Expert Advice

Cord Blood Banking Decisions & Ethics

by Kim Walls

DECISION MAKING SUPPORT

Should I bank my baby’s umbilical cord blood?

On the surface it seems like the main issue to consider is really just financial, as long as no one in your family has a known health issue that can be treated with your baby’s stem cells. But for some people, the question is more complex than just dollars and cents. The decision to bank or not to bank can involve a complex web of symbolic, ethical, moral, health, and financial considerations. Because of that, each parent’s answer is entirely personal.

 

Why do some parents decide to save their baby’s umbilical cord blood in a private/family cord blood bank?

The decision to bank baby’s cord blood is generally made for one or a combination of these 3 reasons:

  • your family has specific health concerns that could likely be treated with cord blood stem cells
  • you can easily (or fairly easily) afford it so there is no good reason why not to bank (in this case, potential ethical concerns have been evaluated and dismissed)
  • you have a strong belief in – or powerful curiosity about – medical advances that will provide more ways to leverage cord blood stem cells, and you want to ensure access to your baby’s cord blood in case it could save a family member’s life or health some day, once those medical advances are made

 

Why do some parents decide not to bank their baby’s cord blood in a private/family cord blood bank?

The decision not to bank baby’s cord blood is generally made for one or a combination of these 4 reasons:

  • cord blood banking fees would create financial hardship
  • there is not enough current evidence to support the value of banking from a cost perspective; the future uses of stem cells are not defined enough for your comfort level
  • the likelihood is just so low that babies will use their own stem cells that parents would rather invest in other things for their child’s future
  • you want to contribute to the community supply of cord blood for the greater good, so you feel a social responsibility to help support the public banks

 

Is cord blood banking worth the cost?

For a family that does not have predetermined medical conditions where cord blood has known current or potential benefits, this question is probably best answered by evaluating your personal finances in the context of faith in medical advances.

All in, it costs about $4,400 – about $0.60 (60 cents) per day to store cord blood stem cells for about 20 years*. If, instead, you put $2,000 in the bank today plus $10 per month for 20 years, you will also spend $4,400. With that money earning 6% interest, compounded monthly, you would yield about $11,200 after 20 years.                                                                                                                                                                    * stem cells can be stored for at least 23 years, maybe longer

How much confidence do you have in modern medical advances around stem cell use and regenerative medicine? Does the choice to bank your baby’s cord blood provide you with peace of mind? What is that peace of mind worth to you? Are there other ways to spend your money that would bring greater peace of mind than cord blood banking? These are hard questions, no doubt.

If finances are a significant concern, the answer here is likely to be against private/family banking. If you are worried about simply making ends meet, then cord blood banking is likely not worth the cost. If you don’t have financial or ethical concerns that would keep you from banking your baby’s cord blood, then it probably makes sense to go ahead and do it. The potential of cord blood science is truly exciting.

QUESTIONS OF ETHICS

Are cord blood stem cells the same as embryonic stem cells?

Cord blood is generally considered a robust and non-controversial source of newborn stem cells for current and emerging therapies. Stem cells from the umbilical cord and placenta are different from both the embryonic stem cells in a fertilized egg or the stem cells obtained from a child or adult. This difference is why the controversy around embryonic stem cells don’t apply to cord blood stem cells.

 

Is it selfish to bank my baby’s cord blood privately instead of donate it to a public bank?

Proponents of exclusively public banking point out that it is in the greater public interest for everyone to donate their cord blood to a public bank instead of saving it for their own family’s potential use. If everyone donates their cord blood, there will be a greater chance of finding a match for anyone who needs cord blood for a transplant or life saving therapy. For proponents of greater community welfare, private/family cord blood banking is sometimes considered an elitist medical luxury.

 

Are there any ethical concerns surrounding cord blood collection or use?

The main point of controversy around cord blood is one of ownership of the stem cells. Who owns them? Is it the baby? In which case, the parents would basically be guardians of those cells until the baby is 18 years old.

Or do the parents own the cells? After all, at the time of birth, the umbilical cord is physically connected to both mom and baby. Legally speaking, private/family cord blood banks tend to consider the parents the owners of the stem cells.

In the case of public banking, the bank has control over decisions regarding those cells – whether they are to be used for transplants, for research or discarded. Technically, cord blood can only be used for research with the parents’ permission. But some parents are skeptical about enforcement of this donation parameter and want to have full transparency about how their baby’s stem cells are used.

For parents who have strict ideas about how they want their baby’s stem cells used (or not used) in the context of medical research, and who don’t trust the stated protections of donation banks, the best choice is probably to choose between private/family banking where they retain ownership, or to discard the umbilical cord blood instead of save it.

 

Are there any privacy issues if I choose to donate my baby’s cord blood?

Cord blood banks that accept donations keep the mothers’ and babies’ names private. They follow guidelines to protect the privacy of the donating family. When a match is found, individuals’ names are shared with neither the patient nor the transplant center, and personal information is not exchanged between a cord blood donor and a cord blood transplant recipient. Donated cord blood is listed by number instead of by name in the medical records.

Even with all those protections, stem cells essentially provide a genetic blueprint of a human, so the ability to protect genetic privacy forever could be questionable. If you are willing to donate blood at a Red Cross blood drive, then you might also be willing to donate your baby’s stem cells. Blood donations save lives. Cord blood donations save lives, too.

While most people don’t have strong opinions about the medical ethics issues of blood ownership and privacy, those who do tend to have very strong opinions. Some are passionately for cord blood donation, and some are equally passionate against it.

Are there spiritual issues to consider around cord blood banking?

Because cord blood stem cells do not have the same connection to the religious and ethical positions around embryonic stem cells, the answer to this question is “no” for most people. That said, there are some lesser-known spiritual considerations you may not already know about.

For example, some Indonesian natives preserve cord blood because they consider it the home of the soul and the place where the soul finds refuge after death. For this group, medical cord blood banking is not an option because their babies’ cord blood serves a spiritual rather than physical purpose. For some native Indonesians, doing anything scientific with cord blood could risk the safety of the soul after death.

If your culture or beliefs also bring up ethical or spiritual concerns, talking with both your care provider and spiritual leader can help resolve this conflict.

 Should you decide for cord blood banking, remember that your choice needs to be included in your birth plan. If you’re birth will be in a birthing center or hospital, don’t forget to pack your collection kit in your hospital bag.

To learn more about prenatal preparation, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

 

Published: December 10, 2016 | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: December, 2016

Kim WallsCord Blood Banking Decisions & Ethics

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