Comprenez-Vous? Oui. We Understand Each Other

Understand me?

That’s a lot to ask. Misunderstandings, loaded labels and dark suspicions are rampant. Society today is remarkably chaotic on so many levels.

It seems we could all benefit if we took a step back, tried to understand and recalled some of what we share in common. First, let’s look at the universality of confronting fertility challenges. Both the personal as well as societal response.

Where We Can Understand

Some experiences transcend language and culture.

This blog alone has had 54,604 unique visitors from 167 countries in the course of five years.  During that time one thing has remained clear: there is no easy or tidy resolution when an emotional tsunami remakes the landscape of our soul. There is a lot of pain.

I discussed this recently with a dear friend of mine who reminded me my very early blog posts contained a lot of anger. Yes, I nodded. I also reminded her it’s hard not to lash out and interpret every word, even the well-intended ones, through the prism of pain.

Hurt people hurt people. 

We cope and heal in the best way we know how. Often that includes deep reflection and some trial and error.  Fortunately, the more we talk and write about the gaping wounds and associated hurt that result when we can’t conceive we also give others a better understanding of the tenderness, compassion and wide berth needed to nurse the wounded soul.

Infertility is not something you ‘get over;’ there is no closure. Instead you will ‘come to terms’ with it. Reminders of what might have been will remain, but the pain will begin to subside. Be gentle with yourself and know that time will be your ally.

It’s been my honor to became better acquainted with women who make a point of broadening horizons on this topic. Collectively, we have spent vast amounts of time devoted to plumbing the depths of this human experience. Last month a conversation I had with Lara, one of the contributors to the French website: BAMP, went live while I was in Michigan to visit my parents.  Lara and I had exchanged emails for several months ahead of the interview publication. Below, for those who don’t speak French, is the translation. As always, I welcome your thoughts and reactions.

 Merci, Lara, pour ce boulot d’interview et de traduction.

English Translation

Pamela Mahoney Tsigdinos is a US-author and blogger living in California. She is internationally recognized for her writing on living with infertility and discussing the personal and societal challenges couples face when infertility treatments don’t succeed.

Lara: What are, in your opinion, the differences between living childless in France versus the US? (for instance cultural ones or social ones depending on the country, for instance in France the government “offers” 6 IUIs and 4 IVFs but once you are done with that it’s very difficult to find a hospital that will take you).

Pamela: In the U.S. there are no government-sponsored fertility treatments or paid family leave. Health insurance is expensive and only 15 of 50 states require insurance coverage for fertility treatment, which means most pay directly, which I did.

So infertility, in addition to being physically and psychologically demanding in the U.S., is financially burdensome to treat. Truthfully, after 10 years of trying to get pregnant I’m amazed that I didn’t end up in debt, divorced or insane. Though there were times I worried desperately about all three becoming reality.

Then you layer on the social/cultural challenges. In the U.S. there is a bias to the ‘conventional happily-ever-after’ Disney ending. American culture celebrates ‘winners’ and there is a cultural demand to ‘never give up.’ As a result, there’s a massive disconnect in this country in terms of supporting those with infertility who stop treatment. It’s considered weak.

How Does France Compare?

I speak with limited knowledge about France (I’ve visited the country several times as a student and later as a tourist). Both countries are very child-centric. Generally speaking, France seems more supportive of those trying to become pregnant and seems to encourage more expression of emotions. From the outside, it appears more open to the complexities of the human experience.

I imagine, though, in France – as in many other parts of the world — there is the same problem we have here in the U.S.: there is no etiquette or language or social protocol to acknowledge those who are ‘involuntarily childless.’

L: Thinking back, when you stopped the treatments, what do you wish someone would have told you? (in other words what would you like to tell to a woman ending her infertility journey without a kid?)

P: Infertility is not something you ‘get over;’ there is no closure. Instead you will ‘come to terms’ with it. Reminders of what might have been will remain, but the pain will begin to subside. Be gentle with yourself and know that time will be your ally. There are so many emotions competing for your attention: depression, anger, frustration, hopelessness and sadness among others. You will also question your beliefs, your relationships and your sense of you are and who you expected to become.

Above all, take the time to grieve your losses and honor and release the emotions. Find an outlet through writing or counseling or exercise or art. The only way to get through grief is to experience it, immerse yourself in it. You are going to have to feel the hurt before you can heal. The recovery will be non-linear. There will be good and bad days, but the good ones eventually begin to outnumber the bad.

Don’t be surprised if people in your life don’t comprehend what you’re going through.

