Lucy Blake

Children Born Through Reproductive Donation: A Longitudinal Study of Psychological Adjustment

BACKGROUND Parenting and childrens adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families. METHODS Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Childrens adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their childs origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins. CONCLUSIONS The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link.

Children conceived by gamete donation: psychological adjustment and mother-child relationships at age 7.

An increasing number of babies are being born using donated sperm, where the child lacks a genetic link to the father, or donated eggs, where the child lacks a genetic link to the mother. This study examined the impact of telling children about their donor conception on mother-child relationships and childrens psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child adjustment were administered to 32 egg donation, 36 donor insemination, and 54 natural conception families with a 7-year-old child. Although no differences were found for maternal negativity or child adjustment, mothers in nondisclosing gamete donation families showed less positive interaction than mothers in natural conception families, suggesting that families may benefit from openness about the childs genetic origins.

Families created through surrogacy: mother-child relationships and children's psychological adjustment at age 7.

Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy on mother-child relationships and childrens psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child adjustment were administered to 32 surrogacy, 32 egg donation, and 54 natural conception families with a 7-year-old child. No differences were found for maternal negativity, maternal positivity, or child adjustment, although the surrogacy and egg donation families showed less positive mother-child interaction than the natural conception families. The findings suggest that both surrogacy and egg donation families function well in the early school years.

Parent–child relationships and the psychological well-being of 18-year-old adolescents conceived by in vitro fertilisation

This article presents the findings of the first study to have followed up children conceived by in vitro fertilisation (IVF) to late adolescence. As close as possible to their eighteenth birthday, standardised interviews and questionnaires were administered to 26 adolescents conceived by IVF and comparison groups of 27 adolescents adopted in infancy and 56 adolescents conceived naturally by previously infertile parents. IVF adolescents were found to have good relationships with their parents that did not differ from those of adopted and natural conception adolescents. At age 18, no young person was distressed about having been conceived by IVF. The findings of this study indicate that as test-tube babies approach adulthood, they are generally functioning well.

Gay father surrogacy families: relationships with surrogates and egg donors and parental disclosure of children's origins.

Objective To study the nature and quality of relationships between gay father families and their surrogates and egg donors and parental disclosure of childrens origins. Design Cross-sectional study. Setting Family homes. Patient(s) Parents in 40 gay father families with 3–9-year-old children born through surrogacy. Intervention(s) Administration of a semistructured interview. Main Outcome Measure(s) Relationships between parents, children, surrogates, and egg donors and parental disclosure of childrens origins were examined using a semistructured interview. Result(s) The majority of fathers were content with the level of contact they had with the surrogate, with those who were discontent wanting more contact. Fathers were more likely to maintain relationships with surrogates than egg donors, and almost all families had started the process of talking to their children about their origins, with the level of detail and childrens understanding increasing with the age of the child. Conclusion(s) In gay father surrogacy families with young children, relationships between parents, children, surrogates, and egg donors are generally positive.

The role of age of disclosure of biological origins in the psychological wellbeing of adolescents conceived by reproductive donation: a longitudinal study from age 1 to age 14

Background The question of whether children should be told of their biological origins is one of the most controversial issues regarding the birth of children through donated eggs, sperm, embryos or surrogacy. Methods In the sixth phase of this longitudinal study when the children were aged 14 years, family relationships and adolescent adjustment were examined in 87 families created through reproductive donation and 54 natural conception families. The quality of family relationships was assessed by standardised interview with mothers and by standardised questionnaires and an observational measure with mothers and adolescents. Adolescent adjustment was assessed using standardised questionnaires. Systematic information on whether and when parents had told children about their biological origins was obtained at earlier phases of the study. Results There were no overall differences between disclosing families and either nondisclosing or natural conception families. However, within the disclosing families, more positive family relationships and higher levels of adolescent wellbeing were found for adolescents who had been told about their biological origins before age 7. Conclusions The earlier children born through reproductive donation are told about their biological origins, the more positive are the outcomes in terms of the quality of family relationships and psychological wellbeing at adolescence.

Gay fathers’ motivations for and feelings about surrogacy as a path to parenthood

