Monday, February 09, 2009

Again...sorry, I can't help myself.

So the author of this blog that I stalk (is it still considered stalking of I occasionally make comments??) posts articles on infertility and adoption on Sundays. Today's article is about dealing with people who you love who are infertile. You can read her post here...she starts by saying that when they were struggling with getting pregnant that ever rule in the article was broken. I too can say that EVERY ONE of these things has happened to me at least once...by coworkers, family, friends, strangers. I know they were never done intentionally...people just didn't know any better. I know I just posted something in infertility earlier in the week...but this is just too good not to share. So here it is...my edited (well, enhanced...cause I love to bold and italicize things) copy of THIS GREAT ARTICLE which you all should read because you love us, or someone like us who is struggling or has struggled with infertility.

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Infertility Etiquette

By Vita Alligood

Chances are, you know someone who is struggling with infertility. More than five million people of childbearing age in the United States experience infertility. Yet, as a society, we are woefully uninformed about how to best provide emotional support for our loved ones during this painful time.

Infertility is, indeed, a very painful struggle. The pain is similar to the grief over losing a loved one, but it is unique because it is a recurring grief. When a loved one dies, he isn't coming back. There is no hope that he will come back from the dead. You must work through the stages of grief, accept that you will never see this person again, and move on with your life.

The grief of infertility is not so cut and dry. Infertile people grieve the loss of the baby that they may never know. They grieve the loss of that baby who would have had mommy's nose and daddy's eyes. But, each month, there is the hope that maybe that baby will be conceived after all. No matter how hard they try to prepare themselves for bad news, they still hope that this month will be different. Then, the bad news comes again, and the grief washes over the infertile couple anew. This process happens month after month, year after year. It is like having a deep cut that keeps getting opened right when it starts to heal.

As the couple moves into infertility treatments, the pain increases while the bank account depletes. Most infertility treatments involve using hormones, which alter the user's moods. (That statement is like calling a lion a cat-my husband would tell you that the side effect is insanity!) The tests are invasive and embarrassing to both parties, and you feel like the doctor has taken over your bedroom. And for all of this discomfort, you pay a lot of money. Infertility treatments are expensive, and most insurance companies do not cover the costs. So, in addition to the pain of not conceiving a baby each month, the couple pays out anywhere from $300 to five figures, depending upon the treatment used.

A couple will eventually resolve the infertility problem in one of three ways:

  1. They will eventually conceive a baby.
  2. They will stop the infertility treatments and choose to live without children.
  3. They will find an alternative way to parent, such as by adopting a child or becoming a foster parent.

Reaching a resolution can take years, so your infertile loved ones need your emotional support during this journey. Most people don't know what to say, so they wind up saying the wrong thing, which only makes the journey so much harder for their loved ones. Knowing what not to say is half of the battle to providing support.

Don't Tell Them to Relax

Everyone knows someone who had trouble conceiving but then finally became pregnant once she "relaxed." Couples who are able to conceive after a few months of "relaxing" are not infertile. By definition, a couple is not diagnosed as "infertile" until they have tried unsuccessfully to become pregnant for a full year. In fact, most infertility specialists will not treat a couple for infertility until they have tried to become pregnant for a year. This year weeds out the people who aren't infertile but just need to "relax." Those that remain are truly infertile.

Comments such as "just relax" or "try going on a cruise" create even more stress for the infertile couple, particularly the woman. The woman feels like she is doing something wrong when, in fact, there is a good chance that there is a physical problem preventing her from becoming pregnant.

These comments can also reach the point of absurdity. As a couple, my husband and I underwent two surgeries, numerous inseminations, hormone treatments, and four years of poking and prodding by doctors. Yet, people still continued to say things like, "If you just relaxed on a cruise . . ." Infertility is a diagnosable medical problem that must be treated by a doctor, and even with treatment, many couples will NEVER successfully conceive a child. Relaxation itself does not cure medical infertility.


Don't Minimize the Problem


Failure to conceive a baby is a very painful journey. Infertile couples are surrounded by families with children. These couples watch their friends give birth to two or three children, and they watch those children grow while the couple goes home to the silence of an empty house. These couples see all of the joy that a child brings into someone's life, and they feel the emptiness of not being able to experience the same joy.

