SUBSTITUTION GESTATION: THE FAMILY IN THE DISCUSSIONS OF THE BRAZILIAN WRITTEN MEDIA

GESTACIÓN POR SUSTITUCIÓN: LA FAMILIA EN LOS DISCURSOS DE LOS MEDIOS DE COMUNICACIÓN ESCRITOS BRASILEÑOS

ABSTRACT

Objective:

to understand the different positions of the subject attributed to the family in the substitution gestation process.

Method:

documentary-type qualitative research, based on Cultural Studies, in the post-structuralism field, based on Michel Foucault's discourse and statement tools. For such, there were analyzed discourses published in the Brazilian written media, between September and December in the year 2016, on subjects who experienced the substitution gestation.

Results:

The speeches point out that the biological parents should monitor and control gestation. They emphasize that the cares with the baby, especially maternal breastfeeding, must be accompanied by the father and realized by the biological mother. Another point is that such technology makes it possible to experience the position of culturally constituted father and mother for the subjects who wish to have children. The discourses reinforce distinct roles for biological father and mother and surrogate mothers, presented as happy with this family formation. The statements divide, distribute and order the roles of motherhood between the two mothers in order in order to naturalize the substitution gestation. To this end, they reinforce the discourses on maternal breastfeeding and emphasize the medicalization of the female body in the substitution gestation.

Conclusion:

the substitution gestation was recognized as a distinct conception form, but reinforce that it does not entail another maternity form. The media are concerned with demonstrating the rituals that assist in the constitution of maternal and paternal subjects, in order to teach ways of living this gestation. Therefore, experiencing the substitution gestation is one of the possibilities for constituting a family.

DESCRIPTORS
Maternal-child nursing; Gender identity; Surrogate mothers; Parenting; Family relations; Woman’s health

RESUMEN

Objetivo:

comprender las diferentes posiciones de sujetos atribuidas a la familia en el proceso de gestación por sustitución.

Método:

estudio cualitativo, tipo documental, con base en los Estudios Culturales, en la vertiente posestructuralista, fundamentada en las herramientas de discurso y anunciado por Michel Foucault. Para ello, se analizaron discursos publicados en los medios de comunicación escritos de Brasil, entre septiembre y diciembre de 2016, respecto a sujetos que vivenciaron la gestación por sustitución.

Resultados:

los discursos señalan que los padres biológicos deben acompañar y controlar la gestación. Además, se resalta que los cuidados con el bebé, en especial la lactancia materna, deben ser asistidos por el padre y realizados por la madre biológica. Otra cuestión es que tal tecnología permite vivenciar la posición del padre y de la madre, constituidos culturalmente a los sujetos que desean tener hijos. Los discursos refuerzan diferentes roles para el padre y la madre biológicos y las madres por sustitución, presentados como felices con esta formación familiar. Los enunciados dividen, distribuyen y orden los roles de la maternidad entre ambas madres, con el objetivo de naturalizar la gestación por sustitución. Por lo tanto, se refuerzan los discursos sobre la lactancia materna y se enfatiza la medicalización del cuerpo femenino en la gestación por sustitución.

Conclusión:

la gestación por sustitución fue reconocida como una forma distinta de concebir, pero hacen hincapié en que no conduce a otra forma distinta de la maternidad. Los medios de comunicación se ocupan en demonstrar los rituales que auxilian en la constitución de sujetos maternos y paternos, para enseñar los modos de vivir de esta gestación. Por ende, vivenciar la gestación por sustitución es una de las posibilidades de constituirse una familia.

DESCRIPTORES
Enfermería maternoinfantil; Identidad de género; Madres sustitutas; Responsabilidad parental; Relaciones familiares.; Salud de la mujer

RESUMO

Objetivo:

compreender as diferentes posições de sujeito atribuídas à família no processo de gestação de substituição.

Método:

pesquisa qualitativa, do tipo estudo documental com base nos Estudos Culturais, na vertente pós-estruturalista, fundamentada nas ferramentas de discurso e enunciado de Michel Foucault. Para tanto, foram analisados discursos publicados na mídia escrita brasileira, entre setembro e dezembro no ano de 2016, sobre sujeitos que vivenciaram a gestação de substituição.

