Given the complex combination of emotions that IVF treatment triggers, Kate Brian explores the possibility that babies created this way might have an extra psychological pull on a mother.
For anyone who has struggled to conceive, a positive pregnancy test result is the moment you’ve dreamt of – the final end to your fertility problems and the start of a new and happy journey to parenthood. Once implanted in the womb, a baby conceived through fertility treatment should be just the same as any other, so why do parents-to-be who’ve had to wait to get pregnant often feel that they’re still ‘different’? And why does the medical profession sometimes refer to children conceived through fertility treatment as “precious babies”?
The subject of ‘precious’ IVF babies hit the headlines late last year with a study that considered the way obstetricians cared for pregnant women who’d had fertility treatment. The researchers looked at invasive tests carried out during pregnancy which had a small risk of miscarriage. It may not be surprising that couples who’d had fertility treatment might feel differently about tests which carried any risk of harming their baby, but this research found that doctors treated them differently
too. The obstetricians in the study were three times more likely to recommend tests which carried risks to women who’d conceived without help than they were to suggest them to IVF/ICSI parents-to-be. The study concluded that the effort patients had put into getting pregnant played a key role when decisions of this kind were made, and that doctors clearly took into account the way in which a baby had been conceived as part of the process.
Evidence suggests that it’s not just during pregnancy that doctors treat IVF pregnancies differently, but right through to birth itself. One study in Australia found that women who’d had IVF/ICSI were twice as likely to have a Caesarean section. Although in some cases there may have been a medical reason for this, in many others it was thought that obstetricians were more inclined to intervene and suggest a Caesarean because they felt that IVF mums might not be able to get pregnant again. And of course, some IVF parents may be more likely to opt for a c-section if they feel a medicalised approach to the birth is somehow a safer option.
In fact, there’s no reason to conclude that an IVF baby is different from any other baby, and no reason for an IVF pregnancy to automatically be any higher risk, so what lies behind the differences in the way the parents are treated? One theory is that because more women who’ve had fertility treatment are older and have more complications, this has led to more medical interventions in their treatment and has itself given rise to the idea that IVF pregnancies need to be treated with kid gloves.
Spokesman for the Royal College of Obstetricians and Gynaecologists Professor Charles Kingsland makes the point that the differences in the way IVF pregnancies are treated are not necessarily to do with the babies themselves or the IVF treatment, but may actually have their closest link to the parents.
“I think these are precious babies not because we’re talking about IVF pregnancies, but because their mothers have tried so hard to have them,” he says. “They are the same as any other babies, but it’s the mothers who tend to be different. They tend to be older and they may have medical complications that may have contributed to their fertility problem and could cause further difficulties in the resulting pregnancy. And as our abilities in reproductive medicine have grown, we are able to create pregnancies in women who, by natural selection, would not have got pregnant.”
There is sometimes an assumption that anyone expecting a baby after fertility treatment ought to be classified as a higher risk pregnancy needing special care, but in fact what most of
us need is more reassurance rather than more medical interventions. If you are expecting twins, if you are an older mother or have existing medical conditions, you may need more medical support – but for most former fertility patients, it’s not the medical aspects of their pregnancy that are different, but the emotions involved.
My first thought when I looked down at a home pregnancy test showing a positive result after four years of trying and treatment wasn’t joy at being pregnant, but an immediate assumption that there must be something very wrong with the test kit. Like many women who have taken time to get pregnant, I’d got so used to living with failure when it came to reproduction that I’d almost stopped believing we might ever be successful. When a hospital blood test confirmed the result, I had to accept that maybe it really was true. The moment was just as exhilarating as I’d imagined it might be, but I still found it almost incomprehensible that this meant we were going to end up with a baby of our own. I’d got so used to my body letting me down when it came to pregnancy that I couldn’t believe I would be capable of carrying a baby for nine months. Of course, leaving the fertility clinic behind was wonderful, but going out into the ‘normal’ world where there were long months between antenatal appointments seemed alarming having grown accustomed to regular monitoring during treatment.
Being pregnant made me feel as if I’d sneaked in through the back door of a club I wasn’t sure I was entitled to join. I worried about buying anything for the baby in case it might be tempting fate, and when I finally allowed myself to start reading pregnancy books I became convinced I had every pregnancy complication under the sun. It was the midwife caring for me who finally made me understand that just because I’d had problems getting pregnant, it didn’t automatically follow that I’d have problems being pregnant!
Speaking to other people, I started to realise that my feelings about being ‘different’ during pregnancy were far from unique amongst women who’d had fertility problems, and that was what led me to write my book Precious Babies – Pregnancy, Birth and Parenting after Infertility. Of course, we all experience pregnancy differently, but for those who have struggled to conceive in the past there are common themes which deserve recognition.
Julie Jomeen, Professor of Midwifery at the University of Hull, says that the research about anxiety amongst pregnant women who’ve had IVF is not conclusive, but she suggests that “the levels of anxiety experienced may be a continuation of a pre-conception state”. She adds, “It’s possible there is a professional perception that these women are more anxious, because the baby is more precious… that is the mother has tried harder to conceive and if the pregnancy does not succeed she has a lesser chance of achieving another successful pregnancy.”
Those of us who’ve had a long path to pregnancy do tend to feel very aware of the time, effort and heartache we’ve gone through to get this far. When many others are excited at the start of their journey to parenthood, we may already feel we’ve been on a difficult trek just to get to this point. Susan Seenan, Chief Executive of Infertility Network UK, says that this can have an impact. “Sometimes after years of trying to conceive, often with many failures along the way, couples who at last find themselves successful after treatment continue to worry – they worry that the pregnancy will fail or that they will not be good parents.”
Midwife Kelly Hill from the University of West Scotland has looked into the psychological effects of infertility on pregnancy. She suggests that the more emotional support before pregnancy, the lesser the impact of anxiety women feel later on. “The provision of counselling during fertility treatment can make a huge difference in reducing these conditions in pregnant women by arming them with tools to cope with their emotions and anxiety, thereby helping themselves and understanding the value of asking for support when needed,” she says.
One thing that really can make a difference during pregnancy and in the early days of parenting is being in touch with others who are having similar experiences. The charity ACeBabes, an off-shoot of Infertility Network UK, provides information, support and advice to the growing number of people successfully using fertility treatment, surrogacy, adoption
or fostering to become parents. ACeBabes has a dedicated website, and a team who understand the issues involved. Susan Seenan says the charity is aimed at anyone who has been through fertility problems on their route to parenthood. “If you have had fertility problems, you never forget how it feels no matter what the outcome, and ACeBabes provides support and understanding from others who understand how that feels.”
Being pregnant after fertility treatment is always going to be special, but knowing where to get support if you need it can make all the difference and ensure that you are able to enjoy the pregnancy you’ve waited so long for.