Desire For Motherhood Research Articles

Motherhood and attitudes towards motherhood in women with Mayer-Rokitansky-Küster-Hauser syndrome.

The aim of the study was to find out what proportion of women with MRKHS have decided to become mothers and have children or would like to have children and consider various options for motherhood. Additionally, the survey aimed at identifying factors that might influence the women's decisions and opinions regarding adoption, gestational surrogacy (GS) and uterus transplantation (UTx). The study group consisted of 100 adult women with MRKHS who filled out questionnaires consisting of 56 questions. The survey was self-administered and anonymous. Most of the study participants were under 30, lived in large cities ( > 150 000 inhabitants) and declared to be heterosexuals in a steady relationship (p < 0.05). While 11 participants had children, 66 out of 89 childless women (74%) expressed a desire for motherhood, but as many as 80 surveyed women have felt pressured to have children. The number of participants for whom a biological relationship with offspring was significant and insignificant respectively equaled (p = 1.000). The majority of the study participants supported the process of legalizing GS in Poland (95 vs 4) yet would opt for commercial rather than altruistic GS (64 vs 31) (p < 0.05). Most respondents stated that UTx is consistent with their faith and conscience (91 vs 4) and found UTx ethical (88 vs 4) (p < 0.0001). The majority of Polish women with MRKHS express the need to become a mother, but only one in ten has a child. The women's interest in biological motherhood is significant.

Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma: We can hope, at least.

In women with recurrent disease who were conservatively treated for atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EEC), the reasons why conservative treatment was chosen persist and outcomes of performing a conservative re-treatment are unclear, as pooled estimates on oncologic outcomes of such a re-treatment are lacking. To provide pooled estimates of oncologic outcomes of conservative re-treatment in women with recurrent AEH or EC. A systematic review and meta-analysis was performed by searching six electronic databases from their inception to March 2022. Studies that allowed extraction of data about oncologic outcomes of conservative re-treatment of women with recurrent AEH and EEC after a conservative treatment. Pooled prevalence of complete response (CR), poor response (PR), and recurrence after conservative re-treatment was calculated. Fifteen studies (12 retrospective and 3 prospective) with 492 women (42.1% AEH and 57.9% EEC) were included in the systematic review, and 10 studies (8 retrospective and 2 prospective) were suitable for the meta-analysis. Pooled prevalence was 85.3% (95% confidence interval [CI] 77.0%-91.0%) for CR, 14.7% (95% CI 9.0%-23.0%) for PR, and 40.4% (95% CI 15.5%-71.4%) for recurrence. Conservative re-treatment in AEH or EC recurrent women has a high CR rate and acceptable recurrence rate that might allow it to be considered a safe and viable option, at least as a first round of conservative treatment. Women with an unsatisfied desire for motherhood or with high surgical risk might avoid hysterectomy and attempt childbearing or spare high-risk surgery.

Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report

Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification. Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy. Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139). Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.

Life design facing the fertility gap: promoting gender equity to give women and men the freedom of a mindful life planning.

Nowadays, society is characterized by enormous and rapid changes, erratic careers, gender discrimination, injustices, and inequities. Discrimination includes professional and educational segregation, the gender pay gap, stereotypical gender roles, and social expectations. In this context, phenomena called low fertility and fertility gap are increasing. Indeed, the birth rate necessary to ensure the replacement of the population is not reached, with severe repercussions at a social, environmental, and economic level. This study aimed to investigate 835 women's perceptions of the desire for motherhood and the associated difficulties. Hierarchical multiple regression and thematic decomposition analyses first highlight a significant difference between the number of children women realistically plan and the ideal number of children they would like. Secondly, the results showed how the parenthood choice is connected to the perception of social and gender inequity. Finally, in a Life Design perspective, preventive actions will be described to support women to get back to the center of life choices, building dignified fair paths and family projects.

Pregnancy in Patients with Moderate and Highly Complex Congenital Heart Disease.

