‘Have you ever talked to any women with Turner Syndrome?’ Adapting interviews for women with mild cognitive impairment

This May, after many months of hard work on behalf of the authors and editorial team alike, saw the publication of a special issue of the journal ‘Methodological Innovations’ which we put together based on submissions to the panel ‘Social Studies of Reproduction: techniques, methods and reflexive moments’ which we convened at the International Sociological Association’s 9th International Conference on Social Science Methodology, in September 2016. A full list of the articles, including author names and URLs to the papers can be found at the end of this blog post.

We asked Kristine Fearon (one of our CRR PhD students) if she would like to write a summary of her paper, indeed her first sole author academic publication, to give readers a taste of what they may expect from the special series.

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Have you ever talked to any women with Turner syndrome?’ Using universal design and photo elicitation interviews in research with women with mild cognitive impairment

Kriss Fearon

https://journals.sagepub.com/doi/full/10.1177/2059799119841933

Qualitative reproduction research very often asks people to share sensitive personal stories and experiences. As a standard part of research practice, researchers are expected to anticipate the potentially upsetting nature of their questions and prepare for the impact this may have on their participants. However, this proactive approach is not always described in research with participants with Turner Syndrome (TS), even though the condition is associated with mild cognitive impairments, some of which may affect the research interview interaction. This blog post, and the paper it is based on in Methodological Innovations, was inspired by the desire to explore how my research approach could be adapted to accommodate the potential needs of my research participants.

My research explored reproductive decision making with women with TS and mothers of girls with TS, who were faced with making choices on their daughter’s behalf. TS is a spontaneous X chromosome disorder associated with a range of symptoms such as short height, infertility, heart conditions and hypertension, cognitive issues such as difficulty with time-management and social cognition, and social anxiety and shyness (Bondy, 2007). It is not a disability, but its symptoms appear on a spectrum so a symptom that is disabling for one woman might only mildly affect another.

As TS and issues related to reproduction are often highly sensitive and personal, I was aware before beginning data collection that this would most likely affect the research approach I would need to take. What was less clear was how some of the symptoms of TS may affect the way the research process and interview interaction was conducted and experienced. Whilst the mothers of the girls with TS did not suffer from the symptoms themselves, I was aware that they may have access needs of their own. Across the wider population, the rate of disability of the women in the age range of the mothers I was likely to interview was 18% (DWP, 2014). As a result, it seemed prudent to prepare suitable adaptations for use by all potential participants and not just those I knew had TS, especially as research indicates that people often feel reluctant or unable to share details of a health condition or disability with new people (ONS, 2014). Furthermore, I was aware that if participants were managing any symptoms without making major changes to their daily life, they may not consider it to be relevant information for an interviewer. This made it more important to discover in advance what might be needed, and plan accordingly.

The first step, then, was to scope the implications. In order to do this, I took advice from people with expertise in TS, who identified relevant issues which may affect some women with the condition and gave suggestions for ways to address them. The issues they identified as potentially important for the interview encounter included working memory impairments; difficulty in interpreting body language and facial expressions; difficulty in decision-making and time management; as well as anxiety. After this, I drew on the principles of Universal Design (UD) as a framework to plan adaptions.

Universal Design (Mace et al, 1998) is a practice originating in architecture which sees disability as being caused by inadequacies in the physical or cultural environment, rather than as something residing within the individual (Barnes, 2011). Applying its guiding principles (such as ‘flexibility’ and ‘low physical effort’) to research meant looking at ways to vary the research setting and interaction to fit individual preferences and needs (Lid, 2014). The choice of research method, photo elicitation interviews, was one important way to achieve this, but adaptions were also made to other aspects of the research approach. This included providing information about consent and photo choice via video as well as in the participant information sheet; leaving the choice of venue to the participant; allowing time for participants to take a break if needed; using words rather than relying on body language and tone to communicate meaning; and allowing more time for the participant to respond to the questions I put to them.

