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On the vicissitudes of early primary surrogate mothering II: loss of the surrogate mother and arrest of mourning.

Among the catastrophic events experienced by infants and young children, one of the most frequent is the loss of an early primary surrogate mother (EPSM). Usually permanent, the loss is often followed by the advent of a new, "replacement" caregiver. One aspect of the emotional environment is unique to this kind of caregiving situation: that parents are often unable to validate the true nature of their child's relationship with the EPSM or, ultimately, the trauma experienced by the child when the EPSM leaves. The marked discrepancy between the parent's and the infant or child's experience of the surrogate mothering leads to an arrest of the child's mourning process, with the potential for serious developmental consequences. Issues related to EPSM loss and its aftermath are examined in the light of two examples. Further exploration of the environment of this kind of caregiving directs attention to the critical need to nurture and protect the attachments of both the infant or child and the parent to the ESPM.

Adult↗

Problems in commercialized surrogate mothering.

Commercialized surrogate mothering is an unworkable arrangement for helping infertile couples to have children. The arrangement requires a woman to undergo artificial insemination, to sustain a pregnancy and to relinquish the child upon birth to the genetic father. During the course of the pregnancy, the arrangement calls for restrictions on the surrogate mother's behavior and authority to make medical decisions concerning herself and the fetus. Such restrictions are unenforceable under contract law, and the usual social mechanisms to induce compliance are absent. Due to the large sums of money involved and the growing industry of surrogate mother brokering, efforts have begun in many state legislatures to regulate the arrangements, and in particular the behavior of the surrogate mothers, in order to increase the predictability and workability of the arrangements. If passed, these state laws could set a dangerous precedent for regulating all women during pregnancy and standardizing the behavior and medical care of pregnant women. Noncommercialized surrogate mothering does not pose these same threats, and is likely to continue for many years to come.

Commerce↗

Successful induced non-puerperal lactation in surrogate mothers.

Ten surrogate mothers seen between 1986-91 were encouraged to breast-feed their babies varying in age between 8 days to 5 months. All the 10 surrogate mothers had experienced pregnancy and child birth in the past. The lactational gap varied from 1 year to 16 years. Presence of milk was noted on 3rd to 8th day after attempting induced lactation in 5 mothers. No milk was seen on manual expression of the nipple even after 2 weeks in the other 5 surrogate mothers. Two mothers achieved complete breast-feeding and they fed their babies for 2 years. Three mothers could achieve partial lactation and these mothers fed for 1 year or more. All these 5 babies registered satisfactory growth.

Adult↗

Surrogacy: the experiences of surrogate mothers.

BACKGROUND: This study examined the motivations, experiences and psychological consequences of surrogacy for surrogate mothers. METHODS: Thirty-four women who had given birth to a surrogate child approximately 1 year previously were interviewed by trained researchers, and the data rated using standardized coding criteria. Information was obtained on: (i) reasons for the woman's decision to become a surrogate mother; (ii) her retrospective view of the relationship with the commissioning couple before the pregnancy, during the pregnancy, and after the birth; (iii) her experiences during and after relinquishing the child; and (iv) how others reacted to her decision to become a surrogate mother. RESULTS: It was found that surrogate mothers do not generally experience major problems in their relationship with the commissioning couple, in handing over the baby, or from the reactions of those around them. The emotional problems experienced by some surrogate mothers in the weeks following the birth appeared to lessen over time. CONCLUSIONS: Surrogate mothers do not appear to experience psychological problems as a result of the surrogacy arrangement.

Adult↗

Surrogate mothers: the legal issues.

