An interview with Quiana, Clinical Nurse Coordinator at WFI

Quiana works in the field of Women Health since 2005. She started in an OBG Clinic in where she gained a lot of knowledge regarding the fertility industry.

Quiana is a Clinical Nurse Coordinator at Western Fertility Institute.

I found it interesting and quite amazing what female bodies can do. It is a life outside of the body, it is like something between nature.”

Quiana works with egg donors, surrogates and people with different fertility issues. I asked her to describe her work with the 3rd parties. She follows egg donors and surrogates during the first part of the process, educating these women about the medication they have to take.

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Most of the women I speak with are educated. They want to know, they ask a lot of questions. I explain to them the medications and I ensure they are taking it on time.

Quiana explained to me the egg donation process. The ovarian stimulation takes from 7 to 10 days, sometimes much longer, it depends on the cases. When the injection starts, the donors are followed during the journey. On the 3rd day, 5th, 7th and 9th day, the blood test and the ultrasound occur to evaluate their response to the medication.

Every person has a different response. We make sure they are followed and there is no a hyper stimulation”.

On the 10th day, there is the trigger shot and 36 hours later the egg retrieval takes place. At that point, the egg donors are followed by medical assistants (for example, like Leslie).
Quiana also follows the surrogates. For gestational carriers, the process is longer because they have to prepare their uterus for the embryo transfer. As Quiana said:

The line of the uterus needs to be around 7mm. There are 3 weeks of medication and during the 4th week, the transfer occurs. We follow them until the 10th week of their pregnancy”.

The critical part of her work, as she said, is when the IVF doesn’t work, because she knows all the efforts that the people involved in these pathways went through. However, at the same time, she loves when she hears about the outcome of a new baby.
I asked Quiana her favorite part of the job and she mentioned, it is when the patients come back to visit the clinic.

Because also if they are the one that made everything, they show us a lot of gratitude and appreciation for the help we gave them”.

“My Bun, Her Oven”, an Anthropological Review

The anthropologist Elly Teman has conducted a field-based research about gestational surrogacy (GS) in Israel between 1998 and 2006, interviewing and observing the interactions between surrogates and intended mothers. “My Bun, Her Oven” is just one of the several publications she has written in this field.

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Elly Teman starts her article by paying attention to the social answer that surrogacy in general receives, saying that the large portion of the thoughts express a sense of discomfort with surrogacy. As she wrote, gestational surrogacy is challenging some of our most deeply conceptual categories, introducing an ambiguity in the concept of motherhood (Teman, 2010), and causing a more visible fragmentation of it – biological motherhood, genetic motherhood and social motherhood (Ragonè, 1994). At the same time, GS reveals the strong cultural assumption in Western society that women “naturally” develop instinctive bonds and love with the babies in their bellies, and they won’t give the babies away unless they are desperate, forced, or out of their minds. For this reason, as Teman has written, surrogacy has been read and treated like a “cultural anomaly”.

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Also, the cases reported in the news help relieve our cultural anxieties about surrogacy. It helps us to prove that our believes are rights and that woman really wants love and take care of the baby she was carrying. We ignore that the large majority of surrogates does not hesitate to relinquish the baby and are happy of it (as reported in the article, out of 25.000 surrogacy births in the US, no more than 30 cases have reached a courtroom).  If the large part of the population believe that mothers have a “natural motherhood instinct” that conduct her to love and feel the baby, in this frame, it is easy to understand why a woman who says “I am not the mother, I am just the oven”, can be seen strange to people, assuming that surrogates are alienated from their bodies.

The article continues introducing the thoughts of one of the most influential anthropologist of the last half-century, Mary Douglas. She taught us that there are many ways to manage the “anomalies” and to protect our categories; in other words, there are many ways to bring back the order caused from a cultural practice that has introduced a change in our system, what most of the people see like an anomaly. The most common answers are: fully banning them, avoiding them from imagining it ever existed or using the anomaly ritually or symbolically to find a way to incorporate it within the accepted cultural values.