In a photo elicitation interview, participants bring images as a way to start the conversation. Some of the benefits of such an approach to data collection identified by other academic researchers (Allen, 2009; Konecki, 2011; Liebenberg, 2009; Luttrell, 2010) are features that had a double function as suitable adaptions. For example, participants with anxiety may have felt more in control when they had time to plan what to say. The photos were a useful way to help to manage time and bring the focus of the conversation back to the topic at hand. Some participants also used photos to express complex thoughts and feelings that might have been harder to articulate with words alone. Through the use of images, the focus of the discussion was often not the participant but her photos, which allowed time to build rapport during the course of the conversation which was particularly important for participants who were shy or worried about

The participants responded generously to the request to bring photos and ultimately brought twice the number that was expected, including items like a baby book, inspirational quotes, drawings, poems, stories, selfies, and songs. One participant used a painting to express a nuanced view of fertility and family. Her peers had married and had children; she thought she had missed her chance to become a mother and was facing growing old on her own. Using the painting below, she described how, through caring for her dogs, she experienced bereavement and loss, as well as fertility and birth.

Image 1 provided by participant

She explained:

My dog had puppies, so I’ve experienced the cycle of life through that and watched her children grow up. It’s nowhere near having your own children but at least I explored 1% of something about that process. […] I just know it’s always been, it’s like a void that you can’t fill, and I know consciously that a dog can’t fill that particular void.

Another participant brought a photo of herself aged five with her grandmother, which she described reflected her desire to continue her own experience of good mothering down the family line.

Image 2 provided by participant

She commented:

That picture of me and my nan is really special to me because she died some years ago. I think she taught me that grandmothers as well are incredibly influential figures. She was an influential figure in my life anyway, because I could see a lot of her influence in my mum as well, so she, sort of, through the way she mothered my mum, she taught my mum how to be a mum to me. So, she was an amazing lady, she was.

A further participant shared a photo of her five-year-old daughter breastfeeding a doll, copying her mum who was breastfeeding her little brother at the time.

She explained:
Obviously she was just copying me, because I feed our son, but again I thought, you’re probably not going to get to do that, and for her, she sees that as such a natural part of having a baby, because for many it is, but the fact that she won’t get that opportunity just made me feel wow, this moment right now, I can’t speak, because that’s really got to me.
This participant had discovered when she was 12 weeks pregnant that her daughter had TS. While the health aspects of her daughter’s TS were well managed, the participant was still grieving about the infertility diagnosis that would face her child. The times when her daughter displayed what she described as mothering behaviour, such as when playing with dolls, putting a cushion up her dress and pretending to be pregnant, or rocking her baby brother to sleep, made her deeply upset about how difficult it would be for her daughter to have a family. This example shows how much more poignant a photo can be when compared to words alone.

Image 3 provided by participant

It is difficult to be certain whether the adaptions made a difference to participants as the study did not set out to evaluate this. However, some participants had potential access needs which they only disclosed when I arrived or during the interview. One mother of a girl with TS did not mention her hearing impairment until we met, having chosen to be interviewed at home so she could control the level of background noise. A proactive approach to planning adaptions was especially useful here: any participant could make this choice, so she did not need to let me know. Another participant remarked, during her interview, on the importance of accommodating cognitive differences as a way to achieve a good rapport and mutual understanding.

She told me:
“If everybody thought the way a person with Turner Syndrome thinks we’d all get on just fine. The only difficulty is that we all live in a world where people don’t. People don’t have chromosome disorders, and they think about things one way and we think about them a different way. Often, they need to take a different approach.”

For me, such a statement from a participant clearly shows why planning around potential communication and access issues is so important for research interviews.

The aim of making adaptions was to try to treat participants respectfully and in a way that acknowledged and met their needs and preferences. In doing so I wished to make it easier for potential participants to become involved in the study, but also hoped that making adaptions would in turn produce research which better reflected the experience and views of this under-researched group of people. Ultimately, the number and variety of items that the women brought to interview, the lengthy interviews, and the sensitive, personal thoughts and feelings that people were willing to share, suggests that participants felt comfortable enough to express themselves in the interview encounter. This was pleasing as an early career researcher and a good lesson going forwards about how to try and make research participation and involvement as inclusive as possible.

This blog is based on an open-access article ‘Have you ever talked to any women with Turner syndrome?’ Using universal design and photo elicitation interviews in research with women with mild cognitive impairment, https://doi.org/10.1177/2059799119841933

More details and links to the other papers in this special issue can be found below:

Introduction: Reproduction research: From complexity to methodological innovation

Nicky Hudson, Kylie Baldwin, Cathy Herbrand, Nolwenn Buhler, Irenee Day

https://journals.sagepub.com/doi/full/10.1177/2059799119829427

 

Men on the margins? Reflections on recruiting and engaging men in reproduction research

Caroline Law

https://journals.sagepub.com/doi/full/10.1177/2059799119829425

 

