When baby makes three or four or more: attachment, individuation, and identity in assisted-conception families.

Using examples from clinical work with parents and children in assisted-conception families, this chapter explores the anxieties, conflicts, and psychological defenses of parents as they intersect with the developmental tasks and emotional experiences of the children. Coining the term "birth other" to refer to the outside party in conception--donor, surrogate, or gestational carrier the resurfacing of early primal scenes and oedipal dramas on the part of parents is connected to psychological strategies and defenses, particularly denial, to ward off anxieties generated by introducing an outside party into the most intimate arena of family life--conception of a child. The parental negotiation of conflicts is then associated to three developmental tasks for the child: confronting one's sense of uniqueness; establishing a sense of belonging; forging an identity based on assisted-conception origins. Lastly, developmental facilitators are outlined to enhance success in each of these tasks respectively: age-appropriate narratives of the child's origins; family reveries (shared fantasies about the birth others and their position in the family); a child's family romances that include the birth other. The intent of this discourse is to sensitize clinicians to the psychological issues in their work with children and parents faced with internal or interpersonal challenges when baby was conceived with the help of an outside party.