Infertility and the Culpable Modern Woman
Infertility and the Culpable Modern Woman.
The reproductive and biology unit at the Royal Women’s Hospital peers through dusty windows over a rooftop building site, and way out, in the blue haze that envelopes the eucalypt landscape, you can see Mt Sugarloaf, softly wrapped on the farthest horizon. In the waiting room sits a diverse array of women and their partners, looking far out, seeming to ponder why their yearning for a softly wrapped bundle has become so distant and out of reach.
In our first interview with the obstetrician, I explained that I was just completing an 8 year PhD. Our two year old daughter was bouncing around the room displaying her usual irrepressible exuberance. The obstetrician surveyed the scene and shook his head. Accustomed to being chastised, by family, friends, neighbours and health professionals - for worrying too much about not falling pregnant in a year, for being too busy, too stressed, for wanting it too much, for concentrating on it too much, for not relaxing about it, for not accepting the karmic fate and timing of the spirit that would choose to enter me, for working too hard and exhausting myself, and so on ad nauseam - I braced for another lecture.
This particular obstetrician, however, was cut in a different mould, for which I was grateful and relieved. He simply informed me of the avenues I could pursue through their service. Perhaps years of experience in infertility had led him to identify its pervasive myths, and like me, to throw them out with the bathwater.
Infertility or ‘sub-fertility’ is a common enough experience for nearly everyone to be the ready custodian of a story from a sister, aunt, cousin, friend, colleague, etc. Being a culture enthralled by solution, these are stories which always come with clear narrative closure, namely, a baby. Sadly, this is of poor comfort if, despite your best efforts, that outcome remains elusive for you. Increasingly you question why there has been no solution for you, and of course, under the mythologising that surrounds infertility, it gets back to you and something you are either doing wrong, doing too much of, or not doing at all.
‘You’re never going to get pregnant until you stop thinking about it so much’, was one blunt response when I expressed frustration at the monthly cycle of mounting hope, then disappointment and grief. ‘Put it out of your mind for a couple of months’, my GP told me. Most of the myths fall into this category – the problem with women who can’t get pregnant is not in their reproductive systems, but in what’s going on in their minds. What we need to do, somehow, is do less and care less.
The solution-oriented stories come think and fast on this score, ‘I fell pregnant the day after I resigned from the job I hated – and I had one scarred fallopian tube that barely functioned’; ‘my daughter had just put her name down for adoption, after trying for 9 years, and that week found she was pregnant’; ‘we took a month off, stopped taking my temperature and just had a rest, and that’s when I conceived’. These are all true stories. They enter the realm of myth, however, when it is assumed that what has been true for one couple, can have universal truth for all.
These are also anecdotes told by people wanting to comfort, they are deeply personal offerings of hope in the spirit of sympathy and care. But the hope being offered is that infertile women do have some control over the situation, we need to engage our minds in a series of tricks that I personally found impossible; to put our bodies out of our minds, to do less in our lives, want less, be less affected by the monthly ‘negative’ or ‘failed’ pregnancy tests.
I began to wonder what assumptions about women, our relationships to our bodies, and mothering were being harboured in these myths. When a Chinese herbalist gently reproached me for having too much on my plate, I let the needle sink, released my breath and replied, ‘you tell me when women haven’t had too much on their plates?’
I thought about women conceiving in war zones, with family members missing, having witnessed unspeakable atrocities, and I questioned whether stress was really such an effective contraception. I recalled reading the desperate letters women wrote to birth control advocate Marie Stopes in the 1920s, pleading for advice having conceived more children than they could feed, who had narrowly escaped death in labour and suffered the repeated deaths of their babies. I thought of our great-grandmothers bearing 6, 8, 12 children and daily cooking and washing without ‘labour-saving devices’, and I questioned whether despair and exhaustion were so effective at inhibiting ovulation.
