(By Lic. Carolina Naddeo) Current society and cultural changes in recent decades have increased the demand for medically assisted reproduction treatments. These treatments must be considered from an interdisciplinary work between professionals, who collaborate in strengthening family diversity, promoting access to motherhood and fatherhood, and guaranteeing rights according to the chosen life plan.
Adaptive anxiety disorders and mood disorders are clearly higher in the infertile population than in the general population.
They are patients who go through a different physical condition and subjective suffering related to personal and psychological issues.
Specifically, assisted reproduction treatments can cause emotional tension, anxiety states during treatment and post-treatment depression.
For this reason, Assisted Human Reproduction Techniques (TRHA), in particular surrogacy, require new containment actors to accompany experiences and new bonding conformations.
The participation of a psychologist or psychologist who provides assistance to go through the experience not only of the surrogate but also of those who will later exercise the paternity or maternity of that new being, the constituents, is fundamental in this whole process of surrogacy.
In this way, an integration work is carried out that ranges from evaluations, connections, and understanding between the members to the monitoring of the socio-emotional transitions of the protagonists.
Guide for accompaniment in paternity and surrogacy
In 2006, the Argentine Society of Reproductive Medicine (SAMeR) drafted a Guide for Psychological Intervention in reproductive medicine treatments.
This guide aims to monitor specific needs, and if necessary, assist regularly in critical situations.
Once the medical treatment has started, work will be done on the different stages to provide information, guidance and guidance.
The goal of psychological intervention is:
- Collaborate in decision making
- Keep stress within tolerable limits
- Optimize the relationship with the environment (family-friends-work).
- Prevent sample collection failures
- Carry out clinical and surgical psychoprophylaxis processes
- Mitigate the effects of the infertility crisis and issues related to losses.
In short, all actions that seek to prevent long-term psychological deterioration.
The role of the psychologist or psychologist will be to provide support and emotional containment, in addition to collaborating with the network between relatives and the environment.
Support to clients
The evaluation and accompaniment or psychological assistance to the clients must:
- Check that the person has full capacity to understand the procedure.
- Address potential psychological risks that may obstruct medical treatment.
- Detect psychopathological factors that may obstruct medical treatment and that could be genetically transmitted.
- Find out if they have coping skills and if they have an adequate social support network.
- Know what the motivations are for surrogacy.
- Analyze whether your expectations regarding treatment are realistic.
- Investigate whether the decision to carry out surrogacy is accepted or rejected by their closest emotional ties.
- Consider what subjective effects the failure of medical treatment would produce.
- In the event that the clients are not accepted, they must be informed of the reasons for exclusion and the impact and effects it has on their emotional state must be evaluated.
- In the event that the pregnant woman has a prior link with the parents, psychological assistance will serve to investigate the possible impact on future relationships among all the participants of the parental project and work together throughout the process.
During the evaluation process, the psychologist or psychologist will provide advice on: comprehensive sexual education, and the biological and symbolic value of genetic material for reproductive purposes. Also possible destinations for potential embryos, integral aspects of medical treatment that may affect their overall health, and the importance of signing consent.
This advice includes relevant legal aspects, especially the non-legal link of the pregnant woman with the baby, explaining about the procreation will.
Psychotherapeutic strategies in surrogacy
The professional may intervene with various psychotherapeutic strategies to promote the transition in the different stages of surrogacy. It will propose psychological evaluations before the start of treatment with accompaniment and psychotherapeutic assistance throughout the process.
These evaluations are composed of semi-directed interviews and psychometric tests prior to the start of treatment, which will be delivered in report format so that it is considered as part of the file of those who participate in the process.
A minimum of three meetings is proposed for the principal and the possibility of one more meeting if necessary. In the case of a couple of clients, it will be a minimum of five meetings and the possibility of one more meeting.
Psychological interviews allow for more personalized treatments, since they investigate interpersonal relationships, history and the socio-family context. They also allow us to go through the reproductive history, the bond of the couple, possible pathologies; and delve into clinical and surgical psychoprophylaxis.
That is why in the sessions it is proposed to work on anxieties, fears and fantasies related to these techniques. Also advise on possible confusional states due to disorientation, memory disturbances, apathy, or irritability.
It is essential at this stage to identify both personal or couple blocks to build the bond with the pregnant woman and, from the pregnancy, help in the construction and strengthening of the bond with the future baby.
Degree in psychology Carolina Naddeo (MN44880 / MP95145), member of the South American Surrogacy psychological cabinet.