Infants and Children in Context. Tara L. Kuther

Maheshwari, 2014).

      In vitro fertilization, introduced in the United States in 1981, permits conception to occur outside of the womb. A woman is prescribed hormones that stimulate the maturation of several ova, which are surgically removed. The ova are placed in a dish and sperm are added. One or more ova are fertilized, and the resulting cell begins to divide. After several cell divisions, the cluster of cells is placed in the woman’s uterus. If they implant into the uterus and begin to divide, a pregnancy has occurred. The success rate of in vitro fertilization is about 50% and varies with the mother’s age. For example, the success rate is 47% in 35-year-old women, 27% in 41- to 42-year-old women, and 16% in 43- to 44-year-old women (Sunderam et al., 2017).

      Assisted reproductive technology contributed to 1.6% of all infants born in the United States in 2014 (Sunderam et al., 2017). As shown in Figure 2.6, about 50% of assisted reproduction technology procedures that progress to the embryo-transfer stage result in pregnancy and about 40% result in a live birth. Infants conceived by in vitro fertilization are at higher risk of low birth weight (Fauser et al., 2014), although it has been suggested that it is because of maternal factors, such as advanced age, and not in vitro fertilization per se (Seggers et al., 2016). Infants conceived by in vitro fertilization show no differences in growth, health, development, and cognitive function relative to infants conceived naturally (Fauser et al., 2014). Because in vitro fertilization permits cells to be screened for genetic problems prior to implantation, in vitro infants are not at higher risk of birth defects (Fauser et al., 2014). However, about 40% of births from in vitro fertilization include more than one infant (38% twins and 2% triplets and higher). Multiple gestations increase risk for low birth weight, prematurity, and other poor outcomes (Sullivan-Pyke, Senapati, Mainigi, & Barnhart, 2017).

      Description

      Figure 2.6 Number of Outcomes of Assisted Reproductive Technology Procedures, by Type of Outcome—United States and Puerto Rico, 2014

      Source: Sunderam et al. (2017).

      Surrogacy is an alternative form of reproduction in which a woman (the surrogate) is impregnated and carries a fetus to term and agrees to turn the baby over to a woman, man, or couple who will raise the child. Single parents, same-sex couples, and couples in which one or both members are infertile choose surrogacy. Sometimes the surrogate carries a zygote composed of one or both of the couple’s gametes. Other times, the ova, sperm, or zygote are donated. Despite several highly publicized cases of surrogate mothers deciding not to relinquish the infant, most surrogacies are successful. In 2015, 2,807 babies were born through surrogacy in the United States, up from 738 in 2004, according to the American Society for Reproductive Medicine (Beitsch, 2017). Longitudinal research suggests no psychological differences through age 14 between children born through surrogacy compared with other methods, including children born to gay father and lesbian mother families (Carone, Lingiardi, Chirumbolo, & Baiocco, 2018; Golombok, 2013; Golombok, Ilioi, Blake, Roman, & Jadva, 2017). In addition, mothers of children who were the product of surrogates do not differ from those whose children were conceived using other methods, and surrogate mothers show no negative effects (Jadva, Imrie, & Golombok, 2015; Söderström-Anttila et al., 2015). Like other forms of reproductive technology, surrogacy is expensive, limiting its access to parents with high SES. Finally, some argue that surrogacy may pose ethical issues. For example, women are often paid at least $30,000 to surrogate a fetus (Beitsch, 2017), creating financial incentives that may be difficult for women with low SES to resist.

      Adoption

      Another reproductive option for prospective parents is adoption. Adults who choose to adopt have similar motives for parenthood as those who raise biological children, such as valuing family ties, continuing a family line, feeling that parenting is a life task, and desiring to have a nurturing relationship with a child (Jennings, Mellish, Tasker, Lamb, & Golombok, 2014; Malm & Welti, 2010). Heterosexual and same-sex adults report similar reasons for choosing adoption (Goldberg, Downing, & Moyer, 2012).

      Adoptive children tend to be raised by parents with higher levels of education and income than other parents. This is partly due to self-selection and partly because of the screening that adoptive parents must undergo before they are allowed to adopt. It is estimated that transracial adoptions, in which a child (typically of color) is adopted by parents of a different race (most often White), account for about one-quarter of adoptions (Marr, 2017). Although there is little research, transracial adoptive children, and especially adolescents, may face challenges in ethnic and racial socialization and identity development (Wiley, 2017). Research reviews are mixed, with some suggesting no clear relation among racial or ethnic identity, parental socialization efforts, and adjustment (Boivin & Hassan, 2015) and more recent analyses suggesting that racial and ethnic socialization is associated with healthy adoptee outcomes (Montgomery & Jordan, 2018). Parents can foster their adoptive children’s ethnic and racial socialization by exposing children to their racial and ethnic heritage and providing opportunities for children to learn about and interact with people who identify with their birth race and ethnicity (Hrapczynski & Leslie, 2018).

      Overall, adoptive children tend to spend more time with their parents and have more educational resources than other children (Zill, 2015). Yet some adopted children show less engagement in class and tend to have more academic difficulties than other children. Longitudinal research suggests that adoption is associated with lower academic achievement across childhood, adolescence, and emerging adulthood compared with nonadopted comparison groups (Brown, Waters, & Shelton, 2017). Adopted children tend to experience greater stress prenatally, early in life, prior to adoption, and during the adoption process that likely influences their long-term adjustment after adoption (Grotevant & McDermott, 2014). Adopted children therefore may show more psychological problems and adjustment difficulties than their nonadoptive peers, in some cases persisting into adulthood (A. Brown et al., 2017; Palacios & Brodzinsky, 2010).

      Children’s experiences prior to adoption and their developmental status at the time of adoption influence their outcomes (Balenzano, Coppola, Cassibba, & Moro, 2018). Children who experience neglect or fear and lack an early bond to a caregiver may experience difficulty regulating emotion and conflict. Biological mothers who choose to adopt may have experienced physical or mental health problems that interfered with their ability to care and form a bond and might be passed on. In other cases, the child may have experienced neglect, deprivation, and trauma, which influence adjustment (Grotevant & McDermott, 2014). Many children adopted from international orphanages arrive with experiences that are harmful, as discussed in the accompanying Lives in Context feature.

      For many children, emotional differences are transitional. Research has suggested that most children show resilience in the years after adoption, but some issues continue (Palacios & Brodzinsky, 2010). Those who develop a close bond with adoptive parents tend to show better emotional understanding and regulation, social competence, and also self-esteem (Juffer & van IJzendoorn, 2007). This is true also of children who have experienced emotional neglect, and those effects hold regardless of age at adoption (Barone, Lionetti, & Green, 2017).

      Prenatal Diagnosis

      Prenatal testing is recommended when genetic counseling has determined a risk for genetic abnormalities, when the woman is older than age 35, when both parents are members of an ethnicity at risk for particular genetic disorders, or when fetal development appears abnormal (Barlow-Stewart & Saleh, 2012). Technology has advanced rapidly, equipping professionals with an array of tools to assess the health of the fetus. Table 2.6 summarizes methods of prenatal diagnosis.

      Table 2.6

      Source: Akolekar, Beta, Picciarelli, Ogilvie, and D’Antonio (2015); Chan, Kwok, Choy, Leung, and Wang (2013); Gregg et al. (2013); Odibo (2015); Shahbazian, Barati, Arian, and Saadati (2012); Shim et al. (2014); and