Donor Insemination : The needs of the couple

by Petra Thorn, PhD
Winter 2010

As a social worker and family therapist, I have been working with couples using donor insemination (DI) to build their families for over 15 years. I have counselled couples before, during and after treatment, and together with Ken Daniels from New Zealand, conducted educational seminars. Though I live and work in Germany, where both the culture and legislation regarding DI is different from Canada, many of the issues I explore and raise with couples and families are likely to be very similar. This first of two articles will focus on the needs of couples. It will be followed by an article on the needs of children in the next edition of this magazine.

Experiencing situations that require major changes in the way we live our lives, and in the plans we have made for ourselves individually and as a couple, can lead to feelings of anxiety, helplessness and vulnerability. We need to re-orientate ourselves. We need time to process and understand the facts and our emotional reactions in order to develop strength to tackle the new situation, make the right decisions and move on with our lives.

Being diagnosed with infertility and realizing that DI may be the only option to build a family certainly belongs in the category of such life-altering experiences. Many of the couples I have counselled or that have attended our seminars have, in one way or another, used the word “confidence” to describe what they lacked when they first heard about infertility and DI. Confidence is what they gained after they had sought support, especially after having attended one of the seminars. Mostly couples need to gain or regain confidence about themselves and about their plan to use DI.

Building a family with the help of DI means building a family with a difference. Being different tends to have a negative connotation but there are many different family types around and those built by DI are no better or worse, but simply different. Couples often say that it is this difference, and the lack of information about using DI to build a family, that makes them feel uncomfortable or sometimes even anxious about pursuing it. Sharing their plan to use DI with friends and relatives and not knowing how they may react adds to this uncertainty.

Being a parent after DI is different from parenthood after having conceived a child biologically related to both parents, or having adopted a child. Parenthood after DI leads to differences between the mother and the father: the mother has biological ties, but the father does not, as it is the donor who shares biological ties with the child. This often results in uncertainty as to the emotional bonding between the child and the father, and concerns as to the way the child may view the donor. As one man who participated in a seminar expressed:

“If I am not the biological father, will the child love me less, and instinctively feel drawn to the donor? Am I worth less because I am only the ‘social’ father? This is what my wife and I fear most, and I’d rather not have a child than be a secondary father.”

Understandably, men need to feel confident that they are fully accepted as fathers by their children. They also need to feel confident that the donor has a different role from themselves. It is helpful for couples to know that young children will bond with those who provide love, care and stimulation on an ongoing and consistent basis. In a family after DI, these will be the mother and the father. The donor does not play a role in the daily life of a child and thus does not have a fatherly role. Research has indicated that the bonding between fathers after DI and their children is no different from the bonding in other families and there is no reason why this should be different.

From the perspective of the child, the father is the only male person who can and does fulfil the role as a father. It can be helpful for couples to use clear terminology when they talk about the donor, both for themselves and later on for their child. Calling the father “father” and the donor “donor” or “the man who gave us the semen” clearly differentiates the two men and is less confusing than talking about a “social” and a “biological” father.

Of course, men may also feel uncertain as to whether they can love a child conceived by DI as unconditionally as they would love a child conceived with their own semen. All the couples I spoke to after they had conceived a child by DI confirmed that, when the child was born, they both felt instinctively drawn to the child and felt that it was “their” child. In an interview I carried out some time ago, a male respondent explained in very simple terms why he felt certain he would be able to love his child:

“I would feel very much as the father. And there is a simple reason for it: The child grows under the heart of my wife, my wife is a part of me, and therefore, the child is a part of me.”

Again, this confirms that confidence is important; in this case, it is the feeling of confidence about the relationship and the commitment to having a child together.