Comments like, "Just enjoy being able to sleep late . . . .travel . . etc.," do not offer comfort. Instead, these comments make infertile people feel like you are minimizing their pain. You wouldn't tell somebody whose parent just died to be thankful that he no longer has to buy Father's Day or Mother's Day cards. Losing that one obligation doesn't even begin to compensate for the incredible loss of losing a parent. In the same vein, being able to sleep late or travel does not provide comfort to somebody who desperately wants a child.
{Holly here...DON'T tell us things like "I'll give you one of mine" or "Be glad you don't have kids - it changes your life"...we KNOW it does. We WANT that change}

Don't Say There Are Worse Things That Could Happen


Along the same lines, don't tell your friend that there are worse things that she could be going through. Who is the final authority on what is the "worst" thing that could happen to someone? Is it going through a divorce? Watching a loved one die? Getting raped? Losing a job?

Different people react to different life experiences in different ways. To someone who has trained his whole life for the Olympics, the "worst" thing might be experiencing an injury the week before the event. To someone who has walked away from her career to become a stay-at-home wife for 40 years, watching her husband leave her for a younger woman might be the "worst" thing. And, to a woman whose sole goal in life has been to love and nurture a child, infertility may indeed be the "worst" thing that could happen.

People wouldn't dream of telling someone whose parent just died, "It could be worse: both of your parents could be dead." Such a comment would be considered cruel rather than comforting. In the same vein, don't tell your friend that she could be going through worse things than infertility.


Don't Say They Aren't Meant to Be Parents


One of the cruelest things anyone ever said to me is, "Maybe God doesn't intend for you to be a mother." How incredibly insensitive to imply that I would be such a bad mother that God felt the need to divinely sterilize me. If God were in the business of divinely sterilizing women, don't you think he would prevent the pregnancies that end in abortions? Or wouldn't he sterilize the women who wind up neglecting and abusing their children? Even if you aren't religious, the "maybe it's not meant to be" comments are not comforting. Infertility is a medical condition, not a punishment from God or Mother Nature.
{along these same lines...DO NOT say "Everything happens for a reason"...even if we agree with you, that is NOT going to help. If you are religious don't tell us it will happen in God's time. We realize this...but it is like telling someone whose spouse gets tragically killed in an auto accident that it was God's plan.}


Don't Ask Why They Aren't Trying IVF


In vitro fertilization (IVF) is a method in which the woman harvests multiple eggs, which are then combined with the man's sperm in a petri dish. This is the method that can produce multiple births. People frequently ask, "Why don't you just try IVF?" in the same casual tone they would use to ask, "Why don't you try shopping at another store?"

There are many reasons why a couple would choose not to pursue this option. Here are a few of them.

IVF is Expensive with Low Odds

One cycle of IVF is very expensive. With all of the hype in the news, many people assume that IVF is a sure thing when, in fact, the odds of success for each cycle are low. Most couples cannot afford to try for one month, much less for multiple times. Considering that it also costs a significant amount of money to adopt a baby, many couples opt for the "sure thing" rather then risking their money on much lower odds.

IVF is Physically Taxing

Undergoing IVF treatments is very rigorous. The woman must inject shots into her thigh daily to cause her ovaries to superovulate. The drugs used are very taxing on the woman, and they can cause her to be become extremely emotional.

IVF Raises Ethical Issues

Ironically, couples who undergo IVF to become parents may have to selectively abort one or more fetuses if multiple eggs are fertilized. Many couples cannot bring themselves to abort a baby when they have worked so hard to become parents. If the couple chooses not to selectively abort, they run the risk of multiple births.

Don't Offer Unsolicited Opinions If They Are Trying IVF

On the flip side of the coin, don't offer unsolicited advice to your friends who do choose to try IVF. For many couples, IVF is the only way they will ever give birth to a baby. This is a huge decision for them to make, for all of the reasons I outlined above.

If the couple has resolved any ethical issues, don't muddy the waters. IVF is a gray area in many ethical circles, and many of our moral leaders don't yet know how to answer the ethical questions that have arisen from this new technology. If the couple has resolved these issues already, you only make it harder by raising the ethical questions again. Respect their decision, and offer your support. If you can't offer your support due to ethical differences of opinion, then say nothing.