I had tried and failed to put my body out of my mind. Like many women, I knew about when I ovulated – it hurt like hell. But even when I stopped marking the calendar, I found I was nevertheless very aware of my cycle, it not being dissociated from mood, desire for certain foods and sex, and other less pleasurable corporeal realities, like sore breasts. I found I could not ignore my body. While bewildered at first from losing faith in the foundational idea that my body was something I directed from my mind, it eventually ceased to be a recalcitrant, disobedient territory that I inhabited. I found instead that my body was my mind.
I tried and failed to ‘do less’. The very idea was laughable. Could I leave my toddler to hang upside down over the table edge while I lounged on the couch? Could I not get her lunch, nor make sure she had enough pants, nor empty her potties? My daughter holds workshops with her comrades at creche, I am still convinced, devising devious ways to ensure she is the centre of my attention and the purpose for my every expenditure of energy. When I sat down to write the final words of acknowledgment for my thesis, she was thrashing next to me on the floor, screeching, ‘take off de glasses, Mummy!’. I was already cornered and fully occupied by motherhood, I reasoned. Regressing to chewing cuds in a paddock, with nary an complicated thought, nor a wayward gesture in the direction of having meaningful work of my own was not going to make me any more fertile.
I listened too to tragic life stories, and soon realised that most people feel thwarted by something uncontrollable that they had once believed had been a matter of self-determination. While there were some important lessons there, they did not offer much solace beyond feeling sad for them, as well as sad for me.
It was only women who had been unable to conceive after trying for years, or who were undergoing IVF, and who continued to live with that sense of not knowing, who offered ways to think about it that were helpful. One said, ‘it is completely out of my hands, there is nothing I can do about it, and I try not to blame myself, or to find reasons why’. Another said, ‘I’ve had to learn to just accept that it might never happen, and to look for the blessings in my life’. Simple, terribly painful, but most importantly, not blaming of the woman herself.
I decided to look for answers that went beyond the accusation that I was too modern, greedy and complicated. I booked in for a laparoscopy. Reproductive choice, I was discovering, covered a wide spectrum that extended from abortion to accessing assisted fertilisation. The findings of the laparoscopy and the lessons of my own body were in the end the most confronting ‘truths’ that I had to deal with. It seemed I had suffered an ectopic haemorrhage 9 years ago. Two sections of one tube were lost, one section from rupture, another from cut off blood supply from where the fetus had lodged and died. At the time, I thought I’d pulled a muscle, and while the pain was severe I had staggered off to bed to see how I’d feel in the morning. My obstetrician told me that generally, without intervention and surgery, women bleed to death. I was lucky to wake up alive. I was left with one working fallopian tube. And in the end I conceived immediately after the laparoscopy, but with an egg released from the side which had no way to convey it to my partner’s sperm. Technically this can’t happen. At the reproductive and biology unit the nurses have learnt to shrug. ‘There’s no accounting for eggs’ they told me. After a year of ‘sub-fertility’ I could only concur in amazement.
The baby was discovered while I was being scanned in order to ‘track my cycle’. The nurse said, ‘I’ll just get your landmarks’, pulled up short and said, ‘oh … there’s something in your uterus’. By this time I had lost so much faith I actually asked, ‘What could it be?’ Not even 4 months of morning sickness and passing out convinced me I was really pregnant. Not until the baby took to kick boxing my insides did I really believe it was there. Like many of the 5% of women who have trouble conceiving I continue to be apprehensive about the baby’s health and to feel wary that something is wrong.
My solution was in the order of conventional of narrative closure and we are ecstatic and humbled. And yet while I went looking for an empirical reason, I conceived in a manner that no doctor can explain. Certainly the ‘reasons’ for infertility should not be located within women’s levels of stress, work or excessive desire for children. And there is no natural justice waiting to grant the gift of conception when women learn to relax, accept fate, be less modern, or to have faith in the mysterious workings of their own bodies.
Life is random and while this is sometimes unbearably painful to cope with, it is not a matter of culpability. In the end it is beyond all measures of reasoning, be they empirical or mythological.