Essay on Prenatal Exposure to Teratogens: Impacts on Fetal Development and Long-Term Effects

Introduction

Teratogens in humans are agents that alter the growth structure of an embryo, therefore leading to congenital disabilities. Around the world, birth defects are the leading cause of mortality (Naroozi et.al 2018). Fetal development is significantly impacted by prenatal exposure. Those who survive infancy struggle with lifelong mental and physical disabilities. Teratogenic agents include growth retardation, malformations, and functional disorder, long term effects on behavior and cognition that may appear later in life. Many factors influence the issue of teratogens, including ethical considerations and cultural beliefs as discussed below.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

Ethical obstacles in addressing the issue of teratogens

Ethics is a field of religion or philosophy that concerns itself with the systematic and moral life and the conflicts involved. Ethics is a generic term for the process of understanding moral life and resolving ethical problems. The ethical principles of medical genetics include respect for the autonomy of persons. Ethical principles include respecting self-determination and respecting their autonomous decisions. The beneficence principle requires that medical practitioners have the best priority for the welfare of persons while maximizing health benefits. (Naroozi et.al 2018). The principle of maleficence requires that there is the prevention of harm to persons or minimizing damage. Above all, justice should be done, where medical practitioners give equal treatment to everyone.

The major ethical issue in medical genetics includes voluntary versus mandatory counseling, safeguarding individual choices as parents, full disclosure of information, testing, and screening, equitable access to services privacy of information from third parties, directive versus non-directive counseling, confidentiality versus duty to inform relatives at risk, non-medical use of parental diagnosis (including sex selection) and issues of gene therapy and research (Naroozi et.al 2018).

The other ethical obstacles faced by medical practitioners stem from practice, which is the fear of exposing the mother and fetus to research. For the long term, many institutions and researchers consider pregnancy a reason for exclusion from research studies (Lyerly & Faden 2013). This has been the norm even when the risk is negligible and the research addresses critical issues of fetal or maternal health. Also though such exclusion is done in the spirit of protecting the mother and the child, such decisions to exclude them from the research agenda come at the profound cost of the mother and the child equally (Lyerly & Faden 2013). Another ethical obstacle is fetal safety, which tops the list of excluding women from research. According to reliable research, this concern is somewhat misplaced. Studies show that simple exclusion does not protect women. Also, half of the pregnancies are unintended, making the women expose themselves to harm even before they know they are pregnant (Lyerly & Faden 2013). Other women being treated for mental illnesses with psychotropic medications become even more complicated. With multiple factors coming into play, the reluctance to include pregnant women in research exposes millions of babies and mothers to unacceptable risks (Lyerly & Faden 2013).

Additionally, there is the ethical concern of equity. There needs to be fair enrollment of the subject for clinical research to be ethical. This principle requires that the subjects or a particular group ought to bear their burdens in participating in the study. Also, a dilemma arises when the interests of the mother conflict with the interests of the fetus. Medical practitioners can use a variety of ethical frameworks to support their clinical decision making. The moral theory instructs that ethical practitioners in such scenarios accept the informed consent of the pregnant woman; in refusing or receiving treatment depending on her autonomy.

Observational research shows another obstacle being individual choices by parents. Untreated maternal mental disorders can affect the child. Fetal growth retardation is associated with mental depression. Maternal severe mental illness is also associated with smoking, alcohol and substance abuse, poor nutrition, and failure to access parental care (Garcias & Schüler-Faccini 2014). All these factors affect the fetus and show how individual freedom and choices versus mandatory counseling comes into play. Coercion is not ethically permissible in such a case because the woman should have full control of her body.

The inclusion of women in research is essential in making significant findings of disease and health in women (Lyerly & Faden 2013). Over the past few years, attitudes on the integration of women in research trials have changed dramatically. More women are now being recruited into research, including pregnant women.

Cultural norms or issues influencing the issue of teratogens

Pregnant women heavily rely on informal information in making decisions regarding their pregnancy (Garcias & Schüler-Faccini 2014). To properly understand cultural practices influencing decision making during pregnancy, it is crucial to recognize cultural attitudes. According to Cohen et al. (2008) beliefs amongst pregnant women determine when they seek prenatal care.

There are many advances in medical research regarding teratogens; however, very few women have information regarding the risks associated with teratogens. There is an elevated risk of teratogenic exposure due to perceived threats (Cohen et al. 2008). Research shows that patients have inaccurate perceptions of risks and find it difficult to understand their risk. Due to this elevated teratogenic risk perception, some exposures can lead to confusion and anxiety amongst pregnant women. Such perceptions of teratogenic risks have been associated with guilt, anxiety, fear, and in some cases, terminations.

