Tips for Couples Struggling with Infertility

infertile woman missing uterus Jewish communityI wrote this post a long time ago, after attending a talk by Natalie Taylor at the Kolech conference on fertility. Unfortunately the topic still relevant for many couples. At the time the speaker was pregnant with twins, who were born healthy.

Natalie Taylor started off by saying that she is not an “expert” on infertility. Yet her journey as an infertile woman was honest and compelling.

She married at 28, and felt a lot of internal and external pressure to get pregnant right away. I summarized her main points, which I believe can help both infertile couples and their communities.

  1. Infertility is very personal. If the couple wants to share with you, they will. Don’t ask questions or make comments.
  2. Infertile couples have lots of unpleasant feelings. First there is the false “competition” with other couples who have married earlier or at the same time, or at the same age. Taylor found it frustrating to see pregnant women everywhere, and couples in shul with children. She feels that the synagogue is a particularly unfriendly place for infertile couples.
  3. Taylor often felt jealous of mothers that she knew. Eventually she grew to accept jealousy as a legitimate feeling. After all, she didn’t want any harm to come to anyone.
  4. Infertile couples often feel like they are going through this alone. She found a support group invaluable, and it helped release many of her tensions.
  5. The couple undergoes many challenges, including professionals who ask intrusive questions or give instructions regarding their intimate life.
  6. Taylor often felt rushed. If the staff at the hospital was on vacation because of a holiday, she missed a month of treatment, and she was unreasonably annoyed with them. At some point she and her husband decided to take a vacation and go to the Canadian Rockies. They remember it as the best vacation they ever had. She strongly advises couples to take breaks.
  7. She praised the staff at Shaarei Tzedek hospital in Jerusalem for their sensitivity and attention to privacy. She formed close relationships with the staff, who mourned with her, as appropriate.

At the time of the talk Natalie had a toddler and was expecting twins, so she was in a different place than a woman who has not yet conceived. Perhaps this enabled her to speak out.

I believe her talk highlighted an inherent contradiction. We know we are not supposed to say anything to couples without children and I certainly don’t blame anyone for keeping their story private. But if couples don’t share, we can’t know what they are going through and learn to offer appropriate support.  Just as with many “taboo” subjects, the more infertile couples are open about their conditions, the more understanding they will get from their community.

Thanks to Natalie Taylor for an important contribution to the discussion of infertility in the Orthodox community and in general.

You may also enjoy:

Guiding Couples through Infertility

Niddah Art: Maybe this Month

Are Rabbis Too Strict about Birth Control and Abortion?

Infertility Articles by Rachel Gurevich:

http://infertility.about.com/od/findingsupport/a/Cultivating-Support-When-Facing-Infertility.htm (for people with infertility)

http://infertility.about.com/od/findingsupport/f/How-Can-I-Support-A-Friend-With-Infertility.htm (for friends and family)

image: daquella manera

Comments

  1. Having gone through infertility in the past and currently dealing with the diagnosis of pre-diabetes, to me the issue is more complicated. Once you tell people, you lose control of the information (unless you’re super-careful). This opens you up to all sorts of unwanted help and advice from people. I was fortunate to have been super-young and super-duper-(healthy)-thin when I was going through infertility, but I still heard so many comments like, “take a vacation” or all the stories about people who other people knew who conceived when they weren’t trying. “Well…. good for them.” was all I could think, because that wasn’t my case and it wasn’t going to help me a bit. And I wasn’t going to start explaining why to people because it’s really none of their business what the issue is. In many ways, I preferred not saying anything to hearing why my infertility wasn’t really real. “You’re only 22, what are you so worried about?”

    Now reading about pre-diabetes, there’s a similar issue – apparently a lot of people (and anyone who knows me well knows exactly what I’m thinking) like to play police and tell you what you can, can’t, should & shouldn’t eat. Which could easily turn those already-not-so-pleasant meetings with such people into a disaster. (It’s OK, my mom taught me well… just sit in the closet and eat the peanut butter/ice cream straight out of the container ;-)) So… I guess it’s all about finding a balance. And then, if the information is “on-the-loose” it’s about how well you know to set limits. It can be really unpleasant.

    And yeah, my infertility story ended well. The pre-diabetes will too 🙂

    • Rachel, anytime you share information about your health issues, or family issues for that matter, you open yourself up for criticism and advice. Everyone has to decide on his or her own comfort level. I was recently misdiagnosed with a chronic illness. When I shared, the first reaction of most people was to give me dietary advice when I just wanted a little sympathy.