Pregnant with possibility: The importance of visual data in (re)presenting queer women’s experiences of reproduction

Sierra Holland

https://journals.sagepub.com/doi/full/10.1177/2059799119829429

 

The ontology of early labour (and the difficulties of talking about it): Using interview methods to investigate uncertain and gendered concepts

Julie Roberts

https://journals.sagepub.com/doi/full/10.1177/2059799119825594

 

Situational ethics in a feminist ethnography on commercial surrogacy in Russia: Negotiating access and authority when recruiting participants through institutional gatekeepers

Christina Weis

https://journals.sagepub.com/doi/full/10.1177/2059799119831853

References from blog post

Aldridge, J (2007) Picture this: the use of participatory photographic research methods with people with learning disabilities. Disability & Society, 22(1), pp.1-17.

Allen, L (2009) ‘Snapped’: researching the sexual cultures of schools using visual methods. International journal of qualitative studies in education, 22(5), pp.549-561.

Barnes, C (2011) Understanding disability and the importance of design for all. Journal of accessibility and design for all, 1(1), pp.55-80.

Bondy, CA (2007) Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. The Journal of Clinical Endocrinology & Metabolism, 92(1), 10-25.

Department for Work and Pensions, National Centre for Social Research, Office for National Statistics. Social and Vital Statistics Division, 2014, Family Resources Survey, 2011-2012, [data collection], UK Data Service, 2nd Edition, Accessed 18 June 2018. SN: 7368, http://doi.org/10.5255/UKDA-SN-7368-2

Konecki, KT (2011) Visual grounded theory: A methodological outline and examples from empirical work. Revija za sociologiju, 41(2), pp.131-160..

Lid, IM (2014) Universal design and disability: An interdisciplinary perspective. Disability and rehabilitation, 36(16), pp.1344-1349.

Liebenberg, L (2009) The visual image as discussion point: Increasing validity in boundary crossing research. Qualitative research, 9(4), pp.441-467.

Luttrell, W (2010). ‘A camera is a big responsibility’: a lens for analysing children’s visual voices. Visual studies, 25(3), pp.224-237

Story, MF, Mueller, JL and Mace, RL (1998) The universal design file: Designing for people of all ages and abilities.

Office for National Statistics. Social Survey Division, 2014, Opinions and Lifestyle Survey, Disability Monitoring Module, July, August, September, November and December, 2012, [data collection], UK Data Service, Accessed 18 June 2018. SN: 7498, http://doi.org/10.5255/UKDA-SN-7498-1

(In)fertility, parenthood and the fertility fight club: a review of Fertility Fest 2018

Last week saw dozens of researchers, scientists, artists, fertility patients, regulators, and campaigners come together for ‘Fertility Fest 2018’ which was organised by Jessica Hepburn and Gabby Vautier. The week-long programme of events brought together 150 artists and fertility experts for the second arts festival of its kind which was dedicated to the discussion of fertility, infertility, modern families and the science of making babies. Unable to attend the festival in its entirety I arrived at the Bush Theatre on Friday 11th to enjoy the packed schedule provided. The morning session offered parallel streams examining the personal experience of using fertility medicine to conceive (The Doctor in the Bedroom), the often-marginalised male experience of infertility (The Invisible Man), and the embodied experience of infertility and reproductive loss (Fertility and the Body). This latter stream included a performance lecture from Shantel Ehrenberg, an academic and performer from the University of Surrey. Ehrenberg’s work titled ‘(In)fertile Territories’ explored her personal experience of becoming childless by circumstance following a diagnosis of sub-fertility with a high Follicle Stimulating Hormone (FSH) at the age of 32. Over the very gentle hum and echo of an ultrasound, Ehrenberg’s piece explored the embodied experience of an uncertain and unexpected fertility diagnosis and examined how the ‘hard and objective data’ mined from her body in the form of fertility assessments contrasted with her ‘soft subjective body’ which nevertheless longed-for motherhood. Drawing on scholarly academic work from across the social sciences, Ehrenberg echoed the concerns and anguish of many other women who experience infertility including a sense of loss and failure. She described how her expectations of future motherhood were shattered through the pelvic ultrasound images provided to her by her fertility doctor who explained her poor chance of genetic motherhood due to her compromised ovarian function. In noting a contradiction between her own personal desires for motherhood and her biological reality, she described how the result of her fertility tests indicated to her ‘what kind of woman’ her body told her she was, or would be; one without children of her own. For Ehrenberg, like many women who suffer from premature menopause, her diagnosis resulted in what she described as a ‘tectonic shift’ in her internalised self-identity and threw her preconceived ideas about how her life would unfold in to a state of flux. Drawing on the academic work of Sarah Franklin and Gayle Letherby, she described how this feeling was made particularly acute by a culture which continues to equate motherhood with womanhood. Furthermore, she noted how the failures of her body served to set her apart from glowing media images of pregnant women such as Demi-More, Beyonce, and Princess Diana who embodied hegemonic ideals of femininity in way which was now outside of her reach. As well as situating her embodied experience of infertility alongside socio-anthropological academic literature, Ehrenberg also shared these through a series of powerful bodily movements which appeared to reflect a sense of powerlessness, a loss of control and which connoted ideas of the empty-armed non-mother who housed a disobedient body unwilling or unable to produce the expected and anticipated gift of motherhood.

