Surrogacy giving hope to childless couples in Uganda
Aug 02, 2006
MELODY Mukisa (not real name) lost her womb at the age of 22 years. This was after a doctor had told her that she had a cancerous tumour and had to remove her womb in order to save her life. Mukisa is now 31 and married, but cannot carry a baby of her own. This however does not mean that Mukisa canâ
MELODY Mukisa (not real name) lost her womb at the age of 22 years. This was after a doctor had told her that she had a cancerous tumour and had to remove her womb in order to save her life. But as it turned out later, it was not cancer. She had fibroids, which did not necessitate removal of her uterus.
Mukisa is now 31 and married, but cannot carry a baby of her own. This however does not mean that Mukisa can’t have her own biological children. She is now a proud mother of twin boys, whom she is even breastfeeding much as she did not carry them herself.
A fertility clinic made this possible by using another woman, who was paid to carry the babies.
Dr. Edward Tamale Ssali of Kampala Gynaecology and Fertility Centre in Bukoto, who conducted the procedure, terms this arrangement as assisted reproduction by help of a surrogate mother.
A surrogate mother is a woman who agrees, usually by contract and for a fee, to bear a child for a couple who are childless because the wife is infertile or physically incapable of carrying a developing foetus.
“Mukisa approached me in 2004. I checked her and realised that she had good ovaries and eggs (ova). We later got a sample of her eggs and fertilised them from outside, then planted them in a surrogate mother’s womb. She was very desperate to have babies; her own babies with her physical features,†Ssali says.
In this case, Ssali conducted In-Gestational Surrogacy (IGS), where the child is conceived by In-Vitro-Fertilisation (IVF), because Mukisa is fertile, but incapable of carrying a growing foetus. He used her eggs plus the husband’s sperms and the resulting embryos were implanted in the surrogate mother’s uterus.
“If you have lost your uterus, but are fertile with normal ovaries and ova, all it takes is to find a surrogate mother to help you carry the children. But it takes patience. One has to keep on trying because we do not guarantee success on the first attempt,†Ssali says.
He says Mukisa tried four times before registering success. “She lined up two possible surrogate mothers: the first was her relative who failed for three times. Then we found our own surrogate mother whom she had never met and she conceived on the first attempt.â€
Ideally, the arrangement/contract should be between the biological parents and the surrogate mother. Ssali says a sister or any relative can do, but couples often do not their kin.
The procedure involves extensive tests; HIV/AIDS, sexually transmitted diseases, general health and physical ability of the surrogate mother plus any other conditions that would threaten the pregnancy and birth.
There are also conditions that the surrogate mother should abide by to ensure that the baby’s health is not jeopardised.
“The surrogate mother should adjust her lifestyle, eat well, attend antenatal care and follow several precautions that any pregnant mother should watch out for to ensure a healthy baby,†he says.
“We took all the necessary tests to ensure that she is health, physically fit and mentally prepared for the experience. She was to have no sex during this time of the pregnancy to avoid catching STDs and sleep under an insecticide-treated mosquito net to avoid malaria, which is a cause for many miscarriages,†Ssali says.
He adds that for one to qualify as a surrogate, she should be willing, must have had babies of her own, not be living with the husband (because he may object), traceable with a good reference (in case of breach of contract) and should know what is expected of her and what she is doing.
Ssali says a lawyer should be involved, but certain couples risk not using one because they do not want to scare the surrogate mother. They prefer a simple agreement.
“During birth, we do not even allow her to see the baby to avoid the natural animal instinct of bonding (unless the couple has agreed on nurturing the relationship, which is rare).â€
Ssali says a lot of women have reproductive problems like bad uterus, incompetent cervix, fibroids, endometriosis, post abortion complications and have had their uterus removed.
Besides, with today’s career women, one may think about children when she has already reached menopause.
“We just offer such women possibilities and give them a chance to have children of their own. It is an expensive procedure but it is the only choice. It costs a minimum of sh13m if one is to conduct all the required medical and physical tests, pay the surrogate mother, hire a lawyer and seek services of a counselling psychologist.†he says.
He says Mukisa got twins because multiple babies are a common occurrence with assisted reproduction. “We place many embryos into the womb. It is like planting seeds,†Ssali says.
However, Fr. Lawrence Kanyike of St. Augustine Chapel Makerere says that surrogacy is immoral and contrary to God’s law.
