Solo mothers and their donor insemination infants: follow-up at age 2 years

BACKGROUND: Findings are presented of the second phase of a longitudinal study of solo-mother families created through donor insemination (DI). METHODS: At the time of the child's second birthday, 21 solo DI mother families were compared with 46 married DI families on standardized interview and questionnaire measures of the psychological well being of the mothers, mother-child relationships and the psychological development of the child. RESULTS: The solo DI mothers showed greater pleasure in their child and lower levels of anger accompanied by a perception of their child as less 'clingy'. Fewer emotional and behavioural difficulties were shown by children of solo than married DI mothers. CONCLUSIONS: The findings from this first cohort of solo DI families to be studied lend further weight to the view that these women represent a distinct subgroup of single parents, who, out of a strong desire for a child, have made the active choice to go it alone. Moreover, this route to parenthood does not necessarily seem to have an adverse effect on mothers' parenting ability or the psychological adjustment of the child.     

Donor insemination: child development and family functioning in lesbian mother families

Findings are presented of a comparative study investigating the family relationships and the emotional and gender development of children raised in lesbian mother families. A total of 30 lesbian mother families with 4-8 year old children created as a result of donor insemination (DI) were compared with 38 heterosexual families with a DI child and with 30 heterosexual families who had a naturally conceived child. A variety of assessment measures, including a standardized interview and questionnaires from the parents and psychological testing of the child were used to collect the data. The quality of the couples' relationships and the quality of the mother-child interaction did not differ between lesbian mother families and either of the heterosexual family groups. The quality of the interaction between the social mother and the child in lesbian families was superior to that between the father and the child in both groups of heterosexual families. Childrens' own perception of their parents was similar in all family types; the social mother in lesbian families was regarded by the child to be as much a 'parent' as the father in both types of heterosexual families. With regard to their emotional/behavioural development, boys and girls raised in lesbian mother families were well adjusted and their gender role development did not differ from that of children raised in heterosexual families. These results indicate that child and family development in lesbian mother families is similar to that of heterosexual families.      

Donor insemination: Dutch parents' opinions about confidentiality and donor anonymity and the emotional adjustment of their children

Results from a comparative study investigating 38 donor insemination (DI) Dutch families with 4-8 year old children are presented. The aims of this study were to investigate parents' opinions on the issues of confidentiality and donor anonymity, to assess the emotional development of the children, and to examine in DI families the association between secrecy with regard to the use of a donor and the emotional adjustment of the children. The DI families were compared to families with a child conceived by in-vitro fertilization (IVF) and to families with a naturally conceived child. Secrecy appeared to be associated with DI and not with IVF: 74% of the DI parents intended not to inform the child about the way in which she/he was conceived, whereas none of the IVF parents intended to keep the secret. Only one set of DI parents and two sets of IVF parents had actually told the child. As to donor anonymity, a spread of opinions appeared among DI parents; 57% preferred an anonymous donor, 31% would have liked non- identifying information about the donor, 9% preferred the donor's identity to be registered and 3% remained unsure. Parents' major concern was to know more about the medical/genetic background of the donor. Mothers and fathers in the DI families differed in their opinions concerning the issues of confidentiality and donor anonymity: fathers, more often than mothers, were secretive with regard to the use of a donor and husbands, more often than their wives, were in favour of donor anonymity. With regard to the emotional development of the children, more emotional/behavioural problems were revealed among DI children than among children who were naturally conceived. No association was found between secrecy and the emotional/behavioural adjustment of the children.      

The European study of assisted reproduction families: the transition to adolescence

BACKGROUND: Findings are presented of the second phase of a European longitudinal study of families created by assisted reproduction. The present investigation reports on data obtained during the child's transition to adolescence. METHODS: A total of 102 IVF families, 94 donor insemination (DI) families, 102 adoptive families, and 102 families with a naturally conceived child were compared on standardized interview and questionnaire measures of parenting and children's psychological well-being. RESULTS: The assisted reproduction families were similar to the adoptive and natural conception families for many of the measures of the quality of parent-child relationships. To the extent that differences were found between the assisted reproduction families and the other family types, these reflected mainly more positive functioning among the assisted reproduction families, with the possible exception of the overinvolvement with their children of a small proportion of assisted reproduction mothers and fathers. The assisted reproduction children were functioning well and did not differ from the adoptive or naturally conceived children on any of the measures of psychological adjustment. However, only 8.6% had been told about their genetic origins. CONCLUSIONS: IVF and DI families with an early adolescent child appear to be functioning well.     

