A Guide To Give To Family And Friends About "Erin's" Infertility
Erin knows that you love her and want her to be happy, to be her "old self" again. But lately, she seems isolated, depressed and obsessed with the idea of having a baby. You probably have difficulty understanding why getting pregnant has coloured virtually every aspect of her daily life. Erin hopes that by reading this booklet, written by psychologists with both personal and professional experience with infertility, you will better understand the pain she is feeling. The booklet also will tell you how you can help her.
SOME FACTS ABOUT INFERTILITY
It may surprise you to know that one out of six women who wants to have a baby cannot conceive. There are many possible reasons for this dismal statistic: blocked fallopian tubes, ovarian failure, hormonal imbalances, toxic exposure, husband's low sperm count, to name just a few. Moreover, after a woman turns 35, it becomes difficult to have a baby primarily because many of the eggs she has left are defective. All these barriers to pregnancy are physical or physiological, not psychological. Tubes don't become blocked because a woman is "trying too hard" to get pregnant. Antibodies that kill sperm will not disappear if a woman simply relaxes. And a man cannot make his sperm swim faster by developing a more optimistic outlook.
WELL-MEANING ADVICE
When someone we care about has a problem, it is natural to try to help. If there's nothing specific that we can do, we try to give helpful advice. Often, we draw on our personal experiences or on anecdotes involving other people we know. Perhaps you recall a friend who had trouble getting pregnant until she and her husband went to a tropical island. So you suggest that Erin and her husband take a vacation, too. Erin appreciates your advice, but she cannot use it because of the physical nature of her problem. Not only can't she use your advice, the sound of it upsets her greatly. Indeed, she's probably inundated with this sort of advice at every turn. Imagine how frustrating it must be for her to hear about other couples who "magically" become pregnant during a vacation simply by making love. To Erin, who is undergoing infertility treatment, making love and conceiving a child have very little to do with one another, now. You can't imagine how hard she's been trying to have this baby and how crushed she feels every month she learns that she's failed again. Your well-meaning advice is an attempt to transform an extremely complicated predicament into a simplistic little problem. By simplifying her problem in this manner, you've diminished the validity of her emotions, making her feel psychologically undervalued. Naturally, she will feel angry and upset with you under these circumstances. The truth is: There's practically nothing concrete you can do to help Erin. The best help you can provide is to be understanding and supportive. It's easier to be supportive if you can appreciate how being unable to have a baby can be such a devastating blow.
WHY NOT HAVING A BABY IS SO UPSETTING
Women are reared with the expectation that they will have a baby someday. They've thought about themselves in a motherhood role ever since they played with dolls. A woman may not even consider herself part of the adult world unless she is a parent. When Erin thinks she cannot have a baby, she feels like "defective merchandise." Not having a baby is literally a matter of life and death. In the Bible, Rachel was barren. She said to Jacob "Give me children or I die ..." (Genesis 30:1). Commenting on this, some sages said, "One who is childless is considered dead." So powerful are the feelings connected with barrenness that the person feels dead or wants to die. Worse, Erin is not even certain that she will never have a baby. One of the cruelest things you can do to a person is give them hope and then not come through. Modern medicine has created this double-edged sword. It offers hope where there previously was none -- but at the price of slim odds.
WHAT MODERN MEDICINE HAS TO OFFER THE INFERTILE WOMAN
In the past decade, reproductive medicine has made major breakthroughs that enable women, who in the past were unable to have children, to now conceive. The use of drugs such as Pergonal can increase the number and size of eggs that a woman produces thereby increasing her chances of fertilization. In vitro fertilization (IVF) techniques extract a woman's eggs and mix them with sperm in a "test tube" and allow them to fertilize in a laboratory. The embryo can then be transferred back to the woman's uterus. There are many other options, as well. Despite the hope these technologies offer, they are a hard row to hoe. Some high-tech procedures are offered only at a few places, which may force Erin to travel great distances. Even if the treatment is available locally, the patient must endure repeated doctor's visits, take daily injections, shuffle work and social schedules to accommodate various procedures, and lay out considerable sums of money -- money that may or may not be reimbursed by insurance. All of this is preceded by a battery of diagnostic tests that can be both embarrassing and extremely painful.
