Life is full of fraught encounters. In the “How Do You Do It?” series, Samantha Selinger-Morris examines the prickly scenarios we sometimes find ourselves in and asks experts how best to deal with them.
Whenever Dr Melissa Cameron hears that a patient plans on not telling their child that they’re the result of IVF, she bristles.
“I always get quite uncomfortable if I hear patients mention that they’re going to keep it a secret,” Cameron, a fertility specialist at Melbourne IVF says. “Because, I think at the end of the day, children have a right to know of their origins.”
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Unlike 30 years ago, when IVF was surrounded with stigma, fertility treatment is now common. More than 8 million people have been born worldwide from the treatment, and an estimated one in 20 Australian babies now result from the process.
So why do people struggle over the decision to tell their children how they came into the world? What are the emotional and psychological ramifications if parents keep their children in the dark about it?
“From a straight family point of view, I wonder whether it’s that feeling of, ‘we couldn’t do this by ourselves’, is it a feeling of failure … potentially,” says Cameron of heterosexual couples, who, unlike gay and non-binary couples, ordinarily don’t need medical intervention to conceive. Other families, she says, might come from religious and cultural backgrounds that don’t approve of the technology.
Then there’s the trauma that comes with the treatment.
“It’s really hard and can be quite associated with a lot of anxiety, depression and mental health challenges,” says Cameron. “And for some people, you might not want to kind of go back there to tell that story.”
But for children who aren’t told, the fall-out can be serious and long-lasting.
“People don’t like being lied to, so adults or adolescents who find out belatedly that they were the result of donor sperm or donor eggs think their parents have told lies for 15, 20 or 30 years, and so they think, ‘well, I can’t trust you’,” says Roger Cooke, an infertility counsellor and adjunct associate professor at Swinburne University. “[They think] well, if you can’t tell me something like this which is clearly something vital.”
He recalls a “very angry” teenager who found out in a school playground that he was conceived with donor sperm, through a cousin whose parents had deduced what had happened.
“I’m sure the parents had at that [child’s] age thought, ‘there’s probably enough time to try and resolve it’ and made all sorts of promises that ‘we’ll never do anything like this ever again’,” says Cooke, adding that children will frequently find out in this roundabout way.
There are other complications, too. Extended family members of people who have used fertility treatment to conceive who find out indirectly have reported feeling betrayed. Whether it’s their right to know, or not, is another matter. And children who have resulted from fertility treatment whose parents told them to keep the fact secret from others have reported, as adults, that this made them feel ashamed.
This is reflected in research on the topic, with one study showing that families who disclosed their children’s origins to them early on in their life experienced lower levels of anxiety, stress and depression.
When is the best time to tell children about how they came into the world? And how?
“If you start when they’re little, babies are amazing. They don’t really talk back — you have all this opportunity to practise your spiel,” says Cameron, who began telling her two children, aged 10 and 13, that they were the result of donor sperm when she changed their nappies on the change table.
“It becomes part of your story, and part of your kids’ story, so that it doesn’t become as awkward as it might otherwise be. Keeping secrets is hard.”
‘Children deserve to feel proud of who they are.’
As for what language to use, Cameron recommends using anatomically correct terms rather than euphemisms for genitalia. She adds that picture books such as Where Do I Really Come From, and The Amazing True Story of How Babies Are Made can be very helpful.
Many of these books introduce the concept of IVF in an approachable and light-hearted way. (“IVF’s super duper common,” reads a page from Where Babies Come From, released by Australian fertility clinic Genea earlier this year. “It helps parents all the time. The babies turn out perfectly, no second noses or blue slime.“)
Parents can be reassured that telling their children they’re the product of fertility treatment can be something of a bonus.
“They appreciate the fact that their parents are being honest with them, and have told them what’s happened,” says Dr Frank Quinn, a fertility specialist at IVF Australia in Sydney.
“Just because dad doesn’t have sperm, or the mother went through early menopause and needed donor eggs, what’s more important is they were brought into a loving relationship, and ‘my mum and dad went through all the hormone injections and did IVF, and spent all that time and effort and had me because they desperately wanted to have a child’. And sometimes that makes them feel even more loved, that [they] had gone to that extent to have them.”
Parents who are struggling with the conversation – perhaps fearing judgment from their family or community – should work through their fears with an experienced counsellor, says Cal Volks, a counsellor at the Victorian Assisted Reproduction Treatment Authority, which offers a webinar called The Time To Tell.
“This is so that if children are told about being conceived with fertility treatment, they do not internalise possible fear or shame or other concerns their parents may have,” says Volks, adding that the conversation is a means of building trust between a parent and a child.
“Children deserve to feel proud of who they are.”
They also need to know about their origins in case they have health implications as a result of the technology, or have other procedures that require doctors to know their complete medical history, says Dr Evie Kendal, a lecturer at Swinburne University who researches the impact of fertility issues on cisgender women.
“We can personalise a lot of medicine now if we have that data,” she says.
Is there perhaps a silver lining to having to have the IVF conversation with a child, such as not having to speak to your kids about your sex life?
It’s not quite that simple.
“In The Amazing True Story Of How Babies Are Made book, there is a picture, quite a schematic diagram of a man and woman having sex. The woman’s on top, which is great — really progressive,” says Cameron, who had her children with her female partner. “But I remember [my daughter] asking lots of questions about that, when she was first reading [it]. And she’d always get stuck on that one.”
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