Abstract STUDY QUESTION Why do gay men choose to start their families through surrogacy? SUMMARY ANSWER Most fathers chose surrogacy because they considered adoption to be a less desirable and/or accessible path to parenthood. WHAT IS KNOWN ALREADY Little is known of gay fathers’ motivations to use surrogacy as a path to parenthood over and above other forms of family building, such as adoption, and no studies have examined fathers’ satisfaction with the surrogacy process. STUDY DESIGN, SIZE, DURATION This study used a cross-sectional design as part of a larger investigation of parent–child relationships and child adjustment in 40 gay father surrogacy families. Multiple strategies (e.g. surrogacy agencies, social events and snowballing) were used to recruit as diverse a sample as possible. Data were obtained from 74 fathers (in 6 families only 1 father was available for interview). PARTICIPANTS/MATERIALS, SETTING, METHOD Semi-structured interviews, lasting ~1 h, were conducted in the family home (65%) or over Skype (35%) with 74 gay fathers (35 genetic fathers, 32 non-genetic fathers and 7 fathers who did not know or did not disclose who the genetic father was), when the children were 3–9 years old. MAIN RESULTS AND THE ROLE OF CHANCE Genetic and non-genetic fathers were just as likely to want to become parents and had similar motivations for choosing surrogacy as a path to parenthood. Most fathers (N = 55, 74%) were satisfied with surrogacy and were satisfied (N = 31. 42%) or had neutral feelings (N = 21, 28%) about their choice of who would be the genetic father. Most fathers received supportive reactions to their decision to use surrogacy from both families of origin (e.g. parents, siblings) (N = 47, 64%) and from friends (N = 63, 85%). LIMITATIONS, REASONS FOR CAUTION Although diverse recruitment strategies were used, data were obtained from a volunteer sample. Therefore, the possibility that fathers who had a positive surrogacy experience may have been more likely to participate in the study, and therefore introduce bias, cannot be ruled out. Due to the high average annual income of the fathers in the study, findings may not generalize to gay fathers with lower incomes. WIDER IMPLICATIONS OF THE FINDINGS It is often assumed that parents’ primary motivation for using ART is to have a genetic connection to the child. This study revealed that whilst genetic fatherhood was important for some gay fathers in surrogacy families, it was not important for all. This information will be of use to surrogacy agencies and organizations supporting men who are considering the different routes to parenthood. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the Wellcome Trust [097857/Z/11/Z] and the Jacobs Foundation. None of the authors has any conflict of interest to declare. TRIAL REGISTRATION NUMBER N/A.

Parenting and the Adjustment of Children Born to Gay Fathers Through Surrogacy

Findings are presented on a study of 40 gay father families created through surrogacy and a comparison group of 55 lesbian mother families created through donor insemination with a child aged 3–9 years. Standardized interview, observational and questionnaire measures of stigmatization, quality of parent–child relationships, and childrens adjustment were administered to parents, children, and teachers. Children in both family types showed high levels of adjustment with lower levels of childrens internalizing problems reported by gay fathers. Irrespective of family type, children whose parents perceived greater stigmatization and children who experienced higher levels of negative parenting showed higher levels of parent‐reported externalizing problems. The findings contribute to theoretical understanding of the role of family structure and family processes in child adjustment.

A Longitudinal Study of Families Formed Through Reproductive Donation: Parent-Adolescent Relationships and Adolescent Adjustment at Age 14

The aim of the 6th phase of this longitudinal study was to establish whether children born through assisted reproduction involving reproductive donation were at risk for psychological problems following the transition to adolescence at age 14 and, if so, to examine the nature of these problems and the mechanisms involved. Eighty-seven families formed through reproductive donation, including 32 donor insemination families, 27 egg donation families, and 28 surrogacy families, were compared with 54 natural conception families. Standardized interviews, questionnaires, and observational assessments of the quality of parent-adolescent relationships and adolescent adjustment were administered to mothers, adolescents, and teachers. The mothers in surrogacy families showed less negative parenting and reported greater acceptance of their adolescent children and fewer problems in family relationships as a whole compared with gamete donation mothers. In addition, less positive relationships were found between mothers and adolescents in egg donation families than in donor insemination families as rated by both mothers and adolescents. There were no differences between family types for the adolescents themselves in terms of adjustment problems, psychological well-being, and self-esteem. Longitudinal analyses showed no differences between family types in negative parenting from age 7 to age 14, and a weaker association between negative parenting and adjustment difficulties for gamete donation than natural conception and surrogacy families. The findings suggest that the absence of a genetic link between mothers and their children is associated with less positive mother-adolescent relationships whereas the absence of a gestational link does not have an adverse effect.

Holding children for procedures; an international survey of health professionals

Children undergoing clinical procedures can experience pain and/or anxiety. This may result in them being unwilling to cooperate and being held still by parents or health professionals. This study aimed to capture an international perspective of health professionals’ reported practices of holding children still for clinical procedures. An online questionnaire was distributed through network sampling to health professionals working with children aged under 16 years of age. A total of 872 responses were obtained from Australia (n = 477), New Zealand (n = 237) and the United Kingdom (n = 158). Responses were from nurses (n = 651), doctors (n = 159) and other professionals (n = 53). Health professionals reported children as held still for clinical procedures quite often (48%) or very often (33%). Levels of holding varied significantly according to country of practice, profession, student status, length of time working within a clinical setting, training received and the availability of resources in the workplace. Health professionals who gained permissions (assent from children and/or consent from parents) before procedures were less likely to hold children still for a clinical procedure than those who did not. Holding children still for procedures is an international practice, which is influenced by training, access to guidance, country of practice and profession. Childrens permission and parental consent is often not sought before a child is held for a procedure to be completed.