Being a 'good' parent: single women reflecting upon 'selfishness' and 'risk' when pursuing motherhood through sperm donation

Single mothers by choice - experiences of single women seeking treatment at a public fertility clinic in Denmark: A pilot study

PROBLEM

There has been an increase in the number of single women deciding to have children through the use of medically assisted reproduction (MAR). These women are referred to as 'single mothers by choice' (SMC).

BACKGROUND

Previous studies have shown how SMC can feel stigmatised.

AIM

Explore if single women seeking fertility treatment in Denmark feel stigmatised.

METHODS

Six single women undergoing MAR at a public fertility clinic in Denmark were interviewed. The interviews were audiotaped, anonymised, and transcribed in full, after provided written consent by the participants to take part in the study. Data were analysed using qualitative content analysis.

FINDINGS

The women would have preferred to have a child in a relationship with a partner. Despite their dream of the nuclear family meaning a family group consisting of two parents and their children (one or more), the women choose to become SMC because motherhood was of such importance, and they feared they would otherwise become too old to have children. The participants did not experience stigma or negative responses to their decision, but they all had an awareness of the prejudices other people might have towards SMC.

CONCLUSION

This study contributes to the understanding of the experiences of single women seeking fertility treatment in a welfare state where there are no differences in the possibilities for different social classes to seek MAR.

Politics, law and a lack of sperm: single women and fertility treatment in the Swedish health system

In 2016 Swedish law was amended to allow single women to access fertility treatment with donor sperm. In this paper, based on interviews, document analysis and autoethnographic insights, I examine the implementation of this law using human rights approaches, specifically the availability, accessibility, acceptability, and quality framework (AAAQ Framework). While the law extended the scope of reproductive rights, the health system was unprepared. Five years on, women seek care in the private sector or continue to travel abroad due in large part to waiting times which can be up to four years in some regions. The paper also provides a meeting point between anthropology and policy analysis. The law change provides a pathway for analyzing the Swedish health system and political context, particularly the relationships between the private and public sectors and between different regions, and the balance of responsibility between national and regional levels. While many of the challenges are unique to the Swedish context, they also offer lessons for countries which have or are considering expanding access to fertility treatment for single women and other patient groups, thus demonstrating the importance of ethnographic approaches in health policy analysis.

Grappling with tradition: the experiences of cisgender, heterosexual mothers and fathers in elective co-parenting arrangements

Elective co-parenting families, meaning two (or more parents) who are not in a romantic relationship having a child together, are becoming more common amongst cisgender, heterosexual parents. The study of elective co-parenting families offers researchers a unique opportunity to decouple co-parenting relationships from romantic relationships, but little research to date has explored their experiences. This study explored two research questions: why do individuals decide to enter into elective co-parenting arrangements? And how do they manage their co-parenting arrangement and their relationship with their co-parent? Interview data from 10 elective co-parents (5 mothers and 5 fathers) were analyzed according to the principles of reflexive thematic analysis. Sociological theorisations of family practices, family display and family thinking were utilized to make sense of the data. The results centred around two organizing themes ('Reproducing the traditional family' and 'Modernising the traditional family'), and participants experienced a tension between these two ideas. Participants aimed to manage their co-parenting relationship with shared values and friendship, but defining their relationship was complex and gendered parenting patterns were ubiquitous. Findings add nuance to theorisations of family life and demonstrate that traditional parenthood ideologies remain pervasive, as parents aim to imagine and pursue parenthood on their own terms.

Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes

Solo motherhood is a family constellation that is becoming increasingly common in high income countries. The demographic characteristics of solo women entering treatment with donated sperm or embryo have been shown to be different from that of cohabiting women. The general importance of perceived social support is frequently amplified when health and quality of life are concerned, and positively affects mental health status, experienced stress, perceived self-efficacy during the transition to parenthood and during parenthood itself. The objective of the present study was to compare demographic characteristics, social network and perceived social support among solo women and cohabiting women awaiting fertility treatment. This objective was explored with a study-specific demographic and background questionnaire as well as through questions on access to practical support and the Multidimensional Scale of Perceived Social Support (MSPSS) assessing different sources of support. This study is a part of a longitudinal prospective multicenter study of solo women who awaited donation treatment in six Swedish public and private fertility clinics and a comparison group of women who were cohabiting/married to male partner and awaited in vitro fertilization (IVF) treatment with the couple's own gametes. A total of 670 women were invited and 463 accepted participation (69% response rate); 207 solo women (study group) and 256 cohabiting women (comparison group). The results show significant differences in age, education, and employment between the groups. Solo women were on average 3.6 years older, had a higher level of education, a higher-income profession, and were more frequently working full time. Solo women perceived an equally high degree of social support from their families, significantly higher levels of support from friends and significantly lower support from a significant other compared to cohabiting women. Solo women expected their mother to be the most supportive person in future parenthood, while cohabiting women most often stated their cohabiting partner to fill that role. The study adds to the body of knowledge of solo women as a sociodemographic distinct group going at motherhood alone, stating a high degree of currently perceived and expected social support. The previously studied negative impact that lack of a co-parent might have, may be attenuated by the expected and perceived social support from family and friends.

