Maternidad lesbiana: Otra cara del cambio social. Un enfoque etnográfico

This paper explores, through a qualitative methodology and an ethnographic approach, the experience of lesbian motherhood, recognizing it as a genuine kinship experience, associated with the care and the time spent together. It is interpreted as a form of the “mutuality of being” in Sahlins, where the biological becomes a metaphor of something that is experienced as a process. In addition, the exercise and visibility of lesbian motherhood is socially constructed, putting into discussion myths about lesbian identity and, at the same time, actively participating in social change, perceived as a long durée process, gradually moving away from static forms of kinship and social relations, towards a vision not necessarily individualistic (based on the “freedom to choose”) rather a process-like and dynamic one. Este artículo explora, a través de una metodología cualitativa, la experiencia de la maternidad lesbiana, reconociéndola como experiencia genuina de formas de parentesco asociada al cuidado y al tiempo transcurrido con el otro, lo que se interpreta como una forma de la mutualidad del ser en Sahlins, donde lo biológico deviene metáfora de algo que se vive como proceso. Además, el ejercicio y visibilidad de maternidad lesbiana se construye socialmente, poniendo en discusión mitos sobre la identidad lesbiana y a su vez, participando activamente en el cambio social percibido como un proceso de larga duración, de paulatino alejamiento de formas estáticas del parentesco y las relaciones sociales hacia una visión no necesariamente individualista (fundada en la “libertad de elegir”) pero sí procesual y dinámica de los mismos.

P–762 Preeclampsia in pregnancies resulting from oocyte donation, IVF or natural conception. A systematic review and meta-analysis

Study question What is the prevalence of preeclampsia (PE) in pregnancies after oocyte donation (OD) compared to natural conception (NC) and to IVF with autologous oocytes? Summary answer PE prevalence in singleton pregnancies after OD was five times higher than in NC and almost three times higher than after IVF with autologous oocytes. What is known already: The indication for OD is expanding to lesbian women requesting shared lesbian motherhood. Previous reviews showed that the risk of PE is higher in pregnancies after OD than after IVF with autologous oocytes and natural conception. Classification on severity of PE is lacking as is the relationship with known risk factors such as maternal age and multiple gestations. Furthermore the actual prevalence of PE following in pregnancies resulting from OD is not known. Study design, size, duration Systematic review and meta-analysis. A literature search was performed using the following databases: PubMed, EMBASE and CINAHL, OpenGrey and Greynet from January 1980 through July 2020. Participants/materials, setting, methods We included retrospective and prospective cohort studies. The study population consisted of pregnancies after OD and NC or IVF and data had to be available about prevalence of PE. We compared the risk of (severe) PE in OD versus NC and IVF pregnancies, subgrouped by parity and maternal age. We calculated individual and pooled odds ratios (OR) and prevalence estimates with 95% CI using a random effect model, while heterogeneity was assessed by the I2. Main results and the role of chance We included 28 studies comprising of 7131 OD pregnancies, 1.139.540 NC pregnancies and 72.763 IVF pregnancies were available for analysis. The risk of PE and severe PE was increased in OD pregnancies compared to NC pregnancies (pooled OR of all subgroups: 5.09, 95% CI: 4.29 – 6.04; I2 = 19% and OR: 7.42 (95% CI: 4.64–11.88; I2 = 49%). The pooled adjusted OR for PE was 3.24 (95% 2.74 – 3.83) for OD versus natural pregnancies.The risk of PE and severe PE was increased in OD pregnancies compared to IVF pregnancies (pooled OR of all subgroups: 2.96, 95% CI: 2.49 – 3.51; I2 = 51% and OR: 2.97, 95% CI: 2.15 – 4.11; I2 = 0%). The pooled adjusted OR for PE was 2.67 (95% 2.28 – 3.13) for OD versus IVF.The pooled prevalence of PE in singleton pregnancies after OD was 10.7% (95% CI 6.6 – 15.5) compared to 4.1% (95% CI 2.7 – 5.6) after IVF and 2% (95% CI 1.0 – 3.1) after NC. The prevalence in multiple pregnancies was 27.8% (95% CI 23.6 –32.2) after OD, 9.7% (95% CI 6.2 – 13.9) after IVF and 7.5% (95% CI 7.2 – 7.8) after NC. Limitations, reasons for caution The precise definition of PE is still a matter of debate. The different criteria could have affected the prevalence estimate. Wider implications of the findings: Nearly one in six women will suffer PE after OD. Women who can conceive naturally i.e. shared lesbian motherhood, should be discouraged to turn to OD. In women with premature ovarian failure factors that increase risk of PE should be avoided. We suggest therefore single embryo transfer. Trial registration number Not applicable

Significance of specialised preconception counselling in oocyte donation pregnancy with prior history of postpartum eclampsia

A well-known complication in oocyte donation (OD) pregnancy is preeclampsia. Here, we present a 31-year-old woman, pregnant after OD. She conceived by the reception of the oocyte from her partner (ROPA) and sperm from a sperm donor. She developed preeclampsia with severe features, necessitating caesarean delivery at 29 weeks’ gestation due to deterioration of her clinical condition. Admission at the intensive care unit postpartum was necessary, because of recurrent postpartum eclampsia and administration of high dose magnesium sulphate for convulsion prophylaxis. This case illustrates the importance of preconception counselling for patients who are considering to conceive by OD and double gamete donation. In this specific case an alternative way to conceive was available. However, ROPA was preferred as part of shared lesbian motherhood. The risk of complications in the subsequent pregnancy has led to an alternative decision to accomplish a second pregnancy.

Sexual identities and reproductive orientations: Coming out as wanting (or not wanting) to have children

In the context of growing visibility, recognition and acceptance of lesbian motherhood and gay fatherhood in countries such as Britain, it is important to ask how younger generations of sexual minorities approach the possibility of becoming a parent. Drawing on interviews with lesbians and gay men who do not have children but may have them in the future, I explore how people become aware that having children is an option. By attending to how this consciousness manifests in conversations and how conversations shape the consciousness, I illuminate specific dynamics that raising the topic of parenthood creates in intimate interactions. My data show that it is often unclear to men and women who form same-sex relationships whether they are socially expected to have children. I argue that this ambiguity requires a kind of ‘coming out’ through which feelings about parenthood are made explicit. Using the concept of coming out, I ask: What if we were to think of people in terms of their ‘reproductive orientations’ rather than sexual identities? I suggest that, similar to expressing sexual identities, articulating reproductive orientations involves aligning with particular life trajectories based on binary logic. However, with ambiguous expectations about parenthood, neither having children nor remaining childfree is explicitly normative. As such, unlike coming out as lesbian or gay, which transgresses norms surrounding sexuality, coming out as wanting or not wanting to have children challenges normativity itself. I reflect on how this ‘normative challenge’ makes it possible to imagine parenthood and ‘childfreedom’ as intimacies of equal value.