Resultados:

os discursos apontam que os pais biológicos devem acompanhar e controlar a gestação. Destacam que os cuidados com o bebê, especialmente o aleitamento materno, devem ser acompanhados pelo pai e realizados pela mãe biológica. Outro apontamento, é que tal tecnologia possibilita vivenciar a posição de pai e mãe constituídos culturalmente aos sujeitos que desejam ter filhos. Os discursos reforçam papéis distintos para pai e mãe biológicos e mães substitutas, apresentados como felizes com essa formação familiar. Os enunciados dividem, distribuem e ordenam os papéis da maternidade entre as duas mães visando naturalizar a gestação de substituição. Para tanto, reforçam os discursos sobre aleitamento materno e enfatizam a medicalização do corpo feminino na gestação de substituição.

Conclusão:

os discursos reconhecem a gestação de substituição foi reconhecida como forma distinta de concepção, mas reforçam que não acarreta em outra forma distinta de maternidade. As mídias se ocupam em demonstrar os rituais que auxiliam na constituição de sujeitos maternos e paternos, para ensinar modos de viver essa gestação. Portanto, vivenciar a gestação de substituição é uma das possibilidades de constituir família.

DESCRITORES
Enfermagem materno-infantil; Identidade de gênero; Mães substitutas; Poder familiar; Relações familiares; Saúde da mulher

INTRODUCTION

We live in a time when motherhood has been discussed, questioned, (re) organized in different contexts and situations, especially in the media texts and images. However, such affirmations as “complete family only with children”, “mother is just one”, “woman has triple journey”, “mother who is mother breastfeeds” are accepted and repeated by us, in a natural manner. Advances in technology have made it possible those women who, for some reason, can not manage to become pregnant, to have children. This fact has produced other ways of being family, mother and father. (Re)inventing this institution unsettles and puts at risk the political and socioeconomic organization in which we live, since, especially on women, there are responsibilities such as the survival, the perpetuation of the species and the perpetuation of the human “race” on the planet. Thus, the female body, because of its reproductive property (gestation, parturition and lactation), was culturally signified as responsible for the cares for education, food, hygiene and basic cares of children, and the parents should be responsible for providing income to the family. With this, the social roles are well divided, with the maternity being assigned a domestic character and paternity a public character.1

One of the possibilities that the technology provided was substitution gestation. This process, popularly known as surrogate belly or solidarity belly, is an assisted reproductive technique of implantation the genetic material of a couple - idealizer of the family - in the womb of another, which will lead to full term pregnancy.2 Such procedures can be conducted by heterosexual or homosexual couples and singles: women and men who for some reason could not, but wish to have a biological child.3 Biology and genetics have made it possible to make up a family with genetic children by infertile people, these areas of knowledge produce life technologies that involve a series of political disputes that are intertwined with a saving of life, seeking to control and manage vital processes of body and mind.⁴ Thus, substitution gestation proposes a new family organization during the pre-gestational, gestational and puerperal process for men and women.

Given its interface with nursing care and women's health, we began to research and read about substitution gestation. From this, we know the narratives of women who wanted to experience motherhood and had their stories published in newspapers, magazines and books.5^-6 Such media highlighted, above all, the importance of motherhood through maternal breastfeeding, baby care and maintenance of the descendants' genetic inheritance.

Realizing that such a procedure could (re)signify motherhood and even (re)configure the family that lives this experience, we decided to analyze the discourses of the written media observing the different positions of subject attributed to the participants in the process of substitution gestation, as well as the meanings produced by the published materials.

We believe that the media universe can be thought from its pedagogical character, because its discourses are addressed to a certain public, and different strategies are used to challenge people.7 The media is a space of circulation for wisdoms and knowledge, through certain techniques that establish power games by which we are always being captured.8 Power is not media’s power - as the manifest owner of the versions chosen or endowed with clear and logical intent - but is exercised and regulated by ideological forces that are rather political, economic and social. 9

To analyze the discourses, we formulated the following research questions: how do media discourses construct meanings for the substitution gestation? How do such discourses assign positions to the family that participates in this process? In order to answer the questions, we analyzed the discourses in newspapers, books and magazines on substitution gestation, aiming to know what has been taught by such media to readers about this topic. Thus, we study the media in order to understand the different positions of the subject attributed to the family in the substitution gestation process.

