When You're Not Expecting Part 3

Then, the months wear on, savings diminish, and mood swings take a toll on their relationship. Perhaps the couple even experiences a pregnancy loss, and all this causes them to rethink their original expectations. For many couples feeling "stuck"

in treatment, it can feel somewhat liberating ultimately to use that time to consider what options they might pursue if the 81woman does not become pregnant. In some cases, this leads to questions about a life without children. In other cases, it opens discussion on what it would mean to consider adoption or surrogacy. The importance of experiencing pregnancy and birth and the significance of genetic ties to one's child are issues that most couples will evaluate. These discussions often wax and wane, depending upon the feelings of each individual. Raising this possibility with one's extended family also brings up issues, particularly if parents or in-laws have strong negative feelings.

At some level, beginning to think about the future in terms of opportunities and options is an ideal antidote for the doldrums of the waiting game.

"Our reaction to adoption when we began our infertility treatments was completely negative. We absolutely believed that having a birth child was the only way to accomplish what was important to us: a pregnancy, a delivery, the experience of nursing, and genetic ties. As our diagnosis became more clear, we learned that we would need to use donor sperm, and I found myself feeling uncomfortable that the baby would be genetically related to me but not to Scott. Then after more months of treatment, I realized my body was going through so much with infertility treatments that I didn't have the enthusiasm I once had for pregnancy, delivery, and nursing. I knew then that I just wanted a baby.The more Scott and I discussed it, the more we agreed that adoption, even with its complexities, was feeling more like a good option for us.We've decided to go to some social functions with adoptive families in our community so that we can get to know parents who made the decision we're thinking of making. We're not ready to give up on infertility treatments just yet, but if we do, I want to be ready to open the next door."

82.The Waiting Game: When Life Is on Hold When Life Is on Hold "My uterus is malformed and I'll never be able to carry a pregnancy. I had always a.s.sumed that I would build my family through adoption. But the more I'm learning about gestational surrogacy, the more interested I am in pursuing that for a couple of cycles. There's nothing wrong with my eggs, and d.i.c.k's sperm also seem to be healthy. We know an attorney who specializes in surrogacy, and consulting her will be important, as I understand legal issues differ depending on what part of North America you live in. My sister has even said she would be thrilled if we would consider having her be our surrogate, which is such a loving offer and also may help with potential legal concerns. Ultimately money will become an issue, but for now both d.i.c.k and I think of surrogacy as our first option, and if that doesn't result in a healthy pregnancy, we always could turn to adoption."

"Our parents are conservative in many ways, and of their acquaintances who have adopted children, there seem to have been problems and sadness. Never mind that plenty of their friends with birth children have had their share of regrets - our parents are convinced that adoption is the path to certain misery.

So, although we've decided not to rock the boat too much, we are definitely going to adopt. We hope that if we are able to find a healthy child our parents will be able to put aside their apprehensions enough to let this baby get a hold on their hearts!"

"As a single woman, with all these months of infertility treatment providing plenty of time to think about future options, I'm feeling increasingly hopeful about pursuing adoption, but even that is complicated. I'm worried that my lack of a partner may count against me. I've been talking with many of my friends about how they could be an extended family for me once I adopt a baby, and they're very excited at the prospect. Many of them are 83parents, and they know the time and energy it takes to raise a child. As I've watched them I believe I have a pretty good idea of both the sacrifices and the joys. I've had the chance to meet a few single adoptive moms, and they've been very encouraging, so I hope to take to heart some of their suggestions as I decide whether to end these futile months of treatment and begin to look in earnest at how to begin the adoption process."

Therapeutic Tips Frustrating as it may be to feel that your life is on hold, the examples in this chapter show that you do have options as to how you handle this stage in the infertility journey. Those women who find their lives consumed by infertility are the ones most likely to feel trapped and miserable. It will take both determination and creativity to shape your life (notice, I didn't say "take control") in new ways and to involve loved ones in this effort. If you are someone who feels best when you are calling the shots, you have learned by now that that approach is likely to result in frustration. To soften your approach, I'd like to encourage you to think about the more flexible response of aiming for resilience - the strength that enables you to keep options open, to explore fully what next steps you feel ready to take, and to decide which loved ones can hold you steady in this process.

