Egg donor pregnancy and issues in motherhood

Medi­cal inter­ven­tion for repro­duc­tion is very libe­ral in the US, so buying sperm and eggs on the Inter­net is easy. Many pre­gnan­cies in the past years had been suc­cess­ful after IVF, from ovum coming from other women sel­ling their eggs. The embryo crea­ted in the medi­cal lab can be trans­fer­red to the woman’s ute­rus or kept fro­zen. We talk about egg donor, but this is a mar­ket exchan­ging human bio­lo­gi­cal pro­ducts and money, not a dona­tion.
The choice to be invol­ved in a medi­cal pro­cess for pro­crea­tion makes the couple facing new thoughts about repro­duc­tion, life and sexua­li­ty. Recei­ving gametes from ano­ny­mous donor puts the couple in a pri­ma­ry pro­cess asso­cia­ting repre­sen­ta­tions of repro­duc­tion with uncons­cious infan­tile sexua­li­ty fan­ta­sies. At the same time with the pain at being infer­tile and giving power to the medi­cal ins­ti­tu­tion that will func­tion as a third in their dyna­mics, the couple faces the conflicts asso­cia­ted with the satis­fac­tion to over­come their limits at get­ting a child, and the fee­ling of debt and trans­gres­sion. Anxie­ties asso­cia­ted with the repre­sen­ta­tion of egg’s donor play an impor­tant role during the pre­gnan­cy and the deve­lop­ment of mothe­rhood and paren­thood.

After the birth of the child, the com­plexi­ty of the mee­ting with the real child, the pro­jec­tions of the nar­cis­sist issues regar­ding its ori­gins, and the split­ting in the couple bet­ween the father being entit­led to claim the baby as his and the mother’s doubts about her right to do so, puts the mother-infant dyad at risk. We have to think about the baby’s psy­chic deve­lop­ment in this spe­ci­fic context.
Egg donor pre­gnan­cy is not a patho­lo­gy and doesn’t deve­lop more disor­ders in chil­dren than any conflic­ted pre­gnan­cy, but there are spe­ci­fic trau­ma­tic expe­riences in the parents that can be explo­red to make us more atten­tive on how to help the couples dea­ling with the new tech­no­lo­gies.
The mutual iden­ti­fi­ca­tion bet­ween mother and infant is under the mother’s own infan­tile uncons­cious repre­sen­ta­tion of being a female. This spe­ci­fic inter­ac­tion helps the mother’s cathexis of her capa­ci­ty to contain babies. That makes the girl facing ambi­va­lence bet­ween envy towards the mother’s body pos­ses­sions and regres­sion to a nar­cis­sis­tic sym­bio­sis. Buying the eggs of ano­ther woman makes the woman dea­ling with envy, depres­sion and rival­ry.
The ute­rus can be expe­rien­ced as a sexual organ or as a silent part of the body, assi­mi­la­ted to the diges­tive sys­tem in an anal invest­ment. The capa­ci­ty for repre­sen­ta­tion of the inter­nal organs is here at stake. Some­times the ute­rus is not dif­fe­ren­tia­ted from a repre­sen­ta­tion of the mother’s one.
This undif­fe­ren­tia­ting makes the woman pre­gnant after an egg donor and a non-sexual impre­gna­tion, having the fan­ta­sy not only at having sto­len the mother’s eggs, but at being in a sym­bio­tic rela­tion again with her mother’s body. This is obser­ved in hypo­chon­driac anxie­ties. For some the first pre­gnan­cy, even with medi­cal inter­ven­tion, is the moment of owing her own ute­rus, but for most of those women, this leads to a repe­ti­tion of infan­tile issues, that could even­tual­ly play a role in the cathexis of the baby after the birth, and the rela­tion­ship with a baby girl.