Increasing numbers of couples have benefitted from, or may be considering use of, the surrogate mother procedure. In this procedure, a couple, usually a husband and wife, enters into a contract with a surrogate mother. Under the terms of the contract, the surrogate mother is artificially inseminated, bears a child, and relinquishes all rights regarding that child to the semen donor and his wife. In exchange for bearing a child, the surrogate mother often receives a fee. In light of such increased use of the procedure, the issue of whether or not the arrangement is legal has particular importance. Questions of legality involve possible violations of criminal baby-selling statutes. Issues of whether adoption is necessary and whether the child is legitimate also are inherent in the surrogate mother arrangement. This Note argues that these questions should be resolved in favor of finding no impediment to the use of the surrogate mother procedure, at least within certain guidelines. However, even in the absence of legal impediment, detailed contracts and thorough medical screening for genetic, physical and psychological problems would further eliminate ambiguities regarding liability. In addition, the Note concludes that legislation should be enacted to deal with the legal ambiguities of the surrogate mother arrangement. This legislation should regulate the parties that enter into such an arrangement and the rights and responsibilities of these parties.

Adoption↗

Mobile surrogate mothers and the development of exploratory behavior and radius of action in infant long-tailed macaques (Macaca fascicularis).

One of the effects of rearing young monkeys on surrogate mothers is a delay in the development of exploratory behavior. An important question is which difference between mother and surrogate mother caused this delay. We hypothesized that the mothers' carrying the infant through the environment promotes the development of exploratory behavior and the radius of action of infant macques. Using surrogate mothers, we reared 9 infants in a peer group with immobile surrogates and 10 infants in another peer group with mobile surrogates. During the 3rd to the 6th month, we observed each infant for 30 min weekly, collecting observational data on several behavioral parameters and on time spent in several areas in the cage. Results showed that exploratory behavior and an increase in radius of action developed more rapidly in the mobile-reared infants.

Age Factors↗

Effects of weaning by surrogate mothers (ACI) on tumor development in SD rats treated with methylnitrosourea (MNU) and/or N-methyl-N'-nitro-N-nitrosoguanidine (MNNG).

In this experiment, methylnitrosourea (MNU) was administered, followed by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), to assess effects of surrogate mothering on tumor. One or two day old male SD pups were treated with or without 30 mg/kg body weight of MNU and nursed by SD or ACI surrogate mothers for 5 weeks. When 6-weeks-old they were then treated with 100 ppm MNNG or tap water for 16 weeks. The tumor incidence in the MNNG alone group was significantly lower than with MNU alone or MNU+MNNG (p < 0.01). Kidney or nerve tumors mainly developed in the MNU group, gastric tumors in the MNNG group, and the two combined in the MNU+MNNG group. The incidence and mean number of tumors did not significantly differ between the two weaning groups. However, mean survival time with the ACI surrogate mothers after treatment with MNU was increased as compared with the SD mother group. Cumulative development of tumors in the ACI surrogate mother group was also delayed (p < 0.05). Similar results were obtained with MNU+MNNG and MNNG alone. The present experiment suggested that tumor induction might be effected by components of the mother's milk.

Animals↗

On the vicissitudes of early primary surrogate mothering.

I have noted estrangement from biological mothers and intolerance of intimate relationships in patients with an early history of primary surrogate mothering. This observation facilitated discovery of such early histories in 31 of 102 patients I examined during a five-year period. With a review of the literature, and clinical examples, I attempt to associate the estrangement and intolerance with the mother's exclusion resulting from her infant's close tie to a surrogate and the infant's inevitable traumatic loss of the latter. In the analyses of screen phenomena, mother and surrogate mother transferences, all peculiar to that caretaking, the surrogate is seen to emerge from obscurity. In the clinical examples (limited to losses of surrogates following the infant's eighteenth month) screen memories, dreams, and eclipse are found to possess a common feature: the image of the surrogate is screened by that of the mother. Biological mother and, in the countertransference, the analyst play a significant role in perpetuating the concealment of the surrogate.

Adult↗

Rearing cynomolgus monkeys (Macaca fascicularis) on surrogate mothers with bottle feeding.