You are living through a time you never expected, and charting a journey will be a new learning experience. So what are the common threads of solace in this chapter?

* Honor your feelings, but strive not to be consumed by them.

Rather than fighting infertility with clenched teeth, try to accept accept it as a part of your life and to think peacefully about how you can move forward as constructively as possible. it as a part of your life and to think peacefully about how you can move forward as constructively as possible.

84.The Waiting Game: When Life Is on Hold When Life Is on Hold * Identify the specific challenges that are a source of frustration and, even as you acknowledge you may not have control over them, brainstorm with loved ones and professionals about alternatives, next steps, new resources, and sources of comfort.

* Think about what comforts you to cushion the frustrations of infertility. Engage your loved ones, if they are willing, in creative plans that they can enjoy with you.

* Consider building some mindful relaxation into your life.

Yoga and meditation are practices that have the potential to open your sensibilities and awareness to new ways of thinking about your life.

* Remember that during a time when you are tempted to focus on yourself, you can choose to focus on others whose needs are compelling and whom you may be able to help. This contributes to your conscious efforts not to let your infertility define or consume you.

85.

Five.

Scheduled s.e.x: When Making Love Becomes Hard Work In my years of counseling infertile couples, I have encountered only one heteros.e.xual couple whose s.e.xual relationship did not suffer as a direct result of their infertility. Same s.e.x couples have the luxury of being able to separate lovemaking from baby making, which gives them a distinct advantage in their relationship.

The comfort and connection of making love can help couples put aside the worries of the day and bask in the warmth of their relationship. When infertility intrudes, it not only makes s.e.x seem like a ch.o.r.e, but it often wreaks havoc with s.e.xual self-esteem. It is not unusual for women to feel bodily betrayal and to think of themselves as barren. Their bodies are being poked and prodded more than cherished and admired, and they watch with alarm as treatments cause them to retain fluid and gain weight. Women also see their male partners feign disinterest in lovemaking (which has now begun to feel more like obligatory Chapter Five baby making), experience the inability to have or to sustain an erection, and endure producing s.e.m.e.n samples on demand, which can be humiliating. Gradually making love is replaced by a carefully timed sequence that results in command ejaculatory performances at the time of your ovulation.

Infertility and Your s.e.x Life Most heteros.e.xual couples don't antic.i.p.ate the s.e.xual fallout that is a.s.sociated with infertility. And as the importance of conceiving erodes the eroticism of lovemaking, you are likely to feel that infertility has handed you a "double whammy." Not only do you feel unable to conceive without medical intervention, but now it even seems as if your infertility specialist is perched on the bedpost overseeing your most intimate moments. Perhaps you can identify with how infertility has intruded into the s.e.xual lives of some of the couples in this chapter: "We had always enjoyed the excitement and the closeness of our s.e.xual relationship. As soon as we decided to stop birth control, we were careful about having s.e.x just before the time I expected to ovulate. But we certainly didn't restrict our lovemaking to that time of the month. Not for the first year anyway. But once we began a formal infertility workup, it was as if the doctor were right there in bed with us. Somehow, s.e.x became a very medical thing, and in the process of timing our intercourse, we pretty much let go of being spontaneous. Even though we both miss it, talking about it hasn't brought the zest back into our s.e.x lives."

