Parenthood journey brings unique mental health challenges for CF adults
Review highlights the emotional labor and identity shifts of parents
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For people with cystic fibrosis (CF), the decision of whether or not to become a parent is fraught with psychological challenges, ranging from difficult fertility treatments to deep concerns about long-term health and family stigma, a new review paper highlights.
The findings underscore the critical importance of providing comprehensive psychological support for CF patients who are considering parenthood. They also emphasize the need for medical teams to treat adults with CF as autonomous individuals who are fully capable of making decisions about their own reproductive lives.
“Despite medical advances, current care models often overlook the emotional labor, identity challenges and autonomy struggles that shape reproductive journeys,” researchers wrote in the study, “Psychological well-being in adults with cystic fibrosis during pregnancy and parenthood: A systematic review,” which was published in the Journal of Health Psychology.
Balancing medical possibilities with emotional needs
“As more people with CF consider or become parents, supporting their journey calls for care that recognizes not just what is medically possible, but what is emotionally meaningful and ethically grounded,” the researchers added.
With modern medical care, the vast majority of people with CF will live well into adulthood, and some may choose to become parents. But embarking on the journey of parenthood poses unique challenges for people with CF. Most patients will require medical assistance to conceive biological children, and parents with CF need to juggle the dual responsibilities of managing a chronic disease and caring for children.
There has been a significant amount of research into the physical impacts of CF on fertility and pregnancy. However, the psychological impact of pursuing parenthood while living with CF has received far less scientific attention, despite having a major effect on people living with the disease.
In the study, researchers combed through the scientific literature to see what is currently known about the psychological impacts of parenthood in CF. The review covered 18 studies published between 1989 and 2025. These studies included a total of 326 participants, ages 19 to 62 years, and were conducted in the U.S., Australia, and Europe.
“This review aims to systematically review and synthesise the available qualitative literature on how pregnancy and parenthood affect the psychological well-being of [people with] CF, identifying key challenges, coping mechanisms, implications for clinical care and identify priorities for future research,” the scientists wrote.
The research team identified four overarching themes. First, CF patients must put a substantial amount of emotional work into decisions about parenthood. As the researchers described it, these choices require “a constant negotiation between hope, fear and uncertainty.” This theme included the psychological toll of navigating fertility treatments, as well as the fact that patients often have to confront their own mortality head-on as they make plans for the long-term future.
Redefining identity and shifting personal priorities
A second theme focused on how parenthood affects people’s sense of identity, leading them to view themselves simultaneously as patients and parents. In the studies, patients generally reported feeling motivated to maintain their health as best they could so they could fulfill their role as parents, but these positive feelings go hand in hand with guilt and worry about not being as present as they wish they could be.
The third theme highlighted how becoming a parent can lead people with CF to change what they consider important. Generally, people with CF who choose to become parents start to focus less on managing their physical health and clinical stability, and more on emotional connections with their families, peer support, and recognition from healthcare providers.
The fourth theme centered around autonomy, noting that people with CF who choose to pursue parenthood often face stigma and scrutiny from medical professionals. This theme highlighted how important it is for healthcare providers and family members to treat adults with CF as grown-ups capable of making their own decisions, and emphasized the need for psychological support when patients navigate these stressful discussions.
“Participants frequently described feeling judged, discouraged, or denied agency in their decisions, often encountering gatekeeping by clinicians, underscoring persistent barriers to reproductive autonomy. Viewing these findings through a reproductive justice lens emphasizes the need for care that upholds autonomy, dignity and equitable access to non-judgemental support, irrespective of an individual’s health status,” the researchers wrote.
Overall, the findings underscore that the psychological challenges of pursuing parenthood with CF need to be addressed just as thoroughly as the medical challenges.
“This review advocates for a shift towards emotionally attuned, person-centred models of reproductive care. This includes integrating psychological support into routine care, validating emotional ambivalence, facilitating peer connection and improving coordination across CF and maternity services,” the scientists wrote.