Lesbian couples requesting donor insemination: an update of the knowledge with regard to lesbian mother families

Although a variety of ways exist of becoming a lesbian mother, an increasing number of lesbian couples have began to visit fertility centres requesting donor insemination (DI). The practice of inseminating lesbian couples remains a controversial issue within the reproductive medicine world. Lesbian mothers offer their children a familial context, which differs on a number of important characteristics from the traditional heterosexual family. In lesbian families, a father has been absent right from the start, and the child is raised by two mothers. The present article reviews whether there is any theoretical and/or empirical evidence for the most common assumptions with regard to lesbian motherhood. It also reports on a number of studies in which the practice of counselling lesbian couples is discussed. Although many important research questions have yet to be addressed, none of the investigations carried out so far could identify an adverse effect of lesbian motherhood on child development. Counselling lesbian couples for DI should aim to provide information about the practical aspects of the treatment. The requests of lesbian couples, however, differ substantially from those of single mothers and heterosexual couples. Counsellors should respect these differences and focus upon the specific living conditions of lesbian families.     

Child development and quality of parenting in lesbian families: no psychosocial indications for a-priori withholding of infertility treatment. A systematic review

Among fertility centres, much discussion focuses on whether to withhold infertility treatment from special patient groups (lesbians, prospective single parent(s), prospective parent(s) of relatively advanced age, or with severe diseases) because it is assumed that this is in the best interest of the child. The present study aimed to establish whether there is any empirical evidence for this assumption. A literature search was made in PubMed/Medline and PsycINFO to identify studies that had assessed psychological outcomes of children and quality of parenting after infertility treatment. Eight studies met the following inclusion criteria: published in an English-language peer-reviewed journal between 1978 and 2002, and focused on psychosocial child development and quality of parenting after infertility treatment in the above-mentioned special patient groups. All reviewed studies focused on lesbian or single-parent families. Overall, the methodological quality of studies as assessed by a standardized set of criteria was high. The evidence of the studies (assessed by the best evidence synthesis method) was strong for the conclusion that in lesbian families the psychosocial development of children (median age 6.1 years) and the quality of parenting are not different from those in healthy heterosexual two-parent families after infertility treatment or natural conception. Therefore, withholding infertility treatment from lesbian families on the assumption that such intervention may not be in the interest of the prospective child seems unjustified. For the other special patient groups, no conclusions could be drawn, because of a lack of relevant studies.     

Non-genetic and non-gestational parenthood: consequences for parent-child relationships and the psychological well-being of mothers, fathers and children at age 3

BACKGROUND: Findings are presented of the third phase of a longitudinal study of children conceived by assisted reproduction procedures involving surrogacy and/or donor conception. METHODS: At the time of the child's third birthday, 34 surrogacy families, 41 donor insemination families and 41 oocyte donation families were compared with 67 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, mother-child relationships and the psychological well-being of the child. RESULTS: The differences found between family types reflected higher levels of warmth and interaction between mothers and their 3-year-old children in assisted reproduction families than in families with a naturally conceived child. A higher proportion of surrogacy parents than donor conception parents had told their children about the nature of their birth. CONCLUSIONS: It appears that the absence of a genetic and/or gestational link between parents and their child does not have a negative impact on parent-child relationships or the psychological well-being of mothers, fathers or children at age 3.     

