But "unborn" adoptees do go on to give birth themselves, and in a few years, so will the first generation of Brave New Babies who were conceived with a donated egg, sired by an anonymous sperm sample, or carried by a surrogate mother.

Childbearing brings unique issues for all of them, as well as for the parents who raised them and caregivers who will attend them.

In discussing childbirth with other adoptees/mothers and adoptive mothers (and in the birth of my own three babies), certain themes seemed common. The themes were loss of genealogical connection; possible stress in the relationship with infertile grandparents-to-be; fears of abandonment; and lack of control and autonomy in the face of institutional power.

They re-emerged throughout each of the phases of childbearing, from puberty through pregnancy, childbirth, post-partum, and breastfeeding.

Genealogical Themes

Most midwives and natural childbirth educators would agree that a woman’s attitude toward pregnancy and her ability to birth are influenced by the self-concept of body image. But for adoptees this self-concept may be incomplete.

Noting the disproportionately large number of adoptees under his care, the British psychiatrist, E. Wellisch, compared knowledge of one’s genealogy to possession of a shadow or mirror image. Although one usually takes them for granted, just as non-adoptees do their genealogy, a shadow or mirror image are psychologically significant as extensions of one’s body image (2)Betty Jean Lifton, 1988. An adoptee who sees neither her shadow cast back through the generations, nor her reflection in the bodies and faces of her kin, may have a distorted or insecure body image.

Another issue comes up during prenatal exams. They remind adoptees that they have no records of family medical or genetic history, nor records of their own birth. Similarly, adoptees are unprepared if a child has a genetically transmitted disease because they have no information about any biological extended family.

Little wonder that adoption therapists list pregnancy and the birth of a child as common catalysts for the adoptee to begin searching for their origins (3)Brodzinsky, Schecter & Henig, 1992.

Relational Stress With Infertile Grandparents

One particularly generous and warm woman in my support group, who is the mother of two grown adoptees, confessed to me that she still feels anger when she sees a pregnant woman. "Even today I still feel a twinge, too, when I get a Christmas card where the children and grandchildren look alike." I felt relieved when she admitted this because I had sensed these same emotions of envy and grief, unspoken, in my mother (4)Steinberg, 1994.

An adult adoptee’s pregnancy reawakens that loss for her parents because they lose one major coping strategy: denying the beauty of birth and pregnancy. When my sister and I were growing up, our mother used to compensate by saying adoptive families were more "special" than other families because the children had been "chosen" (although in reality we were assigned by social workers). "After all, even dogs and cats give birth," she used to say.

Another adult adoptee said her mother developed some time-consuming project that was the focus of her attention for those nine months. The project evaporated once the grandchild was born.

An adoptee’s pregnancy may also revive memories in the grandparents-to-be of feeling on trial by the system. Adopters had to pass home inspections, psychological evaluations by social workers, and invasive fertility testing and/or treatment that made the requirements for biological parenthood seem unfairly easy.

Finally, when an adoptee/mother chooses to breastfeed, it reminds her parents of an option unavailable to them at the time.

Abandonment Issues

Because labor is such a non-rational, high-energy experience, it can bring subconscious fears of abandonment to the fore (5)Gaskin, 1990. I experienced this when I found myself alone and in transition with my second labor. Intellectually, I knew no one could have predicted my transition would happen so suddenly. Only a few minutes before, I was just six centimeters. So the midwives went to check on a mother who had given birth that morning and my husband went to get coffee. The adult-me could forgive them, but, deep down, the abandoned child-me felt like my trust had been betrayed and they had all let me fall off the edge of an abyss.

Interestingly, non-adoptees with whom I spoke also had this experience in labor if they lost a parent during childhood to death or divorce.

Adoptees who suffer symptoms of postpartum depression could find it triggers an even deeper psychological depression—as with anyone who has suffered an unmourned loss. They have re-opened what Nancy Verrier calls a "primal wound," in her book by the same name. No matter how much they are loved, an adoptee’s first life experience is separation and loss of their birthmother(6) Nancy Verrier, 1993.

Loss of Control and Autonomy

The worlds of high-tech obstetrics and closed, sealed-record adoptions parallel each other in several ways.

The pregnant adoptee finds that basic information about herself and her body is controlled by both institutions. This leaves her "grateful" to (or angered by) experts, rather than empowered.

In an adoptee’s childhood, birth is shrouded by secrecy and sealed records. During labor it may be shrouded again, this time by drugs, distraction techniques, and more secrecy.

Many hospitals ritualize the breaking/separating of the mother-child couple in order to claim control. The first separation by adoption is permanent while the second is a temporary re-enactment.

In both sealed-record adoption and obstetric childbirth the adult adoptee/mother is the person most impacted by events, yet her interests are often overshadowed. First, the needs of patriarchal society, the adoption agency, and insecure adoptive parents may take precedence over the adoptee’s. Then, the needs of obstetric wards, doctors and nurses may be put before those of the laboring woman.

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Genealogical Themes

Giving birth as an adoptee is a little like being Eve, the first woman in history to give birth. You inherit no labor hang-ups: you are bequeathed no bone-chilling childbirth stories. You are truly free. (Unless, of course, you were told the antiquated adoption tale that "your mother died in childbirth.")

When we see our newborn, we have the joy of seeing our first biological relative sharing some of our physical traits. I remember thinking, "I’m finally a regular member of the human race." At the time, I could not explain the reason for that thought because I had denied the influence of adoption to a great extent. But at some level I was acknowledging that I had finally cast a shadow into another generation and seen my reflection in my daughter’s infant eyes.

Relational Stress With Infertile Grandparents

Rather than withdrawing, adoptive grandmothers can use a daughter’s first pregnancy to share family birth stories in lieu of their own. For example, by my second pregnancy my mother was comfortable enough to tell me about my uncle’s birth and how my grandmother planned to have him in a rural resort so she could avoid a hospital stay and have him at home. I felt connected with my grandmother and closer to my mother.

If grandparents let the adoptee enjoy fertility, pregnancy, childbirth, and nursing, guilt-free, it can be a time of drawing closer. Especially during the first intense months of parenting, I gained a special appreciation of my parents as I learned that mothering is much more than maternity.

Abandonment Issues

It was only the profound healing I enjoyed with the birth of my son that let me know I was "wounded" in the first place. Two things helped. First was the great trust I established in my labor companion and the midwives before the birth. Second, I had continuous companionship during the later stages of labor.

Themes of Control and Autonomy

An autonomous birth is a very appropriate time for the birthing adoptee to undo past patterns and regain control. That will happen if caregivers reveal, not conceal, information, realizing that the adoptee has a right to know about her body and herself. It will happen if the adoptee finds the strength and support to face childbirth truthfully, with all its potential for pain and joy. She should not be separated from her child immediately after birth. The adoptee’s/mother’s autonomy should have higher priority than the convenience, ego and feelings of others.

In this environment, not only can the "unborn" give birth, they can be reborn by it.