Pediatricians might think that issues related to assisted reproductive technologies (ART) are outside the scope of their practice, but this is not true. The use of ART is increasing and has implications for pediatricians. Neonatologists, for example, are asked to counsel individuals who are gestational carriers. Gestational carriers are surrogates (people who carry fetuses for others) who are not genetically related to the fetuses.
In this month’s Pediatrics Ethics Rounds, Drs. Hayley Wilcox from Tufts University, Christy Cummings from Harvard University, Thaddeus Pope from Mitchell Hamline School of Law, and Mark Mercurio from Yale University consider a case in which a gestational carrier presents in preterm labor (10.1542/peds.2023-062805). She is carrying twins for a gay couple that were conceived through in vitro fertilization with donor eggs and the intended fathers’ sperm. The fetuses are mispositioned (one is transverse and the other breech), and the obstetrician recommends a cesarean delivery.
The pregnant woman’s choices not only have implications for her and her future pregnancies but also for the children and their intended parents.
Potential issues include:
- Can the woman be required to undergo a cesarean section?
- Is her consent necessary to inform the intended parents about this complication?
- When do the intended parents become the medical decision makers for the children?
I encourage you to read this article to see what neonatologists, bioethicists, and a lawyer recommend and consider what you would do if you were in this situation.