“A child must be a fruit of love between two people. But when you get out of that situation to employ science and technology, you get an artificial child that may even be defective because the environment in which it was produced was not natural,†Kanyike says.
“The love must be passed on and manifested in the fruit. The surrogate arrangement does not ensure continuity of this natural motherly love. This love will not be reflected in this child. Male and female relationship is a very serious thing. It is an experience of pleasure that no man should curtail,†he says.
Kanyike adds that just as rape is considered a sin, so is cloning and surrogacy. “It is not any different from these other unnatural, unfriendly, and ungodly acts. It is like putting a human being in a laboratory and that is the problem of technology today. We are supposed to control technology not technology to control us,†he says.
The head of the Tabliq community in Uganda, Hajji Sulaiman Kakeeto also says that surrogacy is morally wrong.
“It is against the teachings of Islam. Being barren is not a crime. Whether you have fertile eggs with a uterus or otherwise, its God’s plan for you to be what you are,†Kakeeto says.
He adds that the children in this case actually belong to the surrogate mother whether they are her eggs or not.
“Even if they transferred both eggs, the babies become hers and are simply illegitimate children,†he says adding that many may consent to such an arrangement because of the financial gains, but “we should search for money in legitimate ways.â€
Dorah Byamukama, the director of Law and Advocacy For Women in Uganda, says surrogacy as a practice happens elsewhere in the world, but could prove complicated here because there are no laws governing surrogacy.
“I ever got a case while in the USA where the surrogate mother refused to hand over the baby and it was a very controversial issue. Surrogacy is generally weird. It is not clear. How can one pursue the case in courts of law in case of breach of contract?†she asks.
“Any way, people can have agreements with terms properly laid out: access of the child or termination of parental rights at birth. But still, that is simply a mutual arrangement. It could hit a snug and I do not know how courts will come in. There is no law or anything really binding,†Byamukama says.
However, Dr. Anthony Mbonye, the commissioner of reproductive health in the Ministry of Health, says, “if the surrogate mother vanishes with the kids, then she has stolen and needs to be pursued in the courts. But if it is a mutual understanding or a written agreement, the better.â€
“Surrogacy is helping to address an infertility problem and there is nothing wrong with it. It is cloning, which is discouraged. The law should not even come in. They should not complicate matters. The cornerstone is mutual consent. It is like the way in which people donate blood and kidneys,†he adds.
Mbonye says the law recognises fertility clinics because they are registered by the Uganda Medical and Practitioners Council, and are regulated by professional ethics that govern sperm donation.
Mukisa is now 31 and married, but cannot carry a baby of her own. This however does not mean that Mukisa can’t have her own biological children. She is now a proud mother of twin boys, whom she is even breastfeeding much as she did not carry them herself.
A fertility clinic made this possible by using another woman, who was paid to carry the babies.
Dr. Edward Tamale Ssali of Kampala Gynaecology and Fertility Centre in Bukoto, who conducted the procedure, terms this arrangement as assisted reproduction by help of a surrogate mother.
A surrogate mother is a woman who agrees, usually by contract and for a fee, to bear a child for a couple who are childless because the wife is infertile or physically incapable of carrying a developing foetus.
“Mukisa approached me in 2004. I checked her and realised that she had good ovaries and eggs (ova). We later got a sample of her eggs and fertilised them from outside, then planted them in a surrogate mother’s womb. She was very desperate to have babies; her own babies with her physical features,†Ssali says.
In this case, Ssali conducted In-Gestational Surrogacy (IGS), where the child is conceived by In-Vitro-Fertilisation (IVF), because Mukisa is fertile, but incapable of carrying a growing foetus. He used her eggs plus the husband’s sperms and the resulting embryos were implanted in the surrogate mother’s uterus.
“If you have lost your uterus, but are fertile with normal ovaries and ova, all it takes is to find a surrogate mother to help you carry the children. But it takes patience. One has to keep on trying because we do not guarantee success on the first attempt,†Ssali says.
He says Mukisa tried four times before registering success. “She lined up two possible surrogate mothers: the first was her relative who failed for three times. Then we found our own surrogate mother whom she had never met and she conceived on the first attempt.â€
Ideally, the arrangement/contract should be between the biological parents and the surrogate mother. Ssali says a sister or any relative can do, but couples often do not their kin.
The procedure involves extensive tests; HIV/AIDS, sexually transmitted diseases, general health and physical ability of the surrogate mother plus any other conditions that would threaten the pregnancy and birth.