In addition to these perceptions regarding environmental, medical exposures, there are also cultural beliefs regarding pregnancy and congenital disabilities. A study by Cohen showed how ethnicity influences the views of individual’s affect their perceptions of defects during pregnancy and birth (Cohen et.al 2008). According to research, a population of Latinos have a popular belief about the "evil eye." According to this belief, the monovalent eye glance of the eye, or pregnancy during the lunar eclipse can lead to birth defects such as a palate or cleft lip (Cohen et.al 2008). Additionally, religiosity is also linked to childbirth defects. In the African context, illnesses and childbirth are related to religious beliefs and even witchcraft (Aziato et al. 2016). During pregnancy, pregnant women are known to intensify their prayers for protection, blessings, and safe delivery. Women in such settings also explore traditional and spiritual options to ensure that they have a safe delivery. The prayer offered to God increases their faith in God and hope that there will not be any defects at birth (Aziato et al. 2016). Certain religious rituals are performed for pregnant women during pregnancy (Cohen et.al 2008). Such rituals include anointing expectant women with holy water. These beliefs prevent the women from seeking proper medical attention leading to complications and giving birth to unhealthy babies.

Other researchers report other cultural practices during pregnancy and post-partum. These cultural practices include restrictions on food and water. It also involves avoiding specific places like graveyards and not going to particular locations (Cohen et.al 2008). There are also specific dietary restrictions, such as avoiding fish. Consumption of fish is believed to predispose women to dietary restrictions. In specific cultural settings, spirituality and childbirth go hand in hand.

A study in Brazil on congenital malformations showed that the causes included substance abuse, marriage between relatives, smoking, and rubella infections. Most of them had erroneous ideas regarding the cause of their misery (Garcias & Schüler-Faccini 2014). The study group consisted of women from all socio-economic groups. In Australia, they believe that it is crucial to follow certain traditional beliefs during pregnancy. Women do not eat certain foods during pregnancy; at labor, women have to lie down for hours; others follow strict rules of staying in bed for several days before and after childbirth (Garcias & Schüler-Faccini 2014). Many mothers have conventional wisdom which is not scientific, this leads to the suffering of most women.

The cultural perceptions generally predispose pregnant women to the risk of getting a child with malformations. This is due to a lack of information, traditional beliefs, or cultural practices that prevent them from seeking proper medical care and counseling (Garcias & Schüler-Faccini 2014). Because many genetic counselors offer their services to many populations, they should consider cultural factors when giving advice. Counselors need to appreciate the cultural codes of their patients and use them in providing proper counseling.

Conclusion

Although many congenital disabilities cannot be prevented, the probability of occurrence can be managed through awareness of the various prenatal factors (Lyerly & Faden 2013). Risks to the fetus's exposure can be decreased if the mother is aware of any vulnerabilities. Therefore, every mother must accept that congenital abnormalities can occur and take steps to prevent such occurrence. Further, early detection and treatment can reduce the long-term impact of congenital conditions (Lyerly & Faden 2013). The medical fraternity should not hide behind the claims that ethics precludes the inclusion of pregnant women and their interests in research. Ethics should be more precise, and justice demands that there should be an inclusion of pregnant women. Over time, pregnant women have not benefited from the research enterprise, and it's about time they also helped.

References

Aziato, L., Odai, P. N., & Omenyo, C. N. (2016). Religious beliefs and practices in pregnancy and labour: an inductive qualitative study among post-partum women in Ghana. BMC pregnancy and childbirth, 16(1), 138. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0920-1

Cohen, L. H., Fine, B. A., & Pergament, E. (2008). An assessment of ethnocultural beliefs regarding the causes of birth defects and genetic disorders. Journal of Genetic Counseling, 7(1), 15-29. https://onlinelibrary.wiley.com/doi/pdf/10.1023/A%3A1022812027511

Garcias, G. D. L., & Schüler-Faccini, L. (2014). The beliefs of mothers in southern Brazil regarding risk-factors associated with congenital abnormalities. Genetics and Molecular Biology, 27(2), 147-153. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-47572004000200003

Lyerly, A. D., & Faden, R. R. (2013). Mothers matter: ethics and research during pregnancy. AMA Journal of Ethics, 15(9), 775-778. https://journalofethics.ama-assn.org/article/mothers-matter-ethics-and-research-during-pregnancy/2013-09

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian journal of public health, 47(6), 875. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077627/