Making Sense of New Conceptions…in a Family Way

The following article based upon the author’s book, Flight of the Stork, first appeared in Family Therapy News, 26(1), February 1995. Those reading a print out will find it on the internet at http://www.perspectivespress.com/abtherapists.html
Introductory Sidebar:
Language and New Forms of Family BuildingWhile language for building families via these routes is still evolving, marriage and family therapists (MFTs) should be aware that important distinctions have entered the lexicon. Assisted reproductive technology, or ART, refers to techniques for conception that require sophisticated medical technology. Examples are in vitro fertilization (IVF), gamete (ovum or sperm) intra fallopian transfer (GIFT), and zygote (or embryo) intra fallopian transfer (ZIFT). Artificial insemination using the husband’s sperm (AIH), is usually considered an ART. Donor insemination (DI), however, can be done at home with a turkey baster with minimal training, and is, therefore, not necessarily an ART. It is, however, a form of collaborative reproduction (CR) , a term used to describe all those options that require the voluntary assistance of a person who will not parent the resulting child. Reproductive collaborators may donate ova or sperm, embryos that have been fertilized in vitro, or gestational capacity to a person or partnership who wish to initiate a pregnancy and parent a child. There can be assisted reproductive technology without collaboration, and collaborative reproduction without technological assistance.In vitro fertilization (IVF) consists of bringing the reproductive cells together in a petri dish in the laboratory; the resulting embryo is then implanted in the uterus of the prospective mother. IVF may be limited to the parenting couple’s own sperm or ova or involve a donor of male and/or female gametes. If a prospective mother has medical problems that preclude pregnancy, mother and father may arrange with another woman to carry the child to term. These “surrogates” are gestational mothers if they are implanted with embryos conceived in vitro, but they may also be genetic mothers if it is their own ova that are fertilized through insemination with the prospective father’s sperm.

Perhaps the most persuasive argument for encouraging parents to inform their children is that it is not always possible to foresee how and when children will come across signs that they have not been been told an important part of the story. Visits to the doctor may raise questions about medical history that are met with discomforting silence, signaling something is amiss. Friends and relatives may unthinkingly comment with wonder on how a child conceived by DI so closely resembles her father. Adults who discover this when they are grown have said that they suspected something all along and that finally being told brought them relief. While information can be troubling, suspicions can be more so.

Because the child has been born through scientific intervention after long effort, she is welcomed with intense devotion and, perhaps, unrealistic demands. How can such a child be merely average! On the other hand, parents may subscribe to a “bad seed” theory in explaining their child’s less admirable traits, misconstruing normal misbehavior as evidence of an inborn defect.