There are also conditions that the surrogate mother should abide by to ensure that the baby’s health is not jeopardised.
“The surrogate mother should adjust her lifestyle, eat well, attend antenatal care and follow several precautions that any pregnant mother should watch out for to ensure a healthy baby,†he says.
“We took all the necessary tests to ensure that she is health, physically fit and mentally prepared for the experience. She was to have no sex during this time of the pregnancy to avoid catching STDs and sleep under an insecticide-treated mosquito net to avoid malaria, which is a cause for many miscarriages,†Ssali says.
He adds that for one to qualify as a surrogate, she should be willing, must have had babies of her own, not be living with the husband (because he may object), traceable with a good reference (in case of breach of contract) and should know what is expected of her and what she is doing.
Ssali says a lawyer should be involved, but certain couples risk not using one because they do not want to scare the surrogate mother. They prefer a simple agreement.
“During birth, we do not even allow her to see the baby to avoid the natural animal instinct of bonding (unless the couple has agreed on nurturing the relationship, which is rare).â€
Ssali says a lot of women have reproductive problems like bad uterus, incompetent cervix, fibroids, endometriosis, post abortion complications and have had their uterus removed.
Besides, with today’s career women, one may think about children when she has already reached menopause.
“We just offer such women possibilities and give them a chance to have children of their own. It is an expensive procedure but it is the only choice. It costs a minimum of sh13m if one is to conduct all the required medical and physical tests, pay the surrogate mother, hire a lawyer and seek services of a counselling psychologist.†he says.
He says Mukisa got twins because multiple babies are a common occurrence with assisted reproduction. “We place many embryos into the womb. It is like planting seeds,†Ssali says.
However, Fr. Lawrence Kanyike of St. Augustine Chapel Makerere says that surrogacy is immoral and contrary to God’s law.
“A child must be a fruit of love between two people. But when you get out of that situation to employ science and technology, you get an artificial child that may even be defective because the environment in which it was produced was not natural,†Kanyike says.
“The love must be passed on and manifested in the fruit. The surrogate arrangement does not ensure continuity of this natural motherly love. This love will not be reflected in this child. Male and female relationship is a very serious thing. It is an experience of pleasure that no man should curtail,†he says.
Kanyike adds that just as rape is considered a sin, so is cloning and surrogacy. “It is not any different from these other unnatural, unfriendly, and ungodly acts. It is like putting a human being in a laboratory and that is the problem of technology today. We are supposed to control technology not technology to control us,†he says.
The head of the Tabliq community in Uganda, Hajji Sulaiman Kakeeto also says that surrogacy is morally wrong.
“It is against the teachings of Islam. Being barren is not a crime. Whether you have fertile eggs with a uterus or otherwise, its God’s plan for you to be what you are,†Kakeeto says.
He adds that the children in this case actually belong to the surrogate mother whether they are her eggs or not.
“Even if they transferred both eggs, the babies become hers and are simply illegitimate children,†he says adding that many may consent to such an arrangement because of the financial gains, but “we should search for money in legitimate ways.â€
Dorah Byamukama, the director of Law and Advocacy For Women in Uganda, says surrogacy as a practice happens elsewhere in the world, but could prove complicated here because there are no laws governing surrogacy.
“I ever got a case while in the USA where the surrogate mother refused to hand over the baby and it was a very controversial issue. Surrogacy is generally weird. It is not clear. How can one pursue the case in courts of law in case of breach of contract?†she asks.
“Any way, people can have agreements with terms properly laid out: access of the child or termination of parental rights at birth. But still, that is simply a mutual arrangement. It could hit a snug and I do not know how courts will come in. There is no law or anything really binding,†Byamukama says.
However, Dr. Anthony Mbonye, the commissioner of reproductive health in the Ministry of Health, says, “if the surrogate mother vanishes with the kids, then she has stolen and needs to be pursued in the courts. But if it is a mutual understanding or a written agreement, the better.â€
“Surrogacy is helping to address an infertility problem and there is nothing wrong with it. It is cloning, which is discouraged. The law should not even come in. They should not complicate matters. The cornerstone is mutual consent. It is like the way in which people donate blood and kidneys,†he adds.
Mbonye says the law recognises fertility clinics because they are registered by the Uganda Medical and Practitioners Council, and are regulated by professional ethics that govern sperm donation.