Psychoanalytic and Literary Perspectives on Procreation Conflicts in Women

In recent years I have seen numerous childless women in their thirties, who come into treatment, often for the first time, with only a dawning awareness of unresolved conflicts about having children. Often their conscious focus is on the inability to find a suitable husband, while unconsciously they fear and eschew motherhood. They are confronting these conflicts after having waited so long that it is no longer biologically optimal, or in some cases even possible, for them to conceive. Many of these patients, having become organically or psychosomatically infertile, are filling gynecologists' offices and fertility clinics in desperate attempts to have at least one child before it is too late, even though the mental conflicts may be unresolved. The extension of adolescence into the late twenties, the emphasis on autonomy in Western culture, and the gradual disappearance of the extended family with its built-in support systems, all contribute to the failure to establish and actualize a maternal ego ideal. Many contemporary women even seem naively unaware of the biological limitations imposed by advancing maternal age. These include decreased fertility due to only occasional ovulation and ever-increasing fetal wastage caused by chromosomal abnormalities and conditions such as diabetes and hypertension. Other concerns are the disabilities of fibroids that interfere with pregnancy and cause pain and bleeding, and an increased incidence of aches and pains generally. Furthermore, psychoanalysts themselves differ in their opinions as to whether it is actually necessary for a woman to bear a child in order for her life to be “complete” (Galenson, 1978). Although many of the difficulties and risks involved in contraception