Although not completely devoid of risk, pregnancy can be managed in virtually all patients affected by even the most complex forms of congenital heart disease. It is not however advisable in patients with any form of pulmonary arterial hypertension. Pregnancy is even manageable in patients with univentricular heart converted to Fontan circulation. A personalised risk stratification should be performed, and patients affected by advanced NYHA functional class appropriately warned of the potential risks. In this setting, metabolomics might represent a novel tool for use in conducting personalised risk stratification. All pregnancies, particularly those at higher risk, should be managed in a tertiary care centre capable of providing the necessary assistance to both the mother and infant. With a few rare exceptions, vaginal delivery is to be preferred over caesarean section due to the lower degree of maternal and foetal complications. The desire for motherhood, at times extreme in women with congenital heart disease, may often be accomplished, thus providing a ray of hope in the lives of these patients.

Assisted Reproductive Techniques in Multiple Sclerosis: Recommendations from an Expert Panel.

Multiple sclerosis (MS) is mainly diagnosed in women of reproductive age. However, there is a paucity of guidelines jointly prepared by neurologists and gynaecologists on managing women with MS and the desire for motherhood. Therefore, in this review we propose recommendations for such cases, with an particular focus on those requiring assisted reproductive techniques (ART). A group of seven MS experts (4 neurologists and 3 gynaecologists) came together for three discussion sessions to achieve consensus. The recommendations reported here focus on the importance of early preconception counselling, the management of disease-modifying therapies before and during ART procedures, important considerations for women with MS regarding ART (intrauterine insemination, in vitro fertilisation and oocyte cryopreservation) and the paramount relevance of multidisciplinary units to manage these patients. Early preconception consultations are essential to individualising pregnancy management in women with MS, and an early, well-planned, spontaneous pregnancy should be the aim whenever possible. The management of women with MS and the desire for motherhood by multidisciplinary units is warranted to ensure appropriate guidance through the entire pregnancy.

Impossible motherhood: From the desire for motherhood to non-motherhood

This article proposes to explore the biographic accounts and everyday experiences of cisgender women who, for various reasons and biopsychosocial conditions, are not mothers. From a feminist focus and using a qualitative methodology, it looks at the complex nature of the experience for women who felt the desire to be mothers and started out on a quest for motherhood. As a result of the thematic analysis of their accounts, we find that some women have undergone miscarriages and repetition miscarriages, facing infertility problems (structural, relational and social) and medicalisation of their bodies using assisted reproduction technology (ART). It has been seen how biomedicine and reproductive biotechnology boost the search for biological (and medical) solutions to social problems related to structural infertility. Furthermore, the importance given to experiencing ‘grief for non-motherhood’, is emphasised, composed of different processes that are socially denied or disenfranchised —such as gestational grief, genetic grief or institutional grief— and performing small rituals to say goodbye. It is demonstrated that, following a process of acceptance of the non-motherhood and self-knowledge, the women in question redefine their identity in new projects. Finally, the relevance of mutual support groups (MSG) is demonstrated as a way of sharing frames of reference, forging empathy relationships and reciprocity networks. The conclusions highlight how the journey from ‘impossible motherhood’ to non-motherhood is a subjective process, involving reflection and a physical and emotional life lesson, that makes it possible to challenge, rethink and overthrow the hegemonic representations of motherhood generating new meanings and social practices bound to non-motherhood.

Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development

ObjectiveTo analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. MethodsIt is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. ResultsSexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. ConclusionFertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.

Politics and Poetics

Politics and Poetics

From myth to comic: Rayco Pulido’s graphic novel Lamia

ABSTRACT In classical mythology, the figure of Lamia stands for the mother who never was. Condemned by Hera to lose all the children she gave birth to, Lamia was consumed by pain and rage to the point where she became a monster. Her rage gives way to a fatal envy of all those fertile women and to their children, whom she steals and kills, thus avenging herself for having been deprived of the experience of being a mother. This article examines a very particular case of reworking of this myth: the Spanish graphic novel Lamia, by Rayco Pulido, published in 2016 and awarded the National Comic Prize in 2017. This analysis will show how the classical myth adapts itself to the visual requirements of the comic books, which have their own codes and communicative strategies. Eventually, Pulido’s comic will be examined in relation to another piece of Spanish fiction: the short story “Lamia”, by Cristina Jurado, published in 2019. This comparison will show how Pulido’s reshaping of the myth fits in with a broader process of reception in which the monstrous nature of Lamia represents the starkest and most bloodthirsty expression of her desire for motherhood.