Given this, we find it important to emphasize that we are not judging such practice or women and men who participate in the gestation of substitution, nor categorizing the women who participate in this process. Therefore, in addition to questioning, dismantling, analyzing the substitution gestation and maternity practices, we place ourselves in the position of caregivers for these families in order to analyze the possibilities and effects of technology on the female body and the life of women and men who live this experience.

METHOD

Documentary research was carried out, with a qualitative approach, inspired by Cultural Studies, in its poststructuralist dimension, especially in Michel Foucault's ideas. The object for analysis are discourses about substitution gestation transmitted in the Brazilian written media.

The Cultural Studies comprise culture and its expressions as a way of life, they are concerned with showing how the media can educate and produce behavior. “We believe that in the media is where things appear and circulate more. Thus, what we are is also the result of the interpellations that the media make to us. In thinking about the media as a place where power is exercised, we remember that it can also be treated as an instance that practices the so-called cultural pedagogy, since we know that the act of teaching is not limited to school. 7^:102

According to Michel Foucault, "the production of discourse is at the same time controlled, selected, organized, and redistributed by a number of procedures designed to ward off its powers and dangers, to dominate its random event, to dodge its heavy and fearsome materiality”. 10^:8^-9

For analyzing the discourses, we use Foucault tools of discourse and statement that guided us in the direction of understanding the positions occupied by men and women who wish to have children. In relation to the statements, we seek to determine their conditions of existence, to establish their limits, to establish correlations with other statements to which they are linked, also showing what they exclude.11 Thus, “the statement belongs to a discursive formation, as a phrase belongs to a text, and a proposition to a deductive whole”.8^:31

The first place we looked for information was in Google search tool, defining as keywords “surrogate belly”, “solidary belly”,^* “temporary uterus transfer”, “replacement uterus” and “substitution gestation”. As an inclusion criterion, we opted only for written media telling stories of people who participated in such a process.

When carrying through this search in the newspapers, we perceive that the “surrogate belly” term has different meanings. It has been used in both the political and sports circles, in soccer. In politics, it refers to electoral maneuvers in which a candidate holding a large fortune sponsors another candidate with high popularity that, after being elected, departs from the position for the financier to occupy it. In soccer, “surrogate belly” is used to designate “smaller” soccer teams that receive players that are not used in “bigger” teams to get more experience and then to be sold. Such stories often appear on searches using the keyword “surrogate belly”. As a result of such, the number of these has been greatly reduced.

When one types the “surrogate belly”, in Google, we come to the Zero Hora newspaper report that told the story of two women. When reading this report, we are interested in the experience of these women and the way the media telling this story. From this, we think of looking for stories in great circulation newspapers in Brazil.

In the search for reports on substitution gestation, we conducted a survey in the newspapers Folha de São Paulo and Zero Hora. In the first one were found 1,038 reports, being selected three reports that referred to a case occurred in the city of Franca in São Paulo. 120 reports were found in Zero Hora newspaper, among them a report entitled “Solidary Belly of Porto Alegre allows a Pernambuco resident to achieve a desire to be a mother’’.

These media referred us to three other media artifacts. The first was a series of five reports from the joint edition of Correio de Gravataí and Diário de Cachoeirinha newspapers, between March and April, 2016. The second was the book Gerando amor,6 in which a couple of natives of the State of Rio Grande do Sul (Gauchos) tell their substitution gestation story in the United States. And the third, was the report of the magazine of 2016 on the book My two girls of the journalist Tetê Ribeiro5 that tells her story about surrogate belly in India. This report led us to the book that was included in the corpus of analysis.

We carried out a discursive mapping of these written media that showed stories of people that experienced the substitution gestation. The search was conducted between January and December, 2016, and the analysis occurred between September, 2016, and April, 2017. For the analysis, we organized and codified the media artifacts with the WM acronym and the numbering followed the chronological order of publication, as shown in Chart 1:

Chart 1 -
Written media codes (WM)

