Thursday 30 July 2015

Openness in Donor Conception

This blog could be titled 'ramblings of a frustrated fertility counsellor on donor conception', or 'my thoughts around the questions ....Why do those (often) annoying clinic counsellors usually suggest being open with a child from the off about donor conception? Why is it important and what's it got to do with anyone anyway?'

There are many reasons why I always suggest to the people I work with to be comfortable with their decisions around being open with any child conceived through donor conception and also for the children of donors - primarily because we know if the parent/s are comfy, then they are modelling that to their child. That there is nothing shameful or embarrassing around their donor decisions.

It is as much for the benefit of the parent/s as the child themselves.

Often when trying to conceive with the assistance of donated gametes we are doing so having embraced a loss of fantasy around how we had hoped to conceive. This applies to heterosexual couples, single people and same sex couples.

Acknowledging this loss is an important part of acceptance of your own situation and the beginnings of an empathic understanding for your future child/rens process in understanding and being comfortable with being donor conceived.

Often things that cause stress, anxiety, depression and confusion aren't just about our conscious thoughts, but the conflicts between those and our unconscious ones.

It is over 20 years since Nancy Verrier published her book The Primal Wound, this book looked at the separation of a child from their birth mother as being the primal wound and showed how adoptive parent's attitudes and fabulous parenting with lots of love still couldn't heal, fix or mend. The laws around adoption changed, it is no longer possible to not disclose adoption, a child adopted no longer has a birth certificate, instead an adoption certificate and preparation for parenthood during assessment which includes the importance of life story work with children.

"But that is adoption.... I'm growing mine/our baby, there is no separation..." Exactly! My hope is that parents embrace that they are growing their own child, thanks to the team who helped them to conceive, including the donor.  This is reinforced by the emerging research in to epigeneitcs, all fascinating - but not nearly as fascinating to me as the research in to foetal maternal and foetal paternal attachment and attunement (or foetal and second parent in the case of same sex couples...sadly no research here yet...)

If I met a donor who hoped to be a genetic or biological parent I would suggest co-parenting or being a pro-active known donor instead of donating through a bank. I've not met any donor who has considered donation as a way of having their eggs or sperm adopted by intended parents or who has visualised a recipient as a surrogate with plans to grow the baby on for them until they are old enough to find them; though I have met recipients who have had this thought,

So the facts around donor conception, a person or couple believe they are 'good enough' to parent and a donor believes they have 'genes worth sharing'  - what a great mix!

Another fact is sadly that women are quite badly designed reproductive wise...obviously in every other way we rock(!) There is very little we can do to enhance or improve our fertility if we are a healthy weight and eat a healthy diet, but our fertility frustratingly continues to decline at an ever alarming rate once we get past 35, It is not just the physical changes that impact, at some unspecified moment our unconscious can undergo a transformation too.  When not thinking about fertility our archetypal images of woman might be domestic goddess, career woman breaking the glass ceiling or a sexual being - but quite overwhelmingly our archetypal image of a woman can become very primal: earth mother, mother earth. We can feel as if we are put on the planet to create babies and can feel as if we're failing catastrophically if we aren't doing so. Some women describe a ticking clock, but to many it's more of an innate drive  - any wait or complication bringing huge feelings of frustration. The encompassing feelings can increase sensitivity to other peoples pregnancies and the thought of not becoming a mum can contribute to feelings associated with failing from a fertility perspective - barren, useless, desolate. The flip side - the feelings around succeeding as a woman, proving your fertility by having a child create a sense of fertile abundance, sky high out of this world feelings that can be just as scary and unboundaried as the negative ones.

Any attempt to try to conceive can often be experienced as if riding an emotional rollercoaster; for many parents whether using donor conception or not, that rollercoaster continues in to parenthood. For those who have used donor conception many thoughts and feelings continue to be challenging. If your unconscious is identifying your donor/s as the genetic or biological parent then there's a conflict; if someone comments on how much your little person looks similar then your unconscious can shout very loudly "They're just saying that to be kind." or "Fraud, I, my partner or we aren't the 'real' parents."

In adoption, families use a life story book as a tool for themselves and their child/ren, This is put together initially by a social worker and includes photos and/or details of the birth family, the reasons why a child is not with their family, sadly often because of inappropriate or inadequate levels of care, photos of different foster carers and social workers and on in to their forever family. Parents through adoption are taught to share this book from the beginning, not as a sad story with a happy ending, but instead as a factual journey where any thought or feeling is OK and there's always a hug for a child when they want one. This accepting non-judgmental approach enables a child to express any thought or feeling without conflicting views to those of their parent/s. As a child develops a more mature view of the world through toddler, child, adolescent and in to adulthood, age appropriate explorations of the facts and implications can take place.

