A gift for life? 

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The development of assisted reproductive technology (ART) presents new opportunities for involuntarily childless women to become pregnant and become a parent. On the other hand, it creates questions and challenges of a relational, societal and ethical character. The project “A gift for life? – a sociocultural exploration of live uterus transplantation between relatives and friends from the perspective of involved parties” addressed such questions and challenges by examining sociocultural aspects of the innovation from different actors’ perspectives.

The aim of this project was to examine how sociocultural beliefs about in/fertility, pregnant embodiment, bodily sharing and close relationships are enacted and negotiated as individuals engage with medical innovation in the field of ART. Through qualitative analysis of accounts and experiences of uterus transplantation combined with IVF (henceforth called UTx-IVF), the project examined how sociocultural beliefs and imaginaries are enacted, reinforced and challenged in the emergence of UTx-IVF. Overall, the project showed how the complexities expressed in different accounts may inform the development of care practices and policies in uterus transplantation specifically, and in the development of ART more generally.

In the medical and ethics literature on UTx-IVF, there has often been a strong focus on the extent to which this innovation offers additional benefits to those associated with the alternatives of adoption and gestational surrogacy. In such literature, a common assumption has been that UTx-IVF is less fraught with ethical difficulties and thus should be considered a less morally problematic option. The project showed how this assumption can be unpacked and pointed to how such assumptions may affect individuals’ approach UTx-IVF and the policy making around the procedure (Guntram 2020; Guntram and Williams 2018). Through an analysis of a 2016 Swedish white paper (SOU 2016:11) which considered amending existing policy regarding altruistic surrogacy arrangements we pointed to inconsistencies policy discussions with respect to altruistic surrogacy and UTx-IVF using living donors. By applying arguments for a restrictive position on altruistic surrogacy to the case of UTx-IVF using living altruistic donors we found that such arguments, if they hold in the case of surrogacy, apply similarly to UTx-IVF.

Relational dimensions and social imaginaries

Furthermore, the project demonstrated relational and gendered dimensions of UTx-IVF, which enriches discussions of risks, benefits, care and support in UTx-IVF. Through qualitative analysis of in-depth interviews with women who have considered and sometimes gone through, UTx-IVF the project demonstrated how negotiations, expectations and entanglements unfold and are managed in the search for a uterus donor (Guntram 2020). It also detailed relational contingencies at stake as UT-IVF unfolds and the potential stress and disparities in access that the requirement of bringing your own donor might entail. These results contribute to expand the ethical discussion of complications associated with the transplantation process. Relatedly, the project demonstrated how in-depth analysis of the histories of those involved, and of shared social imaginaries of reproductive liberty, medical prospects, and female embodiment, make possible for a more nuanced understanding women’s motivations for pursuing UTx-IVF (Guntram 2022). Doing so, it detailed social imaginaries – i.e. collectively formed meanings and affects that shape how we experience our bodies and the social world – materially shape bodies, life trajectories, and desires, and, consequently, women’s approaches to UTx-IVF.

Project title: A gift for life? – a sociocultural exploration of live uterus transplantation between relatives and friends from the perspective of involved parties

Funder: Swedish Research Council

Publications
Guntram L (2021) May I have your uterus? The contribution of considering complexities preceding live uterus transplantation. Medical Humanities 47(4): 425–437. DOI: 10.1136/medhum-2020-011864.

Guntram, L (2022) Reproduction and beyond. Imaginaries of uterus transplantation in the light of embodied histories of living life without a uterus. In Shaw, R. M. (Ed.) Reproductive Citizenship: Technologies, Rights and Relationships. Basingstoke, UK: Palgrave Macmillan.

Guntram L and Williams NJ (2018a) Livmodertransplantation med levande donator – etiskt dilemma? Läkartidningen 115(FEXT).

Guntram L and Williams NJ (2018b) Positioning uterus transplantation as a ‘more ethical’ alternative to surrogacy: Exploring symmetries between uterus transplantation and surrogacy through analysis of a Swedish government white paper. Bioethics 32(8): 509–518. DOI: 10.1111/bioe.12469.

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