Written Media	Code
Folha de São Paulo: “Surrogate Belly’’, grandmother will give birth to her granddaughter in the city of Franca (SP) (09/28/2010)12	WM1
Folha de São Paulo: “My mother gave me life twice”, says mother of girl born to the grandmother (09/29/2010)13	WM2
Folha de São Paulo: Grandmother who generated her own granddaughter is discharged from hospital (10/01/2010) 14	WM3
Zero Hora Solidary belly of Porto Alegre allows for a Pernambuco resident to realize a desire of being mother (09/23/2015)15	WM4
Book: Generating love (2015)16	WM5
Correio de Gravataí and Diário de Cachoeirinha: Lavinia, the name of love (03/28/2016) 17	WM6
Correio de Gravataí and Diário de Cachoeirinha: How everything became possible (03/29/2016)18	WM7
Correio de Gravataí and Diário de Cachoeirinha: Everyone waiting for Lavinia (03/30/2016)19	WM8
Correio de Gravataí and Diário de Cachoeirinha: She is almost there (03/31/2016)20	WM9
Correio de Gravataí and Diário de Cachoeirinha: From fairy-godmother to a mother: Lavinia is born (04/08-09/2016)21	WM10
Marie Claire Magazine: Pregnancy without belly: the saga of a Brazilian whose biological daughters were born in India (05/28/2016)5	WM11
O Globo Couple of men will have a child generated by the mother of one of them (06/05/2016)22	WM12
Book: My two girls (2016)22	WM13

We emphasize that the ethical aspects related to the use of images in this work are in accordance with Law No. 9.610/1998, which deals with copyright.23 The use of such images in the public domain is ensured, especially in the affirmations of article 46, chapter IV, sections I and III, which highlights the importance of the citation of the author and the origin of the work.

RESULTS

The written media refer to substitution gestation as the last alternative to form a family with children, since that they point to adoption as the first option. Such media artifacts show that the couples opted for this new modality of family constitution when nothing else was possible, as we observed in the statements:

After two miscarriages, the publicist [Gabriela] and her husband, Eduardo Breckenfeld, 38, decided to resort to adoption. Friends and acquaintances learned on the purpose and, wanting to help, began to bring proposals from mothers who wanted to give their children. Gabriela even considered acting against the law... Finding out that the arrival of a child with the intended profile could take almost five years has shaken the hope of the future parents (WM 4). 15

Procedures performed, embryo placed and new disappointment. Vanessa [biological mother] did not get pregnant. A second attempt was made. Again the gestation was not confirmed. There were only two embryos left and the chances of getting pregnant were even smaller, which left the couple apprehensive (WM7). 18

After a seven-year journey trying to getting pregnant and already in the adoption line, she [Tetê Ribeiro] and her husband, the journalist Sérgio Dávila, had made one last attempt to have a baby genetically. And then came two, or rather two, [...] Having exhausted the possible alternatives for becoming parents, including the endless waiting line for adoption, we resort to the unknown universe of surrogate bellies (WM13).5

The media use tactics and strategies to tell the stories of the people who experienced the substitution gestation and demonstrate this new family formation way. One tactic to be used is the construction of image-likeness between subjects. The biological mother and the surrogate mother wear the same clothes and appear together in the images (Figure 1). In addition to the subjects wearing clothes with the same fabric and colors, the physical similarity among the mothers causes confusion in the reader, since they seem to be the same person. Thus, three-people gestation is demonstrated as the possibility for forming a happy family and represented as a classical formation.

Figure 1
The new family, represented by the written media as “MON-GODMOTHER”: Fabiana lent her womb to her sister”

This family conception has been reinventing itself according to certain sociocultural conditions and technological possibilities, and paternity and maternity also go through this process. This new reconfiguration of the forms and ways of living the gestation allows for making up families of single parents, happy homoaffectives or heteroaffectives, as we observe in the following excerpts:

You are pregnant, only you are not. [...]I was living in that whirlwind. You can not say "ah, it is normal". It is not normal; it is feasible (WM4).15

Once a month (Tetê Ribeiro) received a bulletin with the situation of Vanita and the babies. I took to mine obstetric, and he told me what that was meaning (blood tests, ultrasounds).5 (WM13).22

When the results of my mother's tests proved that she could generate the child, we talked to my father ... Then, we started looking for an ovule donor here in Brazil. We tried two embryos, one with Julien's semen and the other with mine. Only one worked, but we do not know from who it is. And we do not intend to know. The son is ours.6 (ME12).6