After every medical attempt at making her pregnant, Erin must play a waiting game that is peppered with spurts of optimism and pessimism. It is an emotional roller coaster. She doesn't know if her swollen breasts are a sign of pregnancy or a side effect of the fertility drugs. If she sees a spot of blood on her underwear, she doesn't know if an embryo is trying to implant or her period is about to begin. If she is not pregnant after an IVF procedure, she may feel as though her baby died. How can a person grieve for a life that existed only in her mind? While trying to cope with this emotional turmoil, she gets invited to a baby shower or Christening, learns that a friend or colleague is pregnant, or she reads about a one-day-old infant found abandoned in a Dumpster. Can you try to imagine her envy, her rage over the inequities in life? Given that infertility permeates practically every facet of her existence, is it any wonder why she is obsessed with her quest?
Every month, Erin wonders whether this will finally be her month. If is isn't, she wonders if she can she muster the energy to try again. Will she be able to afford another procedure? How much longer will her husband continue to be supportive? Will she be forced to give up her dream? So when you speak with Erin, try to empathize with the burdens on her mind and on her heart. She knows you care about her, and she may need to talk with you about her ordeal. But she knows that there is nothing you can say or do to make her pregnant. And she fears that you will offer a suggestion that will trigger even more despair.
WHAT CAN YOU DO FOR ERIN?
You can give her support, and don't criticize her for any steps she may be taking -- such as not attending a nephew's bris -- to protect herself from emotional trauma. You can say something like this: I care about you. After reading this booklet, I have a better idea about how hard this must be for you. I wish I could help. I'm here to listen to you and cry with you, if you feel like crying. I'm here to cheer you on when you feel as though there is no hope. You can talk to me. I care. The most important thing to remember is that Erin is distraught and very worried. Listen to what she has to say, but do not judge. Do not belittle her feelings. Don't try to pretend that everything will be OK. Don't sell her on fatalism with statements like, "What will be will be." If that were truly the case, what's the point of using medical technology to try to accomplish what nature cannot? Your willingness to listen can be of great help. Infertile women feel cut off from other people. Your ability to listen and support her will help her handle the stress she's experiencing. Her infertility is one of the most difficult situations she will ever have to deal with.
PROBLEM SITUATIONS
Just as an ordinary room can be an obstacle course to a blind person, so can the everyday world be full of hazards for an infertile woman -- hazards which do not exist for women with children.
She goes to her sister-in-law's house for Thanksgiving. Her cousin is breast-feeding. The men are watching the football game while the women talk about the problems with their kids. She feels left out, to say the least. Thanksgiving is an example of the many holidays that are particularly difficult for her. They mark the passage of time. She remembers what came to mind last Thanksgiving -- that the next year, she would have a new son or daughter to show off to her family. Each holiday presents its own unique burden to the infertile woman. Valentine's day reminds her of her romance, love, marriage -- and the family she may never be able to create. Mother's Day and Father's Day? Their difficulties are obvious. Mundane activities like a walk down the street or going to the shopping mall are packed with land mines. Seeing women pushing baby carriages and strollers strikes a raw nerve. While watching TV, Erin is bombarded by commercials for diapers, baby food, and early pregnancy tests. At a party, someone asks how long she's been married and whether she has any kids. She feels like running out of the room, but she can't. If she talks about being infertile, she's likely to get well-intentioned advice -- just the thing she doesn't need: "Just relax. Don't worry. It will happen soon," or "You're lucky. I've had it with my kids. I wish I had your freedom." These are the kinds of comments that make her want to crawl under the nearest sofa and die. Escape into work and career can be impossible. Watching her dream shatter on a monthly basis, she can have difficulty investing energy in advancing her career. All around, her co-workers are getting pregnant. Going to a baby shower is painful -- but so is distancing herself from social occasions celebrated by her colleagues.
THE BOTTOM LINE
Because she is infertile, life is extremely stressful for Erin. She's doing her best to cope. Please be understanding. Sometimes she will be depressed. Sometimes she will be angry. Sometimes she will be physically and emotionally exhausted. She's not going to be "the same old Erin" she used to be. She won't want to do many of the things she used to do. She has no idea when, or if, her problem will be solved. She's engaged in an emotionally and financially taxing venture with a low probability of success. Overall, only about 11 percent of those people using special fertility treatments succeed in having a baby. The odds are even lower for women over 40. The longer she perseveres, however, the greater her chances of pregnancy become. Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a childless life. At present, though, she has no idea what will happen. It's all she can do to keep going from one day to the next. She does not know why this is her lot. Nobody does. All she knows is the horrible anguish that she lives with every day. Please care about her. Please be sensitive to her situation. Give her your support, she needs it and wants it.
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