A couple who chooses the IVF route has a hard, expensive road ahead, and they need your support more than ever. The hormones are no cakewalk, and the financial cost is enormous. Your friend would not be going this route if there were an easier way, and the fact that she is willing to endure so much is further proof of how much she truly wants to parent a child. The hormones will make her more emotional, so offer her your support and keep your questions to yourself.


Don't Play Doctor


Once your infertile friends are under a doctor's care, the doctor will run them through numerous tests to determine why they aren't able to conceive. There a numerous reasons that a couple may not be able to conceive. Here are a few of them:

Blocked fallopian tubes
Cysts
Endometriosis
Low hormone levels
Low "normal form" sperm count
Low progesterone level
Low sperm count
Low sperm motility
Thin uterine walls

Infertility is a complicated problem to diagnose, and reading an article or book on infertility will not make you an "expert" on the subject. Let your friends work with their doctor to diagnose and treat the problem. Your friends probably already know more about the causes and solutions of infertility than you will ever know.

You may feel like you are being helpful by reading up on infertility, and there is nothing wrong with learning more about the subject. The problem comes when you try to "play doctor" with your friends. They already have a doctor with years of experience in diagnosing and treating the problem. They need to work with and trust their doctor to treat the problem. You only complicate the issue when you throw out other ideas that you have read about. The doctor knows more about the causes and solutions; let your friends work with their doctor to solve the problem.


Don't Be Crude


It is appalling that I even have to include this paragraph, but some of you need to hear this-Don't make crude jokes about your friend's vulnerable position. Crude comments like "I'll donate the sperm" or "Make sure the doctor uses your sperm for the insemination" are not funny, and they only irritate your friends.
{I have had people say "Spend a night with ___ and you'll get pregnant"...um, ya...THAT'S what I want to do}


Don't Complain About Your Pregnancy


This message is for pregnant women-Just being around you is painful for your infertile friends. Seeing your belly grow is a constant reminder of what your infertile friend cannot have. Unless an infertile women plans to spend her life in a cave, she has to find a way to interact with pregnant women. However, there are things you can do as her friend to make it easier.

The number one rule is DON'T COMPLAIN ABOUT YOUR PREGNANCY. I understand from my friends that, when you are pregnant, your hormones are going crazy and you experience a lot of discomfort, such as queasiness, stretch marks, and fatigue. You have every right to vent about the discomforts to any one else in your life, but don't put your infertile friend in the position of comforting you.

Your infertile friend would give anything to experience the discomforts you are enduring because those discomforts come from a baby growing inside of you. When I heard a pregnant woman complain about morning sickness, I would think, "I'd gladly throw up for nine straight months if it meant I could have a baby." When a pregnant woman would complain about her weight gain, I would think, "I would cut off my arm if I could be in your shoes."

I managed to go to baby showers and hospitals to welcome my friends' new babies, but it was hard. Without exception, it was hard. Stay sensitive to your infertile friend's emotions, and give her the leeway that she needs to be happy for you while she cries for herself. If she can't bring herself to hold your new baby, give her time. She isn't rejecting you or your new baby; she is just trying to work her way through her pain to show sincere joy for you. The fact that she is willing to endure such pain in order to celebrate your new baby with you speaks volumes about how much your friendship means to her.
{Don't complain about your unplanned pregnancy in front of an infertile friend. If you feel that way, FINE, but don't spout off about it infront of someone you KNOW cannot get pregnant. Don't go on and on about how inconvenient the timing is...we would KILL to be that inconvenienced}

Don't Treat Them Like They Are Ignorant

For some reason, some people seem to think that infertility causes a person to become unrealistic about the responsibilities of parenthood. I don't follow the logic, but several people told me that I wouldn't ache for a baby so much if I appreciated how much responsibility was involved in parenting.

Let's face it-no one can fully appreciate the responsibilities involved in parenting until they are, themselves, parents. That is true whether you successfully conceived after one month or after 10 years. The length of time you spend waiting for that baby does not factor in to your appreciation of responsibility. If anything, people who have been trying to become pregnant longer have had more time to think about those responsibilities. They have also probably been around lots of babies as their friends started their families.