A woman infer­tile or too old to pro­duce eggs will have trouble at reco­ve­ring a sense of her crea­ti­vi­ty and of an ero­tic part of her body. The ute­rus is seen as her own mother’s pro­per­ty as it was in the girl’s fan­ta­sy and with the medi­cal inter­ven­tion, it becomes the fetus’ one when the pre­gnan­cy is suc­cess­ful, with the doc­tors che­cking on the it on a regu­lar basis, under the husband’s super­vi­sion : Some women expe­rien­ced their repro­duc­tive organs as sto­len by the next gene­ra­tion and dis­con­nect them­selves from the pre­gnan­cy or start to deve­lop para­noid anxie­ty. Invest­ment in the baby as a future source of love and pride is at stake. Defense mecha­nisms against the aggres­sion towards the fetus and when facing intense guilt towards their own mother make the pre­gnant women regai­ning the anal cathexis of their body they had during todd­le­rhood. Diges­tive issues during the pre­gnan­cy are per­ma­nent, and after the birth, preoc­cu­pa­tion with control of dirt, clean­li­ness and expul­sion are impor­tant, lea­ding to pro­blems at taking care of the baby’s body. Breast fee­ding is dis­gus­ting and unplea­sant, the infant’s vomi­ting and feces are source of hor­ror and fee­lings of per­se­cu­tion. Depres­sion is often hid­den behind hypo­chon­driac preoc­cu­pa­tion, with a dif­fi­cul­ty at crea­ting a repre­sen­ta­tion of her­self as a mother and of the child as a per­son. Buying eggs in the inter­net is expe­rien­ced as a trans­gres­sion that is source of omni­po­tence and shame. This will play an impor­tant role later on, when the parents will choose to tell the child or not about this unu­sual concep­tion and its ori­gins.
A patient repor­ted the dream, after she knew that the fecun­da­tion bet­ween the egg from the donor and her husband’s sperm was suc­cess­ful : She is pre­gnant from her mother’s lover and is full with dis­gust, she is guil­ty of wan­ting an abor­tion and feels trap­ped in the pre­gnan­cy ; losing her free­dom, she is depres­sed and her life is rui­ned. Ano­ther repor­ted that dream during a pre­gnan­cy she kept secret from her parents : She is on the sea, swim­ming, hope­less to find the ground ; she is loo­king for her mother who is too far away and she could die from exhaus­tion.
Time plays an impor­tant role for those women, after years or months of fai­lures to get pre­gnant, medi­cal inter­ven­tions, anxie­ty and nar­cis­sis­tic damage. There is a sense of triumph at being pre­gnant, with a maso­chis­tic com­pro­mise to conceive a baby at any price. Some women can­not choose the egg donor’s sys­tem, being hurt by their own infer­ti­li­ty and having concern for the future child’s well-being. Some will go for it, making real the idea­li­zed wish to conceive a baby, to pay for what they think has been a sin­ful life in their youth.

