Relatedness in clinical practice

The ever-evolving perceptions of families and family-building lead to challenges in the clinical consultation for those wishing to have a family through assisted conception. The myriad of options available mean that great skill is needed to introduce these choices to the intended parents and to facilitate the exploration of their meaning. This chapter will discuss how the concept of family is approached in clinical practice in the United States and the challenges this presents to professionals and intended parents. First, it will examine the changing conceptions of what constitutes a family. Parents through donor conception often say that third-party assisted reproduction allows them to have ‘a child of their own’, and this chapter will explore the corresponding emotional and psychological meanings for parents. The chapter will go on to consider disclosure of donor origins to the future child. In particular, the chapter will explore how professionals from a multitude of training backgrounds (mental-health professionals, nurses and doctors) present information about disclosure in consultations and the influence these approaches have on intended parents. It will also discuss how the influence of support materials such as children’s books, websites, movies, television and support groups can affect how the concept of family is portrayed to intended parents. The Internet has implications for the accessibility of information for donor-conceived persons, donors and intended parents, potentially circumventing the control of the assisted reproductive technology (ART) clinic, and these developments will also be discussed. The first author (AMB) is a psychologist who has worked in third-party assisted reproduction in the USA for over twenty-five years, and this chapter draws on her professional experience.