Awaiting Your Miracle Baby Planning the Rest of Your Life

"It seems like everything is on hold until we get a baby," Margaret B. said.

"We did that, too. We put off buying a house, getting a car, changing jobs, taking a vacation..."

"So have we," Bryan W. interrupted. "We spend all our extra money on medical bills. We can't do anything else."

"The menstrual cycle takes over your whole life," Steven S. added.

Kathy agreed. "Every time we want to leave for the weekend, I have to go in for ultrasound or Steven has to collect a specimen for AIH. There's no time for making other plans. "

"We don't even go to my parents' house anymore," Shelley T. said. "I can't stand all the questions: 'When are you going to give us a grandchild?' Or, 'Why don't you just relax? Let nature take its course.' "

Kathy interrupted. "I don't go to baby showers anymore either. I used to cry for days afterward and I don't need that kind of grief."

"You have the right to avoid painful situations," the RESOLVE leader agreed. "There's no rule that says you have to force yourselves to face these situations all of the time. You have to plan your own life and be true to your own needs.

"You need to give yourselves permission to move on with your lives. Putting off buying new clothes because you may need a maternity wardrobe instead; delaying your vacation because you might miss a call from the adoption agency; keeping your old job because if you get pregnant you don't want to lose your maternity benefits—it can go on and on. Giving up your other dreams and all the fun in your life only adds to your frustration and anger."

Then Margaret B. spoke: "I'm beginning to understand what you're saying. We aren't just upset about our fertility problem; we're also upset about how our fertility problem is ruining the rest of our lives."

"So if we would try to live like normal people, we would be happier." Richard B. reached for Margaret's hand. "It would do a lot for our marriage, too."

Even when only one partner must be medically treated, I find that the fertility problem affects them both because the couple loses control of their destiny, the couple undergoes fertility treatment, and the couple shares the emotional strain of dealing with friends and family. Infertility does not just affect one person; it affects the couple .

In this chapter I want to help you rethink the attitudes that may be interfering with your self-esteem, your sexuality, and your progress toward pregnancy. You are entitled to have the freedom to be yourself and to consider new options apart from what others expect or demand. I want to put you back in control of your life so that you can deal with your marriage, your family, your friends, and your career. And I'm certain that as a couple you will grow closer and stronger from your efforts.

Coping with a fertility problem is as significant a life crisis as adjusting to the death of a loved one. Because of the ambiguity of the loss, however, couples with fertility problems have difficulty getting over their crisis: there is no body to bury and no clear-cut stopping point. Perhaps it's more like having a loved one missing in action. There's always hope: just one more month of treatment, just one more surgery, maybe next month will be The One. With each attempt the couple develops renewed hope, and with each failure the couple mourns their loss. Then, once again, they muster up enough strength to get back on the emotional crisis roller coaster: they try again, and again, and again.

Riding the Emotional Crisis Roller Coaster
Shock and denial. When you learn that you are "infertile" or that your fertility treatment has failed, at first you become numb. You may have difficulty thinking, experience emotional swings and outbursts, and show impaired judgment. You may only be able to function from day to day and not really believe the facts: "This can't be happening to me. I'm not infertile, I just can't get pregnant." "Until now I had a perfectly ordered life; then everything just hit the wall." This period of adjustment may last several weeks or even a couple of months

Searching and learning is a period during which you want to learn everything you can about infertility, so you can make some sense of it. you read everything you can get your hands on and talk to infertile couples every chance you get. you may frequently find yourself becoming angry, restless, impatient, and indecisive. You begin to feel guilty about what you perceive as past transgressions: an abortion you had as a teenager, an affair that caused PID, or using birth control for so many years. During this time, studies show that you are at greatest risk for developing an illness.

Bargaining and guilt is a stage where you attempt to regain control of your life and do a lot of crying. You may look to God for answers or promise to "be good" if you get pregnant. You may find yourself saying, "What did I do to deserve this?" "Maybe I'm too selfish," "It's your fault," or "Maybe we don't deserve children; our marriage isn't the greatest in the world."