Hannah’s Suffering: The Power of Voice

Hannah’s story in the Old Testament has been written about considerably by Jewish feminists, womanist theologians, and other biblical scholars. This paper strives to build upon these works in asking the reader to consider Hannah’s story from a liberatory theological theory of suffering by Sölle, as well as a postmodern and non-religious lens as discussed by Sandoval’s Theory of Oppositional Consciousness in Methodology of the Oppressed and Lorde’s “Transformation of Silence into Language and Action”. This paper asks if this narrative can serve as an example of taking back one’s power by confronting a complex system of power and oppression for Black women. Intercessory prayer aptly defines the personal as political, especially with the multiple minoritized identities of Hannah. I argue that Hannah’s story can serve as a complex narrative of differential consciousness and the reclamation of one’s own power, by using her voice. Her audacity to correct a prophet, fight for her valid desire of motherhood, and determine her own happiness is evidence of an empowerment ethic that is necessary for minoritized women in a post-modern era and political climate where the erasure of all forms of difference and consciousness is the priority.

Sophia Wants a Baby and So Do I

A poem about the desire for motherhood despite the dehumanization of patients in the medical-industrial complex, as explored with the social humanoid robot Sophia who said it was her right to have a baby after being given citizenship by Saudia Arabia.

Paths to Motherhood for Women with Cystic Fibrosis.

Cystic fibrosis (CF) is no longer a disease limited to childhood. With medical advancements, many of those with CF live into adulthood and have similar life goals as their non-CF peers. Most women with CF want to become mothers. However, available options and the related decision-making process is not well understood. The purpose of this study was to explore the decision-making framework of women with CF to better understand the factors they consider when deciding on a path to motherhood. Qualitative interviews were performed using a grounded theory approach. Inclusion criteria were women with CF who became mothers through biological pregnancy, adoption, or gestational surrogacy. Results: Twenty-five mothers with CF were interviewed. A distinct decision-making process was identified through which women started with a desire for motherhood, assessed several factors, then eventually took the path they felt was right for them and their family. Our findings provide women with CF a framework that other women with CF have used to assist in making decisions about their reproductive options. Conversations about family planning should occur early and regularly between women with CF and their health care providers. The decision-making process to achieve motherhood for women with a chronic illness, such as CF, includes consideration of unique factors that should be included in clinical conversations.

Factors Associated With Long-term Survival in Women Who Get Pregnant After Surgery for WHO Grade II Glioma.

Women with a World Health Organization grade II glioma (GIIG) often question clinicians about the effects of pregnancy on their disease. Previous reports have indicated a higher risk of glioma progression during and after pregnancy. Here, the aim was to investigate postpregnancy outcomes and predictive factors affecting overall survival in female patients who underwent GIIG surgery. Inclusion criteria were adult women who have been pregnant after a GIIG resection and with a stable oncologic status at the time of pregnancy (no ongoing oncologic treatment, no contrast enhancement, no debilitating clinical condition). Relevant cases were identified from a databank (1998-2021) of patients who underwent surgical resection for a histologically confirmed GIIG in our department. Among 345 women with GIIG in their reproductive years (age <45 years), 16 patients (4.6%, mean age at delivery 30.9 ± 5.1 years) were pregnant (twice in 5 cases). The mean interval between the last oncologic treatment (surgery alone in 11 patients, surgery followed by chemotherapy and/or radiotherapy in 5 patients) and pregnancy was 3.5 years (range 0.75-10 years). Two patients experienced seizures during pregnancy. The delivery was vaginal and uneventful in all cases but 1 (1 caesarean). All children had normal mental and physical development. The glioma behavior changed in 7 patients (43.7%), with an acceleration of the velocity of diameter expansion and/or the occurrence of a contrast enhancement during or within 3 months after pregnancy, resulting in medical treatment and/or reoperation in the early postpartum period in 7 cases. The median clinical follow-up from delivery was 5.3 years (range 1.25-11.6 years). Four other patients received delayed adjuvant therapy for glioma progression. Seven patients (43.7%) died at a median time from delivery of 3.9 years (range 1.25-5.9 years). Overall, the median survival from delivery was 5.75 years. A crucial finding is that patients who underwent a complete surgical resection and patients with stable lesions before pregnancy lived longer (log rank, p = 0.046 and p = 0.0026, respectively). Tumor residual volume and tumor speed growth are strong predictive factors conditioning postpregnancy long-term survival in patients with GIIG. Identifying patients at risk is critical to provide relevant counsel to women with GIIG with a desire for motherhood.