In addition to facilitating the dream of being a mother and/or father and having a family, substitution gestation provides other pleasurable moments, such as experiencing pregnancy and preparing to receive the baby, including baby shower (Figure 2), including couples in rituals and traditional family ideals. The statements and the images show this point:

In the distance, Gabriela bought clothes for Martin and Pilar, set up the room and organized a baby shower (WM4).15

Figure 2
The baby shower, represented by the written media as “FAMILY: grandmothers and aunts await the princess arrival”

The written media demonstrate that biological and surrogate mothers participate in the pregnancy, go both to the doctor's office or take the exams to their doctor to analyze, but divide the maternal roles. Surrogate mothers have to gestate, and biological mothers have other roles, since that the discourses determine that the biological mother should control, care for and watch over the surrogate mother.

The baby is very pampered and Fabiana [surrogate mother] supervised by the whole family (WM8).19

After birth, this mother dedicates her cares to the baby and becomes critical to her/his survival. Thus, the written media propose ways for biological mothers to experience motherhood and to “prove” that they love, that they will be excellent mothers, even though they have not gestated their children. To this end, some biological mothers perform hormonal treatment to stimulate the production of breast milk that makes it possible to breastfeed their baby, as stated in the following statements:

Talita is taking hormones to stimulate breastfeeding (WM3).14

I am taking drugs to stimulate the production of milk and thanks to God I am able to breastfeed my daughter. It is a wonderful, indescribable feeling, said Talita (WM2).13

Another issue is the division of what seemed indivisible a few years ago, the possibility of care in the puerperium in two women and just one gestation. The immediate postpartum is reproduced by the image (Figure 3) of the happy and fulfilled biological mother, sitting in a hospital armchair, implying that she participated in the labor process and is breastfeeding and counting on the father's support to perform this function, which can be observed in the images and excerpts:

Figure 3
Breastfeeding, represented by the written media family as “HUNGRY: soon after birth, Lavinia was conducted to Vanessa's arms for breastfeeding while the father drooled”.

After Lavinia was born, she went to the lap of the father and mother to do what is called skin to skin when the baby has contact with the parents to get to know each other (WM10).21

I have no problem with the fact that they were not born from within me. I feel 100% mom, I can not even remember that they were not generated in my belly! (WM13).22

The media present the maternal love as possible in the substitution gestation. They reinforce the notion that mother is one and irreplaceable, since that biological mothers, even if they have not gestated their children, can love them and build the bond with the child that was born by the surrogate mother.

DISCUSSION

Since the middle of the last century, new reproductive technologies have transformed our way of thinking on the split between nature and culture, “with the progress of genetics one can imagine countless families”.24^:53 However, the classic view of family, in largely reinforced by the media culture, has as a consumer audience heteronormative people, a sponsor client, who aspire to a traditional family ideology.25

When analyzing the written media, there seems to be, on their part, the defense of the substitution gestation, since that, in their statements, they try to highlight the speed and the efficiency in solving the problem of the difficulty to become pregnant. At first, the statements seem to show the difficulties through which the couple must pass before attempting the substitution gestation. They suggest that, just after certain steps, the couple would then, be released to the substitution gestation. Shortly thereafter, media discourses seem to discourage couples from attempting adoption, as they point out the difficulties and the long queue for having a child that way. In the end, substitution gestation appears as a more adequate, practical, agile and fast alternative, and, in addition, would allow the planning and organization of the couple's life. Such enunciative game makes the substitution gestation to appear as a specific and paradoxical object, as an object that men produce, manipulate, use, transform, exchange, combine, decompose, recompose, and eventually destroy.11

By using the image-likeness construction tactic among parent, biological mother and surrogate mother, the media attempts to convey the idea of three-people gestation as usual and thereby naturalizing such a practice.26 This new family modality reflects the historical changes that have taken place in the society, inspiring new family nuclei, far from those family models considered traditional and standardized.25 This family stereotype, with children, father and mother, is constantly changing in the composition/organization of family relationships, since that medical health knowledge establishes possibilities for reaching the desired family. Thus, infertile couples emerged within the genetic family universe, forcing us to rethink such a family constitution.

