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Excursus: Plannable pregnancy

Freezing eggs as a precautionary measure so that you can still get pregnant later – at a time when your natural egg reserves are depleted? Or having a simple blood test to check whether your unborn child has a chromosomal abnormality, such as Down syndrome? These two examples show the possibilities that modern medicine offers in the field of reproduction today.

Who is driving these developments? Is medicine creating more and more services that are utilised because they are "just there"? Or is medicine responding to social demand?

Medical services must always be seen in the context of social developments - and can in turn have an impact on them. "What is common and widely accepted in society in terms of prenatal examinations is also influenced by how 'easy' and methodologically risk-free a technique is to use," says Prof Dr Christiane Woopen, medical ethicist at the University of Cologne and Chair of the European Ethics Council. "The social consequences this can have and the serious conflicts for the pregnant woman associated with the result can increasingly fade into the background."

How is an "increased risk" defined in a pregnancy when the range of diagnoses ranges from mild to severe impairment of the unborn child? Is the pressure to have a "normal" child becoming ever greater? And what if the question of abortion arises?

Then there are the social conditions within which people decide to have children. With permanent employment contracts and/or family-friendly employers, family formation is less risky than in a professional environment in which even an announcement of parental leave can cause lasting disgruntlement among superiors.

A broad range of local support services for life with children also provides greater security: an infrastructure designed for families with a sufficient number of daycare places, sports clubs, playgrounds and cultural programmes. And in the event that a child with disabilities is born, there needs to be a political and social willingness to take them in, as well as an individual willingness.

The discussion paper "Plannable pregnancy - perfect child?" published by the Leopoldina together with the Konrad Adenauer Foundation in February 2019 deals with the various facets of this topic. Interactions between medicine and society".

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