"Once Mike learned that his sperm count was low and the quality of the sperm was poor, he was completely demoralized, and that affected our s.e.x life dramatically. I felt as if I 88 Scheduled s.e.x: When Making Love Becomes Hard Work When Making Love Becomes Hard Work had to take care of both of us, because he just about melted into the woodwork every night. It didn't matter that I told him he has always been a great lover - as far as he was concerned, if he couldn't produce healthy sperm, he was failing as a husband. It's gotten so bad that he has told me he would understand if I wanted a divorce so I could find someone who could give me babies! I keep telling him that I don't think of him as a baby machine, but his self-esteem is shot to h.e.l.l, and so is our love life." had to take care of both of us, because he just about melted into the woodwork every night. It didn't matter that I told him he has always been a great lover - as far as he was concerned, if he couldn't produce healthy sperm, he was failing as a husband. It's gotten so bad that he has told me he would understand if I wanted a divorce so I could find someone who could give me babies! I keep telling him that I don't think of him as a baby machine, but his self-esteem is shot to h.e.l.l, and so is our love life."

"We had a whirlwind courtship, and when we were married three months after we met, we decided to try to conceive right away. After all, we were both in our mid-thirties, and we knew the clock was ticking. Well, it's still ticking three years later, and we're beginning to wonder if we ever had a love life. The first six months were very special, because we felt that our lovemaking, in addition to bringing us close s.e.xually, might also produce a baby who would bring us together in new ways as a family. But once we began our infertility workup, the lovemaking felt more and more obligatory, the timing of intercourse felt like an a.s.signment, and we pretty much lost any sense of spontaneity that we'd ever had. I think the really rough thing for both of us is that we haven't had time to enjoy being married without the cloud of infertility hanging over us. It colors everything we do. I worry that the reason Tod doesn't reach out to me s.e.xually is that I'm becoming a different person from the one he fell in love with - both physically and emotionally. In our honeymoon pictures I was thin, energetic, and smiling. I know I'm not that way any more, and I'm afraid that it may just be easier for him to bail out of this marriage than to stick with the miseries and the broken dreams of our infertility."

89.

"You know, it's amazing to me how many people think that infertility means we don't know how to conceive a baby. Half the advice we're getting from well-meaning friends and relatives has to do with frequency of intercourse, positions after intercourse, jockey shorts - you name it, we've heard it. And let me tell you, it's downright embarra.s.sing when the advice comes from my own mother! I know she means well, but it feels as though she's right there in the bedroom orchestrating our lovemaking according to something she's read in her latest health magazine! No wonder Ross and I feel as if our s.e.x life is screwed up - that's what a lot of people are suggesting. So when we do get into bed, we feel an uncertainty. Everyone else seems to know how to go about lovemaking so that a pregnancy results - what's wrong with us?"

"I can't believe how upset I felt last month when I discovered that Matt had m.a.s.t.u.r.b.a.t.ed to satisfy himself s.e.xually. After I was finished ranting about his wasted sperm and his thoughtlessness, I settled down to discuss it. His perspective was that it wasn't my fertile time of the month, and he believed I was so focused on conceiving that I wasn't interested in s.e.x unless I was about to ovulate. My perspective was that I am absolutely focused on our having intercourse when our chances of conceiving are best, but that doesn't rule out making love at other times of the month. But Matt is right in saying that I never initiate s.e.x the way I used to before infertility entered our lives. All of my initiating is based on my ovulation kit, and I guess I believed that he would give some signal when he was in the mood. So it's probably a good thing we sat down and talked about it. It made me realize that I'm so tuned in to my ovulation cycle that I've shut out all the memories of the good s.e.x we've had. I really want to recapture some of that again."

90.Scheduled s.e.x: When Making Love Becomes Hard Work When Making Love Becomes Hard Work "Ron told me that he needed to take a rest from infertility. So we agreed on three months of no treatment, no calendars, no ovulation kits, no s.e.m.e.n samples. But I guess I was naive to think that our s.e.x life might brighten up a bit. Even before our 'vacation' Ron had trouble maintaining an erection, and the last two times he had to produce s.e.m.e.n samples, it took him a couple of hours. The humiliation of s.e.x on command has taken a terrible toll on him. So for him, the vacation from infertility also included a vacation from s.e.x - I think he was afraid that his experiences with not being able to have an erection would reappear, and he just wanted to avoid that humiliation. So I'm going to try to encourage him to arouse me without intercourse, and see if maybe we can find new ways of pleasuring each other.