Anger grows from the senselessness and futility of the situation. You become resentful, enraged, and feel helpless. You feel that you've lost control of one of your basic rights. You say, "Why me? All sorts of other people can have babies. I'm a good, wholesome person, so why do I have to suffer?"

Optimism and hope grow as you begin to believe that treatment will help. You work hard at your treatment, but your anger and frustration increase with each failure. You may even start to con yourself: "I'm sure everything will work out," "It doesn't really matter anyway," "I should feel happy— I've got everything else I could want," "Maybe if we adopt, I'll get pregnant," "Maybe we shouldn't have any children."

Depression descends from your pain, despair, emptiness, and sadness. For many, life loses its meaning and pregnancy becomes an obsession. You try more bargaining: "We'll do anything." Any failure—at workup at school, in bed—is seen as "another example of my inadequacy." You begin to think that you may be going crazy: "I'm trapped in hope; I don't want to hope anymore."

Reorganization follows depression and is characterized by better judgment, better eating and sleeping. The obsessive drive is gone; you are healthier; you begin to get your priorities into perspective. You stop fighting what's happening and realize that like it or not, fertility problems are part of your life and need to be dealt with, not denied.

Acceptance and resolution take place when the doctor says, "We've done all we can." Once the pain subsides, you begin to say, "Maybe it would be okay to decide not to have children"; "If I never have a baby, I at least have a husband who loves me. We're going through this together and he's right with me"; "I was courageous to get this far." You begin to laugh and make plans to get on with life unless you have renewed hope—a new treatment, a new doctor, a breakthrough in technology—and then you hop aboard the emotional roller coaster for another round.

The time people spend in each stage of emotional crisis varies from one person to another. Their ability to help themselves, to communicate, to handle their thoughts, to manage anger, to adjust to stress, and to resolve conflicts help them move through the stages. People who fail to deal with any one stage of grief get caught—caught in bargaining and guilt, caught in anger, caught in depression. People who learn to deal with each stage, one step at a time, accept their situation, take control of their lives, and start living again. Many of my patients have done this and you can learn to do it, too.

Recognize the Danger Signs of Excessive Stress
Sometimes stress levels build to unreasonable levels. Your coping skills fail and you begin to use inappropriate and ineffective techniques to resolve your problems. If you find yourself resorting frequently to the mechanisms described below, you may want to seek outside counseling or do some quiet thinking and talking with your spouse or close friend about what is happening.

Displacement—redirecting your feelings from the original person or problem to another person or object. For example, when Michelle P. became upset with her mother, she would take it out on her husband. After her husband gently called this to her attention, they worked out a strategy for her to deal more effectively with her mother.

Dependency—letting someone take care of you and make all of your decisions for you so you are free to "opt out" of life. For example, Vicky M. let her husband take care of all the funeral arrangements for their stillborn child. Vicky always regretted that she hadn't picked out the dress their daughter was buried in. she hated her weakness.

Aggression—moving against another person. Dan M. spent all of his time figuring out how to get back at someone instead of figuring out how to level with the person about how he felt. When he learned to say "Ouch!" he found that people really didn't intend to hurt him, they just didn't understand.

Passivity and evasion—seizing power by becoming passive, by avoiding responsibility, or by pouting. John T. used to say, "I don't care—do what you want," when he really didn't feel that way. Then he learned that people would consider his feelings if he shared them. That was the first step John took toward taking control of his life.

Sexual withdrawal—expressing disapproval or anger by withholding sexual favors. Not wanting to make love after an argument is understandable, but using sex to get your way is inappropriate.

You may wish to rate yourself on the checklist below. If you have too many pluses for your own comfort, you may want to seek outside counseling. Often a counselor can quickly relieve your anxiety by helping you get your priorities in order and pinpointing the key elements of a problem so you can deal with each stressful situation one step at a time.

Continued