Wednesday, July 20, 2011

Talking about Infertility: 7 Things NOT to Say

I wrote several months ago that I’m in a good place right now with our inability to conceive children. I’m perfectly happy and content as a wife and have no depression, anger, discouragement, or “why me?” syndrome going on. Seriously, should we ever be blessed with children, yay! I do pray for the grace of children; I would love to be a mother. But if not, then that’s totally okay, too.

Despite the fact I’m not angsty and upset about it anymore, I do continue to receive frequent advice, comments, and questions from well-meaning people who are more upset about my infertility than I am. They’re upset that I’m not upset, and by golly they want to fix me.

For the most part, I can brush off the barbs, but the awkwardness is harder to get around.

I do not share the following thoughts as a tirade against well-meaning busybodies. But I don’t think those without infertility issues are aware of the effects of their comments, and I don’t think most people know precisely what to say (or not to say) to a young bride who possibly can’t have children.

From my experiences over the last few years, here are the most hurtful and unhelpful things to say to a woman who is bearing the cross of infertility:

1. Advice of any kind
Giving unwarranted advice on any matter is not a good idea. Infertility is no different.

Did the woman ask you for advice?
I have never asked anyone other than my husband, doctors and Creighton practitioner for advice about infertility, and yet many people feel it necessary to contribute their two cents. This is the most intimate and personal of all subjects, please refrain from giving unrequested advice.

Do you regularly discuss a woman's ovaries, cycles, fertility signs, and methods of intercourse?
Do you have no shame? Even if I didn’t struggle with infertility, I would never wish to discuss these topics. Ever. Never. My inability to conceive shouldn’t make these topics fair game for coffee conversation. Please have a little modesty.

2. Advice Disguised in the form of the Question:
What you say: “Have you tried...?”
What I hear: "Run for the hills!! Awkward and possibly x-rated question about to ensue!"

Very closely related to the advice of any kind, but much more pernicious, is posing advice in the form of the question: "Have you tried...?"

Originally, for the purpose of sharing exactly how tactless, crass, and downright lewd people can be when speaking to women struggling with infertility, I intended to share a sampling of the “friendly advice” I’ve been given prefaced by “Have you tried?”

Upon second thought, however, it would be worthless to expose the comments except for their shock value. Truly, you would not believe some of it. Suffice it to say I’ve been asked, by very well-meaning but misguided people, if my husband and I have ever tried all sorts of various maneuvers I blush to think of.

Am I supposed to or even allowed to answer "yes"? Do you really want to know the answers? Am I supposed to answer at all? Can I just pretend you didn't ask me those questions?

3. "I just heard about.... (fill in the blank)... and immediately thought of you."

It's a nuanced hybrid of the "Have you tried?" and the unwanted advice with an additional humiliation.

"I just heard about this (doctor, method, theory, pill, shot, cream, herb, hormone, supplement, gel, suppository), and immediately thought of you."

Imagine yourself in this situation: someone comes up to you in a public place, rests a hand tenderly on your arm, looks deeply into your eyes, is positively bursting with excitement, and says with the most eager anticipation possible, "I just heard from one of my friends who read an article in a magazine about your condition. There's this gel cap suppository for Irritable Bowel Syndrome and the second I heard about it, I thought right of you!"

Really? Does that instantly conjure up my image in your mind?

It's humiliating to know that there are a large number of people who, whenever they see a progesterone cream, instantly think of me. What's worse is that they tell me about it over the holy water font after Mass.

Please know that, as infertility effects me so personally and deeply, I have done exhaustive research on this subject. I know you just heard about this (fill in the blank), I'm grateful that you want to help, but I've eaten, slept and breathed this topic for years. If I haven't heard about it (which hasn't yet been the case), I trust my doctor has and I'll discuss it with him soon. But please... next time you see a daisy, think of me.

4. Religious Consolation
What you say: “It'll happen in God's time.”
What I hear: "You don't trust God." "You're not patient enough." "I have insider knowledge that He will eventually give you children."

This statement shouldn’t  be taken harshly, because the person who says it is almost always a well-meaning little old lady. But it can be very hard to hear, for while intended to be consoling, it’s actually quite loaded. It assumes:

- that you know what God will or will not do for me (He WILL grant you children, just not right now)
- that I'm not accepting His will for me right now
- that I'm not being patient because I dare to desire children now instead of waiting passively

We will die in God’s time. It will rain in God’s time. Everything happens in God’s time. You’re actually stating the obvious and it’s not really relevant to the conversation. It gives hope for something that may never happen, and berates the woman in the meantime. Far from being helpful and consoling, this statement used to rile my feathers more than most of the others. Now I just smile and nod.

5. Affirming the Gift of Life While Insinuating…?
What you say: "Being infertile must really make you understand that children are a gift, hm?"
What I hear: "Kids are a gift and you ain't got ‘em."

This is actually a new one, and yet I’ve heard it more than a few times in recent months. Well, yes, I am in a unique position to understand that reality more than most people. And… so… you've been given several gifts and I've got none... what's your point? How exactly would you like me to respond?

6. The Creighton Cure-All
What you say: “You should try NaPro Technology!”
What I hear: “You’ve been living under a rock for the last decade. Let me be the first to tell  you about this new wonder method that can fix absolutely anything and is 100% Church approved.”