Another way to naturalize the substitution gestation is to announce that the biological mother can breastfeed. Since that such media seek to demonstrate that roles attributed to the mother by her biological characteristics can be lived, scientific-biological discourses gain breadth and strength, becoming truths about the process on forming masculinities and femininities.27 Such discourses are nothing more than the reverberation of a truth arising before our eyes; and when everything can be said about everything, things can return to the silent interiority of the subject and self-consciousness.10

On the other hand, gender studies consider that from the seventeenth century, there was a social construction of the kind of mother we know.28 This is nothing more than performative acts, and these performances can manifest in any body, therefore, of the tradition that inexorably links body to gender. The body, in this statute would not only be a natural thing, but a politically regulated surface.29 Thus, “the exercise of motherhood is not a phenomenon determined by nature, but a cultural practice that depends on learning. Women are not born mothers, but they learn to be mothers in different ways”.30^:97

In this way, we understand that the media discourses teach ways of being a mother, highlighting activities that must be fulfilled during the baby's waiting period and after birth. Thus, it is advised/recommended to perform the baby shower during the gestation period, suggesting maternal breastfeeding after the birth so that the woman assumes the socially constituted maternal roles. “The ritual defines the gestures, behaviors, circumstances and all the set of signs that must accompany the discourse [...]”.7^:39 Such rituals are evidenced in the statements of the media when they present the biological mother experiencing the new old-fashioned gestation. This mother can follow-up exams, control the feeding, buy the layette and even make a baby shower. Thus, the media artifacts reinforce the essentialization of woman as responsible for motherhood, they are concerned with defining and regulating what it is to be a mother within our culture. 31^-32

A classic book on the theme, written by Elisabeth Badinter, in 1985, points out that in the modernity a new mother emerges accepting and assuming ways and manners for sacrificing herself so that her child may live, and live better, thus beginning the era on proofs of maternal love. The “first proof of mother's love for the child is breastfeeding”.33^:310 The media highlight other forms of maternal sacrifice, featuring women who undergo hormonal treatments to in vitro fertilize and breastfeed, and also, report on the importance of medicalization of the female body for the success of these maternal tasks. We realize that biological mothers are concerned with occupying and exercising the role of mother constituted, distributed, disseminated, defended, and reproduced by the media and exercise motherhood in order to demonstrate all their maternal love.

Thus, the statements produce and sustain meanings about the mother who loves and breastfeeds and, at the same time, reinforce powerful discourses such as of the Ministry of Health that stimulate breastfeeding. Breastfeeding is believed to bring psychological benefits to the child and mother. Delightful breastfeeding, eye contact and continuous contact between mother and child certainly strengthen the bonds between them, providing intimacy, exchange of affection and feelings of security and protection for the child, and self-confidence and fulfillment for the woman. Breastfeeding is a very special communication form between mother and baby and an opportunity for the child to learn very early on how to communicate with affection and trust. 34^:23

In Figure 3, we can see the reproduction of the immediate postpartum, in which the biological mother is happy and fulfilled, sitting in a hospital armchair. We perceive the materialization of motherhood discourse: the mother breastfeeding and counting on the father's support to perform this function. The traditional roles of motherhood and fatherhood are reproduced in this statement, especially on gender typification, being the role of the mother represented as primary and the figure of the father as distanced, in an organization and asymmetric positioning.35 Such effects of discursively, also found in the State policies, and are grounded in historically represented competences, represented as feminine.36 We highlight that these statements are linked to a referential framework that is not made up of things, facts, reality or beings, but of possibility laws, and rules of existence for the objects that are found named, designated or described for relations that are firmed or refused among the subjects.11

The discourses and statements seek to evidence the substitution gestation as a distinct form of embryo’s conception; however, they do not lead to a distinct form of motherhood.37 They confirm that maternal love is possible in the substitution gestation, reinforcing the imaginary that mother is just one and irreplaceable. To that end, they try to emphasize that biological mothers, even if they have not gestated their children, are able to love and build the bond with the child that was born by the surrogate mother. In this way, the discourses induce us to think that such love does not have the characteristics of the relationships lived in the liquid modernity, in which we give priority to the networked relationships, which can be easily dismantled and woven according to our desires and impulses.38 If, on the one hand, statements and speeches reinforce the idea that maternal love is solid, resilient, indestructible and modern, on the other hand, there are some putting it under suspicion, and perhaps, we refuse to think that maternal love is not because we could question the absolute love of our own mother.33