Fifty-two cynomolgus monkeys were reared in peer groups on surrogate mothers and fed by bottle during the first months of life. A description of the technique of bottle feeding and the structure of surrogate mothers is presented. Results are shown in a growth curve. Inter-individual differences in body weight were very large. The mean weight was higher in males than in females, but no significant sex differences in growth occurred. The weight of mother-reared infants stayed within the standard deviation of the mean weight of the artificially-reared subjects.

Animals↗

Midgestational abnormalities associated with in vitro preimplantation N-methyl-N-nitrosourea exposure with subsequent transfer to surrogate mothers.

Mouse blastocyst functions have been shown to be disrupted by in vitro exposure to N-methyl-N-nitrosourea (MeNU). After exposure, the chemically treated blastocysts were transferred to the uteri of pseudopregnant surrogate mothers. Implantation rate and birth rate have been shown previously to decrease in a concentration-dependent manner. Because of the large progressive decrease in the 50% effective concentration (EC50) for cytotoxicity, implantation rate, and live birth rate, we have investigated the midgestational effects of preimplantation exposure to MeNU after the transfer of treated embryos to surrogate mothers. A concentration-dependent decrease in normal implantation and a concurrent concentration-dependent increase in resorption number was observed in surrogates sacrificed at gestational age day 12 or day 15. Gross malformations were significantly increased by preimplantation exposure, in vitro, to MeNU. Fetal body length did not differ between fetuses developed from solvent-treated blastocysts and those that developed from natural pregnancies (nontransferred control) at either gestational age examined. Fetal body length was significantly shorter in fetuses developed from MeNU-treated blastocysts.

Abnormalities, Drug-Induced↗

Surrogate mothers: whose baby is it?

Advances in medical technology offer infertile couples who wish to raise children alternatives to adoption. The increasing number of surrogate mother contracts creates a myriad of legal issues surrounding the rights of the natural mother, the natural father and the child that is produced. In this Article, the Author discusses the legal issues and rights of the parties under the Constitution, the surrogate contract and family law principles. The Author proposes that courts should consider a surrogate contract as a revocable prebirth agreement which allows the natural mother to keep the child if she chooses. In addition, the Author advocates an interpretation of the statutes forbidding baby selling that would prohibit surrogate contracts in which the mother is paid a fee for the child.

Child Advocacy↗

Effects of surrogate mothering on physiologic stabilization in transitional newborns.

This experimental study was conducted to determine whether surrogate mothering during the first hours of life will affect physiologic stabilization in the transitional newborn. Two groups of 8 normal newborns were studied. The treatment was given on cue and consisted of rocking, cuddling, visual and verbal interaction, and non-nutritive sucking to satiety. The control group received routine nursing care. The experimental group's mean axillary temperature correlated with increasing age (r = +.91, p less than .001) and leveled at 2 hours of life at 98.2 degrees F (36.8 degrees C). Control group temperatures fell continuously to 97.4 degrees F (36.3 degrees C) following removal of the newborn from under an infrared heat unit. The experimental group's mean respiratory rate correlated negatively with increasing age (r = -.81, p less than .009). The experimental group's mean heart rate was higher at 3 1/2 hours (p less than .01). The control group's mean heart rate correlated over time (= -.82, p less than .007). Heart murmurs were heard 16 times in 5 controls and 6 times in 3 treated newborns. The frequency difference was significant (p less than .05). Experimental newborns cried an average of 2.1 minutes. This was less (p less than .01) than the controls (38.5 minutes). Electronically measured sucking strength was higher (p less than .001) for the treated newborns (81.5 mm Hg) than for the controls (20.5 mm Hg) prior to the first feeding at 4 hours. The experimental group ingested a mean of 13.75 cc of sterile water at the initial feeding, compared to 5 cc for the controls. Sucking and swallowing difficulty was seen in 6 control and 3 experimental newborns. These data suggest that interaction and soothing by another human facilitates transitional newborn physiologic adaptation.

Adaptation, Physiological↗

Motivation of surrogate mothers: initial findings.

