Are IVF pregnancies more 'precious'?
- 29 December 2013
- From the section Health
Women who have gone through fertility treatment often say it had a huge emotional and psychological impact on them and their partners.
In many cases, couples have spent years trying to conceive before going through several cycles of IVF, which can be expensive and traumatic, with no guarantee of success.
So are pregnancies achieved through assisted fertility treatments viewed as inherently more precious to everyone involved?
A study from Plymouth University published last month suggests they are. Dr Yaniv Hanoch asked 160 Israeli obstetricians and gynaecologists whether they would recommend a test for a serious medical condition during pregnancy.
He found that doctors were three times more likely to recommend the test, which carried a small risk, for a natural pregnancy than for an IVF pregnancy.
Dr Hanoch, associate professor in psychology, said: "When considering a procedure that may endanger a pregnancy, the value ascribed to loss of that pregnancy may seem greater if the pregnancy was achieved by tremendous effort."
In 2005, Minkoff and Berkowitz published a study in the American journal, Obstetrics and Gynecology entitled 'The Myth of the Precious Baby'.
It said that because increasing numbers of pregnant women were aged over 40 and more were pregnant thanks to assisted reproductive technologies, this had resulted in more ceasarean deliveries, reinforcing the idea among obstetricians that they were dealing with 'precious babies'.
On the ground, there is less evidence of sensitivity and understanding from health professionals towards women with IVF pregnancies.
Susan Seenan, from the Infertility Network UK, says the system lets these women down.
"When these women finally go to their GP and say they are pregnant, they are referred for ante-natal care and that's it.
"Even when they make it known they have had IVF, they are seen as just another pregnant lady."
She says sometimes even when women reveal they have suffered miscarriages or have had fertility issues, there is a lack of sympathy.
She says fertility treatment is widely recognised to be a physically, psychologically and financially demanding process - and it can leave women feeling they have been on an 'emotional rollercoaster'.
"A lot of women feel very anxious, because they have been through so much, and many women really do worry that everything will be OK.
"Until you go home with your baby in your arms, that anxiety is always there. People need to understand why they are feeling vulnerable and anxious.
"If they have been through the IVF system they will have had a lot of attention, appointments, blood tests and scans - and they expect that attention to continue."
Instead, many women are left feeling isolated when they are most in need of reassurance.
Seenan says this could be remedied by providing support in the form of a phoneline to call in times of anxiety or information leaflets to read.
Research does seem to confirm higher levels of anxiety in women with IVF pregnancies, says Julie Jomeen, professor of midwifery at Hull University, who adds that their feelings can mean they want a more medicalised approach to their pregnancy.
Older mums-to-be may request a caesarean section delivery, believing that it is safer, for example.
Or a woman who is scared of losing her baby throughout pregnancy, may need reassurance that normal symptoms of pregnancy, such as backache, are not something more serious.
Mr Tim Child, medical director at the Oxford Fertility Unit at the University of Oxford, acknowledges that women who have conceived naturally can have anxieties too, but he says it would be understandable if IVF women felt they needed more support.
"Some women like to feel they have access to extra information as required, even if it's just a phone number to speak to a midwife about any aches or pains."
He says not all women want to disclose that they have been through IVF because there is still some stigma attached to it. Others may want to be treated the same as every other woman, so their IVF history may not always appear on their personal notes.
Medically, there are slightly higher risks of complications in IVF pregnancies, particularly if the woman is older, has underlying health problems or is having twins, so Mr Child says consultants should be vigilant.
A study is currently underway at Oxford into how midwives care for women have had fertility treatment.
When women with IVF pregnancies are open about their anxieties, what they are looking for is not special treatment in the belief that their baby is more precious than anyone else's, but reassurance and support during the final stages of a long and emotional journey.
Even when the baby is born, it doesn't end, Susan Seenan says.
"Because the baby has been wanted for so along, you put pressure on yourself to be a perfect parent. So you're not allowed to complain when it cries at night or doesn't feed well. But in the end, we are just parents like anyone else."