Artificial reproductive technology (ART) has a very long history. Before the first success story of childbirth through ART, there were several attempts, including the use of animals, to prove it successful. The practice of ART dates back to as early as 1890: a professor from the University of Cambridge reported the first known case of embryo transplant in rabbits. However, the first successful human case happened in 1977 despite previous failed attempts (Kamel, 2013). ART can be described as the technique used to replace the natural process of reproduction that is executed by fertilizing the human oocyte outside the body, culturing the embryo in a laboratory, and the transfer of the embryo to the uterus. (Marlene B. Goldman & Maureen C. Hatch, 2000). The purpose of ART is to solve infertility in both men and women. People turn to ART because they have some medical conditions– tubal blockage, blocked vas deferens, non-functioning ovaries, and low sperm count- preventing them from childbirth in a natural way. In some men, the epididymis can get blocked, stopping sperm from reaching the vas deferens and being ejaculated. This blockage can happen on one side or both sides. When a man has a blockage in one side of the epididymis, it can result in a reduced sperm count.
There are two popularly known techniques of ART: in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). IVF is often when the woman medicates to super-ovulate, and then the eggs are collected, fertilized with sperm and transferred into her womb. ICSI is done when the sperm finds it difficult to penetrate the egg. ICSI is when there is an ovarian stimulation; the eggs are then collected after they are matured and fertilized with the best semen from a collected sample and then injected into the womb. When it becomes difficult to carry a pregnancy by the egg donor, surrogacy is orchestrated. The practice of surrogacy is also a technique of ART. This paper will argue for the acceptability of ART in Ghana on the grounds of her cultural values. Before that, we must first discuss the cultural values concerning childbirth to which Ghanaians ascribe. If otherwise, will the advantages of ART override the ethical issues likely to be raised by Ghanaians?
Just like every other society in Africa, Ghanaian societies are largely communitarian, which has transcended into every aspect of their social life. Ghanaian cultures define womanhood and manhood on communitarian principles: The popularly held view on a woman and a man is the ability of a person to bare children of their own. Thus, a couple's social status depends on the number of kids they have. Many cultures in Ghana consider children to be a source of blessing and wealth. Ghanaians value children in four ways: societal recognition, inheritance, social and economic support, and friendship (Josephine Mpomaa Kyeia, Adom Manub, Agnes M Kotohb, Charles Ampong Adjeia & Augustine Ankomahb, 2021). Ghanaians believe the properties made by one in this life are to be inherited by their children; they assume children bring joy and happiness to parents; they are also of the view that they need to have children to have someone cater for them in their old age. These are all ways Ghanaians value children. As a result of the
value of children to the family and community, people are stigmatized and traumatized when they are childless. When couples remain childless after one or two years of marriage, people associate bad stories with them, especially women. Traditional Ghanaian societies consider infertility as the greatest calamity that can befall a couple. Considering the cultural value of childbirth in Ghanaian communities, anyone will argue that Ghanaians will accept ART. Before we can make such an assertion, we must weigh ethical issues concerning multiple pregnancies, surrogacy and sex selection that are likely to arise from the practice of ART.
One of the health complications that come with ART is multiple pregnancies with high risks of premature birth and weight loss. The probability of multiple pregnancies with ART is high compared to normal pregnancies. Thus, many eggs are implanted into the womb to increase the chances of giving birth in ART. The number of embryos implanted into the womb will result in the same number of babies developing. For instance, in India, the number of babies produced is estimated to be more than half a million; the probability of giving birth to twins increased from 2% to roughly 43%, and that of triplets and more increased to 3% (Dineshwori, 2021). The human womb is delicate and designed to carry one child at a time. A pregnant woman rarely conceives more than two children. Conceiving more than two babies has negative consequences like death, hypertension, diabetes, eclampsia, premature, and weight loss. It may also result in mental health and physical disabilities. To put limitations on having multiple pregnancies and its risk, often, one embryo to three embryos are implanted. The government, like the US, can pass bills to guide the practices of ART, thereby making it safe for Ghanaians.