Perhaps part of what fuels this perception is that infertile couples have a longer time to "dream" about what being a parent will be like. Like every other couple, we have our fantasies-my child will sleep through the night, would never have a tantrum in public, and will always eat his vegetables. Let us have our fantasies. Those fantasies are some of the few parent-to-be perks that we have-let us have them. You can give us your knowing looks when we discover the truth later.
{Yes, we haven't had children yet...but as a whole, infertile women and men have read more information on parenting than non-infertile people...we read about it to help pass the time, give us hope and encourage us. We would take a night filled with diarrhea and vomit and snot and crying in a heartbeat..because it would mean we had a CHILD in our home}

Don't Gossip About Your Friend's Condition

Infertility treatments are very private and embarrassing, which is why many couples choose to undergo these treatments in secret. Men especially are very sensitive to letting people know about infertility testing, such as sperm counts. Gossiping about infertility is not usually done in a malicious manner. The gossipers are usually well-meaning people who are only trying to find out more about infertility so they can help their loved ones.

Regardless of why you are sharing this information with someone else, it hurts and embarrasses your friend to find out that Madge the bank teller knows what your husband's sperm count is and when your next period is expected. Infertility is something that should be kept as private as your friend wants to keep it. Respect your friend's privacy, and don't share any information that your friend hasn't authorized.
{It is embarrassing to run into someone and have them ask if your period came yet...enough said}

Don't Push Adoption (Yet)

Adoption is a wonderful way for infertile people to become parents. (As an adoptive parent, I can fully vouch for this!!) However, the couple needs to work through many issues before they will be ready to make an adoption decision. Before they can make the decision to love a "stranger's baby," they must first grieve the loss of that baby with Daddy's eyes and Mommy's nose. Adoption social workers recognize the importance of the grieving process. When my husband and I went for our initial adoption interview, we expected the first question to be, "Why do you want to adopt a baby?" Instead, the question was, "Have you grieved the loss of your biological child yet?" Our social worker emphasized how important it is to shut one door before you open another.

You do, indeed, need to grieve this loss before you are ready to start the adoption process. The adoption process is very long and expensive, and it is not an easy road. So, the couple needs to be very sure that they can let go of the hope of a biological child and that they can love an adopted baby. This takes time, and some couples are never able to reach this point. If your friend cannot love a baby that isn't her "own," then adoption isn't the right decision for her, and it is certainly not what is best for the baby.

Mentioning adoption in passing can be a comfort to some couples. (The only words that ever offered me comfort were from my sister, who said, "Whether through pregnancy or adoption, you will be a mother one day.") However, "pushing" the issue can frustrate your friend. So, mention the idea in passing if it seems appropriate, and then drop it. When your friend is ready to talk about adoption, she will raise the issue herself.
{NEVER NEVER NEVER tell someone to "Put in your adoption papers, then you'll be sure to get pregnant". This minimizes the importance of the decision to adopt...as if 'adopting' is just another infertility treatment}

So, what can you say to your infertile friends? Unless you say "I am giving you this baby," there is nothing you can say that will erase their pain. So, take that pressure off of yourself. It isn't your job to erase their pain, but there is a lot you can do to lesson the load. Here are a few ideas.


Let Them Know That You Care

The best thing you can do is let your infertile friends know that you care. Send them cards. Let them cry on your shoulder. If they are religious, let them know you are praying for them. Offer the same support you would offer a friend who has lost a loved one. Just knowing they can count on you to be there for them lightens the load and lets them know that they aren't going through this alone.
{When we lost one of our babies a dear friend sent me some flowers. I can't even begin to tell you how much that meant to us}

Remember Them on Mother's Day

With all of the activity on Mother's Day, people tend to forget about women who cannot become mothers. Mother's Day is an incredibly painful time for infertile women. You cannot get away from it-There are ads on the TV, posters at the stores, church sermons devoted to celebrating motherhood, and all of the plans for celebrating with your own mother and mother-in-law.