Fertility Sparing Treatments in Endometrial Cancer Patients: The Potential Role of the New Molecular Classification.

Endometrial cancer is the most frequent gynecological malignancy, and, although epidemiologically it mainly affects advanced age women, it can also affect young patients who want children and who have not yet completed their procreative project. Fertility sparing treatments are the subject of many studies and research in continuous evolution, and represent a light of hope for young cancer patients who find themselves having to face an oncological path before fulfilling their desire for motherhood. The advances in molecular biology and the more precise clinical and prognostic classification of endometrial cancer based on the 2013 The Cancer Genome Atlas classification allow for the selection of patients who can be submitted to fertility sparing treatments with increasing oncological safety. It would also be possible to predict the response to hormonal treatment by investigating the state of the genes of the mismatch repair.

On Becoming a Mother After Cancer Survival: A Comprehensive Literature Review

Abstract &#x0D; Problem identification: The desire for motherhood is one of the top priorities for most female young cancer survivors. The risk of infertility after cancer therapy is an important concern with several physical and emotional consequences. This comprehensive literature review aims to summarize and contextualize recent research that has been carried out on female fertility after cancer, suggesting future research and clinical directions.&#x0D; Literature search: Searches included the keywords “cancer”, “female”, “adults”, and “fertility”. Studies were selected if focused on infertility issues in female cancer survivors.&#x0D; Data synthesis: Eight themes were identified: the effects of anticancer treatments on fertility; fertility preservation methods; international recommendations regarding infertility risk; health professionals’ attitudes towards fertility preservation; patient’s concerns regarding the risk of infertility; patients' information needs; and the impact of the risk of infertility in patient’s quality of life.&#x0D; Conclusions: Psycho-oncologists should be integrated in the oncofertility teams to assess patients’ needs before cancer treatment initiation.

Grossesse après les premières procédures d’embolisation des fibromes utérins en Afrique subsaharienne en Côte d’Ivoire

ObjectiveTo report the obstetrical outcome of patients wishing to conceive after embolization of uterine fibroids in Côte d’Ivoire. Materials and methodOver a 72-month period from February 2012 to February 2018, a prospective observational and descriptive longitudinal study focused on 181 non menopausal patients who had symptomatic uterine fibroids for which they had benefited from embolization of the uterine arteries. Among them, some were selected taking into account the inclusion criteria and were regularly monitored by their obstetrician-gynecologist. ResultsThe mean age of the 65 patients was 40.7 years and 16.3% of them had a history of myomectomy. The mean uterine volume and size of dominant myomas before and six months after embolization were 849.5cm3, respectively; 67.7cm and 584cm3; 45.4cm (all these measurements are in centimeters), i.e. a reduction rate of 33% and 43%. Of the 65 patients, eleven of them with an average age of 36.7 years were able to conceive, a rate of 16.9%. Among these 11 patients, 8 had had one pregnancy and three had had two each, for a total number of 14 pregnancies. The mean time from uterine fibroid embolization to pregnancy was 34 months with extremes ranging from 06 to 60 months. Among the obstetric complications, there was one case of placenta accreta which required hysterectomy and two cases of placenta previa which had progressed well after cesarean delivery. ConclusionThe onset of pregnancy is possible after embolization of uterine fibroids. This less invasive procedure than myomectomy can also be offered to patients with a desire for motherhood. However, there is little agreement on fertility status after UFE and fertility rates after UFE have not yet been effectively quantified. Also, the decision to favor EFU over myomectomy in women wishing to maintain their fertility remains limited by the small size of our sample. We should analyze more patients who are trying to conceive after UFE and use longer follow-up.

