Counselling Before Donation

How donors and lesbian couples can benefit?

by Dr. Petra Thorn   www.pthorn.de

It is becoming increasingly common for lesbian couples to use donor insemination (DI) in order to fulfil their wish for a child. If you intend to go through a licensed clinic in the UK, the clinic will recommend counselling prior to starting treatment. Counselling can also be helpful if plan a home insemination. In this short article, I will describe what we as counsellors focus on and how you can benefit from counselling.

The aim of counselling is to provide you with information, ensure that you understand the psychosocial implications and help you in the decision-making process for or against DI. 

One of the first decisions you have to take is whether you go through the medical system (a clinic) or whether you plan self-insemination. One option is not better than the other, but for you as a couple and for the child as well as for the donor, the implications may be very different. Men who donate via a UK clinic undergo a screening process which means that the likelihood of catching an infectious disease is minimal. Men who donate at clinics also enjoy legal protection: They will have no paternal responsibility towards the child. In most cases they are anonymous at the time of donation, but children have the right to access their identity upon maturity. This is very different if you carry out self-insemination with the semen of a man known to you: If man donates outside a medical setting, there may not be any screening for infections and legal paternity becomes a complex issue (see: http://www.prideangel.com/p63/faqs/Fertility-Law.aspx); it may be necessary to seek legal advice prior to treatment. 

If you know the donor, it is helpful for all involved to clarify his role. This is easiest in counselling sessions with you as the lesbian couple and the donor (and his partner) together. The three of you will have to define his involvement in the child’s upbringing, the terminology that you consider appropriate for him and how you manage his role in your larger social context: your family, your circle of friends and of course the donor’s family and circle of friends. The terminology the three of you consider appropriate will symbolize the degree of the donor’s involvement: In some cases, he will be called a “father” or “daddy”, suggesting that he will have a close bond to the child, in others, he may be called “uncle Tony”, suggesting that the child will know him and he will have a role similar to a close family member, but not be in the position of a father. In others again, the words used to describe the donor may signify a clear boundary between the lesbian family and him: he will be called by his first name, without any other attributes suggesting emotional closeness to the child.

It may be a lengthy process between you and the donor to agree on what suits your situation and your expectations. There is no right or wrong – but it is important to clarify this issue before you start inseminating. At the same time, you should bear in mind that feelings and expectations may change once the child is born. The man who provided his semen may feel more attached the child than he had expected, and he may voice a desire for more contact. Therefore, it is vital that the relationship between the three of you is such that any changes in feelings or in life circumstances can be openly shared and discussed. 

If the donor has an active part in your family, it is helpful to discuss what the expectations of all of you are: will he see the child on a regular basis, will he celebrate Christmas or the child’s birthday with you, will he be introduced to the grandparents of the child – and will the child be introduced to his own parents as their grandchild? Furthermore, the three of you should be aware that older children may voice needs of their own – and they don't necessarily reflect the agreements of the adult parties. Adolescents may want to determine themselves how much contact they have with their donor, and you as the parents will have to discuss this with the donor, adapt and find a balance that suits the child. Should these discussions be challenging, you can seek counselling again. All fertility counsellors are aware that family building using DI can have very long-term implications and provide support to families and donors many years after the child has been born.

Once you have decided to use DI and you start talking to family members and friends about you plan to have a child, you may find that not many people know what DI entails. They may have questions and you are likely to have to explain what insemination procedures there are and what options you have. You will be the “expert” in these situations and you may find others to be sceptical. It is helpful to signal your willingness to share you knowledge and experience and thus to counter any taboo or secret that has been associated with DI for so many years.  At the same time, once your child is born, you may have little desire to be in the position of such a “pioneer”. Counselling can help you as parents to navigate your balance between ensuring that lesbian families via DI will become increasingly visible and accepted and maintaining your private life as a family. 

In some cases, lesbian couples become pregnant quickly. In others, it takes a long time and can require not only inseminations but more advanced infertility treatment. If the latter is the case, you are likely to undergo the typical emotional roller-coaster that all couples in infertility treatment experience: Hoping for successful treatment, waiting for results, mourning and grieving if treatment fails – and deciding when to end treatment. This can be a trying time for yourself and for you as a couple. In this phase, counselling can support you, can help to find an emotional balance and ensure that you as a couple provide emotional and practical support for each other. Should you decide against further treatment, counsellors are there to explore alternative family building options (such as adoption) or prepare a life without children.

Last but not least, counsellors can explore with you how you can share the DI conception with your future child as well as your family and friends, can show you resources such as story books and guidance literature and are there for any other issues linked to the DI conception and fertility treatment.

Petra Thorn is a family therapist and infertility counsellor in private practice (www.pthorn.de) and has published widely in the area of family building by donor insemination. She has also written books for children (www.famart.de) and guidance literature for parents.