Tuesday, November 18, 2008

I finally get it

It's now about four years since I first read an infertility blog and more than that since I found message boards. During that time, I've read a lot of heartfelt posts and comments that have hit me right in the gut because I could connect so completely with what the writer was saying, experiencing, and feeling. Other posts, I didn't have the personal experience to relate to, but I could imagine the situation, and could feel profound empathy, even though I had never been exactly in the same place. But every now and then, I've read something, obviously coming from a place of sincere emotion, that made me think, "hunh?"

The community affected by infertility is large and diverse, so it's probably not surprising that we sometimes have different emotional reactions to the same basic set of problems. I've always thought of myself as someone who makes a great effort to try to understand other points of view, and who usually eventually achieves at least limited success. However, I have been genuinely mystified by some things that I've read over the years.

The "primary vs. secondary infertility" discussion is a great example. Anybody that's been around the web block a few times has run into this classic debate: which is worse, primary or secondary infertility? I have always been dumbfounded by people who claimed that secondary infertility was worse, or even in the same universe as primary infertility. It's not that I don't believe that they believe that, but it has always been clear to me that there is something that I'm not getting, something that they're not getting, or both.

I once read a message board post on a board for women who had been trying to conceive their first child for several years in which the writer explained that she wasn't so much upset that she didn't have children, but rather that it wasn't her choice. A number of other women agreed. I was flabbergasted.

Finally, I've never been able to really grasp how someone could struggle with infertility for many years without seriously pursuing medical help if they could afford it. I've seen lots of women that I admire and respect choose this option, and I respect their choice and believe that it must be best for them, but something in my heart has always cried out, "but don't you want to at least TRY?"

A few days ago, I was thinking about this, probably prompted by this post, when suddenly, I had what was to me a revelation. Probably everybody else already knew this, but just in case, I'll spell it out: Grief about infertility is a different problem from grief about involuntary childlessness. Infertility is at the root of both, obviously, but these problems are made of fundamentally different stuff.

Infertility is by definition a failure to be able to (easily, at least) do something that most people can do--have sex and end up with a baby just like that. Learning to live with the fact that you can't do something pretty basic is hard. Since most people or couples are not aware that they're infertile until they try to conceive, it is usually a shock, and feels like a loss: of self-esteem, of control, or dignity, of hope. Many feel betrayed by their bodies. Made less a man or a woman. Frustrated and helpless as they watch others effortlessly (and in some cases, without even wanting it) do this thing that they can't do. It's hard.

Involuntary childlessness can happen for a number of reasons, including medical problems or the absence of a committed partner coupled with the unwillingness or absence of means to become a single parent. It seems that people react to involuntary childlessness in a huge number of ways. For some, it marks every day with sadness and the feeling that there is something very important missing, while for others, it seems to fall closer to the feelings that I have about my own involuntary mansionlessness, which can be summed up as "it would be nice, but whatever".

It seems to me that a lot of the things that I haven't been able to grasp about people's varied responses to infertility can be explained by the idea that while most infertile couples are upset by both the fact of their infertility and their involuntary childlessness, the relative importance of each of these factors varies dramatically between people.

It seems to be a spectrum. On one end, there are the people that don't care at all about being infertile, they just want a child. For people of this type, the realization that they are infertile often leads to an immediate decision to adopt. On the other end, there are the people who are gutted by the loss of their fertility, but bothered less by childlessness itself. In the middle, there are people who are bothered by both to a fairly equal extent.

I'm in the middle, but closer to the first type: I was more bothered by childlessness than infertility. For the first year that I was trying, I was definitely upset about infertility itself. It seemed so unfair that I couldn't just have sex with my husband and get pregnant like a normal human being. Teenagers can do it. People with serious substance abuse problems can do it. People who make godawful parents can do it. Why couldn't I?

At some point, I got over that. Five stages of grief later, I think I really am at a place where the infertility part of infertility doesn't really bother me too much. Of course it would be lovely to just have sex with my husband and end up pregnant. I still fantasize about that happening for us, but no longer in a desperate, unhealthy way. It would be nice, but the main thing that would make it nice is if it resulted in a healthy live baby at the end. I am no longer concerned at all about the process. For me it's about the outcome.

