Mirror, Mirror on the Wall, Who’s the Fertile of Them All?

As a therapist specializing in women’s issues, I have regularly witnessed the struggles that many women and girls have with weight. After all, rare is the woman who has not felt the effects of our society’s obsession with thinness, on the one hand; and with food, on the other. I dare you to watch a television show that targets females or read a women’s magazine without finding ads for rich foods and recipes, interspersed with messages that we can, and should, achieve physical perfection – whose cornerstone is a standard of thinness most of us cannot attain. For many, those mixed messages create contradictory attitudes and behaviors about body size and diet. We are tempted to eat, eat, eat; while we obsess about being thinner, thinner, thinner. As a result, some of us battle being overweight or underweight while others become caught in a vicious cycle of losing weight and gaining it back. Those fights are painful. They affect our body image and self esteem.  And, as many women who decide to get pregnant find out – sometimes too late – they affect our fertility. Body fat plays a critical role in human reproduction and either too much or too little of it can lead to infertility.  According to the American Society of Reproductive Medicine (ASRM),  the recommended Body Mass Index (BMI) range for women who are trying to conceive is between 18.5 and 25. A BMI over 25 is considered “overweight” and anything beyond 30 is considered “obese”. On the other end of the spectrum, a BMI under 18.5 is considered “underweight”. Women who are overweight or obese...

Carry a Big Umbrella: Handling Baby Showers During Infertility

If there is one piece of mail that every infertile woman dreads getting, it is the pastel-colored invitation with pictures of diapers, baby carriages or pacifiers. For most of those who go through infertility, a baby shower is not a cause for celebration. Instead, it is a reminder of painful realities: that other women get pregnant easily while we suffer for months to get a positive pregnancy test; that they are transitioning to a new phase of life while we are remaining behind; that they are about to join The Mothers’ Club – in which we have been denied membership and to which, we fear, we may never belong. The baby shower is a festivity devoted to all that makes us sad: pregnant bellies, birth stories, frilly clothes and infant toys. It is a reminder of how much our society glamorizes and sometimes even fetishizes mother and baby.  And we, as silent witnesses to the celebration, are torn. A part of us, too, rhapsodizes over motherhood – why else would we pursue it with such fierce commitment and persistence? A part of us, however, fears we may not attain it – or at least not in the full genetic and gestational way we had initially envisioned. So, we know that attending the shower may make us feel sad, hopeless, isolated, anxious, and – more than anything – terrifically envious. And still, the pregnancy celebrated is often that of a woman we love: a sister, a cousin, a dear friend. She is someone whose well-being we cherish and upon whom we would never wish any pain, least of all the...

12 Rituals of Miscarriage

“Ten years ago I stood in a temple in the Kamakura district of Tokyo, staring at hundreds upon hundreds of gray Buddha statues. Ranging in size from around 4 to 12 inches, they lined walkways, went up steps, and edged paths. Some were adorned with beads and flowers or wore little hand-knit caps; others had bibs with cartoons and white, ruffled baby hats. They stood silently amid the rock arrangements and soft bamboo trees. Their sheer numbers were breathtaking. Later I learned that this temple was a place specifically for women who had had pregnancy losses–some early, some late, even some whose losses where the result of intention to end a pregnancy.” (Wendy Ponte, “Solitary sadness” Mothering, July/August 2002). Rituals are an important part of our life. They provide an important tool for working through feelings of grief and a way for families to come together and feel whole again. Yet, while some societies have developed elaborate rituals and behaviors for mourning pregnancy loss, the Western world has remained painfully devoid of such rituals. As a result, couples who want to acknowledge and grieve the loss of an unborn child frequently have to create their own ceremonies and traditions. Couples choose different types of ceremonies depending upon their own belief system. Some find comfort in traditional religious services with clergy officiating, while others prefer quiet meditation, or the symbolism of one poignant act, such as planting a tree. Often, the anniversary of the miscarriage or the due date of the unborn child becomes the focus for remembrance rituals. Simple or elaborate, religious or secular, the point of all such...

Infertile Mother

I know a woman. When I think of her, the first word that comes to mind is Mother. No, she doesn’t have a child. And still. Mother. Before she opens her eyes in the morning, her first thought is of him. Her dream baby. She saw him in her sleep again last night. He was so vivid, his small fist grasping her finger, his big eyes locked on hers, his face so eerily familiar. She even smelled him in her dream. Could that be a sign? In bed, she studies her body. Is it warmer? Is it cramping? Is her breast tender? She goes to the bathroom. She checks, as always, for signs from her womb. Is it ready? Is it receptive? Or is it bleeding out another month of hope? Another cycle of disappointment. Mother. I know a woman. It’s barely light out, but she is already at the doctor’s office. She has sat in this waiting room dozens of times. She has read all the magazines. She has studied all the baby announcements framed on the walls, imagining what hers would look like. She greets the nurse with the familiarity of an old friend. And why not? Lately she has seen the nurse more frequently than she has seen her best friend. Only the nurse has seen the needle marks puncturing her arms and the landscape of bruises coloring her thighs. And only the nurse knows that all these needle marks and all these bruises are there to ready her body for an embryo created from the core of another woman. Mother. I know a woman. She...

Have You Lost the Spark That Lights the Darkest Hour?

This morning there was a lot of sadness in my office. My client “Dawn” has just miscarried after conceiving twins with IVF. She could barely drag herself in to see me—she has been literally hiding under the covers for the few days since her miscarriage. Now, in my office, doubled over with anguish, she was questioning her ability to go on. Two years of unsuccessful fertility treatments and now this pregnancy loss have broken her spirit and left her defeated and hopeless. “The future is empty for me” she said, “I will never be happy again”. Those words didn’t surprise me. After all, women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer. Surprising,though, was the fact that the words were coming out of Dawn’s mouth. You see, Dawn has always described herself as “a real bad-ass.” She’s confronted a great deal of adversity in her life and has emerged from it as tough and as rugged as a street fighter. When she first started fertility treatment, her attitude was, “Bring it on!” True to form, in the following two years she’s fought for her dream family with tenaciousness and unfaltering optimism. But now, she feels like she can no longer bounce back. She feels broken beyond repair. Listening to my client today reminded me of three basic truths about resilience: 1) Most of us posses it. Like Dawn, many people have dealt with trouble or misfortune, and have picked themselves up, dusted themselves off, and went on with life, frequently strengthened by the challenge they’d faced. You too may have...