  2. Toby Galili says

    I can relate to much of the information and feelings in this post. Most importantly, I think that it is important to share information about the process and remind couples who are struggling with infertility that they are not alone.

  3. Hi!

    “Just as with many ‘taboo’ subjects, the more infertile couples are open about their conditions, the more understanding they will get from their community.”

    I wish that were so… I was open about my infertility in the last few years before I conceived the twins (as compared to the very early years of trouble, when I was completely secretive.) I found the support I got consisted of advice giving (much of it really extreme), segula giving, reassurances that “it’ll happen”, comments about “G-d’s will”, etc., etc. In other words, nothing helpful. I was glad for it not to be a total secret, but I don’t think any casual friend “learned” how to support me just because they knew. If anything, it just opened me up to more insensitive comments.

    BUT… that is the support I got from casual friends. My close friends, the ones who knew what was going on, were supportive.

    In my opinion, if you’re really close friends with someone — in other words, you both already share freely with each other touchy topics — it would be ok to just ask them, “I hope you don’t take this as prying, and if you don’t want to talk about it, that’s fine. But I was wondering if you might be struggling with infertility? Because if you are, you can talk about it with me.” I wouldn’t go up to a casual friend and ask.

    I also don’t think it’s fair to expect every infertile person to *want* to be an advocate for the entire community. Could I have educated the people who made the insensitive comments? Yes. But I didn’t feel it was worth expending the emotional energy. Now, with close friends, it’s totally worth it. But “the community” at large? Not really. A smile, a nod, and just understanding they mean well was all I was willing to offer.

    I have a few articles on this topic, too, but your blog won’t let me post any of them. Let me know if you want the URLs to add at the end of your blog.

    Glad you posted about the topic. It’s an important one!

    Rachel

    • Rachel–I’m not surprised at those reactions, as I wrote to the other Rachel. It’s a long-term process. And most couples are certainly not in a place to be advocates for others.

  4. I have a number of close friends who’ve gone through infertility, and I’ve found it’s sometimes tricky to be a good friend to them. You can’t always wait for them to bring up the topic – sometimes they are waiting for you to acknowledge it and let them know you care.
    I think I recently struck a good balance with a friend who was going through yet another IVF cycle – I asked her about it through all the days of treatment, then announced that I was now butting out and would not ask anything about how it went – it was now up to her to keep me posted at her own pace. Thank God the treatment was successful, and she told me about her pregnancy once she was good and ready to make it public, a few months later.

  5. thanks for sharing – also all the links. it is less of a problem in frum circles but often out of choice couples delay having kids only to find they are challenged in this area. What do you think of the advice given to adopt a kid in the meantime

    • Observer says

      By and large the advice around adoption is simply stupid. It’s often given by people who don’t understand the dynamics and have all sorts of ideas of how people “should” and “shouldn’t” feel. And, somehow infertile people (or people who are having issues) are “supposed” to feel very differently than people who aren’t infertile – although no on ever seems to offer a reasonable explanation for that.

      I’d also point out that “adopt a kid in the meantime” has connotations that indicate a fair amount of ignorance of the process, and are also likely to offend many people. You don’t adopt a child so easily- it is NOT something you do “in the meantime.” It’s a real commitment and takes time, effort and, in many cases, a fair amount of money. And what happens when “meantime” is up? Adoption is a life-long commitment.

      I’m not saying that a couple should not adopt until they have exhausted all fertility options. I am saying that when dealing with that decision it is vital to understand the level commitment needed for adoption and the repercussions, both short and long term, of that decision.

      It turns out to be a good decision for many people – including those that have adopted and biological children. But it’s a HUGELY individual decision.

      • sylvia_rachel says

        I agree, and I would add that “we can’t get pregnant” is not, by itself, a good reason to decide to adopt. If you’re going to get on the adoption roller-coaster, it should be because you want to adopt a child, not just because you haven’t been able to conceive one. The fact that many people arrive at the decision to pursue adoption after their efforts to conceive a child fail does not mean that adoption is the right choice for every infertile couple. Adopted children should not feel that they were a disappointing second choice or last resort, and adoptive parents should not feel that way either.

