title: Cross-border reproductive care for law evasion: a qualitative study into the experiences and moral perspectives of French women who go to Belgium for treatment with donor sperm.
abstract: One consequence of the legal diversity in Europe is that legal restrictions on treatments can be evaded by going abroad. Many French lesbian couples and single women are crossing the border to Belgium because they are denied access to treatments with donor sperm at home. This is the first qualitative research study into the experiences and moral perspectives of these women. Between June 2012 and May 2013, 11 lesbian couples and 2 single women were recruited at the department of reproductive medicine at Ghent University Hospital. The data from the semi-structured interviews was analysed using inductive thematic analysis. The results show that these women face several additional challenges to the already difficult process of cross-border treatment. Before they can start the treatment, they can only obtain information from the internet or from stories of friends who also went abroad for treatment with donor sperm. During the treatment, they need to find local clinics or physicians to monitor their cycle. Several women managed to game the French system to ensure partial reimbursement for their treatment when they were successful in finding a physician who was willing to prescribe drugs and perform tests. Most women had difficulties justifying their absence from work. In general these women felt that they were discriminated against and that their rights were not protected because of who they are. In that regard, the lack of legal recognition of the genetically unrelated partner in their country was particularly hard to cope with for the lesbian couples. These women have to develop many different strategies to deal with the difficulties they face during cross-border reproductive care. It is concluded that it is very important that they find a physician who is willing to support them in their 'baby project'.
authors.affiliation: Bioethics Institute Ghent, Ghent University, Ghent, Belgium. Electronic address: wannes.vanhoof@ugent.be.
authors.forename: Wannes
authors.initials: W
authors.lastname: Van Hoof
authors.affiliation: Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
authors.forename: Guido
authors.initials: G
authors.lastname: Pennings
authors.affiliation: Department of Reproductive Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
mesh_terms: D000041:Absenteeism; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D054626:Consumer Health Information / Q000379:methods; D005260:Female; D005602:France / Q000208:ethnology; D018452:Homosexuality, Female; D006806:Human Rights; D006801:Humans; D007315:Insemination, Artificial / Q000331:legislation & jurisprudence / Q000379:methods* / Q000523:psychology*; D008297:Male; D057193:Medical Tourism; D036301:Qualitative Research; D013074:Sperm Banks
keywords: Belgium; France; Lesbian; Reproductive tourism; Single mothers; Sperm donation