Pregnancy and child outcome after oocyte donation

During the last decade oocyte donation has been highly successful for treating women previously thought to be hopelessly infertile. The pregnancy rate after oocyte donation is among the highest reported for any fertility-enhancing procedure. Most investigators have noted an increased rate of obstetric complications in these pregnancies. In particular, pregnancy-induced hypertension appears to occur more often than expected, and the Caesarean section rate is high. However, the majority of oocyte recipients experience a favourable pregnancy and perinatal outcome. When perinatal complications occur they are usually related to multiple gestation. The high frequency of multiple pregnancy after oocyte donation, as well as in all other fields of assisted reproduction, deserves attention, and efforts to avoid multi-fetal gestation must be made. There are only a few studies on post-natal growth and development of young children born after oocyte donation. The health of these children appears to be within normal ranges. The psychological consequences of the treatment on the child require further investigation. Thus far, studies have shown normal socio-emotional development in the child and a warm relationship between the parents and the child in oocyte donation families.     

Parenting and psychosocial development of IVF children: a follow-up study

BACKGROUND: This report details a follow-up study of the parent-child relationship and the child's psychosocial development after IVF. The pilot study compared 31 IVF families and 31 families with a naturally conceived child when the children were aged 2 years. Twenty-seven IVF and 23 control families participated again when the children were aged 8-9 years. METHODS: Fathers and mothers completed questionnaires assessing parenting variables and the child's behaviour. For most children, behavioural ratings were also obtained from the child's teacher. RESULTS: No significant differences were found between IVF and control parents' reports of child behaviour, parenting behaviour, parenting stress and most of the parenting goals. The parenting goal adjustment was significantly more important for IVF than for control fathers; religion was more important for IVF than for naturally conceiving mothers. Teacher ratings of the child's behaviour did not differ significantly between the IVF and control groups. All couples but one had talked to other persons about the IVF conception; 75% of the IVF parents had not yet informed their children. IVF parents who had informed their child observed more (internalizing and for fathers also overall) problem behaviours in their child, compared with IVF parents who had not yet disclosed the IVF conception. CONCLUSIONS: Parenting and the children's psychosocial development do not differ significantly between IVF families and control families.     

Children: The European study of assisted reproduction families: family functioning and child development

Findings are presented of a European study (conducted in theUK, Italy, Spain and The Netherlands) of family relationshipsand the social and emotional development of children in familiescreated as a result of the two most widely used reproductivetechnologies, in-vitro fertilization (IVF) and donor insemination(DI), in comparison with control groups of families with a naturallyconceived child and adoptive families. Mothers of children conceivedby assisted reproduction expressed greater warmth towards theirchild, were more emotionally involved with their child, interactedmore with their child and reported less stress associated withparenting than mothers who conceived their child naturally.Similarly, assisted reproduction fathers were found to interactmore with their child and to contribute more to parenting thanfathers with a naturally conceived child. With respect to thechildren themselves, no group differences were found for eitherthe presence of psychological disorder or for children's perceptionsof the quality of family relationships. The findings relatingto the quality of parenting and the socio-emotional developmentof the children were similar in each of the four countries studied.     

Planned lesbian families: their desire and motivation to have children

BACKGROUND: There is no information about the desire and motivation for children among planned lesbian families. The overall aim of this research was to examine whether planned lesbian families differ from heterosexual families in desire and motivation to have a child. The reason for studying this is that desire and motivation to have children are characteristics that are supposed to effect parenting and the parent-child relationship. METHODS: A total of 100 lesbian two-mother families were compared with 100 heterosexual families. All data were collected by means of questionnaires. RESULTS: Lesbian parents and heterosexual parents rank their parenthood quite similarly; however, happiness is significantly more important for lesbian mothers than it is for heterosexual parents and identity development is less important for lesbian mothers than it is for heterosexual parents. Furthermore, compared with heterosexual parents, lesbian parents had spent more time thinking about their motives for having children, and their desire to have a child was stronger. CONCLUSIONS: Lesbian parents especially differ from heterosexual parents in that their desire to have a child is much stronger. The study's findings may be helpful for counsellors in their work to inform and assist lesbian couples in their decision to have a child.     

