Ms Edwina Oakes:

I am the chairperson of the Irish Fertility Counsellors Association, IFCA. I thank the committee for the invitation to share our perspectives with the members. The IFCA was founded in 2008 by a group of specialist fertility counsellors in response to emerging issues clients were experiencing while preparing for investigations and treatment. Since then, we have grown our membership to 25 professionally qualified counsellors, psychotherapists and psychologists with specialist training in fertility. We believe the work we do holds significant value for clients thinking about embarking on their fertility journey. We believe that all patients making reproductive choices deserve the opportunity to speak to a qualified and experienced mental health professional who can guide them through the implications of their decisions and support them as they make those decisions. Our role as specialist fertility counsellors is to listen and support clients in a non-judgmental way.

There can be complex considerations around assisted reproduction, which can be very challenging for the clients. We believe that the provision of a structured counselling service in surrogacy cases serves to guard against the exploitation of the intending parents and is also in the best interests of the resulting child. As specialist fertility counsellors, we are trained to create a confidential and safe space for clients to talk through their feelings, concerns, losses and hopes and to explore the future implications for them and for their families. The IFCA wishes to highlight the importance of implications counselling for intending parents and surrogates. Implications counselling for intending parents is in line with best international practice. It allows the intending parties an opportunity to carefully consider all the possible implications of their decisions and how those may impact them in future. Implications counselling includes social, legal and ethical considerations to be contemplated when creating a family and it also allows the opportunity for intending individuals to voice any concerns or fears they may have. Specialist fertility implications counselling would assist in preventing the exploitation and coercion of intending parents and ensure an understanding of the full implications of the surrogacy process.

As specialist fertility counsellors are in the room with the intended parties, we are uniquely positioned to facilitate addressing any areas of concern our clients may have relating to creating a human being. Some clinical research has been conducted by an IFCA member, Dr. Ciara Byrne, clinical psychologist, in conjunction with the National Infertility Support and Information Group, NISIG. Dr. Byrne conducted research on the socio-emotional experience of these parents. Her research findings indicated that there is a strong clinical need for psychological support among Irish parents of children born through surrogacy. The key findings that emerged are that: parents had concerns that their child would reject them; parents had significant concerns regarding disapproval from the community; and parents also felt they lacked the practical and emotional tools for communicating with their child about their origin story. Equipping parents with the tools for healthy family dialogue around their origin story is key to promoting positive mental health amongst children.

Professor Golombok and her colleagues at the University of Cambridge have spent four decades examining the impact on the child and on the family of psychological adjustment to alternative family forms, including those families created through donor conception and surrogacy. They have found that those families who disclosed donor and surrogate origins to children in the preschool years generally showed more positive emotional outcomes when the children reached middle childhood than children from non-disclosing families. In contrast, the evidence for surrogate or donor offspring told of their origins as adolescents or adults indicates negative emotional reactions such as shock, betrayal and confusion. When parents choose not to disclose origins through surrogacy or donor conception to their children, it is most often due to their own feelings of fear and the perceived lack of tools on how to communicate with their children.

The IFCA is firmly committed to supporting all parties in surrogacy treatments to ensure that the process is normalised, humane and fair to all.

High-quality specialist fertility counselling is one way to ensure that the risks of exploitation or coercion to intending parents is minimised. We are happy to engage further with the committee in any way it sees fit and to answer any questions committee members may have, either today or at a future date.

I offer my sincere thanks to the committee for the opportunity to address it on this important issue.