There is another issue attached to the role of the donor. Men may also feel threatened because the donor is able to provide something they cannot: viable semen to conceive a child. This may cause low self-esteem. It can be useful to view the donor from a different perspective: rather than somebody who competes with or replaces the male partner, he can be seen as somebody who helps the couple to fulfil their desire to have a child by giving them one vital ingredient as a gift: his semen. The following reflects this shift in perspective:

“We had a hard time deciding on DI because we kept viewing the donor as somebody who would replace my husband – after all, the donor had what my husband did not have. After a while we came to the conclusion that we should not define the situation by what my husband did not have, but rather by what my husband did have. My husband had (and has) love, commitment and a great desire to build a family with me. The only thing he did not have was the semen. The donor gave us his semen, and we happily accepted his important gift, but of course, the donor did not have all the other very important ingredients of what it takes to make a family. At least he did not have this for us, but of course he may have this for his own family.”

Couples tend to feel ambivalent about sharing their plan to use DI with family members or friends. However, the female partner often has a need to talk about the difficulty the couple is experiencing; and there is a certain degree of uncertainty or even anxiety regarding possible reactions. Despite an increasing amount of media coverage and other publicity about DI, the general public does not tend to be well-informed about it. The stigma and taboos surrounding it have decreased in recent years, but a certain amount remains. The following statement by a man indicates what he and his wife felt initially:

“I was unsure whether I should talk to my parents about the fact that we were planning to use DI. They are the older generation. Maybe they would have associated it with having an extra-marital affair or they would have felt awkward towards a child. They did not know anything about medical treatment or DI and they may have reacted in a pretty negative way. And this was the last thing we needed at that stage. We did need their support and understanding, but we could not have coped with any negativity about DI. Therefore it took us a long time to decide to talk to them. In the end we did. We just could not make them believe that everything was fine. They felt something was wrong. Initially they were surprised and a little concerned about using DI, but after we had talked to them several times and had discussed it in more detail, they fully supported our decision. We felt very relieved and we talked to some friends and more relatives about DI afterwards.”

It does take courage and confidence to discuss DI with relatives and friends. However, once couples have resolved some of the more personal issues, such as the way they view the father and the donor, they may feel a little more relaxed about talking to others. Of course nobody knows how others may react. I have talked to many couples who have discussed DI with others, and almost all reported that friends and relatives reacted in an understanding way. Several reported that it took some time until they understood what DI entails and they had to make some adjustments, but these adjustments may be similar to the ones couples have to make themselves when they are initially confronted with infertility and have to consider DI. A woman who had talked to her parents several times explained this:

“When we talked to my parents, they needed time to digest it. We did not really get many opinions or reactions, but lots of questions. They were a bit dumbfounded about it and it took them some time to think about it. In the end, they were very happy once I got pregnant.”

Couples need to feel confident about their decision to use DI, both within themselves and toward others. There are many resources to improve your confidence about DI. There are books you can read, support group meetings and counsellors you can consult. As I mentioned at the beginning of this article, in Germany we have conducted many educational seminars for couples. We have also evaluated these seminars and found that it is the combination of several factors that has contributed to fulfilling the needs of couples considering DI. These are:

the provision of structured information,
being able to explore challenging emotional reactions,
sharing with others in the same situation
having the opportunity to meet couples, who have not only succeeded in having children through DI but who feel proud about their family.

Using DI may emerge from a difficult situation, but there are resources available that help you to regain confidence so that the family you intend to build can be based on strength and commitment.

About the Author

Petra Thorn is a social worker and family therapist who has worked with infertility patients for over ten years; with her PhD and further research she specialized in the area of donor insemination. She provides individual and couple counselling and conducts group seminars for couples considering DI and has published a book for couples considering DI and books for heterosexual and lesbian families who want to share the nature of conception with their child. She was also involved in establishing the German patient organisation “Wunschkind e.V.” and is currently Chair of the German Infertility Counselling Network. Dr. Thorn is involved in the organisation of the annual meeting of the International Consumer Support for Infertility (iCSi) and is a lecturer at the Protestant University of Applied Sciences in Darmstadt (Germany). www.pthorn.de.

The author’s colleague, Ken Daniels, is an adjunct Professor at the School of Social Work and Human Services of the University of Canterbury, New Zealand. He has carried out research and published in the area of assisted human reproduction and family building using DI for over 30 years. He is author of the book Building a family with the assistance of donor insemination which was published in 2004