Parent-child interactions in pediatric bipolar disorder

Parent-child relationships may have a significant effect on illness characteristics of children with pediatric bipolar disorder (PBD), and these relationships may, in turn, be affected by the child's illness. We characterized maternal reports of parent-child relationships using the five-factor Parent-Child Relationship Questionnaire (PCRQ) in 60 families (30 PBD youth and 30 matched controls). Data on child proband and parental psychopathology were also obtained. Compared to controls, parent-child relationships in the PBD group were characterized by significantly less warmth, affection, and intimacy, and more quarreling and forceful punishment. Among PBD participants, elevated symptoms of mania, comorbid ADHD, an earlier age of illness onset, living in a single parent home, and the presence of a parental mood disorder were associated with greater parent-child relationship difficulties. These findings have implications for the development of interventions that focus on the quality of parent-child relationships, in addition to symptom management, in the treatment of PBD.     

Review: psychosocial well-being of parents and their children born after assisted reproduction.

OBJECTIVE: To critically review the empirical literature published from 1980 through June 2000 on the psychosocial well-being of parents and their children born after assisted reproduction. METHODS: A computer-based literature search of PsycINFO and Medline was conducted. Empirical studies were reviewed to document the psychosocial impact of infertility and its treatment on the families involved in terms of quality of parenting, family functioning, and child development. RESULTS: Several common findings appeared across the studies reviewed. With regard to quality of parenting and family functioning, mothers of children born using assisted reproduction report less parenting stress and more positive mother- and father-child relationships than mothers of naturally conceived children. In most cases, no statistically significant differences in child functioning in terms of emotions, behavior, self-esteem, or perceptions of family relationship have been reported. CONCLUSIONS: The summary findings are positive and reassuring for parents and their children born after assisted reproduction. This critique of the published literature provides interpretative and methodological refinements for future research.     

Families created by gamete donation: follow-up at age 2

BACKGROUND: Findings are presented of the second phase of a longitudinal study of families created through gamete donation. METHODS: At the time of the child's second birthday, 46 donor insemination families and 48 egg donation families were compared with 68 natural conception families on standardized interview and questionnaire measures of the psychological well being of the parents, parent-child relationships and the psychological development of the child. RESULTS: The gamete donation mothers showed a trend towards greater pleasure in their child accompanied by a perception of their child as more vulnerable, with egg donation mothers tending towards greater pleasure and donor insemination mothers tending towards greater concern. The fathers did not differ on any of the variables under study. CONCLUSIONS: The findings from this recent cohort add further weight to the growing body of research showing that the absence of a genetic link between a parent and a child does not necessarily jeopardize the development of a positive relationship between them.     

Internalizing symptoms and disorders in families of adolescents: a review of family systems literature

Internalizing symptoms and disorders are relatively common during adolescence and impact considerably on social and emotional functioning. Using a family systems framework, this paper reviews the current literature examining the impact of internalizing symptoms and disorders on the functioning of the family system, the spouse subsystem and the parent-child subsystem. Moreover, literature examining the relationship between parents' and adolescents' internalizing symptoms and disorders is reviewed. The reviewed research demonstrates that there exists an association between internalizing symptoms and disorders and poorer functioning at various levels of the family system. Longitudinal studies have generally reported that parent internalizing symptoms and disorders predict poorer functioning in the family system as well as internalizing symptoms and disorders in adolescents. However, few longitudinal studies have examined whether adolescent internalizing symptoms and disorders predict poorer family functioning and internalizing symptoms and disorders in parents. Those that have examined such effects report mixed results. On the basis of our review, we make recommendations about future research directions. In particular, it is argued that more research on the reciprocal effects of internalizing symptoms and disorders within families is needed to better understand the antecedents and consequences of these conditions for families of adolescents.     

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0-5 years was examined. Musical activities were used to promote positive parent-child relationships and children's behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.     