What I'm most worried about is that when the three months are over he won't want to end this vacation. The cost of his being s.e.xually humiliated just may be too high."

"Sam and I both work in pretty demanding jobs, and we are each expected to travel a lot. Initially when I didn't get pregnant, we thought that the stress of our lives was to blame.

Then, when we took all of our charts to an infertility clinic, they pointed out to us that we were rarely in the same part of part of the country the country around the time that I ovulated. So before we proceeded with any treatment, we decided to get a grip on our travel and work schedules. We needed to see whether we could be together in bed at the right time of the month! Well, we've managed to minimize our travel for the next six months, but now that we're both at home more, we're entirely focused on having my ovulation cycle determine when we have s.e.x. But we really aren't having much s.e.x at other times. I'm not sure what's going on. It's true we're both exhausted by our work and the late hours, but I'm also sensing that, given how good 91 around the time that I ovulated. So before we proceeded with any treatment, we decided to get a grip on our travel and work schedules. We needed to see whether we could be together in bed at the right time of the month! Well, we've managed to minimize our travel for the next six months, but now that we're both at home more, we're entirely focused on having my ovulation cycle determine when we have s.e.x. But we really aren't having much s.e.x at other times. I'm not sure what's going on. It's true we're both exhausted by our work and the late hours, but I'm also sensing that, given how good 91we are at our jobs, trying to conceive has become another job we're trying to succeed at. And we can't ask our bosses to keep us off the travel circuit for more than half a year, so we're actually under the gun to conceive quickly. But there's a part of me that would like to step off the fast track so that our lives together can include more s.e.xual closeness, even when it has nothing to do with conception."

"We don't feel ent.i.tled to enjoy s.e.x for its own sake, not when we're such miserable failures at conceiving. So our s.e.xual encounters are programmed by the calendar, pretty mechanical, and tied to baby making. The more I think about it, it's not just s.e.x that we don't feel ent.i.tled to enjoy. We've pretty much given up everything that was fun in the early years of our marriage. Either it costs too much, or it's too much trouble, or it gets in the way of treatments, or it requires a commitment we don't feel we can make until we know whether or not we're going to be able to have a baby. So we get up each morning, go to work, come home, read or watch TV, and go to bed, and it begins again the next morning. My mother says she thinks we should get counseling because we both seem so depressed, and maybe she's right. It's one thing not to be able to have a baby, but it's another to watch your relationship go down the tubes in the process."

"Stew and I are so blessed to have Amy, who was born five years ago. But in some ways secondary infertility feels especially unfair. Here we are, knowing that we've successfully conceived once. And no one can pinpoint what the problem is. In the meantime, here is Amy, who knows that I go to the doctor for help in getting pregnant, asking when a new brother or sister is going to be born. I think Stew and I want 92 Scheduled s.e.x: When Making Love Becomes Hard Work When Making Love Becomes Hard Work this baby as much for her as we do for ourselves. We find ourselves becoming absorbed with Amy, and each night we fall into bed too tired to make love, except when my ovulation kit tells us that the time is right. Our lives are so busy that we don't set a priority on making time for s.e.x that isn't aimed at conception. Parenthood is very special for us, but there are times that I think we need to pay attention to ourselves as lovers, not just as parents." this baby as much for her as we do for ourselves. We find ourselves becoming absorbed with Amy, and each night we fall into bed too tired to make love, except when my ovulation kit tells us that the time is right. Our lives are so busy that we don't set a priority on making time for s.e.x that isn't aimed at conception. Parenthood is very special for us, but there are times that I think we need to pay attention to ourselves as lovers, not just as parents."

"I've had two miscarriages, and there's a part of me that is afraid to get pregnant again because I don't know if I can stand the heartbreak of losing another pregnancy. And Aaron has pretty much told me that he feels guilty, because he's the one who made me pregnant. So here we are in this awful dilemma: we want to conceive, but we're terrified of another miscarriage. Of course this has taken an awful toll on our s.e.x life, since we a.s.sociate pregnancy loss as an outcome of lovemaking."