Yes, there are probably some Catholics who have never heard of Dr. Hilgers, the Pope Paul VI Institute, the Creighton Model System, or NaPro Technology. These are the same Catholics who couldn’t tell you the name of the current pope, what time Mass is this Sunday, or who painted the picture of Our Lady of Guadalupe. Of course I’ve heard of it, and not that it’s really any of your business, but yes of course I’m using it.

I truly have a great deal of respect for Dr. Hilgers, the Pope Paul VI Institute, and all of the work that they’re doing. Dr. Hilgers boasts a much greater-than-average success rate and has helped thousands of couples with a wide range of gynecological issues. NaPro Technology is not, however, a wonder cure or the panacea it is so often lauded to be.

I think too often people place far too much hope onto a method, a man, or a medicine. Success rates of 70% still mean 30% can’t be helped. And for those who fall in the 30% category, hearing people who have never had fertility issues (or even from those who have) lauding, hailing, praising and placing implicit faith in the system as “no, it will help you,” is a little hard to bear.

My Experience with the Not-So-Radically-Different Approach of NaPro Technology

I can also say that most people who promote NaPro Technology (especially for infertility) have NO idea what it actually entails.

My devout Catholic, Dr. Hilgers trained, certified Creighton NFP only NaPro technology doctor suggested, as a first round treatment, using birth control pills and fertility drugs. She also recommended my husband to undergo a male fertility test by morally illicit means. Uum… how is that any different from what my secular OB/GYN recommended? I left that appointment so confused, upset, and dismayed that I almost completely threw in the towel on Creighton.

Thankfully we found another Creighton doctor (a few hours away) who uses bioidentical hormone therapies that do not include birth control pills, but he (and Dr. Hilgers) still prescribes fertility drugs. Fertility drugs are not morally problematic at all, but they’re also not any different than what a non-Creighton doctor would do. So in my case of infertility (and there are many different causes of infertility, so this doesn't apply across the board) NaPro technology doesn’t have some hidden bag of tricks unavailable to other doctors, though it’s always publicized and hailed as being radically different. The main difference in my case, as far as I can see, is that Creighton doctors will never push or recommend IVF. And that really is a boon, to be sure.

NaPro Technology might also have a different bag of tricks for other gynecological problems, so I’m not trying to discount it wholesale! I just want to temper the rampant enthusiasm and undying faith that so many people place in this system.

7. Everyone’s Perfect Solution
What you say: “Why don’t you just adopt?”
What I hear: dagger plunge, twist, thrust, rip heart out, leave her there to bleed to death

“Why don’t you just adopt?” Oh, that the answer to all of life’s most crushing pains could be so easily answered by such a simple solution.

“It’s never going to happen for you. Why don’t you just give up all of this nonsense of conceiving a child in the life-giving love of your marriage, growing bone of your bone and flesh of your flesh within your womb for nine months, sacrificing your body while giving birth, nourishing your child with her mother’s milk, bearing a child with your husband’s radiant eyes and sheepish smile… you’ll still have a kid and will be helping someone else out, too!”

Adoption is a calling, it’s not a fallback plan when all other methods fail. You don’t tell a woman in her mid thirties who hasn’t found a spouse yet, “Why don’t you just become a nun? Clearly you’ll never find a man so why don’t you just give up, give of yourself and go don the veil?”

Of course it’s a worthy call! Of course it’s a good thing to do! But you can’t guilt a noble calling upon someone because the desire of her heart isn’t happening.

Adoption doesn’t cure infertility, it eliminates childlessness. Something very real… entirely integral to what it means to be a woman, the primary purpose of her marriage, the centrality of her very being, is lost by the inability to conceive and bear children, to procreate. You can’t just plop a baby on her lap and expect everything to be all better.

And you know what? Maybe we do want to adopt. Maybe it is our calling. But your question requires a response I may just not want to give you.

The question proposes a quick and easy solution for a process that is far from quick and easy. The question assumes we can handle wait lists (especially for infants) that could last several years. The question assumes we are prepared for an adoption that can fall through at the last second, causing unspeakable emotional agony. The question assumes we have a separate bedroom in our house and a stable enough income to pass the home study. The question assumes we have the $30,000+ required to adopt. Let me open my house, my bank statements, and my heart to you to answer your “simple solution” question.

Adoption isn’t as easy as going to the local group home, picking up a cheery cherub and taking her home. That’s what your question makes it sound like. Please, don’t think a) your simple solution hasn’t occurred to us, or b) your simple solution is, in fact, so simple.

So What DO You Say?

Must you say anything at all? Tragic as its malfunctioning is, I don’t really see how my reproductive system should ever be our topic of conversation. But I assure you, if I ever do need to talk about it, I’ll broach the subject with you, my dear friend… my sister… my mother… not you, a casual acquaintance in a chance meeting.

No, I feel the need to say something. Alright, if you must say something, then please let it be a simple but empathetic:

“I’m praying for you,”

especially if you actually are. I would never turn down a prayer! I truly appreciate them. I cherish them. I live on them.

Amen.

Comments are open for now. If I start receiving advice, suggestions, corrections, or any other unwanted feedback, I’ll have to close them ;). Thanks!