Lesbian families and family functioning: an overview

OBJECTIVES: In the last 30 years a growing body of studies on lesbian parents and the development of children has been published. METHODS: Four computerized databases were identified studies for inclusion in this review of research on lesbian families, namely PsychInfo, Educational Resources Information Centre (ERIC), Medline, and the Social Sciences Citation Index. RESULTS: Forty-four empirical studies on lesbian families published between 1978 and 2003 were reviewed. In the research on lesbian families two phases were identified. To begin with, systematic studies on lesbian families focused on lesbian families with children who were born in a previous heterosexual relationship. More recently, studies included lesbian families whose children were born to the lesbian couple (planned lesbian families). In both phases, articles reporting results on children's development (such as sexual identity, emotional/behavioral development, social relationships and cognitive functioning), and parental functioning (such as mental psychological health and parenting skills). This paper presents and discusses major finding of the reviewed articles. CONCLUSION: Studies in both phases have emphasized that lesbian and heterosexual families are very much alike. However, it is the stigma of lesbianism that makes the family situation of lesbian families different. PRACTICE IMPLICATIONS: Healthcare workers should be informed about the similarities and differences between lesbian families and heterosexual families, and about the non-traditional family situation of planned lesbian families.     

Mother-child reminiscing about everyday experiences: implications for psychological interventions in the preschool years

The preschool years are a critical period for all aspects of child development, and any disruption to cognitive or socio-emotional functioning at this stage has potential repercussions for current and future functioning. There is, therefore, a need for clinical interventions that optimize the functioning of children at risk of psychological disorders. In the current paper, we review research showing that the way in which parents discuss everyday experiences with their young children has significant implications for the children's cognitive and socio-emotional functioning. Specifically, mothers who engage their child in a rich elaborative style of talking about past experiences have children who also develop an elaborative style of remembering and reporting personal experiences. Evidence suggests that elaborative reminiscing can benefit children's social and self understanding, the quality of the parent-child relationship, and language and emergent literacy. Moreover, findings show that elements of the elaborative style can be identified and taught to parents. We propose that elaborative parent-child discussion about the past could form the basis of developmentally sensitive intervention during the preschool period.     

Neuromotor, cognitive, language and behavioural outcome in children born following IVF or ICSI-a systematic review

BACKGROUND: The effect of in vitro fertilization (IVF) or intracytoplasmicsperm injection (ICSI) on the developing human brain is unclear.The objective of this study is to evaluate neurodevelopmental(ND) outcome of children born following these techniques. METHODS: This systematic review includes studies which compare a groupof children born following IVF/ICSI to children born after naturalconception by assessing outcome in terms of neuromotor development,cognition, speech/language and behaviour. Specific attentionis paid to the studies’ methodological quality based onstudy design, attrition, blinding of the assessor, validityof ND tests used, confounders included and group size or poweranalysis. RESULTS: Twenty-three out of 59 studies had a good methodological qualityincluding 9 register-based (RB) and 14 controlled studies. RBstudies suggested that IVF/ICSI per se does not increase therisk for severe cognitive impairment (i.e. mental retardation)or neuromotor handicaps such as cerebral palsy (CP), the associationof IVF/ICSI and CP being brought about by the association ofassisted conception with risk factors, like preterm birth. Ingeneral, controlled studies of good quality did not report anexcess of ND disorders in IVF/ICSI-children. However, the majorityof studies followed the children during infancy only, therebyprecluding pertinent conclusions on the risk of ND disordersthat come to the expression at older ages, such as fine manipulativedisability or dyslexia. CONCLUSIONS: A negative effect of assisted conception on the developing humanbrain is not identified; however, further research of high methodologicalquality in children beyond pre-school age is needed.     

Children's responses to conflict between their different parents: mothers, stepfathers, nonresident fathers, and nonresident stepmothers.

Children who have experienced parental separation have potentially 3 sets of parents whose relationships may impact on them: mother and former partner, mother and stepfather, and father and new partner. Children's accounts of their response to conflict between these different parental dyads were studied, in relation to the quality of their relationships with these parents assessed with child interviews and questionnaires, and to maternal reports of the children's adjustment, in a sample of 159 children growing up in different family settings. Involvement in conflict within 1 parental dyad was chiefly unrelated to such involvement in conflict between the other parental dyads. In contrast, there was evidence for "spillover" effects in relationships within families; for instance, high frequencies of conflict between parents were linked to more troubled parent-child relationships. Children were more likely to side with the parent to whom they were biologically related than with stepparents. Involvement in mother-nonresident father conflict and in mother-stepfather conflict were both associated with adjustment problems, independent of the qualities of positivity and conflict in the relationship between child and parent. Implications for views on "family boundaries" are considered.