Teman has used the category introduced by Mary Douglas to read the experience of the subjects involved in her research. In “My Bun, Her Oven” she has shown how these women tried to resolve the anomaly introduced by the surrogacy, using the meanings she collected during her fieldwork. For examples, surrogates used many strategies to distance themselves from the so called “surro-baby”, using the genetic disconnection for distancing themselves from the title of mother. At the same time, the intended mothers wanted to take this “title”, wanting to be recognized as the only Mother, publicly and privately. How? They participated in many of the symbolical actions that common mothers do: reading pregnancy books, accompanying the surrogate to every doctor appointment since the delivery. In other words, they were experiencing the pregnancy from the “outside”, acting they were pregnant too.

As Teman has shown in this article, both Israeli intended mothers and surrogates used some symbols and rituals to describe their surrogacy’s experiences. With their stories and thoughts surrogates and intended mothers are slowly deconstructing the ideological idea of motherhood, showing other different meanings related to that.

As Teman suggested anthropologists provide insights starting from the ways people involved in the practice give meanings to their actions (2010:33).
During my research, I will use Temas’s article to understand and read the way in which surrogates often describe the relation with the baby they are carrying. Below one example collected during the fieldwork:

S.: “You know, it is hard to explain what I think about it. Maybe it sounds weird, but I don’t feel any maternal bond with the surro-baby I am carrying. I know he is not my child because we don’t have any genetic connection […]

S.(Encino, 11/02/17).

 

References
Ragonè H., 1994, Surrogate Motherhood: Conception in the Heart. Boulder, CO: Westview.

Teman E., 2010, “My Bun, Her Oven”, Anthropology Now, vol.2 n. 2.

 

“What Egg Donation is All About”. An Interview with Leslie, Medical assistant & Senior Egg Donor Coordinator at WFI

Leslie began her journey at the Western Fertility Institute as an intern in April, last year. Throughout the process she became a Medical Assistant in April, and a Senior Egg Donor Program Coordinator. As Leslie said, she had a “very big teacher, Quiana”. She was taught about fertility and surrogacy during her internship; before that, she never thought about working in this field.

A medical assistant helps nurses and doctors, and has several other functions. Leslie spends most of her time doing blood work. As she said, taking blood is not just a routine job: “I am kind of a confidant for surrogates and egg donors. I try to construct a personal relationship with them. I know their journey, their troubles, their history…”.

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She continuously follows the journey of the egg donors. Leslie is by their side for all the steps of the procedure. There are many reasons why a woman enters in the egg donation process. As Leslie pointed out: “Whatever the reason why a woman is making this act, she needs to be informed more about the process of the egg donation. She is giving a part of herself away, it is a part of them”. She makes sure they are informed of the possible connections that egg donation can construct.

As she explained to me, every donor receives a different protocol. In general, the medication that a donor has to follow takes about 10 days. Every 1 or 2 days, the donor has to make a blood analysis at WFI in order to see if the follicles are growing (2mm each day). When the eggs are “ready”, the egg retrieval occurs. At WFI they are performed every Wednesday and Friday. The whole procedure takes about 2 hours: 30 minutes to prepare the patient for the surgery, 15 minutes for the retrieval itself, and the time left for the recovery. “We wait until the patient feels comfortable, we control the situation and make sure everything is fine”. Leslie follows donors throughout all the journey.

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She works also with the surrogates, but the relationships she constructs with them are quite different. If a donor is going to WFI every 2 days, the surrogates spend less time at the clinic. The relationship that Leslie is building with the donors is more intense because they spend more time together talking about egg donation, the medications, but also about the everyday life. She said that probably this connection she feels is related with the age and the experience that the patient has. In comparison to the donors, the surrogate already knows what a pregnancy is, they know what to expect from it. “They had experienced the gestation, so they know what will happen to their body. Yes, they ask a lot of question about the medication, and in general, about all the medical procedures. I make sure donors understand what egg donation is all about. I make donors understand the procedure. I try to explain to them all the information I know; it is a way to keep them more involved. They can trust us. They become basically family with us”.

I asked Leslie her favorite aspect of her job, she mentioned: “My favorite part is connecting with people. I love helping people with their journey. I am part of their story, I am helping them to create a family”.