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Tuesday, December 25, 2012

Parenting After Assisted Reproduction: What You Wanted to Know But Were Afraid to Ask


Nancy Freeman-Carroll, Psy.D.
On Monday, October 1, 2012, the William Alanson White Institute Parent Center presented an evening discussion for parents, mental health professionals, and educators entitled:

Parenting After Assisted Reproduction:
What You Wanted to Know But Were Afraid to Ask

I participated in this panel discussion, along with my colleagues Allison Rosen and Anne Malave.  What follows is a summary of my part in the panel, “Thinking about Disclosure:  Some ideas about what to talk about, when and how (Including videos to watch on YouTube!).”

It’s not uncommon… Parents worry about how to talk about assisted conception with their kids, with their family and friends, with their kids’ friends, teachers, classmates, etc.  In my experience, nearly everyone who uses egg donation, at some point, wants to know how to talk about it, and even if they begin talking, they have questions down the line, as their kids grow, about what to say next, or how often to talk about it.  So, you, too, may find yourself up late (or very early) searching online for more information about talking about Assisted Conception. 

The Internet can offer too much information or you can find information antagonistic to the choice of assisted conception, so I would like to suggest a useful shortcut.   Try going straight to Johnson & Johnson Health Channel (full disclosure: I have no relationship to this organization) – and look for Egg Donor Child.  You will find a video interview of Allegra and also a video of her with her mother.   Allegra and her twin brother were the first children born from egg donation in New Jersey; she is an articulate young adult who speaks to many concerns about disclosure.

I’d like to use Allegra’s interview to talk about disclosure and why it is important.
Here are three things Allegra says that I think should be highlighted:
1.  “I’ve known I was conceived via egg donation for as long as I can remember.”

2.  “I don’t know very much about the donor…I kind of like keeping it in my imagination, like a mystery – cause it is a mystery and a miracle that I was born…”

3.  “I’m not genetically connected to my mother, but we are very much alike”

Allegra was told about her conception via donor egg at such a young age that she can’t remember much about a time when she didn’t know this about herself.  Simply, this information has been with her, and her understanding of it has grown as she developed.  Children learn about all sorts of things that make up their identity in much the same way, for example, who is in their family, what gender they are, and what values matter in their family.

The main advantage of early disclosure is clear:  there is time to learn about assisted conception as children grow.  In a perfect world, parents should try speaking about their choice of assisted conception from the very beginning, even before their children can understand what they are talking about.  The main resistance to talking about donor conception is parent’s discomfort.  The easiest way for parent’s to address their feelings about talking is to try it, and repeat it, again, and again.

Children approach this subject and others that parents might find difficult, like how are babies made, with curiosity and interest; they have no preconceptions about what is the right or normal way to be conceived or who is in a family.  Adults have to come to terms with their life stories so that they can speak of them more easily.

When parents can use the language of assisted conception in a matter of fact way (i.e.:  for you to be born we needed a sperm/ovum donor and that made it possible for you to be created) then they can add to the child’s understanding of reproduction as they grow up (i.e.:  We all come from the combination of ovum from a woman and sperm from a man.  These special cells have inside them information about how our bodies will grow). Talking easily about reproduction is a challenge for individuals who have struggled with infertility.  Starting early gives parents time to get used to telling their story. 

Allegra’s mother choose to tell her kids at around age three, using a moment when someone complimented them on their swimming – she chose this because it provided an example of something that she felt differentiated herself (and in this case her husband too) and her children –she could confidently say – Daddy and I can’t do this, but you can, and your donor could too (she was a life guard) – you and your donor are alike in this way.  Young children can learn that there is another person who was involved in their creation, without really understanding what this means, and parents can help them gain real understanding of the fact of donor gametes as they grow more sophisticated in their thinking about reproduction and genetics.  There are many moments in life that leave room for this kind of conversation – all the most obvious aspects of appearance –many of which have a clear genetic component, such as eye color –create space to introduce the donor. 

Early talking erases the problem of finding the “perfect” time to talk about assisted conception – but timing also matters in how often and when you talk about the donor.  As with most of life, moderation is key—not too much, but also, not  never!  All children need room to identify with their parents, and in usual, loving situations, they will, no matter what they know about the genetic connections they have or do not have with a parent.  Allegra, for example, emphasizes how she and her mother are very much alike, even though they look completely different!  She also de-emphasizes what she knows about the donor (minimal info typical of an anonymous donor), and chooses instead to fashion something positive and wonderful from this problematic mystery.

In many families, where donors are anonymous, parents have no choice but to present their children with this special problem:  the donor is a specific person who gave a very special part that made your birth possible, AND we may never know more about that person or more about that special part, her DNA.  This conundrum is a unique benefit of disclosure!  As kids grow and gradually understand DNA and genetics, they will learn that we know some things (i.e.: DNA is important) and other things are a mystery (i.e.: how environment—in utero, early, later, etc.—interacts with genetics from moment one throughout life).  Who we become is mysterious and miraculous!  Children who have the opportunity to talk about this with their parents from a young age are getting early training in how to hold contradictory and complex ideas in mind, and this is a great life skill.

Stay tuned for a follow-up panel discussion, again at the White Institute, including myself and colleagues, on January 30, 2013!  In the meantime, I can be contacted at drnancyfreemancarroll@gmail.com or 212-6650442.

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