From Offline to Online: Understanding Chinese Single Mothers' Uncertainty Management in Interpersonal and Online Contexts

Divorced and unwed single motherhood is heavily stigmatized in Chinese cultural context, preventing Chinese single mothers from actively seeking the information and support needed and negatively impacting their wellbeing. Drawing on the theory of motivated information management (TMIM), this study tested how perceived stigma and cultural norms influenced Chinese single mothers’ search for information and social support from families, friends as well as from online communities. Using two-wave data collected from 226 single mothers, findings support the utility of the TMIM in explaining information management and support seeking behaviors and contribute to situating the TMIM process within larger socio-cultural contexts. Practical implications regarding how to facilitate more effective uncertainty management and enhance Chinese single mothers’ wellbeing in interpersonal vs. online contexts are discussed.

The opposite of a step parent - The genetics without any of the emotion: 'sperm donors' reflections on identity-release donation and relatedness

This paper draws upon data from an online survey with closed- and open-ended questions completed by 168 identity-release sperm donors who had all donated in the UK between 2010 and 2016. Paying particular attention to the qualitative data obtained from the donors' responses to the open-ended questions, this paper explores the sperm donors' thoughts and feelings about being an identity-release donor and about future information exchange and contact with offspring conceived with their gametes. It shows that the majority of donors regarded identity-release donation as their preferred method of donation, supported the removal of anonymity, did not have concerns about being an identity-release donor and indeed saw positives for both the donor-conceived offspring and themselves. However, it also highlights that the donors' thoughts and feelings about being an identity-release sperm donor, how they saw themselves in relation to the individual conceived with their donation, and their preferences for information exchange and contact, varied greatly. The paper explores how identity-release donation is surrounding by many unknowns and consequentially sperm donors struggle to conceptualize what it means to be an identity-release sperm donor. As well as adding to the literature on donor conception, relatedness and kinship, by giving voice to sperm donors' own views and experience of the identity-release regulatory context, and their thoughts and feelings about future information exchange, this paper will help policy makers and clinicians prepare for the imminent time when donor-conceived individuals in the UK can start requesting their donor's identity.

Exploring Swedish single women's decision to choose motherhood through medically assisted reproduction - a qualitative study

New legislation was introduced in Sweden in 2016, giving single women access to medically assisted reproduction (MAR). While Swedish single women's characteristics and motivations for choosing motherhood through MAR were assessed in our previous pilot survey, their experience of considering and making the decision to undergo MAR has not been assessed through a qualitative approach. Thus, the aim of this study was to explore Swedish single women´s experience of making the decision to choose motherhood through MAR. The study design was a qualitative method with a semi-structured interview guide used for individual face-to-face interviews. Sixteen single women accepted for MAR were interviewed individually during their waiting time to start treatment. Qualitative content analysis was used to analyse the data. The data analyses resulted in three main categories: (i) longing and belonging; (ii) social exclusion and support; and (iii) evaluation and encounter. The overarching theme reflects the decision to become a single mother by choice: motherhood through MAR - an emotional and ambivalent decision to make on your own. In conclusion, to reach motherhood, by giving birth to one's child and not deviating from the norm as childless, was considered important among these women when making the decision to become a single mother by choice.

The journey to solo motherhood - An explorative study

OBJECTIVES

In high-income countries, the number of women who choose to become single mothers is rising. This trend is also reflected in Denmark. The aim of this study was to explore the decision- making process of becoming a solo mother.

STUDY DESIGN

This study was designed as an explorative, qualitative study. Semi-structured interviews were conducted face to face or by telephone, to explore women's thoughts and experiences of becoming solo mothers. A systematic text condensation and interpretation were used to analyze the interview material.

RESULTS

Twenty solo mothers-to-be participated in the study and 38 interviews were conducted, before and after pregnancy. Four themes related to the journey of solo motherhood emerged from the data analysis: The dream of motherhood in a nuclear family - a shattered dream, Achieving socio-emotional acceptance, approaching motherhood with a comprehensive plan, and the fatherless child.

CONCLUSION

The nuclear family was considered as the ideal family among our participants. The decision to become solo mother was characterized by a long process of reorganizing ideas about a family. In the effort to feel more secure about being a solo parent, to control the process and reduce vulnerability, most women drew up a detailed motherhood plan, even before embarking on the project.

Single women and motherhood: right now or maybe later?

Purpose: The decision to have a child might be postponed by the lack of partner, and elective egg freezing (EEF) can afford single women more time to find a suitable companion to reach the desired family structure. Alternatively, some women decide to have a child on their own thorough in vitro fertilization (IVF) or intrauterine insemination (IUI) with donor sperm. This study investigates the motivations and personal characteristics of single women undergoing IVF/IUI or EEF.Materials and methods: This is a cross-sectional study including 281 heterosexual single women who underwent either IVF/IUI with donor sperm for solo motherhood (208) or EEF (73) in 2015 at a large fertility center. An anonymous electronic survey was sent after starting the treatment.Results: The most common reason for not having fulfilled the motherhood desire was lack of partner (72.4% IVF/IUI and 65.9% EEF). We found that women undergoing IVF/IUI report a longer motherhood desire, >10 years (71.3% vs. 54.3%), live closer to their families (75.5% vs. 56.5%), and perceive a stronger family support than women undergoing EEF (85.4% vs. 68.8%). Finally, 100% of EEF obviously knew about the possibility of IVF/IUI with donor sperm, while 59.9% of IVF/IUI knew about EEF.Conclusion: Our results underscore the relevance of family ties in the decision to undergo IVF/IUI as single women. Moreover, these women might not be fully informed about social freezing as an option to postpone motherhood. Health professionals should be aware of these differences when counseling single women on fertility choices.