Motherhood Desire as a Stimulant for Fertility Tourism Intention

This paper investigates the relationship between participants’ motherhood desire and travel intention and behaviour, through the mediating role of attitude, subjective norm and perceived behaviour control. The study adopted a questionnaire among a sample representative of females with fertility complications in Gulf Cooperation Council (GCC) countries in Egypt. In total, 138 questionnaires were gathered and tested using a partial least square structural equation modelling using WarpPLS 7.0. The findings support the proposed model and show that motherhood desire has a positive influence on attitude, subjective norm and perceived behaviour control. Also, we found that the positive effect of TPB dimensions on actual behaviour is subject to females’ intention to visit Egypt for fertility tourism. Besides, the study revealed that attitude partially mediates the link between motherhood, tourists’ revisit intention and tourists’ actual behaviour. This suggests that the positive effect of motherhood desire on tourist revisit intention and actual behaviour is subject to attitude. Drawing on the theory of planned behaviour (TPB), we develop an integrative model exploring the relationship between three distinct TPB dimensions and their influence on travel behaviour for childbearing. Such findings hold important implications both for the research community and medical tourism practitioners.

Teenaged mother's narratives: methodological dilemmas in tracing an emergent, yet muted, desire for motherhood

ABSTRACT This paper reflexively considers the muted narratives of a desire for pregnancy and parenthood in teenaged women's accounts of their journey to motherhood after deciding on abortion with their first, unexpected, pregnancy. By contrast their accounts were replete with good citizenship narratives that attested to pregnancy avoidance. Through the use of the Listening Guide, a feminist, layered, reflexive approach to data analysis, these accounts are considered in the wider social and cultural ‘narratives’ in the interview data, and the interviewee/interviewer relationship. It is suggested that the young women draw on dominant cultural tropes of the good teenager and mother, shaped by the desire to present themselves to the interviewer as acceptable citizens. It is debated whether the young women choose relative silence regarding their growing desire for pregnancy to avoid judgment in a society that problematises young motherhood, or are silenced by the same dominant discourse. Discussion considers what such a muted narrative might represent in a political and socio-cultural context. With narrow definitions of what is acceptable in the teenage years, and for motherhood, the young women's desire to present as acceptable may eclipse valuable contextual considerations that are important to practitioners and policy makers in providing effective support.

Parenthood desire, childbearing plans and oocyte utilization among women who previously underwent planned oocyte cryopreservation

Research questionTo examine the motivations, life circumstances and parenthood aspirations of a cohort of women who underwent planned oocyte cryopreservation (POC) at a Canadian academic IVF centre. DesignA single-site, cross-sectional, anonymous quantitative study using a study-specific questionnaire administrated via SurveyMonkey®. Of the 224 women who completed at least one POC cycle between 2012 and 2018, 198 were reached by email and invited to participate. ResultsOf the 98 (49.5%) questionnaires returned, 86 were fully completed and were analysed. Mean age at first POC cycle was 35.7 ± 2.4 (range 27–43) and at survey was 37.7 ± 2.5 years. At POC, 77% were single and 97.7% childless. At survey, 96% had not attempted to use their cryopreserved oocytes, yet 26 (30%) had tried natural conception or fertility treatments. Of these, three conceived naturally and two by assisted reproduction. Eighty-five per cent expressed a strong motherhood desire and 67.1% indicated that usage of their cryopreserved oocytes was mostly contingent on relationship status. Many expressed a desire for shared genetic parenthood within a committed relationship. Forty-seven per cent did not want to carry a pregnancy beyond the age of 46. ConclusionThe findings of this study confirm the central role of age and relationship status in influencing women's POC decisions and oocyte utilization plans. The late age at POC could be explained by women using it toward the end of their peak reproductive years to leverage their remaining chances of genetic motherhood. Surveying women at later points following POC would help to gain a more comprehensive picture of their oocyte utilization and disposition plans.