Pregnancy and childbirth from the bioethical standpoint

17 April 1998


The ICB deals with the ethical issues connected with care during pregnancy and childbirth, recognised “vital conditions” for the woman and the unborn child, which appear worthy of protection not only in relation to the life and health of each individual, but also deserve dutiful assistance in the psychological and social field. The opinion focuses on some social phenomena, which, in addition to the falling birth rate, the progressive shift of the age at marriage and the postponement of the birth of the firstborn, which determine an overall increase in the age of the woman at first pregnancy, reflect on the characteristics of the care proposed to the pregnant woman. A consequence of this is the extremely high “emotional investment” of parents towards their children, strongly imposing on themselves the notion of “preciousness” of embryo-foetal life which has led to a greater commitment in caring for the newborn baby’s health. This tendency has determined a medicalization of pregnancy, from which prenatal medicine has ensued.

The ICB also deals with assisted procreation techniques, drawing attention to the issues related to the risk both to the mother and the unborn child (with particular reference to prematurity and possible embryonic selection). The ICB is eager to denounce that the equality to which any future child is entitled, albeit undeniable on purely ethical grounds, finds many exceptions in the current reality of being born, as the existence of disease and hazardous events seem able to influence, if not the affirmed right to life and the pursuit of happiness, at least its area of application. Therefore, it is hoped that the positive affirmation of the value of life will prevail as an ethic conquest in a technological society in continuous growth and that the right to be born of every child will always be guaranteed and reiterated as a “duty” of all those who are capable of offering it help.

Considering this, the ICB, deems it appropriate to affirm the following conclusions: in the treatment of infertility and the search for responsible paternity and maternity, the prophylaxis of induction of multiple pregnancy must be pursued by highly experienced personnel and in facilities furnished with all the appropriate diagnostic equipment; it is unanimously agreed to request that in the case of recourse to in vitro fertilisation techniques and repositioning of embryos in the uterus, these should be compatible with the potential survival of all embryos; the right to be born, when the capacity of autonomous life has been reached, should be recognised to everyone, as it is untenable, on ethical grounds, to make a selection regarding survival among human beings based on their degree of health.

The ICB also emphasises the importance of proper and continuous prenatal care for the woman and the unborn child, as well as the significance of adequate training and collaboration of health personnel. The ICB recommends that giving birth at home should only be possible in a limited number of cases, however, it encourages maximum humanization of the hospital environment; in this context, it reiterates that the current tendency to favour caesarean section is not acceptable, unless strictly motivated by objective clinical “indications”. The Committee, recognising suitable legal protection of women when pregnant and giving birth as regards abstention from work, urges law makers to define more fully legal protection of the unborn child;

lastly, the ICB considers it the duty of the Public Health Service to make basic policy choices having as their primary objective the health of the mother and the unborn child.

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