Well over a century after the early attempts to achieve pregnancy via artificial insemination, Louise Brown, the first test-tube baby was born in July 1978 in Oldham and District Hospital in Greater Manchester.

The procedure known as in vitro fertilisation (IVF), coming under the umbrella of Assisted Reproductive Technologies (ARTs) raised the hopes of millions of previously untreatable couples worldwide to achieve conception.

However, the excitement was marred partly by ARTs very low success rate, relatively high cost for treatment cycles and complications such as ectopic pregnancies or miscarriages 

ARTs became more controversial socially, culturally and ethically with the introduction of the third party into the procedure namely, conception via egg donation.

This was particularly true with regards to how different cultures would accept pregnancy via a third party. On the one hand, having children is a must and even enforced by religion: ‘Marry and multiply for I will make a display of you on the Day of Judgement’ and on the other hand there is a strong reluctance by people particularly in developing countries to accept third party involvement.

As Pir Jalian found that Iranian mothers of children conceived with egg donation have reservations about their actions and how their child will be accepted in the society. Lack of genetic links was one main factor for not wishing to accept conception by egg donation.

Such is the case that raised the importance of whether Iranian women’s concern may manifest itself even during their pregnancy if achieved by donor egg and hence affect maternal-fetal bonding and health beliefs.

Similar studies on Western women is very limited, the few reported have found little or no evidence that maternal bonding for women with a natural pregnancy differs from that of mothers with an egg donor
conception

In view of possible cultural differences that exist in attitudes towards conception by egg donation, my study aimed to find maternal bonding (feelings and emotions for her fetus, interactions with her fetus) and health beliefs from a non-Western perspective.

I used three questionnaires in a hospital in Tehran (to assess 21 Iranian women pregnant via egg donation and 50 who naturally conceived) namely:

• Maternal-Fetal Attachment (MFA), measuring the degree of mother fetus attachment for example: ‘I picture myself feeding the baby.’;
• Fetal Health Locus of Control, measuring women’s beliefs about their own responsibility, chance and health
  professionals’ involvement in the health of the unborn baby, for example: ‘God will determine the health of my baby’; and,
• Maternal Health Practices, measuring women’s health actions important to pregnancy outcome for example ‘Since becoming pregnant, I think I am practising a healthy lifestyle.’

My results showed that Iranian women who conceived via donor egg compared to women who conceived naturally scored lower on interaction with the fetus, attributing characteristics to the fetus and giving of self, considered both chance and professionals playing a more significant role in the health of their baby (rather than themselves) and paid significantly less attention to their own health activities.

My findings have implications for practitioners and couples to consider cultural differences and beliefs when deciding on having a child by third party involvement. Intervention at the early stages may help a stronger maternal bonding and health practices of women with children conceived via donor egg.

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Image credit: Freepik

Dr Manijeh Pir Jalian is a clinical psychologist and doctoral researcher, working on perceptions and consequences of children born by egg donation at Middlesex University in London.