IVF and Ever After: The Emotional Needs of Families by Nichola Bedos Rockpool, HK$180 More than three million in vitro fertilisation (IVF) babies have been born around the world since the first in 1978. It's predicted that in a quarter of a century - and partly because of the established global trend for delayed motherhood - one in three births will involve IVF. In response, Nichola Bedos, a psychotherapist and infant mental health specialist, has written IVF and Ever After: The Emotional Needs of Families, a superb examination of, and guide through, the intense impact of IVF on parents and their children. Global numbers? Eighty million people are infertile. For those considering treatment, skilled psychological support is critical. Emotional complexities must be explored before IVF can be attempted. 'Arriving at the door of an infertility clinic without having reflected on the feelings evoked by a diagnosis of infertility can be disastrous,' Bedos writes. The aftermath of successful and unsuccessful IVF cycles not only affects the family, but a wider circle of relatives and, ultimately, the community at large. Because of increasingly effective technology, infertile and older couples, carriers of genetic abnormalities and same-sex couples can now become biological families. IVF presents challenges on almost every level - medico-legal, ethical, religious, emotional, and physical - for parents and their children, who may later contend with issues about their genetic heritage and sense of identity. The Australian Institute for Health and Welfare also found that the IVF baby death rate is twice that of the naturally conceived: one in 50 is stillborn or dies within a month. Women who pursue the process are saddled with unnerving possibilities: parents undergoing IVF are nine times more likely to produce twins than non-IVF parents. More than 50 per cent of women using IVF struggle to care for their newborns after C-sections. More than half of all IVF mothers switch to bottle-feeding in the first three months, citing failure to establish a 'good' milk supply. IVF parents experience what Bedos calls 'a pervasive fear of loss' kindled before the IVF treatment process. Three times more likely to seek help from parenting centres, IVF parents often have no confidence in their parenting skills. Invasive IVF procedures can create a sense of loss of ownership of the body, and sexual intimacy can be corroded or distressingly defused. Because of the interference, IVF mothers can also feel unrelated to their babies - which is, as Bedos has seen, a serious threat to the self-esteem of parents and children. Stress hormone levels of women undergoing IVF treatment have been shown to be similar to those of people with a life-threatening illness, and this in itself becomes an obstacle to effective living. Maternal stress hormones cross the placenta, infiltrating the fetal bloodstream. Studies have shown that this affects the baby and leads to a more sensitive newborn. There's also evidence that anxiety causes premature birth. The book's one flaw is its rejection of co-sleeping, a practice which, when undertaken with caution (no drugs or alcohol, light bedding, etc), can result in newborns who don't cry at night, a circumvention of sleep apnea (believed by some to be the cause of sudden infant death syndrome) and an incorruptible mother- child attachment. Despite acknowledging the bliss of having her firstborn fall asleep in her arms, Bedos recommends the cot, a relatively recent invention believed by specialists such as Margot Sunderland to be, in part, responsible for the dehumanisation in our culture. As ethnologist Wolfgang Winkler noted, the entire behavioural repertory of a baby is adapted for continuous mother-child contact: 'It is not biological to place our babies in cribs. Sympto-matic of this is that the babies cry out of loneliness with abnormal frequency in our culture, while one scarcely even finds this among primitive people.' That said, IVF & Ever After is destined to become a parenting classic. Bedos' lucidity and talent for simplifying complex philo-sophical issues all contribute to her psychotherapeutic impact. But ultimately, it's her generosity that reels readers in. Her receptivity to emotional reactions so subtle that they escaped the attention of international specialists for more than 20 years qualifies her as an authority in the field. Importantly, she believes in the sanctity and wider significance of the family unit, and in preserving it as a locus of comfort and nurturance for all its members.