Dr Shantel Ehrenberg during her performance lecture ‘(In)fertile Territories’

In the afternoon I attended the stream on ‘The Business of Fertility’. This session questioned whether the ‘fertility industry’ at large was doing enough to support and meet the needs of IVF patients and customers especially as they profited from, what another speaker referred to as, the ‘emotional, physical and financial torture’ of infertility. Sharing two scenes from her upcoming play ‘Genesis Inc.’, the writer Jemma Kennedy quickly and convincingly showed the tension and negative impact IVF treatment can have on intimate relationships and highlighted the often-gendered burden of IVF treatment on men and women. Kennedy also shared her own experience of ‘social’ egg freezing, a technology which she drew upon to preserve her reproductive potential following the breakdown of her relationship. She commented that the intensity of her broken relationship and anxieties about the future meant that she spent several thousand pounds on a technology that is only likely to provide her a 5% chance of future pregnancy. As she underwent the procedure alone, without a partner, and during a distressing phase in her life, Kennedy commented that she did not ask the requisite questions about the technology to enable her to be sufficiently informed about how likely it would be in providing her a live birth in the future. She described how, at the time, it did not occur to her to ask her clinic if they had experience in achieving a live birth from frozen eggs, or how many eggs she may produce following stimulation, and how many she would need to have a realistic chance of motherhood in the future. She commented that she therefore believed counselling to be important not only for women and couples attempting a conception immediately, but also for those making use of technologies such as egg freezing. Kennedy’s assertion about the importance of counselling for users of egg freezing is without a doubt correct and, as our research on egg freezing has shown, she is not alone in the ambivalent and uncertain experience and relationship she had with egg freezing nor the uncertainty she shared about whether the technology will ever help her to realise motherhood. Echoing the findings of our research on this topic, Kennedy explained that even if she had known that her frozen eggs would only give her a further 5% chance of motherhood she would still most likely have gone ahead with the procedure. This was in-part because she wanted to know she had, in some way, increased her chances of motherhood in the future even if only by a fraction. Nevertheless, as authors have argued elsewhere, much more information and transparency is needed with regards to individual women’s likelihood of success using frozen eggs to conceive, as well as how many rounds of stimulation and retrieval she may require to undergo to collect a sufficient number of eggs for freezing.

Jemma Kennedy talking about her stage play and experience of egg freezing

Whilst all the sessions I attended at the festival were thought provoking and engaging, I particularly enjoyed the play ‘Eggistentialism’ by Joanne Ryan which was on in the evening (a review of which can be found here), and the ‘Fertility Fight Club’ part of the day. For the un-inducted, the Fertility Fight Club ran on the Friday, Saturday and Sunday, each time with different contributors who were passionate about the topic of which they spoke. Each speaker had a ‘round’ of 10 minutes to get a particular issue ‘off their chest’ and convey to the audience the key information they wanted them to know and understand. Friday’s session began with Joyce Harper who talked passionately about IVF ‘add-ons’ and asked patients: ‘Why are you paying for unproven fertility treatments?’. Similar to another talk I recently attended at the fertility show in Manchester delivered by Kate Brian, Harper began by discussing the hierarchy of evidence noting how many treatment ‘add-ons’ have not been proven to be effective in randomised control trials which she described as the best and most reliable form of evidence. Sharing details of the traffic light system she helped implement she implored fertility patients to ask for evidence for any treatment ‘add on’ they are offered. Harper’s talk was, as always, lively and engaging however questions remain about how we even define a fertility treatment ‘add-on’. Should we, for example, consider treatments such as acupuncture and reflexology as fertility treatment ‘add-ons’ especially given the rate that these treatments are often taken up by fertility patients? And would providers of these treatments, like the providers of more high-tech ‘add-ons’, be able to substantiate any claims they make about increasing the success rates of IVF.

