Reproductive health law, surrogacy experts: There must be very strong criteria!

In Albania, the Ministry of Health has recently submitted for public consultation a draft law on sexual and reproductive health. The project has sparked debates over several innovations related to medically assisted reproductive therapy procedures, which are currently not fully regulated by law. Professionals in the field of medicine say for the Voice of America that the draft law has shortcomings and does not deal in depth with the problems related to the fetus and the mother. A very controversial moment is related to the involvement of the surrogate mother.

Representatives of the health system and experts on social developments in the country are raising concerns about the draft law on sexual and reproductive health. The obstetrician-gynecologist, Astrit Bimbashi, tells the Voice of America that together with a wide group of doctors, they were waiting for legal regulations for assisted medical reproduction therapy. For 20 years, there has been no control in this field, he says, while adding that even this draft law leaves a lot of ambiguity.

"The draft law is deficient because it does not mention social, psychological or economic incentives, so nothing. It is simply allowed or forbidden. The inclusion of the term sexual and reproductive has manipulated those who made this law, to call reproduction as assisted reproductive therapy. I think that the word "sexual" in the name of the bill should be removed and the reproductive health law should remain, which has several basic points: pre-reproduction, reproduction and post-reproduction, adolescence, the mother who gives birth to a baby from 0-6 years old, as well as post-reproduction menopause until the woman's death. But to make 7 pages about reproductive medical therapy and leave with three lines a major problem in Albania which is feto-maternal health, we don't think it's right" - argues Astrit Bimbashi, obstetrician-gynecologist.

The inclusion in the bill of a woman's right to become a surrogate mother has sparked a lot of debate. A surrogate mother is a woman who becomes pregnant through an embryo created by in vitro fertilization, and carries a fetus in her uterus until birth on behalf of another couple, who is unable to give birth to a child in the normal way. Currently in Albania, in vitro fertilization has been regulated by law for more than two decades, and is performed almost entirely in private health institutions. But in some of these, even though it is not provided for in the law, medically assisted reproduction procedures have been carried out for some time, with surrogate mothers, or as it is called "surrogacy". The obstetrician-gynecologist Afërdita Manaj welcomes the inclusion in the bill of this technique in reproductive health, to help family well-being and a woman who cannot give birth.

"Surrogacy is necessary. Let's not close our eyes and act like it's not done here. Therefore, it should be regulated by law, controlled by the state. Taxes should be imposed for this medical service and controlled. To protect human rights. The law avoids abuses" - says Prof. Dr. Afërdita Manaj, obstetrician-gynecologist.

The field of action of the draft law is also for foreign citizens, which means that they can also carry out medically assisted reproduction procedures, including surrogacy, in Albania. The discourse of the surrogate mother in Albania is aimed at a time when the European Parliament has just approved new rules for the prevention and combating of human trafficking and the protection of its victims. The new law, which was approved with 563 in favor, 7 against and 17 abstentions, also penalizes forced marriage, illegal adoption and the use of surrogacy at the EU level.

Even though the obstetrician-gynecologist Bimbashi admits that he has performed such procedures in the private health system, he is skeptical about them.

"We as a clinic have performed cases before, but never for a fee. Being a very delicate matter, we asked the woman to find the surrogate mother herself. It is a tragedy for a married couple not to be able to have children. But from the political side, when I see that the European Parliament votes with 563 votes against surrogacy, and only 7 votes in favor, it means that you cannot turn this product into what you think it should be" - argues Astrit Bimbashi, obstetrician-gynecologist.

Carrying out medically assisted reproductive procedures through surrogacy is a very expensive practice, experts say, and can encourage abuse.

"I very much agree that surrogacy should be carried out for mothers who need it, but there must be very strong criteria. Certain diagnoses must be determined that influence couples not to have children and go towards surrogacy. If we leave it free without strong controls, so that foreigners can come and do surrogacy in Albania, for diagnoses that can be made up or falsely created by doctors, it can lead us to abuses for reasons of profit. "- says Alban Haxhi, obstetrician-gynecologist, for the Voice of America.

One of the other aspects of the draft law, where experts in the field of medicine and social developments are concerned, is related to the increase in the time for termination of pregnancy, with the woman's desire for various reasons, from 12 weeks to 14. The reasons are still unclear. of this new legal definition, but experts think that this postponement in time raises many discussions as the gender of the fetus becomes distinct and this may promote the phenomenon of selective abortion.

"Postponing the term for the voluntary termination of pregnancy from 12 to 14 weeks allows the criminal trend of selective abortion, due to the difference in the sex of the fetus. When it comes to selective abortion, we are compared to Azerbaijan and some other countries that have it at a high level. I think that selective abortion is criminal," Gëzim Tushi, a sociologist, told the Voice of America.

Gynecologist Afërdita Manaj also believes that in this context the draft law should be revised.

"Perhaps voluntary termination of pregnancy from week 12-14 should not have been allowed. Until week 12 it was fine. I am not of the opinion that this should become routine because many people can use this to choose the gender of the child" - argues Prof. Dr. Afërdita Manaj, obstetrician-gynecologist.

The Ministry of Health, in a public reaction after critical positions on the new elements brought by the draft law "On sexual and reproductive health", stated that this document has been submitted to public consultation that will help absorb the opinions of interest groups and guarantees that at the end of this process, the draft law will also reflect the conclusions drawn from these consultations./VOA