The author presents demographic and motivational data on 125 women who applied to be surrogate mothers. Several complementary motivations were noted: the desires for money, to be pregnant, to "give" a baby, and to resolve internal psychological conflicts.

Adolescent↗

Mother surrogate and nutritional status of preschool children.

The study was conducted on 200 preschool children to find out the effect of mother surrogate on the nutritional status. The nutritional status of children was found to be affected by the time devoted by mother on child care activities, working status of mother and type of family independently and jointly. The children cared by mother had better nutritional status than those children who were cared by servants and any other family member in the absence of mother. It shows that no one can substitute the care provided by the mother.

Child Care↗

Protein alterations associated with N-methyl-N-nitrosourea exposure of preimplantation mouse embryos transferred to surrogate mothers.

Mouse preimplantation embryo functions have been shown to be disrupted by in vitro exposure to N-methyl-N-nitrosourea (MNU) with subsequent transfer to the uteri of pseudopregnant surrogate mothers. Increased gross malformations and decreased fetal body lengths in the midgestational period have been previously documented. Protein extracts were isolated from day 12 mouse fetuses developed from MNU- or solvent-exposed blastocysts and analyzed by two-dimensional electrophoresis. The electrophoretic patterns reveal six protein alterations in day 12 fetal tissue induced by MNU treatment at the blastocyst stage. Five of these alterations involve shifts in isoelectric point (pI) and the other alteration involves a quantitative increase in a protein. The possibility that two of the proteins which exhibit a shift in pI following MNU exposure represent the cell adhesion molecules, N-CAM and L-CAM (based on similar Mr values), was investigated by Western blot analysis. No pI alteration in L-CAM or N-CAM expression is seen after MNU exposure. These results demonstrate that in vitro MNU exposure of preimplantation embryos results in protein alterations in midgestational fetuses. Thus, the effects of MNU exposure on preimplantation embryos may be manifest long after exposure, and subtle, non-lethal mutations may play a role in poor fetal outcome after early chemical exposure.

Animals↗

[Surrogate mothers and ovarian transposition: two attitudes to be considered in young women with cervical carcinoma. A case report].

In cases of cervical cancer, there are 2 major advantages to preserving the ovaries, with or without transposition: hormone function is maintained during subsequent cancer treatment and patient quality of life is improved. We report the first case of pregnancy in a surrogate mother following stimulation of a transposed ovary before irradiation and chemotherapy for a squamous cell carcinoma of the uterine cervix. Because of the wide dissemination of information on the technical progress in this area, patients are now in a position to make therapeutic choices that are no longer guided by strictly medical considerations.

Adult↗

Immunological relationships between murine surrogate mothers and transplanted embryos, as studied by local GVH reactivity.

C57BL/Ks (H-2d) female mice were transplanted with early (stage 2) embryos of the A/J (H-2a) strain. Spleens from mice exhibiting successful pregnancies were tested at days 16 to 19 of gestation in a local graft versus host (LGVH) assay using (C57BL/Ks X A/J)F1 recipients and proved to be significantly more reactive than virgin controls or mice carrying transplanted syngeneic fetuses. This increased reactivity was specific for the transplanted embryo's strain. Other controls included donors with semi-allogeneic (F1) transplanted fetuses and females naturally pregnant by allogeneic males which did not give reactions significantly different from virgin control spleen cells. Para-aortic lymph node cells (PALN) obtained from the same A/J embryo-transplanted females showed a strong T suppressive activity both on their own spleen cell (SC) reaction as well as on the reaction obtained with virgin SC. This suppressive activity also appeared to be embryo-strain specific. Serological tests revealed the presence of mast cell-degranulating (anaphylactic) antibodies but not of hemagglutinating or complement-fixing cytotoxic activities. The A/J offspring obtained after embryo transfer to C57BL/Ks females presented at the age of two months significantly lower LGVH reactivity against the surrogate mother's strain. The differences in the responsiveness of the mice transplanted with allogeneic embryos compared with those with conventional pregnancies are discussed.

Animals↗