When I think about infertility and childlessness separately, all of a sudden, I "get" what other people have been telling me about their feelings. It DOES suck to be left out of a great miracle like natural (unassisted) conception and reproduction. If that was your dream, then I can see how IUI's or IVF or donor conception or adoption wouldn't feel like a solution to your problem at all. And I can also see how secondary infertility could seem particularly cruel--having experienced the miracle once without even realizing that it was your one and only time, only to find out that what you thought was the trial run was really the final event.

For me, while infertility itself was a blow, it was one that I could take. What brought me to my knees was fear of childlessness. Fear of not having a child that was genetically part me and part Mystery, but also fear of not having a child at all. So to me, secondary infertility already feels a bit like the promised land.

I still am bothered by the fact that I may not end up being able to give the Egg a sibling. I will try, but failure is a very likely outcome. And if I fail, it will hurt. But this time, I know I'll be OK. I am not childless. I have a little Egg who sets my heart aglow with joy every day.

My period arrived on her first birthday. I am now officially trying to conceive again.


WaterBishop said...

I really hope this time around goes more smoothly. :)

I am one of those people who said I was angry about my choice being taken away. But lately, the idea of childlessness has been scaring me more and more.
Your post puts it out there and seems to ask if we are satisfied with our identities on the spectrum. Or maybe that is just in my mind.
Either way, as always, thank you for a poignant entry that makes us think.

Sarah said...

Great thought sara, that's the best model I've heard of for understanding our responses. I always thought of it as one long continuous scale- first you grieve infertility, then get on with the business of resolving childlessness but I think you're right that they are independent variables. I envision you could plot yourself on a grid with one scale on each axis and then it's easy to see why we all have to find our own path. Great thoughts!

Anonymous said...

A very interesting post! I had not considered childlessness and infertility separately, though that may be because we had our first success shortly after getting medical help. And what motivated us to get that help was the fact that childlessness was (for me) never an option to consider.

Samantha said...

That's a really excellent description. I have friends without partners who have felt a lack of children, and I can see where they are coming from much better after reading your post.

Jamie said...

Beautiful post. Definitely puts some perspective on all of the issues that can arise amongst infertiles.

Good luck trying to conceive a sibling. In a way, I'm lucky as I know that there is no chance at all of conceiving naturally. Seems stupid to say I'm lucky to have to do IVF but in a way I am. There isn't the constant roller coaster every month -- I have to put the roller coaster into drive to make it happen.

Secondary infertility is definitely a different beast. I hope your journey through this field is shorter and easier than the last.

Anonymous said...

Well said, Sara! I hadn't made that distinction, and it needs making. For me, my infertility was a shock, and my sadness at possibly being childless was enormous. Now that I have a child my infertility doesn't seem so bad (also because we are happy with just one).
I'm glad your period came so soon after night weaning. I wish you a speedy and easy journey to child #2.

Lut C. said...

An interesting distinction, but I still don't quite get the argument that secondary is worse than primary infertility. Perhaps in a while though ...

Kymberli said...

Beautiful, beautiful, BEAUTIFUL post. I LOVE this post. Good luck to you as you embark on trying again.

I left something for you on my blog!

Marie-Baguette said...

I can't really make the distinction between the 2 (maybe because I am too tired). But I think people want to cling to silly ideas. I had friends who had fertility problems who did not want to use a fertility monitor because it would "break the magic". How about IVF to break the magic? Duh! There are also bloggers I don't like to read because their choices make me uncomfortable (donor eggs, donor sperm, surrogate, triplets and more... thought I realize I would donate my eggs in a heartbeat to my sister if she needed them, and would surrogate for her). And I hate the ones always getting pregnant on the first IVF try and not being THANKFUL. That drives me mad with jealousy!

Rachel Inbar said...

I will be keeping my fingers crossed for you.

JENN said...

Thanks Sara for a well thought out post and "spelling-out" for me.

Good luck with round 2! Hopefully, it goes a lot smoother than round 1.

Kami said...

Good luck this round!

I think your observations are spot on. I have found I can be empathetic to people dealing with secondary IF if I try to see it from their perspective. Sometimes it is the first time they have dealt with life going completely wrong.

I think the people who say that secondary is just as bad as primary (and experienced both) are the ones where they never really had to face childlessness the first time. They may have had trouble, but not THAT much trouble.