Mother's Day is an important celebration and one that I relish now that I am a mother. However, it was very painful while I was waiting for my baby. Remember your infertile friends on Mother's Day, and send them a card to let them know you are thinking of them. They will appreciate knowing that you haven't "forgotten" them.
{We know that there are other women in our life and the day should be spent celebrating them and not wallowing in our sorrow...but the ENTIRE day is a reminder of what we CANNOT have...so if we feel the need to skip out on church or cry a bit, put your arm around us and tell us you love us}

Support Their Decision to Stop Treatments

No couple can endure infertility treatments forever. At some point, they will stop. This is an agonizing decision to make, and it involves even more grief. Even if the couple chooses to adopt a baby, they must still first grieve the loss of that baby who would have had mommy's nose and daddy's eyes.

Once the couple has made the decision to stop treatments, support their decision. Don't encourage them to try again, and don't discourage them from adopting, if that is their choice. Once the couple has reached resolution (whether to live without children, adopt a child, or become foster parents), they can finally put that chapter of their lives behind them. Don't try to open that chapter again.
{As someone who has decided to stop infertility treatments I can tell you it is a hard decision to make. Having people constantly ask if "We're sure" or telling us about something one of their friends tried does not make it easier.}

7 comments:

Abby said...

I appreciate you posting this. I'm always worried I'll say the wrong thing so I wind up saying nothing at all, which I'm then worried you'll take as a sign I don't care at all, which isn't true of course. I just don't know what to say. Also, I was always worried about telling you about my previous pregnancies. You are my friend so I wanted to include you in our news and lives, but I know how difficult it must be hearing that time and time again from other people. But then I don't want to NOT tell you, because that would make you feel bad also like you're the only one I'm keeping it from and I'm singling you out from our news because of your condition and situation. I just don't know how to say things without making things worse for you, you know? So this article was good, thank you.

Holly said...

I know it is hard on people, and that is why I wanted to share this. I have talked at great lengths with one of the girls here in the office, she was on the other end of things. Her sister miscarried and then she got pregnant. She didn't tell her for a long time because she just didn't want to hurt her anymore than she already hurt.

Everyone is different, but for me I would rather know than not. My SIL was almost 7 months pregnant before they finally told us. My WHOLE family knew except us. I felt so betrayed that they all had kept such a secret from us for so long. I thought back to all the conversations I had had over the period that everyone else knew and I didn't and I felt like an idiot.

It always hurts when I hear of someone else who is pregnant....but I have noticed that some hurt less than others. When my SIL got pregnant again we were the first ones they told. I still cried, but I was able to deal with it better because I didn't feel betrayed or ignored.

I have picked up a bit of a 'sixth sense' over the years. I can tell someone is pregnant before they tell me...all because of the way they act towards me...well, to be accurate it is the way they DON'T act towards me.

I don't expect a personal visit complete with tissues and chocolate to announce a pregnancy...I just want to know (and NOT through the grapevine) and then allow me to grieve a little, then I'll be ok. Well, not ok, but better.

Sorenson Family said...

Nathan--this is your cousin Melissa Ward Sorenson. I hope you don't mind me adding your blog to my list. Holly I feel like I know you even though we haven't met. I appreciated your thoughts on infertility--it can be an awkward subject and sometimes it's hard to know the right thing to say--after reading this I will definitley be more supportive and sensitive to my friends with similar challenges.

Sheila said...

Holly, what a beautiful article. Thank you for posting that...I would've clicked your link by the way...when I have time, I love to read things you post.

This has helped me too, understand some of the things that can hurt without knowing it. I hope and pray I have never said anything to you all that was hurtful. I'm not trying to win the best SIL award, but I wanted to tell you how much you and Nathan mean to me and that we have had your names in our prayers night and day for the last 2 years. You're an amazing woman! I have learned a lot from you. Where would any of us be without family? Thanks for the post. I hope your day is full of color and light! Love you, S

Just me said...

Great article. I think this is something that is really hard for people to understand if they haven't gone through it.

Shaun and Emily said...

Thanks for posting the article. I have really been working on being more sensitive to others. I have had a lot of experiences where such insensitive things have been said concerning things I am going through. Unless someone has been through your same experience there is no way they can know how difficult that particular experience has been. Sometimes I have tried not to become offended when such things are said but it is difficult nonetheless to be reminded of a painful experience when someone says an insensitive comment.

Kara said...

Wonderful article Holly! I will be sure and pass it along.

Hugs!!!