I always encourage the same approach with my clients. Creating a photo album of your pathway to parenthood myth-busts for you and your family; thinking about a heterosexual couple using both donor eggs and donor sperm - a photo of the couple when they first met, another when they had an abundance of love and were hoping to have a family, followed by a picture of them on the computer - exploring fertility and options. (There is usually lots of research) Mummy and Daddy tried and tried to make a baby and sadly it didn't work. You create your own narrative in your words that you're comfy with. ...We went to see a doctor who said that in order to have the best chance of a healthy happy baby they recommended using donor eggs and donor sperm.

I believe it's important to include the recognition of a sadness, rarely do people choose donor conception for non-medical or practical reasons. A same sex couple express a sadness that they weren't able to make a baby together and for single parents a recognition of not settling for the wrong relationship in order to provide a two parent family. This confirms for your unconscious that sadness is an OK reaction to donor conception...not just for you but for a child (and possibly wider family members).

The clinics I work with have access to donated sperm and eggs on patient powered catalogues on the internet, a photo of the parent/s on the computer - 'we went on line to find the right donor for us.' You might be thinking what, surely not? or  why?  The answer, because it reassures a child that the donor didn't choose the parent, the donor didn't hand select a harem of women to grow them a family; recognising all donors in the UK are able to create up to a maximum of ten families.

If your clinic lets a member of staff match you with a donor, then a photo of you confirming the match on the phone or by email. Your journey is unique to you, but keep it simple.

The next photo a beaming selfie of happy smile and positive pregnancy test, followed by scan photos and pregnancy shots, then the 8-12 best pics showing the edited highlights of each year moving forwards.

When I suggest to clients that they start sharing those images from around six months, once their routine is established, if their own family book is available near the high chair to look at whilst spoon feeding, they often look bemused. We rarely speak to children about eggs and/or sperm, (obviously not called seed as you cannot get pregnant eating an apple) talking around conception this early on desensitizes us, so we are more prepared and comfortable with the words coming out of our mouths when a child can understand.

Often people think the right age to tell is 'when they are old enough' but by that age (whatever age it is) children often have a strong trust in their parents, so sharing now that parenthood was by a slightly different route can sometimes cause confusion and/or possibly contribute to a lack of trust or a belief that it is somehow not 'right' even if it's not wrong.

Thankfully the Donor Conception Network produce excellent guidance around telling and talking at any age, but I am aware that sadly some people are put off by their strong views around telling, having not read far enough to reach the parts that do explain why.

For solo parents or same sex couples the queries from children often start at very young ages, around 14-18 months a child can ask 'where's my daddy?' or 'want a mummy'; having talked for around a year at this point, parents are comfy in responding factually, in the case of a solo heterosexual Mum - 'Mummy wasn't going to settle for the wrong daddy, so chose the right donor, you can find out about them when you're older.' Communication between adults and children is rarely all about the words spoken, body language and tone, the way we say things is just as, if not more, important. If a child senses Mum is upset, instead of questioning in the future they may internalise and keep things in, project thoughts and feelings on to Mum by acting out or take their questions as they get older to other people who they are comfortable talking to, who won't get upset.

So back to basics for parents, why do we promote openness in donor conception - because we are aiming for emotionally well families who can communicate factually at all ages without triggering unresolved losses around fertility.

For donors we also promote openness, we would never want a donor's child to believe their parent gave away half siblings or had eggs or sperm adopted out. Sharing that Mum donated eggs or Dad donated sperm again from an early age enables age appropriate exploration of the facts and confirmation that their parent is their parent - and to some other children they may be their donor too and that those children may have questions in the future; but hopefully with parents who've been advised to be open about donor conception, the intention that those children will be seeking information about a donor and not a long lost relationship with a waiting genetic parent who abandoned them as an egg or sperm.

Recent article on donor conception:

http://www.telegraph.co.uk/lifestyle/wellbeing/11607985/Is-it-time-to-question-the-ethics-of-donor-conception.html

Vera Fahlberg article on Life Story Books (adoption focussed) https://www.pactadopt.org/app/servlet/documentapp.DisplayDocument?DocID=259