After a decade of infertility, I have seen my share of motivated doctors. I have seen OB/GYNs who referred me to other OB/GYNs who referred me to reproductive endocrinologists and then we moved states and started the process all over again. I have had moments where a doctor has shown me great kindness. I have had moments of great frustration in trying to communicate with a doctor about our infertility issues. Meeting with an infertility specialist is an incredibly vulnerable position.
So here are 8 thoughts I’d like to communicate to those doctors who are working with infertile couples.
Be honest- We need to hear the truth from somebody who can explain it in ways we understand. Don’t sugar coat it. Let us hear and see the real numbers and show us comparisons to “normal” numbers. Give us time for it all to sink in before moving to the next step. Before we can move forward, we really need to understand where we’re coming from. Realize that this is going to be emotionally difficult for us, but it doesn’t mean we need to be sheltered from it. Give us copies of our test results so we can continue to do research to help us understand our reality.
You are not God- We don’t expect you to work miracles. Unless you imply you can work miracles. It may not be helpful for us to hear about how many people in a similar situation get pregnant. The truth is that you can’t promise us that WE will get pregnant even if everybody else in our situation does. Help us have realistic expectations by not implying that this is a problem that’s easy to solve.
Be sensitive to our ethical considerations- Infertility treatments have become more and more ethically complex. Each couple needs the freedom to come to their own conclusions about what they’re comfortable with. They may not be okay with every kind of treatment option available and they need to know you won’t pressure them beyond what they feel is acceptable. And please don’t minimize the potential long-term complexities of options like using donor eggs or sperm. A child may some day want to know about their genetic heritage and couples need to be comfortable with that reality. While your job may just be the medical side of these procedures, someone in the process needs to help the couple think about this from a whole life perspective.
Be supportive of family building outside of pregnancy- Your office may be the first place a couple contemplates adoption as a possibility. While that has nothing to do with the services you provide, your attitude towards adoption can help a couple see that their dreams of family may still be possible, or it can make couples feel that anything outside of pregnancy won’t be as fulfilling. Ideally, I would love to see infertility specialists partner with adoption agencies to have information available so couples understand that finding the end of the pregnancy road may be the beginning of their journey towards family.
Don’t dismiss us because we’re young- I’m sure there are many couples that end up at the doctor’s office out of an abundance of caution and their youth makes it seem silly for them to be there. But many of us come to you young (I was 22) because we know something isn’t right. Be respectful that even if you think we have plenty of time because you’re used to dealing with older couples, this is still a difficult season for us. We need thoughtful answers and wise counsel, not just to be dismissed because we have “plenty of time”.
Be respectful of our budgets- In a perfect world there would be no price too high to pay for being able to conceive and carry a biological child. But in reality, we can’t all afford the investment required. Be upfront with patients about what their insurance will or won’t help with and what this is actually going to cost. And please do it BEFORE you start treatments. What seems financially obtainable for you might be totally beyond what our current budget will allow. We need time to think through those options or even to save up money for treatments.
We are more than our bodies- When you give us difficult news about our fertility, please realize that this will be terribly emotional. As a couple we may blame ourselves or blame each other. We may need time to work through it all before we’re able to commit to the next step towards healing or possible pregnancy. If we make band-aid fertility decisions on what is a gaping emotional wound, we may find ourselves in a very unhealthy position if these treatments don’t work. Know what resources are available in your community for infertility support and help connect us with others in our position.
We want to understand– Talk to us about WHY we might be having these issues and about root causes. Fertility is incredibly complex. Help us understand any nontraditional treatment options worth investigating. Listen to our questions and don’t assume you already know what they are. Talk to us about books worth reading, websites worth visiting, other doctors we may need to see.
Most women who have spent extensive time with infertility specialists could tell you about a time when they felt so supported by their doctor or a time they felt belittled. I know I have my experiences.
The second miscarriage I went through was quite traumatic. I didn’t have any idea we could get pregnant and the exciting surprise made the miscarriage seem all the more cruel. It all started with a trip to the ER while I was in incredible pain. The ER had a difficult time figuring out what was going on, so it took several days before we knew for sure that we had lost our baby. I was angry and sad and couldn’t understand what was going on. In the midst of all that, I found such comfort in the faces of my boys. Josh was just three and Danny (who was still our foster child) wasn’t even a year old yet. It was hard to get too sad when I had those kids needing me and calling me “mama”. So a couple weeks after our miscarriage I was scheduled for a routine follow-up with my OB/GYN and I was feeling much more peace about our situation. I couldn’t find childcare for our little foster baby, so I brought him with me to the appointment. When the doctor walked into the room and sat down with me and this 9 month-old baby, the first words out of his mouth were, “So the question is, how do we get you a baby?” I was flabbergasted. That wasn’t my question at all. I clearly HAD a baby right there in my arms. He then went on to talk about the fertility options we could try, how he thought although things hadn’t been successful in the past, he thought he could get us pregnant. Then he talked about how special pregnancy is and how nothing can compare with the bond you feel with that child. I was totally offended. This was clearly a person who didn’t understand the beauty of adoption and had no desire to hear what we wanted for our family. He was offering solutions to problems I wasn’t expressing. I have heard from other patients that he is a great guy and a kind doctor, but I never went back to his office.
The first OB/GYN we ever met with to discuss our infertility was an experience I’ll never forget. While I was prepared for a violating physical exam, what he did instead was just sit with us and answer our questions. He listened for a long time and we never felt rushed. He talked to us about potential treatment routes. He told us what he could help us with and what we’d need a specialist for. He scheduled further testing. And then he asked me to lay down on the exam table. I wondered what kind of exam this could be since I hadn’t changed into the usual exam gown, but then he had Brian come over beside me. He took Brian’s hand and said, “This is where we’d like to see God grow your child” and placed Brian’s hand on my stomach. The doctor then put his hand on top of Brian’s and prayed for us. He prayed that God would grant us the ability to carry life. He prayed for wisdom in our decision making. He prayed for the health of our relationship through this potentially stressful time. It took ten years for his prayer for pregnancy to be answered with a “yes”, but I thought of that doctor many times throughout our pregnancy process. God had a plan to bless us with pregnancy, but it took a lot longer than we imagined and I’m incredibly thankful for the adoption “detours” along the way.
Being the kind of doctor that listens and expresses respect for his patients may mean you are part of the healing process for the couples you work with. Not just physically, but through the difficult emotions of infertility, too.
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