Why Suba North MP wants Bills on reproductive health passed

According to WHO, clinical infertility is when a couple has been unable to conceive after one year of frequent unprotected sex.

Assisted medical reproduction involves using technology to achieve pregnancy. Examples include intrauterine insemination where sperms are placed in a woman's uterus to facilitate fertilisation.

There is also In Vitro Fertilisation (IVF) where the eggs are harvested and put together with sperms in a petri dish and fertilised then the embryo is transferred into a woman's womb.

According to the Bill, a person qualifies for assisted reproductive technology where it is certified by a medical doctor, and cannot use that procedure for any purpose other than human procreation.

Millie says the Bill emanates from her own experience and the experience of friends whom she has seen struggling with procreation.

"After undergoing heavy menstrual periods for years, I was diagnosed with fibroids. I could not have children or get pregnant in my prime. Even after the fibroids were removed, I had no clue about assisted reproduction technology and didn't know that I could still have a child," says the Suba North MP.

She adds that women also don't get preconception information and some give birth to babies who don't survive for long.

"They end up thinking they have been bewitched yet they have genetic conditions affecting their pregnancy or their newborns. The Bill is advocating for women to have access to preconception information."

The Bill says no person shall obtain sperm or ovum from a donor under 18 years.

The challenge is that Chapter Four of the Constitution stipulates that life begins at conception. But in assisted reproduction, it's difficult to define at what point conception is done; is it after fertilisation in the petri dish or after implantation of the embryo in the uterus?

The other challenge is what happens to embryos that are not transferred to the uterus, if they get thrown away is it abortion or murder? What if parents die and someone else carries the embryo, do the children have the right to inherit their dead parents' property?

The Bill also will give direction to women who need a third party, especially when they don't have eggs or a uterus and need an egg donor or to rent a uterus. The Bill will also clarify at what point one needs gamete donation (sperm and egg).

"At the moment there are no laws that prohibit the number of embryos to be planted, but there are countries where you only implant one embryo at a time. Bearing in mind the more embryos implanted the higher chances of a multiple pregnancy which are problematic," says Ayieta Lumbasyo, a legal and ethical officer at Nairobi IVF centre.

The Bill says in the event of multiple pregnancies arising out of a surrogacy agreement, all the children born out of the pregnancy shall belong to the commissioning parents.

Dr Lumbasyo suggests that if the assisted reproductive Bill becomes law, it should be able to answer various questions on regulations and policies on sperm and egg donors, confidentiality, eligibility of the donors and surrogates, disclosure of risks, at treatment level how many embryos should be created, donor anonymity, registration of children born out of surrogacy, how long one can preserve their eggs and much more.

In the Bill, the technology expert is mandated to ensure confidentiality is maintained throughout the entire process and all parties are aware of the rights of the child born through the reproductive technology process

Through a signed agreement with the third party, the Bill stipulates that the surrogate mother who carries a child on behalf of a couple shall relinquish all parental rights of the child at birth.

The Bill suggests that "a person shall not do any act at any stage of the assisted reproductive process to determine the sex of the child to be born."

While giving feedback on the Bill, Yatta MP Robert Basil suggests that one should be allowed to choose the baby they want so as not to be discriminatory of people's choices.

Women opt for surrogacy because they may lack a uterus, have significant uterine diseases like fibroids or endometriosis, repeated IVF failure, have high blood pressure, have cancer, age, have donated organs, or are biologically unable to get pregnant.

The Assisted Reproductive Bill of 2019 did not see the light of day in the Senate when it was tabled.

Gilgil MP Martha Wangari says the Bill failed because most legislators thought it would allow gay people to start families.

"The LGBTQ factor has made a lot of good laws die, as the church will be up in arms saying if it's a social adoption arrangement, then we will have gay parents having surrogates to carry their children," says Ms Wangari.

The biggest challenge in surrogacy is at birth registration where the person giving birth is registered as the mother. The Bill is trying to come up with a way of ensuring registration of the intended parent.

"Those who get a child through surrogacy have to go to court to adopt their baby so that they can be legally theirs, yet the eggs and sperm are from you and your spouse. We need to have a simpler way of transferring the legal parentage to the intended parents" says Millie Odhiambo.

The Family Reproductive Health Care Bill 2022 will deal with issues of access to reproductive education and information, access to preconception information and services, family planning, safe motherhood, fatherhood, and reproductive healthcare for men.

"I want to tell our religious leaders that when you hear about reproduction it is not about abortion, it is about conditions affecting the reproductive health of men and women and also addressing the issue of our young women dying from unsafe abortions" says Millie.