Writer and broadcaster

My daughter, who has depression, is considering IVF to become a single mother. The Guardian.

Dear Annalisa

My daughter is in her early 40s, a senior manager in the public sector working long hours. She would have really liked to have met a partner and had a family. However, having been single for a number of years, she is now considering IVF treatment. She is aware that it doesn’t always result in pregnancy and of the challenges of bringing up a child alone.  

At times she has taken medication for depression, which has been helpful, but has stopped to prepare for IVF on the advice of her GP, but she is very unsure of whether she is doing the right thing. 

I am not sure if the effects of coming off the antidepressants are causing her to wonder if she should continue with the IVF. The pressure of her age together with whether she will cope on her own and be a good mother is adding to her anxiety. 

These doubts suggest to her that this means she can’t want a child as much as she should. 

While I would love to have a grandchild (she is my only child and has been estranged from her father for many years), I feel at a loss at how to help her to make the right decision. I will support her whichever choice she makes. I am concerned about her depression and coping alone with a baby; she does have a good network of friends who are very happy to support her. 

The right thing for whom? I think this is the key question. Some decisions have no right or wrong answer and take a lot of working out. This is one such. I can’t offer you a short cut to a resolution. Only more things to think about.

There is something about IVF that seems to sometimes result in a more conscious decision about whether someone wants to have children. There is less of the laissez-faire about it because it’s so medicalised. Your daughter could go down the IVF route and, as you’ve said, it fails to result in a pregnancy, just as sex doesn’t always lead to one, either. But I wonder if the trying is important, or the result?

I consulted Sara Barratt, a family psychotherapist at the Tavistock Clinic (aft.org.uk). She had an interesting viewpoint, which is that you and your daughter seem to have a very close relationship (which is good!) but wondered “if you are both being very careful around each other. Might your daughter be thinking you really want a grandchild?” I wondered how honest you were really being with each other.

It’s something to think about: who wants this baby, and for whom? Your daughter might possibly be thinking you want her to have one. You’d be amazed how much even adult children want to please their parents. “If you and your daughter are very close,” said Barratt, “you might be worried about upsetting one another.”

Barratt also wanted you to think about what the costs would be of not making a decision. “What are the consequences of not going ahead with IVF – what would that be like? How would your daughter feel in five, 10 years’ time if she doesn’t?”

Equally, your daughter needs to think about what happens if she does have a baby: what will happen with her job, who would help her look after the child, who would offer emotional and practical support if it were needed?

These are really questions for your daughter as the greater impact – whether she has a baby or not – would, of course, be on her.

Then Barratt wondered about your daughter’s depression. Obviously, she is under the care of the GP, but she wondered what had caused it? Was it ever dealt with through talking therapy rather than solely pharmaceutically, valid though that can be? This is really important because, depending on the cause of the depression, having a baby could have an impact on your daughter’s mental health; not necessarily negatively, but obviously that would be more of a worry.

I think even one session with a counsellor – see if she wants to go alone or with you – might help. It would be beneficial to talk about things in a different place, with another person who could bring in another viewpoint to stop you both going round in circles. Sometimes counselling is offered with IVF treatment. It’s something to consider.

Life has clearly not been easy for the two of you. With your daughter estranged from her father (what happened?) it’s been just the two of you for a long time. In the absence of a romantic partner, it sounds as if you have been providing a great deal of the emotional support for your daughter. I think a bit of honest, gentle talking, with a neutral third person, will pay dividends.

This article first appeared in The Guardian Family section on 31 October 2014.