Prof Joyce Harper in the first ’round’ of the ‘Fertility Fight Club’

The second round of the fight club heard from Sheridan Voysey who after being diagnosed with male factor infertility underwent repeated rounds of unsuccessful IVF treatment with his wife and who after 10 years of trying to create a family had to relinquish his desire for fatherhood. Voysey, who documented his experience coming to terms with unwanted childlessness in his book ‘Resurrection year’, shared the perils of ‘coming out’ as an infertile couple or person in the public eye. He described how he personally became the target of online abuse and often had his experience of infertility and unwanted childlessness dismissed by unkind readers who repeatedly berated him to ‘just adopt’. He noted how the process of adoption was by no means simple and had also not resulted in him and his partner becoming parents. Voysey also described other hurtful and highly gendered comments he received including readers telling him to ‘man-up’ about his infertility thereby trivialising his experience of unwanted childlessness and further devaluing the pain he felt as a childless man. Voysey therefore wanted people who were struggling to conceive to have their feelings of disappointment and loss validated and not diminished by the suggestion that an infertile couple or person should ‘just adopt’. Instead he suggested that well-meaning individuals could instead ask a couple struggling to conceive ‘whether adoption could be a possibility’ for them, whilst remembering that the process of adoption is not easy and does not guarantee parenthood.

The third speaker was Dr Zeynep Gurtin from the London Women’s Clinic who spoke about social egg freezing. Echoing the findings of our research on egg freezing, Gurtin described how users of this technology were not seeking out the technology to deliberately postpone or delay motherhood. Instead she described how women’s use of this technology was shaped by their lack of a suitable partner. Furthermore, Gurtin articulated how women felt significant fear and pressure to find a partner to have a child as they entered the final years of their fertility. Such a finding reflects that from our research recently reported in The Conversation. Here we detailed how women sought to freeze eggs so not to engage in what we have termed ‘panic partnering’ that is, entering into a relationship with a partner they would not have otherwise chosen, simply to prevent unwanted childlessness in the future.

The final speaker was the theatre director and IVF mother Sarah Esdaile, who gave a passionate and rousing talk about how ‘mother is a verb’. Esdaile became a mother following egg donation and described how she had received negative comments from others asking her about the ‘real’ mother of her daughter. She described how motherhood is not about conceiving, carrying, or birthing genetically related offspring but is found in the love and care a person provides to an often very much wanted child. Similar to Jemma Kennedy in the earlier session, Esdaile underlined the importance of counselling for those undergoing IVF, and described how the sessions she had with her counsellor helped prepare her for the birth of her much wanted and treasured daughter.

Kylie Baldwin

The play ‘Genesis Inc.’ featuring Harry Enfield is running at the Hampstead Theatre between the 22^nd and the 28^th July.

 

 

Considering motherhood, ‘Eggistentialism’ and the gendered inequalities of parenting.

The upcoming fertility-fest organised by Jessica Hepburn has the CRR buzzing with excitement, the wide variety of speakers and exhibits on topics which many of us have spent several years researching is a rare treat for us as academics. I was however recently lucky enough to get something of a sneak peek at one of the acts presenting at the festival; the stage play by Joanne Ryan called ‘Eggistentialism’.

Conceived during an ice breaker at a theatre development scheme, and reflecting the thoughts and feelings of many women in their 30s, the play sees Ryan share her ambivalences about the possible role which motherhood may one-day play in her life. Musing on her own reproductive future the play examines the sexual as well as social politics of contemporary motherhood and through the use of an animated slide slow, maps key moments in the history of Ireland between 1916 and 2017. With a focus on the politics of the family, reproduction and sexual relationships, the play examines emotive and distressing topics such as the forcible removal of babies from unmarried mothers, poor access to reproductive and sex education for young people, repressive legal barriers to contraceptive technologies, and the denial of access to safe and legal abortions for tens of thousands of women in Ireland which still continues today.

In the play Ryan draws a comparison between the reproductive and mothering experiences of the older women in her family and herself. In doing so, she notes how the comparatively liberal experiences of her generation who had access to reliable contraception and seemingly egalitarian relationships with intimate partners, has meant that she is now part of the first generation of women for whom the experience of motherhood is not considered a simple inevitability, but a ‘choice’ which she is able, but also required, to make for herself.

