Extreme desire for motherhood: Analysis of narratives from women undergoing Assisted Reproductive Technology (ART)

Abstract

The problem of infertility and its consequent treatment (denoted as Assisted Reproductive Technology or ART) represent an increasing phenomenon, especially in industrialized countries. Confronting with one's own procreative limitations can generate strong negative emotional reactions. This study aims at understanding how the desire for motherhood manifests itself in infertile women undergoing ART, studying their emotional and subjective perspective. An in-depth explorative research study was conducted on 17 infertile women attending an Italian hospital clinic for fertility treatment. Emotional text analysis was conducted to analyze the corpus of their interviews, allowing the identification of four thematic domains (clusters) which refer, respectively, to the following emotional dimensions: an inclination to selfsacrifice, seen as the price to be paid for the desired success of the treatment (Cluster 1), pursuit of inclusion in the world of procreative mothers (Cluster 2), precarious equilibrium between the deep desire for a baby and the withdrawal from the treatment (Cluster 3), surrender to any possible consequence in order to obtain the desired mother-child relationship (Cluster 4). The witness of the couples' suffering for their condition of infertility and their strong desire for parenting can represent a source of high pressure for the fertility care staff, as they are the only ones responsible for the fulfillment of the great dream of biological parenthood. For these reasons, a multidisciplinary approach, which involves psychological as well as medical experts all working together, could benefit both the patients and the healthcare professionals and improve the quality of the reproductive healthcare services.

What about fertility staff emotions? An explorative analysis of healthcare professionals’ subjective perspective

“…With regard to performance anxiety, it seems mainly related to the strive for achievement in performing a highly specialized, technical and demanding job ( Fitzgerald, Legge, & Frank, 2013 ), as well as to the stressful conditions of the ART environment, involving work overload and time pressure ( Gerson et al, 2004 ; Harris & Bond, 1987 ; Simpson & Bor, 2001 ). Consistently with previous research on ART patients ( Langher et al, 2019 ), the ART treatment seems to be described as a step-by-step path consisting in huge obstacles to be overcome, which may induce anxiety feelings also in the fertility staff and predispose to an obsessional form of reparation ( Boivin et al, 2012 ; Caputo, Fregonese, & Langher, 2018 ). Indeed, hypervigilance and constant effort to repetitive and structured technical actions could suggest a compulsive way to placate anxiety evoked by infertility as a damaged condition that one tries to remedy.…”

“…Finally, the present manuscript deals with the emotional experiences of ART staff members in line with the previous research study focused on the experiences of patients with infertility problems (Langher et al, 2019).…”

“…Finally, the present manuscript deals with the emotional experiences of ART staff members in line with the previous research study focused on the experiences of patients with infertility problems ( Langher et al, 2019 ). Both research projects were carried out in the same time period, in the same ART clinic and rely on emotional text analysis as used method.…”

“…Emotional text analysis (ETA; Carli, Paniccia, Giovagnoli, Carbone, & Bucci, 2016 ) was used to explore the study participants’ subjective experience, in line with previous research in healthcare settings ( Caputo, 2014 ; Caputo, 2018a ; Caputo, Giacchetta, & Langher, 2016 ) and with specific regard to fertility issues ( Langher et al, 2019 ). From a methodological perspective, ETA is grounded on a psychoanalytic theory of language ( Fornari, 1976 ) that, according to a ‘double reference’ principle, considers language as having both a lexical-cognitive (conscious) and symbolic-affective (unconscious) function.…”

“…Besides this, also the experience of infertility treatment represents as an overwhelming condition that dominates patients’ daily routine ( Daniluk, 2001 ; Redshaw, Hockley, & Davidson, 2007 ) and may represent a critical moment because of the intrusion of medical procedures in the couple’s intimate life (e.g., injections, stimulations, oocyte pick-ups). In this regard, patients undergoing ART procedures may perceive treatment as a source of deep stress, anxiety and concern ( Purewal, Chapman, & van den Akker, 2018 ; Stanhiser & Steiner, 2018 ), which increase with the progression of therapeutic failures, generating a sort of "failure syndrome" ( Langher, Fedele, Caputo, Marchini, & Aragona, 2019 ; Milazzo, Mnatzaganian, Elshaug, Hemphill, & Hiller, 2016 ; Verhaak et al, 2005 ). Patients also show higher levels of depression and shame, compared to people with infertility problems who do not undergo ART ( Galhardo, Pinto-Gouveia, Cunha, & Matos, 2011 ).…”