In this “[…] context of social medicalization, medicine, technology and consumption are intrinsically linked, and Reproduction teclogy are one other product offered by the market of technology and medical service.”39^:3 We perceive that having a child seems to be an object of consumption, where children are desired by the joys they provide, which no other object of consumption, however ingenious and sophisticated may it be, can provide.38

Thus, we understand that the tactics used to tell stories of people who experienced substitution gestation make possible the construction of a power-learning game about the family and about the roles of motherhood and fatherhood. In this game, the statements teach us how to accept, act, look, think, live and live substitution gestation, reinforcing powerful discourses. However, we believe that the will of truth can be seen as prodigious machinery intended to circumvent the already told and said truths. Therefore, nothing prevents them from being placed under suspicion so that none of them will continue being ignored. 11

We point out as limitations of this study the corpus of analysis, that is, the use of written media artifacts that told stories about substitution gestation experienced by Brazilians, so that the information can not be generalized. In other countries the results may be other due to cultural differences, since that media positions the family in culturally constructed maternity and paternity roles. However, the results make possible new research related to the theme, especially in relation to the nursing care that could be provided for this new modality of gestation and family constitution.

CONCLUSION

Media discourses place biological parents and mothers to experience substitution gestation by exercising culturally constituted maternity and paternity roles. To do so, they teach behaviors that produce a file of ways of being a mother and father and living the substitution gestation. In this way, they reinforce the image of the woman who loves this child unconditionally, even without having conceived, and reaffirm the idea of solid and unfailing maternal love. With this, they reproduce and intensify the maternal role instituted by the public health policies.

Another way for positioning the family in the traditional roles of maternity and paternity is highlighting the possibility of living a gestation according to the norms, when they demonstrate the parents experiencing rituals of baby shower, gestation album, breastfeeding and organization of layette. In this context, the media seek to emphasize the happiness of the biological parents and mothers during the gestation, demonstrating that such gestation can be lived in a natural and socially accepted way, so that this new family arrangement is possible and happy.

On the other hand, the reports and books omit the conflicts and dilemmas experienced during the substitution gestation, especially the anxieties and insecurities of having a child born in another womb. Omitting these concerns is part of the discourse, that is, the unspoken is a technique that is used to make up the representation of motherhood and paternity in a romantic way.

Caring for these women, these mothers, these bodies, this family, since the period before pregnancy to the puerperium, is one of the challenges for the nurse and for the multidisciplinary team. Substitution gestation can bring sadness, depression and grief to the biological mother, as she may experience mourning for the loss of the idealized baby that has been gestated in another body. We believe it is important for the multidisciplinary team to be attentive to these signs to build this woman's care plan. Thus, we consider it is important to discuss what, how, with whom and what cares should be addressed in the puerperium consultations, both for the biological mother and the surrogate mother.

Throughout the analysis we observed that the media sought to highlight the roles of biological father and mother, giving visibility to these subjects. With this, we identified issues that allowed the development of new research on substitution gestation, especially research on surrogate mothers and their torments during pregnancy. Another possibility would be to investigate the adversities experienced by fathers and mothers during the substitution gestation, seeking to represent it in a less romantic way.

Therefore, we believe that we must (re)think about our practices, since that substitution gestation can lead to complications and constraints for the surrogate mother who will not breastfeed, mainly because of decreased oxytocin production, impairing uterine involution in the post- childbirth Finally, we emphasize that in this context, it is important to update, (re)invent, (re)signify the teachings, reception and nursing care for these women and for the new families, considering the possibilities that the new technologies have been imposing on the body.

REFERENCES

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NOTES

• *
  First, it was acessed the link in https://www.facebook.com/Barriga-Solid%C3%A1ria-Uma-chance-de-Expandir-oAMOR-pelo-AMOR-25496294172458/, just after it was identifyed the Zero Hora newspaper report.

• ORIGIN OF THE ARTICLE

  Extracted from the dissertation - Who goes out to your own does not degenerate? the (dis) order of the gestation of substitution, of the Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Sul, in 2017.

• CONSENT ON USE OF IMAGE

  The reproduction of the photos used in this research was authorized by the author.

Publication Dates

• Publication in this collection
  01 Aug 2019
• Date of issue
  2019

History

• Received
  02 July 2018
• Accepted
  04 Oct 2018