Another ethical issue that may arise as a result of ART has to do with surrogacy. Surrogacy is when a woman gives consent to carry the pregnancy of parents unable to conceive for medical or social reasons, surrogacy is either traditional or gestational. Traditional surrogacy is when the surrogate mother donates an egg for pregnancy, while gestational surrogacy is when the surrogate mother carries and conceives the baby. One might assume it will be difficult for many Ghanaians to accept, considering her cultural practices and beliefs. Surrogacy is not without any dispute of who is the mother of the child; the method used does not count. An interpretation of the Ghanaian cultural notion of motherhood is required to resolve the ethical issue of who is the mother of a surrogate child, albeit scientifically and legally, can be settled.
In Ghanaian societies, any woman older or the same age as your mother is also your mother: a woman does not have to conceive you to be called your mother. Despite Ghanaians defining womanhood as the ability to bear a child, they are not so particular in the concepts of motherhood. A woman in the age bracket as a child's mother is referred to as the mother and has the right to care for or punish the child in the absence of the biological mother, vivid in compound houses or extended family homes. Aunties or older women are the mothers of every child in a compound house. Much emphasis is not placed on biology when defining motherhood in Ghanaian communities. Ghanaian cultures are not stringent on conceiving a child to be labelled the mother. Motherhood defines by the capabilities of a woman to care for a child. Due to this, most Ghanaian children have more than one woman they refer to as a mother. It is in this light that I seek to argue that the ethical issue of who the mother of a child is does not come up in Ghanaian society. Therefore, with much education on the benefits of surrogacy, it will be widely accepted by Ghanaians. In addition, this practice does not violate any cultural values of Ghanaians.
The practice of ART brings up ethical issues concerning sex selection reproductive technology. ART allows parents to select the sex of their child before birth. There are both natural and artificial means of sex selection before delivery. Natural has to do with taking herbs and food or tracking ovulation cycles to determine the conditions most suitable for the preferred sex to thrive better than the other. Artificial sex selection, which is much more reliable, is scientifically engineering the semen to supply more of a specific type of chromosome to produce a preferred sex. Some families usually prefer a particular sex than the other because that sex has little or no chance of inheriting a genetic disease than the other. However, some families have no medical reasons for preferring a particular sex. There are medical and non-medical reasons for practicing sex selection. The social practice of sex selection has raised the ethical issue of likely producing a gender-biased ratio population. Ghanaians have a high preference for male children because of how patriarchal Ghanaian societies are structured. Ghanaians often place higher social values on the male child than the female child. As a result, mothers without a male child go through social prejudices. Mostly, the man is encouraged to divorce or marry another woman if the first fails to produce a male child. Marital issues and the practice of polygamy in Ghana are partly because of the demand for a male child. Sex selection gives the couple a chance to select the sex of the child, thereby reducing marital issues and polygamous practices. Weighing on these benefits by sex selection, it will be accepted by most Ghanaian cultures. Some may argue against sex selection because it may lead to a gender-bias ratio population. Nonetheless, when there are restrictions on sex selection, it will not lead to a gender-bias ratio population (Morgan, 2021).
In conclusion, popular Ghanaian cultures and beliefs do not clash with the practices of ART. With the right education and restrictions put on the practice of ART, ethical issues that may arise will be resolved.
Dineshwori, L. (2021, July 25). World IVF Day 2021: The Risks of Multiple Pregnancy After
IVF. Retrieved from The Health Site: https://www.thehealthsite.com/pregnancy/infertility/worldivf-day-2021-the-risks-of-multiple-pregnancy-after-ivf-827636/
Josephine Mpomaa Kyeia, Adom Manub , Agnes M Kotohb, Charles Ampong Adjeia, &
Augustine Ankomahb. (2021). Reproductive BioMedicine and Society Online. ORIGINAL
ARTICLEBeliefs about children and the psychosocial implications of infertility on individuals
seeking assisted fertilization in Ghana, 88–95.
Kamel, M. R. (2013, July 22). Assisted Reproductive Technology after the Birth of Louise
Brown. Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799275/
Marlene B. Goldman, & Maureen C. Hatch. (2000). Women and Health. Academic Press.
Morgan, S. N. (2021). Assisted Reproductive Technologies and Indigenous Akan Ethics: A
Critical Analysis. African Values, Ethics and Technology, 229-241.