  6. Thanks for writing this. I struggled with infertility for two years before conceiving my first child with much medical assistance. (If any readers are Chicagoans and need a practice to go to, Dr. Helen Kim and Dr. David Cohen at the University of Chicago are spectacular and compassionate and I owe my motherhood to them. And both Jewish, not that it matters for treatment, but they were both helpful in both commiserating about how painful it can be to go to bris after bris when you\’re going through infertility.)

    For the first year of our infertility, we didn’t talk to anyone because my husband is a very, very private person. Eventually, he understood that I really, really needed to talk about it, and even he found it very liberating to do so. Obviously, not everyone will feel that way, but it worked for us. And now, in my synagogue community, I am very, very open about what we experienced and I make sure that all of our clergy know I’m willing to talk with anyone and everyone about it, so that couples going through the experience can approach me if they want to. Not everyone is going to want to be in that position, but if you’re an extreme extrovert, like me, and you’ve survived infertility with your mental health intact, consider becoming a resource for others in your community.

    This article also does not mention miscarriage, which so often goes hand in hand with infertility. There is little available in the Jewish tradition to help deal with this issue, but so many families have been through it – even those who did not otherwise experience infertility issues. “Tears of Sorrow, Seeds of Hope” by Nina Beth Cardin helped me a lot.

  7. sylvia_rachel says

    Another thing that’s really annoying is to hear “Just relax and it will happen” or “My [sister/cousin/friend/SIL] did such-and-such and all of a sudden she got pregnant!” when in fact you have an identifiable medical problem that relaxing, or whatever, is not going to fix. (I’m not saying relaxing doesn’t help, because at least you’re relaxed. But if you don’t have ovaries, to pick an example not at random :/, no amount of relaxing, eating more or less of this or that, losing weight, gaining weight, etc., etc., is going to magically make you able to get pregnant without medical intervention.)

    • Observer says

      I’ve seen one RE assert that there is no such thing as “unexplained infertility”, but rather only “we haven’t done enough digging to know the reason.” I’m not sure he’s 100% correct, but certainly the fact that there are so many *know* medical reasons for infertility speaks to the fact that even when we don’t know the reason (yet), we can assume that odds are that it’s a medical issue that won’t respond to “just relax”.

      As for the “my cousin’s aunt’s sil’s cat” did something that (supposedly) worked, don’t even get me started. Sometimes it’s even true. But it doesn’t mean it’s relevant to the next person. And, sometimes it sounds like a product of “broken telephone” or skilled sales pitch by a quack. I do have to say, though, that unlike the “just relax” comments, this stuff happens to lots of people, not just those dealing with infertility.

  8. As a couple suffering from infertility, recurrent pregnancy loss and neonatal loss, I take HUGE offence at the second sentence of this article “Unfortunately the topic still relevant for many women.”. WOMEN are not just the only people affected by infertility. My husband is affected too, as are we together as a couple. Writing an article about infertility and making it a women’s issue is PART of the problem.

    • Leora, of course you are right, it was an insensitive error. I corrected the post, and I wish you both the best.
      -Hannah

      • thanks! 🙂

        I think a lot of people, even doctors, make this a ‘woman’s issue’ when it isn’t. Especially in our case, which is male factor infertility. If I married a different man, my infertility would go away. But my husband will always struggle to have kids. I think men and women react differently, but it’s still a couple’s issue, as well as both individually a ‘him’ and ‘her’ issue.

  9. My husband and I suffer from fertility problems. I decided not to be private about it, as I don’t believe it needs to be a secret if I don’t want to be. That doesn’t mean I shouted it off the rooftops, but I told people, and I told them it was not a secret. Many people here have expressed a worry or have experienced people’s ‘advice’ and comments. I too have been there, and I found the best way to deal with it was to be blunt, and tell them that what they were saying wasn’t helpful or made me feel hurt, and if I could, tell them what a better reaction would have been. Though some people were somewhat taken aback by my candidness, it had the desired effect – either they would not make further comments (good), or they would be more sensitive the next time around (even better). And I when I opened up about our challenges and wouldn’t accept insensitive remarks, I found a lot genuine support and well wishes. Thankfully, my story ends well as we now have a healthy baby after a few years of being childless, and the people around us were able to truly appreciate how great our joy was and really share it with us because they were aware of what we went through.
    Don’t be afraid to tell someone that their comment makes you feel bad! You have a right to protect your feelings. The more times people correct a bad piece of advice or an insensitive comment when they hear it, the more educated they will be for future encounters, both with you and with other fertility challenged couples.