. Gestational Surrogacy The carrying mother is not biologically related to the foetus Altruistic surrogacy The surrogacy as a kind gesture Commercial surrogacy A contract for money BABY M In 1986, Mary Beth Whitehead gave birth to Sara following artificial insemination She had agreed a contract with William Stern $10,000 plus medical expenses Mary Beth changed her mind, and told Stern he could keep his money. At 5 weeks old a court ordered her to give up Sara to William and Elizabeth Stern Sara became Melissa BABY M The Judge decided that the case was a custody case, rather than a surrogacy case. William Stern had a right to the baby as a biological father. Mary Beth was deemed an unfit mother her other children were never taken into care. Later the court of appeals overruled this decision, reinstating Mary Beth as the baby's legal mother but decided it was in Melissa’s best interest to stay with the Sterns DILEMMAS OF SURROGACY Many surrogate mothers feel a sense of achievement Some women go through the surrogate process time and time again They also benefit from the money and/or expenses They assist people to have a child of their own
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