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...

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...

Postcard from the Barren Land

I am quite familiar with the tundra myself. In my late twenties, I was finishing up my doctorate in clinical psychology and doing a residency at a Chicago hospital, when I first began learning about infertility. The hospital had a large fertility clinic and, as part of my training, I began leading support groups for the couples who were going through in-vitro fertilization, or IVF. I was taken aback by the emotional demands of infertility, and by the drastic differences between men and women when coping with those demands. I was curious to understand these differences and to see if the “feminine” style of coping was more effective than the “masculine” (which I suspected), or the other way around. I decided to research the couples at the clinic and document the results in my doctoral dissertation. I spent a year studying infertile couples and writing my paper (to my surprise, men’s coping strategies, such as emotional distancing, distraction and humor, seemed to work better than women’s, but more on that later). Throughout this I continued to see infertile clients and began building what would become later a thriving clinical practice focused on infertility. But first, it was time for my husband and me to have a child. We started trying to get pregnant, then trying and worrying and then trying and panicking. Eventually we learned that we were part of the small group of infertile couples who is dealing with both a male and a female factor. We ended up undergoing five years of medical treatment that culminated in several cycles of IVF. I learned, during those years, that...

Siberia of the Soul

“In the depth of winter I finally learned that within me there lay an invincible summer.” Albert Camus This is a blog about surviving a Siberia of the soul. If you are infertile, you know this place well: it’s the social and emotional exile which women experience when they’ve been trying, unsuccessfully, to have a child. It’s the frozen tundra of women who cannot be mothers. If you’re not infertile, imagine this: you’re the proverbial fly on the wall at any social gathering of women: a cocktail party, a shower, a luncheon. Imagine yourself hovering over them and eavesdropping. Notice how quickly their conversation turns to children. From the initial “do you have any kids?” to the exchange of concerns, tips and advice; to the heroic tales of pregnancy and birth–women’s conversations are seldom devoid of references to motherhood. That’s because the “moms club” is the world’s largest club. Numerous in members, not very exclusive, sometimes involuntary, but still, a club. When you have a child, you become a card-carrying member, you learn the secret handshake, and you uncover mysteries that “only a mother could understand”. We live in a society geared toward, even obsessed with, motherhood. Despite their liberation from traditional gender roles, most American women view being a mom as central to their feminine identity. Do you remember a 1970’s song that went something like this: “When I grow up, I want to be a mother… one little, two little, three little blessings from above”? From an early age, women receive the message that, no matter how much they succeed in other areas of their lives, they...