Then there is the time of the pre­gnan­cy, limi­ted and well struc­tu­red, when the psy­cho­lo­gi­cal deve­lop­ment of a woman into a mother can take place ; With hea­vy medi­cal sup­port, a lot of anxie­ty about the qua­li­ty of the pre­gnan­cy and the sur­vi­val of the fetus, there is a strong ambi­va­lence towards the forei­gn egg. The level of inse­cu­ri­ty and control­ling reac­tions in the part­ner plays an impor­tant role. The anal issues rela­ted to the baby’s arri­val aggra­vate those anxie­ties.
Few months after the birth, after emo­tio­nal tur­bu­lence and anxie­ty at mee­ting with a baby dif­fi­cult to adopt, some women have to deal with the pres­sure of the doc­tors at get­ting a new pre­gnan­cy as fast as pos­sible, in order to bene­fit from the fro­zen eggs. Mothers feel their body as a tool for pro­du­cing babies when they are not rea­dy to invest in a new child.
Dea­ling with an ima­go of omni­po­tent mother idea­li­zed in her repro­duc­tive capa­ci­ties and source of aggres­sive fee­lings, some of those pre­gnant women deve­lop a dis­gust for the female body, can­not look at them­selves in a mir­ror while pre­gnant. One of them des­cri­bed how hor­ri­fic it was for her to see her mother’s detes­ted body while loo­king at her­self.
In my cli­ni­cal expe­rience with egg donor pre­gnan­cies, I met with spe­ci­fic issues :
‑The ques­tion of the abi­li­ty to love and to iden­ti­fy with the new baby.
‑The regres­sion to infan­tile sexua­li­ty, with strong defenses that led to inabi­li­ty to touch the infant and breast­fee­ding pro­blems.
‑The mater­nal maso­chism when at the same time having a fan­ta­sy of being omni­po­tent and eter­nal.
‑The pre­valent nar­cis­sis­tic cathexis into the child, with the goal make that pre­cious baby a pre­co­cious pre­for­ming child.
‑The obser­va­tion of intense nega­tive reac­tions in babies, with the risk of deve­lo­ping des­truc­ti­ve­ness ins­tead of plea­sure and libi­di­nal cathexis.
I have trea­ted many cases of women in their late 40s who got a last chance of beco­ming pre­gnant after having been single for long. Having eggs from a donor was their only way to get the idea­li­zed pre­gnan­cy. They chose ano­ny­mous donors on the inter­net, spe­cu­la­ting about ori­gins, eye color, intel­lec­tual capa­ci­ties and ima­gi­na­ry capa­bi­li­ties. They suf­fe­red a great deal of doubts during that pro­cess, with envy at the husband’s capa­ci­ty to have his sperm impre­gna­ting the egg. During the pre­gnan­cy under intense medi­cal sur­veillance, the drea­ming pro­cess about the baby was poor. The anxie­ty to car­ry the pre­cious pre­gnan­cy in a depre­cia­ted body asso­cia­ted with the weird sen­sa­tion to be a contai­ner for a forei­gn crea­tion made dif­fi­cult the regres­sive fan­ta­sy of sym­bio­tic rela­tion with the fetus. The split bet­ween mother and fetus became acute at the end of the pre­gnan­cy. As soon as the baby was born, and far more when they had a baby girl, those mothers expe­rien­ced the new crea­ture being very wel­come by the father and the grand­pa­rents as a pre­fect girl, the mother felt depre­cia­ted, depres­sed. Imme­diate rival­ry was in place, to the huge dis­tress of the new mother.
Most of those new mothers coming for consul­ta­tion with their infant, were dea­ling with des­pair at not being able to love their new­born, or thin­king they gave birth to a child who couldn’t attach to them. Some had dis­so­cia­ted them­selves from any fee­ling and sen­sa­tion, func­tio­ning in a concrete mecha­ni­cal beha­vior, like in the ‘blank depres­sion” des­cri­bed by Andre Green. They couldn’t find any plea­sure in the body contact with the child. I had to label their nega­tive fee­lings as sad­ness and anger, some­times pro­jec­ted in to the baby.
The trau­ma of the past ste­ri­li­ty, the mis­car­riages, IVF, medi­cal treat­ments and anxie­ty over their pre­gnan­cy had made them sen­si­tive to any judg­ment about their capa­bi­li­ty for mothe­ring a child.

Gustave Klimt
Gus­tav Klimt, détail

We observe how beco­ming a parent signi­fies confron­ting a “deve­lop­men­tal pro­cess of mour­ning” for the future parent (Pala­cio Espa­sa, 2004) who must cede the place he had occu­pied as the child of his parents. The pre­sence of the infant makes the couple to assume the role of the parent, in an inter­ac­tive dyna­mic bet­ween iden­ti­fi­ca­tion with the child and libi­di­nal and aggres­sive drives. I obser­ved that most of couples consul­ting after egg donor pre­gnan­cy have deve­lo­ped a maso­chis­tic rela­tion to the baby.
There guilt fee­lings towards their own parents and the donor result in sub­mis­sion to accept all the child’s demands without any limit, in a need for expia­tion, while pro­jec­ting into the infant a gran­dio­si­ty asso­cia­ted with all the nar­cis­sis­tic wishes that are part of this kind of dif­fi­cult pre­gnan­cy. The mother feels being unwor­thy ; any symp­tom in the baby, fee­ding, slee­ping, anal issues, reac­ti­va­ting infan­tile sexua­li­ty fan­ta­sy and conflicts, is inter­pre­ted as an accu­sa­tion. Aggres­sion is pro­jec­ted into the baby, and most baby girls are felt as mean and des­truc­tive, left in a manic state of non-contai­ned agi­ta­tion. The sado­ma­so­chis­tic qua­li­ty in the dyad with the strong super­e­go source of intense guilt, plays a role in the child’s low self-esteem and depres­sive reac­tions.
There is a trau­ma­tic impact of medi­cal inter­ven­tions in repro­duc­tion. It’s impor­tant for psy­cho­ana­lysts to be aware of the role of pre­ven­tive inter­ven­tions, and to make the gyne­co­lo­gist as the pedia­tri­cians aware of the signs of lack of libi­di­nal invest­ment in the pre­gnan­cy as in the baby. Most of the suf­fe­ring in those cases is quite silent, but will have a strong impact in the child’s deve­lop­ment. Psy­cho­ana­ly­tic inter­ven­tions can help to work with the parents with their repre­sen­ta­tions of the ori­gins of the child that inter­fere with the infant’s own needs.

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