Their well-meaning but often ignorant comments can feel like death by a thousand cuts. Since it’s very hard to educate while you’re in pain, point family and friends to blogs like this one to help them better understand you and your experience. Forgive those who don’t know that they are hurting you. You will tap into and find an inner strength. One of the silver linings to this experience is that that will develop a new level of compassion and empathy that will serve you for the rest of your life.

Control Can Feel Elusive

The lack of control will make you feel vulnerable and lost. Combat that sense of aimlessness by actively focusing on reinventing yourself and your life. Find small ways to reward yourself. Acknowledge your growth and set new goals. Remember there are many paths with new and unexpected ways to find meaning and value.

L: The “decision” of stopping treatments, not start (or continue) adoption and pursue a life without children, did it come gradually, and how long did it take?

P: It’s slow. You feel like you are searching for clues to deconstruct a mystery. Each one leads you to another blind alley. In the U.S., in particular, there is no clear ‘off ramp’ from pursuing treatments as long as you have money and the stamina to continue with medical intervention.

The lack of an end point is part of the problem in moving on and carving out a new path. A visitor to my blog had a very astute observation about why is it it is so hard to accept infertility. She wrote: “Infertility in this day and age has two features that make it unlike other losses – such as divorce or the death of a loved one. First, it does not happen at any specific time. There is no event. You just keep trying and then, somewhat arbitrarily, realize it’s over. This makes it hard to get to the grieving stage, and hard for others to grieve with you. Second, because of all the medical and legal technology out there, you have to decide when to ‘pull the plug’ on the project. This makes you complicit in your own loss. No matter what happens, it was your ‘choice’ (to stop treatment, not to adopt, whatever…) Others can look at you and just say, ‘well, she made her decision,’ or, ‘I guess she didn’t want it that much.’ But it’s not a choice, any more than refusing life-prolonging treatment under intolerable conditions is a choice.”

This ‘gray’ vs. ‘black and white’ scenario raises an added complexity for women like me without a clear cut pregnancy inhibitor. Hypothetically, I could have tried donor eggs or surrogacy but there was no guarantee that would have worked for us either.

Advanced reproductive medicine has been both a boon and curse. It has helped hundreds of thousands who need extra help to get pregnant, but it’s also created inflated expectations for those who can’t conceive. As a result, when Mother Nature and science find their limits we routinely find ourselves at the end of a long, painful road without the social safety net and support that accompanies other equally devastating life experiences.

Until conventional wisdom catches up with reality — that fertility treatment is far from a sure thing and is not without great financial, emotional and physical risk — those of us with conditions causing infertility are in the unenviable position of being damned when we fail with treatment and damned if we don’t try it.

As for adoption it is equally costly, demanding and presents its own labyrinth. Most in my ‘unexplained infertility’ situation reach financial, emotional, and social exhaustion and are unprepared to suit up for another battle. Age is another factor. I was 43 by the time I gave up on my dream of getting pregnant, which made me less appealing to a birth mother seeking an adoptive parent. We could have another longer discussion on this topic, but I will leave it there.

L: Following this “decision” did your vision of life in general change a lot?

P: Yes. I became more resilient. There wasn’t always forward momentum. Sometimes I went backwards or sideways, but in time I pushed through the darkness and uncertainty. I also discovered I was stronger than I ever thought possible. After mourning my losses it took me more time to realize that in setting aside one set of dreams, I hadn’t ‘given up.’ I embraced something else. Transformation and reinvention take time. My life might not be ‘ordinary’ but it could be ‘extraordinary.’

Peace and joy returned to my life once I found my voice. Equally important, though, was having others validate and acknowledge all that I had lived with and through. If there’s one message I want to leave as my legacy is it it is this: the best way to help those struggling to come to terms with infertility is to be willing to ‘see’ and ‘hear’ about the complexities that infertility inflicts rather than to minimize or dismiss it. As a woman in Finland once wrote to me, “Feeling validated (and heard) is one of the greatest things on earth.”

L: What outlook do you have on maternity in general? Did you compensate this absence of children one way or the other?

P: I’ve learned that there is more than one way to be maternal. There is a concept called ‘generativity.’ It’s a time in adulthood when we develop a sense of being a part of the bigger picture. We give back to society in some way. Psychologist Erik Erikson brought to light that if an adult doesn’t get to experience generativity then they can experience stagnation.

Like others I’ve come to know I’ve discovered that there are other ways to understand, to feel ‘generative’ and relevant beyond having or raising children. For me there’s something energizing about turning over new stones and building a path that helps the next generation. My advocacy and writing fills me with profound satisfaction. I’ve seized the opportunity to apply all I’ve learned. I encourage others to do the same. Multiply the value of what you understand,what you’ve learned by sharing it with others.

L: Stay tuned and feel free to contribute to the conversation as we plan part II of this interview! And check out this perfectly timed new piece from Pamela.