Partnership IssuesUnlike the situation of adoptive parents, whose senses of legitimacy as parents are equal to one another, families built through CR have an imbalance in genetic parenthood that can have psychological consequences. When one parent feels more “legitimate” than the other parent may become significantly more attached to the child than the other, who may retreat both emotionally and from decision-making responsibility. In a worst case scenario, secrets about the other parent’s not being genetically related have been used as ammunition in marital battles, sacrificing the child’s welfare to a power struggle in the parental partnership.The greatest challenge for families formed by these means is to create a sense of equal psychological relatedness between the child and each of his parents, even though only one of them contributed genetically to his creation. MFTs can help adults maintain a commitment to deal with each other directly about differences between them in feeling empowered and responsible as parents rather than involve their child in their conflicts.Care must be taken to avoid attributing too much significance to the differing genetic ties. For example, a mother who thinks of her husband as not sharing child care equally may tell herself that this is so because donor semen was used to conceive– while in nearly every other house on the block moms must look to other factors to explain to themselves why they are shouldering more than fifty percent of the responsibilities for children who live with both genetic parents.The most important factor in children’s psychological adjustment to the circumstances of his origins is how parents feel about how they formed a family. Ideally, parents will have worked out any lingering doubts, both for themselves as individuals and as a couple, before conception. There is no way, however, to totally anticipate how a child’s development can churn old issues to the surface, as, for example, when a child talks about a genetic parent as a “real” mother or father. A parent who can discuss these issues matter-of-factly and without defensiveness, who is open to a child’s questions about key figures in her conception and birth, will foster the child’s positive self-regard. The story of “how you came into the world” need not be problem-free, but, if children are to feel good about themselves, it must be one that can be talked about freely without upsetting parents.Talking with Children about ART and CollaborationIn thinking about how to talk about CR, parents’ decisions about what and how to inform their children will vary depending on family composition, the child’s age, and the particular procedures involved.In families formed by male and female parents the topic of collaboration can be introduced as one of several means of uniting sperm and ovum, for example: ” To start a baby, an ovum from a woman’s body must join with a sperm from a man’s body. Sometimes the ovum and sperm get together when a woman and a man have sexual intercourse. Sometimes a woman and a man try to start a baby, but a baby doesn’t grow. There are lots of reasons why that can happen. Sometimes the reason is that the father’s sperm can’t join with the egg. Then, if they really want to grow a baby, they may get sperm from a man, who gives his sperm so that people who want a baby very much can grow one in the mother’s uterus.”“Does that mean Daddy’s not my real father?” may be the child’s next question. Telling a child, “I’m not your parent” is both untrue and destructive. Instead, a helpful answer could be “Daddy will always be your dad. It’s just that Daddy’s sperm didn’t make you. The donor is your genetic father.” Like children who enter their families through adoption, they may think about who is their real mother or father, and, as in adoptive families, parents will want to talk with them about what it is that makes a parent real, offering both/and solutions to either/or questions. Reaffirming parenthood, followed by an exploration of the many ways to be a parent is the best response here, too. Parents (or MFTs) can ask the child “What do children’s daddies do?”, so that they can realize for themselves that daddies are clearly the fathers who take care of children. Younger children need to know that a parent’s commitment to them is unshakeable, whether or not they are linked genetically.For children with both a mommy and a daddy, perhaps the best time to introduce the special circumstances of their conception is in the early primary school years. The development of concrete operational thinking, typically at about seven years of age, allows children to begin to make sense of the terms genetic mother and genetic father , avoiding the confusion of introducing such complex concepts to still younger children. Delaying confiding this information still later, however, runs the risk of adding to the emotional turmoil set in motion puberty. While cognitively children may not be able to assimilate all the complexities of CR, even in middle childhood, those who are not told until they are adolescents or adults are more likely to be angry at having been kept in the dark about their origins. Children born from CR using unknown donor gametes, because they do not know both of their genetic parents, will face some of the questions about identity that confront children who were adopted. As they grow older, and especially as they approach adolescence, the task of building a stable, cohesive identity is challenged by what—and whom–they don’t know. They will want to know more about the relationships among reproductive collaborators, exploring issues of social justice. In adolescence, when they are figuring out who they are and what it means to be like or unlike their parents in forging their own identities, they will be interested in knowing more about the genetic parent and how their looks and personalities may derive from him or her.
Nontraditional familiesNontraditional families will have no choice about early disclosure. For the children of always-single parents and same-sex couples, questions about the “missing” parent arise when they have both the experience and the ability to recognize that people come in two sexes and that most families include both male and female adults. This usually occurs when a child is about three, and questions are likely to e a variant of “Do I have a daddy?” It wasn’t until Bill, the son of lesbian couple, was almost four, and his biological mother was regnant with her second child, that he wanted to know how his two mommies had been able to have a child without a daddy. “How come I don’t have a daddy?” can be answered in terms accessible o preschoolers, who frequently see people as related to each other because they want to be. Single mothers might answer: I wanted very much to be a mommy, but I didn’t know anybody I loved enough to live with and make a family with.” Lesbian couples, on the other hand, can explain that their love for each other led them to want o create a family together, so their child has two mommies, instead of daddy and a mommy.Telling children that they have two mommies or just a mommy, two daddies or just a daddy, is an important part of their family story. it’s important, also, to add that they have a birthmother or a biological father, so that they know how to respond when other children ell them in no uncertain terms that it is impossible to have a baby if you don’t have both a mother and a father. The absence of a mother ill need more explanation than the absence of a father among young children who have not yet connected the father with pregnancy and birth. School yard een nursery school– discussions of this topic ccur much sooner than most parents expect, so some mention of the ther biological parent needs to be part of the story of a child’s origins early on.When preschooler asks her gay parents, “Do I have a mommy?” A father might respond: “You have two daddies. You don’t have a mommy, but u do have a birthmother, because all babies grow inside mothers’ bodies. We wanted to have a family very much, so we found a woman who agreed to be pregnant with you. I gave same sperm that the doctor put in your birthmother’s vagina, and you began to grow, just as every baby starts when a sperm from a man joins with an ovum from a woman.” [For further discussion of how to talk with children about these and related issues, see Flight of the Stork,]

References/ResourcesBernstein, A. C. (1994). Flight of the Stork: How Children Think (and When) about Sex and Family Building. ¿Indianapolis: Perspectives Press.Brodzinsky, D. M., Singer, L. M. and Braff, A. M. (1984). “Children’s Understanding of Adoption,” Child Development, 55, pp. 869-878.Cooper, S. L. and Glazer, E. S. (1994). Beyond Infertility: The New Paths to Parenthood. New York: Lexington Books.Glazer, E. S. (1990). The Long Awaited Stork: A Guide to Parenting after Infertility. Lexington, MA: Lexington Books.GLPCI. Gay and Lesbian Parents Coalition International, P.O. Box 50360, Washington, D.C. 20091

Johnston, P. I. (1994). Taking Charge of Infertility. Indianapolis: Perspectives Press.

Lauritzen, P. (1993). Pursuing Parenthood: Ethical Issues in Assisted Reproduction. Bloomington, Indian University Press.

Martin, A. (1993) Lesbian and Gay Parenting. New York: Harper Collins.

Anne C. Bernstein, PhD, is in private practice and teaches family therapy at the Wright Institute, Berkeley, California. She is the author of Flight of the Stork: What Children Think (and When) about Sex and Family Building (Perspectives Press, 1994) and Yours, Mine, and Ours: How Families Change When Remarried Parents Have a Child Together (W. W. Norton, 1994). She is a former member of the Board of Directors of the American Family Therapy Academy and is an AAMFT Clinical Member.

If you enjoyed this article, you’ll love Dr. Bernstein’s book Flight of the Stork: What Children Think (and When) about Sex and Family Building. To view its table of contents click here. For its reviews click here

Return to homepage