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.

The power of speech

Well, Eggbert has finally decided to grace us with a few words, and at the same time to cement her reputation as a nursing-obsessed drama queen. Without further ado:

Her first word (in Mysterious): Oh no! (it's one word in the Language of Mystery)

Her second word (first in English): boobie

Needless to say, I'm mortified that I taught my innocent child such a silly name for the human breast. Nonetheless, I plan to tell this story at her wedding.

View from the other side

If you're wondering where I've been lately, the answer is sleeping. For the first time since Eggbert was born, I now have a reasonable expectation of 7-8 uninterrupted sleep every night. It doesn't happen every night, but it happens more often than not. Several times in the last two weeks or so, I've caught myself thinking "what is this feeling, I feel great!" and then realizing that this is what it feels like not to be sleep-deprived. Now I've never been one to take sleep for granted--I've always had a healthy respect, nay, love, for the stuff, but I am still finding myself astonished at how much of a difference a good night's sleep makes.

Yes it's true that I'm still bf rather a lot, despite the closing of the all-night bar. I had originally planned to exclusively breastfeed until age 6 months, wean by 9 months, and be doing another IVF cycle by now. It kind of cracks me up to think about it. I clearly had never met myself, or Eggbert, if I thought that was going to fly. It might have worked if Eggbert had been a different baby, actually. I do have a spine somewhere under all of the mush, but I just wasn't equipped to deal with denying the boob to a baby that was (well, actually, is) absolutely passionate about it. I expected that she would like it, but I had never expect that she would love it so much. To this day, she cackles with glee when the boob comes out, and dives on it, making little happy sounds, whenever she sees it. Every. Single. Time. It doesn't matter if she just ate 3 seconds ago. The boob always fills her with delight.

I did try to get things under control earlier. I tried night weaning in August, and it was a disaster. The first time she woke up at night and a boob wasn't forthcoming, she screamed blue murder for what felt like an hour. She never really seemed to settle down, she just finally seemed to collapse with exhaustion. I was holding her and trying to calm her for much of it, but she was just so angry and upset that nothing that I could do helped. It was awful. I really think that even the staunchest CIO supporter would have been shaken. I held out for three nights, counting the minutes until the sun rose, so it would be "morning", and I could give her the damn boob already. After the third awful night stretched into the third awful day (she was horribly cranky, I was horribly cranky), I decided that maybe for whatever reason, she just wasn't ready. Since then I have felt like a terrible wimp, so it felt really validating to my instincts as a mom that this time, she whined a little for five minutes the first night, was easily soothed, and that was pretty much that. I don't think she's even woken up at night in a week, and when she does, it's just for a quick cuddle and then back to sleep (and let's face it, that's almost better than uninterrupted sleep).

So here we are. These days, I'm nursing her in the morning, and then not again until about 7 pm, then again at 8, and occasionally again when I go to bed, if she happens to wake up. I stopped pumping over a month ago, and will finish my frozen breastmilk stash early next week, so she'll soon be on cow's milk throughout the day. There are still no signs of my period, but I'm trying not to stress about that. In a while, once I'm sure she's doing well with the cow's milk, I'll work on phasing out the 7 pm feeding. After that, well, I don't know. We'll have to see.

That wasn't even what I was going to post about. Last weekend I spent some time with a friend from my Korean language class that I hadn't seen since the week that Eggbert was conceived, because she no longer lives in Korea. She is now 15 weeks pregnant with her first child. I realized that this was the first time that I'd had a friend be pregnant for the first time after me. All of my friends had their first kids years ago (mostly about 10-20 months after I started trying to conceive, as if to torture me), so it was my first time being the one in a position to offer advice. I'd love to say that I was graceful about it, and carefully kept from spewing assvice, but honestly nothing could be further from the truth. So many words spilled out of me on a huge number of topics from birthing and breastfeeding to how to choose the right stroller/pram, that I thought I might drown in my own verbiage. It wasn't pretty. Luckily, my friend had the patience of a saint. I hope that she understood that I was just excited for her.

The most interesting thing about this encounter, though, was seeing how nervous she is about this pregnancy. She conceived easily, and has never suffered a loss, yet even at 15 weeks, she can't stand to buy anything, or plan anything, because she's so conscious of all of the things that could (but probably won't) happen. She could barely even mention the due date without saying something like "if we make it that far", and she admitted that she had tried to arrange an ultrasound during her four-day visit in Korea, just to reassure herself that the baby was OK. Hearing all of this really challenged my own stereotypes about "fertiles", and the difference between "fertiles" and "infertiles". It turns out that there are nervous types on both sides of the fence, and that conceiving easily doesn't necessarily guarantee peace of mind. Who knew?

The bar is closed

Dear customers of Mommy's Milk Bar,

This notice is to inform you that MMB will no longer be providing 24-hour service due to staff exhaustion. Our new hours of operation are 7-8 am, 6-10 pm weekdays, and 7 am-10 pm weekends and holidays. We apologize for any inconvenience, and as always, we appreciate your loyalty.

