Saturday, June 26, 2010

Should Secondary Infertility Rates of Birth Mothers be Disclosed in Adoption Counseling?


I came across a very recent study that was published in the journal Psychoanalytic Inquiry and conducted/written by Isabel Andrews titled "Secondary Infertility and Birth Mothers."  Isabel Andrews is affiliated with the Adoption Jigsaw, an entity that has provided search and reunion services, counselling, and support groups for mothers and adoptees separated by adoption in Western Australia.  Andrews was extremely respectful to mothers and recognized the deep loss that many of these mothers feel and expressed it eloquently in her article.

Why Look Into First Mother Infertility?
It was actually two books by Nancy Verrier and finding other research that repeated/supported Verrier's finding that 40-60% of mothers who have lost children to adoption did not go on to have other children that prompted Andrews to conduct this study.  She too found that 40-60% of the original mothers seeking support from Adoption Jigsaw did not go on to have other children and wanted to determine if this percentage was accurate.  She conducted a study that recorded (1) secondary infertility of original mothers seeking support from Adoption Jigsaw (2) secondary infertility reported from data recorded during the search and reunions conducted through Adoption Jigsaw and (3) information that was returned on questionnaires sent out to original mothers.

Andrews categorized her findings by listing three distinct groups of original mothers.  Of original mothers who attend support groups, 40-60% had not had other children.  Andrews feels that in society, original mothers may not necessarily be regarded as being "mother" to the children they relinquished for adoption which may cause a more profound feeling of loss if they have not experienced motherhood and parenting by having more children.  However, when they attend a support group with other original mothers, their motherhood is acknowledged which is supportive and uplifting.  13-20% of the randomly selected group of first mothers had not gone on to have more children.  23% of original mothers who searched for their surrendered descendants have not had other children. 

Though a small sample in WA, Andrews feel that these findings can apply to first mothers universally or at least extend to the first mothers in the rest of Australia.

Andrews speculated that since stress has had ties to infertility that perhaps stress is also a factor in why some original mothers do not have additional children.  She does state that there is no way to know for sure without doing individual case studies.  Some respondents to her study confided that the relinquishment of their child impacted their lives and that they did not find men they wanted to have children with or did not want to have any more children.  Over 60% of the respondents to the survey chose a 9-10 (on a scale of 9-10) on how much their surrender had impacted their "decision or inability" to have additional children (Andrews, 2010, p. 87).  Andrews acknowledged that medical infertility does not encompass all mothers who have not had additional children; most of the mothers who did not chose not to.
"Losing a baby is one of life's greatest traumas; losing a baby to adoption is just as traumatic, if not more so.  When a baby dies, the parents receive enormous support, love, and understanding,  A funeral is held, cards, flowers, and visits recognize their devastation.  When a mother or couple lose a baby to adoption, particularly in the past, there is no recognition of birth, and thus none of loss" (Andrews, 2010, p. 91).
When this study was reported in the adoption community in the U.S., the headline introducing the abstract and link to the article (which the general public cannot access without paying about $30 or having a membership to the journal) stated, "Most Birth Mothers Have More Children."  From the actual text of the study, this was clearly not the implication that Andrews drew from her own research. Andrews concluded by nodding toward the United States, urging a change in how we counsel expectant mothers.  Andrews holds that secondary infertility (whether by a medical issue or simply unintentionally never having anymore children) is a real issue in this population and that counselors are compelled to disclose this in adoption counselling.  This current pregnancy may be a mother's only opportunity to parent and it is unethical, as is so often done in counseling, to tell her she is guaranteed to be able to parent other children in the future.

References:
(Andrews, I. (2010). Secondary infertility and birth mothers. Psychoanalytic Inquiry, 30(1), 80-93.).