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Author Topic: Use of 'Birth Others' Affects the Kids  (Read 2094 times)
dadams
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« on: January 26, 2010, 12:48:48 AM »

Interesting reading. Particularly the concept that some children may already know before being told.


http://www.medpagetoday.com/MeetingCoverage/APsaA/17988

APsaA: Use of 'Birth Others' Affects the Kids
By Kristina Fiore, Staff Writer, MedPage Today
Published: January 15, 2010

NEW YORK -- Children born of assisted reproductive technologies (ART) may face psychological battles, sometimes whether they know the facts of their conception and gestation or not, researchers here said.

Diane Ehrensaft, PhD, a psychologist in private practice in San Francisco, said the presence of a "birth other" -- say, a surrogate mother or a sperm donor -- is "the most significant ingredient in developmental progression of children in ART families."

"I'd also highlight one hidden feature that people don't pay attention to, and that's the siblings," Ehrensaft said at the American Psychoanalytic Association meeting here. "As children grow, they feel these are the people who can tell them more about who they are."

Ehrensaft, the author of "Mommies, Daddies, Donors, Surrogates," said there are three questions that children born using assisted reproduction have to deal with in their development, all of which have conscious and unconscious undercurrents: Am I different? Who do I belong to? and Who am I?

To address some of these issues in clinical practice, Ehrensaft defined 23 characteristics that are shared by all children created with the involvement of a "birth other." Among them:

* They were all conceived via a scientific or medical procedure.
* The child will have "intentional" parents -- those who intended to have him or her but called on science to make it happen.
* Unlike adopted children, ART children were never relinquished by anyone.
* The child may never know the identity of the people responsible for his or her conception or birth.
* He or she may live in a family of genetic asymmetry -- one parent may be genetically related, the other may not.
* The child may have a genetic parent who is a virgin.
* He or she may live in a family with two mothers whom he or she is biologically related to -- for example, an "egg mommy" and a "womb mommy."

Ehrensaft cited a case report of a five-year-old patient with developmental issues who was born with the help of an egg donor.

The girl had never been informed of the way she was conceived, but in her play, she would request a mother figure to abandon her, and replace her with a new, random mother.

"My understanding was that she was telling me about how she unconsciously knew her egg donor origins," Ehrensaft said. "Maybe her father was leaking it to her, maybe she overheard her mom talking about it. But mostly I thought this was unconscious. "

She added that when the mother did reveal that the girl had been born of an egg donor, the girl replied: "I knew that."

"I don't think this is an isolated occurrence -- this knowing-before- telling," Ehrensaft said.

Mali A. Mann, MD, of the San Francisco Center for Psychoanalysis and Stanford University, who was a moderator of the discussion, said the analyst's feeling is the best guide for detecting what is unconscious and what's not.

"If something is being unconsciously transmitted, it can be very powerful," Mann said.

The issue of parents of ART children addressing questions about origin is a challenging one, researchers said. Parents may be hesitant to come forth about "birth others," primarily because they do not want to be rejected.

"Parents are anxious about attachment [to the 'birth other']," Ehrensaft said. "It's one of the most threatening things to them."

She added that the majority of families are "going into this blind," with little help from physicians or mental health professionals as to how to address questions that come up.

Researchers at the discussion said guidelines should be drafted and ultimately distributed to parents in these situations.

Their answer to addressing questions of origin: Just like any birds and bees discussion with children, Ehrensaft said, parents should "tell them the truth at the developmental level that they can handle."

Primary source: American Psychoanalytic Association
Source reference:
Ehrensaft D, et al "Psychoanalytic Aspects of Assisted Reproductive Technology" APsaA 2010.
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