Updated: Aug 6, 2019
I was interviewed this week for an article that I believe is going to be published on #Mamamia sometime soon and it provoked a few really interesting questions for me. It was about the potential ‘demonisation’ of ‘infertile women’, with a link to the portrayal of #infertility in #TheHandmaidsTale…..
firstly… let’s talk about the concept of ‘infertile women’…..
Infertility is defined as the inability to conceive after 12 months of actively trying - that means unprotected intercourse at the time of ovulation, every month for 12 months. Statistics tells us that roughly 80% of couples will conceive after 12 months of trying, a further 5% after the following 12 months and Fertility Treatment will provide a further *roughly* 5%. We also know that if you have not conceived after 6 months of trying, there is a 50% chance that you will need help (we can talk about that ‘help’ and what it means in a later blog)
‘Infertility’ is most definitely a couples’ issue and is never totally attributable to one or other party…. statistically speaking roughly 30% of cases are due to a female factor, 30% to a male factor, 30% to both and 10% to unknown reasons (this is the most frustrating diagnosis!), but in reality, if a couple can’t get pregnant, there is very little to be gained from laying the blame at one or other partner’s feet. A diagnosis of sub-fertility or infertility is always best approached by the couple as a team… so ‘infertile women’ is a bit of a misnomer…. it is true that childlessness is most often felt more strongly by the female partner, and the desperation to have a child is often stronger in the women… but it is not always the case.
That longing for children can be really hard for some people to understand - sometimes it is hard for the male partner to understand too… one of my first clients at #twolinesfertility was the male partner of a lovely girl who I never actually met until her (twin!) babies were well on their way (I think she was 25 weeks pregnant when we met?). He would ring me almost weekly and we would chat about why his wife was feeling the way she was, and how he could support her and help her deal with what they were going through. He didn’t understand her sadness when an IUI didn’t work. ‘But she was never even pregnant’ he’d say.. and I would say ‘no, but she had already planned what weeks should take off work and what colour to paint the nursery!’
As women, we try really hard not to overthink things, but when it comes to fertility and making babies, we know how much it’s going to turn our lives upside down when it finally does happen (and it does for most - eventually!) and our brains are wired such that we plan and plan and plan… we want it all to work out ‘just so’…... that first month off the pill (or other contraception) ,we think; ‘right, so if it works this time, *which it probably won’t*, the baby will be due in October - oh that means I’ve already had my last Christmas without a baby and I didn’t even know it!…. and it will be an Spring baby, I’ll still need lots of snuggly warm clothes… How many weeks would I be *if it works this month, which it probably wont*, weren’t we thinking about a holiday - I wonder if I’ll be able to fly? I don’t want to go to Sally’s wedding feeling sick…. oh when’s that? Oh no, it’s in April, so if it works this month I won’t be able to drink at the party and everyone will know… but will I be ready to tell people yet? I don’t know… I better work out all the dates - oh hello Google my friend………..” and so on… so when a few weeks later we discover that it didn’t work this month, we are slightly relieved - now we can probably drink at Sally’s wedding in April…. but now what about the holiday we were planning September…. and so on and so on….
So then 12 months down the track (remember ‘infertility’ is defined as 12 months of trying without success) we are totally exhausted from all the thinking, we’ve cancelled and put off so many things ‘just-in-case’ and we’re nervous wrecks…. and then we walk down the street and see the cliche little miss 17 year old, pregnant, with a ciggie hanging out of her mouth and we lose it… it’s not fair…..
It really takes its toll on partnerships/relationships.. the guys just don’t get it to the same extent…. they don’t have the daily reminders of their non-parenthood.. they tend not to see the tummies everywhere, the prams all over the place, they don’t let their feelings and thoughts run away with them… to most guys, it’s just ‘We do this, and then we might get that, or we might not.. either way, we’ll just do it again if we need to’.
Secondly, the interviewer asked about the anxiety that women going through fertility treatment feel coming from their friends - sometimes even outward hostility… like their friends are uncomfortable or frightened by their desperation.. and this got me to thinking too…. When my husband and I were thinking about starting a family of our own (he already had children so I was already a step mum) I felt very much like having children was some sort of a club that I may never belong to… one to which I was not permitted entry until I had my own children.. a certain smugness about my friends and family that had children already and their never ending ‘it will happen for you…’ and ‘what will be, will be’ and ‘be careful what you wish for…’ combined with ‘ohmygod, sleep while you can’ and ‘just you wait…’ placations that just didn’t help…. It is only with the benefit of hindsight that I can see that these were people who cared deeply about me and wanted only the best for me. I’m sure if many of them had a magic wand they would have made things happen much more quickly for us if they could.
I also know that working as a clinical embryologist I met so soo many couples that I just wanted to *magic* children for them.. being on the outside of someone’s fertility journey is really hard…. harder still when you’ve been there yourself and you know that it doesn’t matter how many times you say ‘I’ve been there’ or ‘this sucks doesn’t it’, you just can’t take the pain, frustration and longing away.
So yes, that longing, that desperation is hard to understand unless you’ve been there… and if you’re staring down the barrel of your fourth year of not sleeping a full night, with a screaming 3 year old, a teething toddler and a newborn… you may very well struggle to understand why anyone would want to put themselves in this position!
Your friends with children are probably spending at least half their time dreaming of a time when they could sleep in as long as they wanted, go to restaurants and movies when they felt like it, not to mention the often reported feeling of losing themselves in their children - so they could potentially feel almost jealous of their childless friends and the free time they seem to have.
I can also imagine that they would probably feel that there’s only so many times they can apologise for being fertile. It’s hard to know what to say when you are knocked up for the third time even though you can’t quite remember how, and you’re not sure you even want it….. and your best friend, who started trying at the same time as you did all those years ago, is still not pregnant with her first… it’s not surprising that those friendships often struggle.
And then there are the people who don’t have children, either because they haven’t started trying yet, or who are childless by choice, who can sometimes hold an opinion that ‘if you can’t have children - maybe there’s a really good reason for that’ .. insinuating that fertility treatment is a ‘waste of public funds’ and have a tendency to almost look down on people who are so desperate to have children that they would subject themselves to the intrusion of fertility treatment.
People also tend to look at things only from their own perspective and feel that any weirdness in friendships must be because of their own situation or something that they themselves have done, when in reality, the friend might not even remember that they are having treatment. Fertility treatment is so incredibly all-encompassing… infertility governs your every waking moment (and often your dreams too) and going through treatment involves daily injections, operations, scans, creams, counselling… it totally takes over your life… every twitch, every twinge is analysed and investigated and focussed on….. again, it’s not surprising that that kind of self-absorption and focus can take its toll on friendships.
So what would I say to women going through IVF who are feeling demonised? And what would I say to their friends, and the wider community, about how women going through IVF are feeling?
I would say that demonised is a strong word. I would encourage these women to look within, and without, and around… perhaps they are ‘case-building’.. like a good lawyer, they’ve made a judgement about their friends behaviour, and they are gathering only the evidence that supports their case, rather than looking at ALL the evidence… that perhaps their friend just doesn’t know what to say, they want to support and be there for you, but they just don’t know how, or maybe everything they’ve tried has been wrong, or maybe they are suffering with their own guilt at how easy it was for them, when it's so hard for you. Sometimes a simple honest frank discussion can get all that sorted out. A simple ‘this is really shit and I hate it’ can be enough.. from either party! No need for placations, no need for cliches, and no need for egg shells.