The play begins with Ryan waking up on her 35^th birthday with the hangover from hell, the type of hangover which makes you question your life choices, and the decision about whether she wants to become a mother rests firmly at the forefront of her mind. Aware of her advancing age, and fearful that she may not have ‘enough eggs left over to make an omelette’, like many women before her she takes to the internet for advice about her fertility and possibility of motherhood in the future. What results is a particularly funny skit which sees Joanne’s computer screen quickly overrun by alarmist media headlines about fertility decline and older motherhood which cascade before the audiences’ eyes to the rumbling overture of Carl Orff’s Carmina Burana. Finding that the decision about whether or not to become a mother has not yet been made for her by ‘Mother Nature’, Ryan decides to undergo an ovarian reserve test to assess the state of her fertility and is told that she is still within the normal range for a woman of her age. With no moment of clarity provided by the results of these tests, Ryan ponders what her life would look like should she remain childfree. She concludes that she wouldn’t need to have a child in order to experience fulfilment and happiness but remains anxious about the thought of entering old age without building a ‘legacy’ and a family who could care for her should she become unwell or infirm. She also notes how despite growing numbers of women coming to the end of their fertile lives without becoming a mother, the language used to describe such women often remains derogatory (selfish, shallow, bitter, self-absorbed) with connotations of incompleteness and lacking in essential qualities of femininity; such a fact troubles Ryan.

However, Ryan’s personal ambivalence about motherhood appears to centre on what she perceives as the pressures of modern day motherhood, remarking that during her grandmother’s lifetime keeping a child alive, well fed, and warm appeared to be the extent of a woman’s mothering responsibilities. By contrast she notes how contemporary motherhood is characterised by what she describes as an ‘endless triage of difficult decisions a woman is constantly judged for’. Evoking the notion of the ‘mummy wars’, it appears that Ryan’s ambivalence about motherhood is at least in part shaped by her anticipation of engaging in, or being required to engage in, a process of intensive mothering (Hays, 1998; Baldwin, 2017). This expectation of mothering intensively leads Ryan to note how becoming a mother would almost certainly see the end of her much beloved ‘city breaks’ as the demands of motherhood would require not only a complete reorganisation and reorientation of her life, but would also entail a high degree of personal sacrifice and altruism in putting the needs of her child before her own. The perceived demands of motherhood also lead Ryan to worry about ‘losing herself’ in the process of becoming a mother.  Most significantly however Ryan notes how the transition to motherhood would change her life completely as the burdens of raising a child would more than likely fall disproportionately on her shoulders, by comparison she notes that for her partner Rob, it would be ‘business as usual’.

The fear that the burden of parenting, and other associated domestic tasks, would fall disproportionately to her is perhaps not unwarranted given the context in which she makes her decision. After all, it was only in 2016 that men in Ireland were first able to take state mandated paternity leave (with shared parental leave still not available), and whilst maternity leave is accessible for many women, it is often only paid at a statutory rate with employers not required to top up women’s income as seen in England. Ryan also cites statistics which paint a depressing picture of the low rate of Irish men’s involvement in domestic tasks and in the delivery of unpaid care. This leads her to fear that should she and Rob decide to become parents, the egalitarian relationship which they have enjoyed thus far would be disrupted with Rob being applauded for ‘babysitting’ his own child whilst she faces her career being side-lined and independence marginalised. In raising these issues Ryan recognises the deep gendered inequalities parenting can bring to a previously equal intimate relationship which Ryan is perhaps the first in her family to enjoy.

I am not going to spoil the ending of the play for you by divulging what Ryan eventually decides, you will have to attend the Fertility Fest to see for yourself, but I can thoroughly recommend the play as a wonderful mix of both a hilarious stand-up routine and a personal monologue which is emotionally honest, intelligent but also highly engaging and entertaining.

‘Existentialism’ is running at the Bush Theatre on Friday 11^th and Saturday 12^th May, for more details see https://www.fertilityfest.com/ or follow @eggsplay on Twitter.

References

HAYS, S. (1998) The cultural contradictions of motherhood: Yale University Press.

BALDWIN, K. (2017) ‘I suppose I think to myself, that’s the best way to be a mother’: how ideologies of parenthood shape women’s reproductive intentions and their use of social egg freezing.  Sociological Research Online 22 (2), 1-15

 By Dr Kylie Baldwin, Senior Lecturer