Sincerely,

The Management

Bedside manner?

Yesterday Eggbert and I went to the doctor for flu shots. We have been going to the same International Clinic (nested within a major hospital) since we got here, so the nurses all have known me and Eggbert since before she was born. Eggbert's appointment went swimmingly. She was weighed and measured (15th percentile and 12th, respectively), had her temperature taken, and was pronounced cute, smart, and healthy by the doctor. She didn't like the shot much, but got over it quickly when offered a boob. (My doctor's office is great. They have a private place to nurse little ones right there.) All in all, a good visit.

Then it was my turn. I had to go to a different doc to get the vaccination prescribed. I didn't request my normal doc, since I wanted to get an appointment right after Eggbert's for the sake of convenience. They ushered me into an office, and there was the Asian version of Doogie Houser. I swear this kid was 12. He said that he was a resident and would be taking my medical history. I wasn't thrilled, since I knew this would take forever and Eggbert and Mystery were waiting outside, but I know that residents have to learn somehow, so I said OK. He asked a million questions in just about the worst English that I've heard since I've been here. (This isn't a criticism--my Korean is abysmal and I'm grateful that there is a clinic where I can get care in English--I'm just setting the stage here.) I answered them all to the best of my ability--3 or 4 times in some cases because his comprehension was about as good as his speech. Then he asked the question. "When was your last menstrual period?"

I laughed and said "it's been almost two years now--well, not quite, I think it was February 2007. I had a baby last November and am still breastfeeding."

He stared at me and said "two years?"

"Well, not quite," I said, "more like 20 months. 10 months since the baby was born."

"Is there something wrong with you?" (Remember, this is the DOCTOR!)

"No, I'm still breastfeeding and haven't had my period yet. I have a baby. I'm breastfeeding."

"Have you been diagnosed with menopause?" (Again, remember, this is the DOCTOR!)

At this point I was shouting. "It's called lactational amenorrhea. It's perfectly normal!"

He kept staring at me, lip trembling.

Finally the "real" doctor came in, and prescribed the damn shot.

I am still livid. I really don't feel that I should have to PAY for the privilege of explaining the facts of life to a so-called professional. I wish that I could attribute it to language problems, but he clearly understood the word "baby", and had my chart right in front of him, so the information was all there. And the bedside manner? Imagine if I hadn't been a neurotic infertile (which he obviously didn't know, because he clearly hadn't read my chart), and didn't know that lactational amenorrhea is, indeed, normal. I probably would have been terrified.

Actually, I am terrified. I'm terrified by the fact that someone could pass medical school without learning even the basic facts about female reproductive biology. Horrifying.

Perfect moments

Since I started the IVF cycle that ended up producing Eggbert, there have been, interspersed among the normal ups and downs of life, a series of moments so perfect, so sublime, that they take my breath away. The moment that the second line popped up on the pregnancy test. The first time I felt movement. The first time I saw her, wet and confused and so, so beautiful. Her first smile. Her first laugh. A million quiet moments just being with her. Kami reminded me the other day that these moments are worth sharing.

Last Sunday, I had one of those moments. It was the first cool weekend at the end of a long, sweltering summer. While I'm a hot-weather fan in general, the weather has put a damper on our ability to take Eggbert on fun outings, since she tends to get too hot and fussy pretty quickly. So, we were quick to take advantage of a cool but sunny day.

The Han River runs through the city of Seoul, and a long narrow park runs along much of the south bank of the river. It's a typical city park--only 50 meters or so from one side to the other, but it's a precious green space in a sea of concrete. There are bike paths, playgrounds, and lots of nice places to sit and just be. We took Eggbert to the park, and she had her first ride on a swing, and took her first steps on grass. She was both confused and delighted. Watching her toddle along, wearing a cute outfit coupled with the ugliest shoes known to man (more on those another time), holding Mystery's hands and laughing. I realized that I was completely, perfectly happy. There is more to me than being a wife and mommy, but I can't think of anything that could bring me such complete joy than just being with the two people that I love most in the world, healthy and strong, sharing an adventure on a sunny day.

I heart my commenters

Thanks to all of you, and especially those who weighed in about the bottles. You didn't all agree with each other, and my path is still not entirely clear, but hearing your opinions made me feel a lot better about both options. Sometimes it's very helpful to get an outside perspective, and it's also reassuring to get confirmation that the answer isn't obvious. Sometimes I wonder if I'm just getting myself worked up over nothing.

In response to Jenn's comment about waste management--excellent point. Their waste management is dreadful. They typically burn garbage or just leave it in piles to "rot" (which of course plastic doesn't do, so it eventually ends up in the river). It's pretty horrible. However, since their solution to bottle feeding is buying plastic bottles, my donating a few won't change that equation. There is an active resale market for usable items, though, and extended families share and support each other, so if I give my bottles to someone, they are likely to be used for many years to come by a variety of different women. Surely that isn't any worse from a waste management perspective than going into a Korean landfill or incinerator now.

For the record, Mystery thinks it's a no-brainer and that we should give them to the villagers.