"So many infertile people I know say that their lovemaking has been shot to h.e.l.l. But once Bob and I found out that medical procedures are the only way I'll be able to conceive, we were able to separate having s.e.x from making babies. Now we know that if we have s.e.x, it is for the pure fun and l.u.s.t of it all. We pretty much avoid s.e.x after each medical procedure, because we're afraid of disrupting the embryo from implanting in my uterus, but when the test results come back negative and we've come to terms with one more disappointment, we know we're in the clear for a few more weeks to enjoy each other s.e.xually.

When we were first diagnosed with infertility, I told Bob that we would have to work really hard not to let this stress take a toll on our marriage. And for both of us, the joy and the comfort of lovemaking have helped sustain us through the past couple 93of years. Much as I hate being dependent on doctors to help us get pregnant, it's a blessing that we haven't lost our s.e.x lives to infertility."

Seeking Counseling for Your s.e.x Life There's little question that lovemaking is likely to be a casualty of your infertility struggle, unless you are a lesbian or unless you know that intercourse will not produce a pregnancy. One's s.e.x life is often too awkward to discuss in a support group, too "non-medical" to discuss with your physician, and too personal to discuss with friends and family. Counselors can help individuals and couples think through ways to keep the s.e.xual flame alive despite the onslaught of infertility or pregnancy loss.

If you find your s.e.x life dwindling in the midst of the many stresses of infertility, this is an ideal time to consider meeting with a counselor to discuss ways of separating the hard work of baby making from the comfort and satisfaction of lovemaking. If you are using the services of an infertility clinic, inquire about whether a social worker or a psychologist is on staff. If not, the Infertility Awareness a.s.sociation of Canada (IAAC) or RESOLVE can provide the name of the nearest support group, which will likely have a referral list of counselors who specialize in working with infertile couples and individuals. Or, if there is no support group in your area, you may be able to find support from the social worker of your local hospital, a family service society in your area, or any infertile acquaintances who may themselves have had a good experience with a counselor. Some counselors have a sliding fee scale, so don't let money stand in the way of getting help. Above all, don't give up lovemaking; it is too precious to lose. With some effort, you can find a caring professional who will help you sort out the important s.e.xual 94 Scheduled s.e.x: When Making Love Becomes Hard Work When Making Love Becomes Hard Work issues in your struggle with infertility, such as the couple in this story has done: issues in your struggle with infertility, such as the couple in this story has done: "Our counselor asked about our s.e.x life on the first visit! I was shocked speechless, but she laughed and said that s.e.xual spontaneity was an expected casualty of infertility, and that we'd probably feel better knowing that. Ethan and I hadn't even talked about it to each other, so it was pretty awkward having this conversation with an absolute stranger. But, to our surprise, she offered some advice and some ideas that we've followed, and our s.e.x life has rebounded somewhat. Don't get me wrong - I still have no interest in s.e.x when a bad test result comes back, and I don't always tell Ethan when my period is over because sometimes I'd rather be held than be s.e.xual, but at least we're not as remote from each other s.e.xually as we were before counseling. Our counselor has suggested that we save the bedroom for lovemaking and for sleeping - no reading, no computers, no TV, no eating, and especially no talking about problems, including infertility. Her theory is that if we have distractions or unpleasant a.s.sociations with what we do in the bedroom, it will be harder to a.s.sociate that room with s.e.xuality, with desire, and with closeness. She also suggested that we have some fun with our s.e.x life - candles, ma.s.sages, suggestive lingerie, erotic magazines. Now, I have to admit, some of the things she suggested we hadn't even thought about before before we were infertile! But it's been a kick seeing what new ideas we can come up with. And Ethan and I agreed that one week he would initiate s.e.x at least one time, and the next I would. We're in a much better place with our s.e.x lives than before we began counseling. We still feel the emptiness of not having a baby, but at least we have the kind of s.e.xual closeness that means so much." we were infertile! But it's been a kick seeing what new ideas we can come up with. And Ethan and I agreed that one week he would initiate s.e.x at least one time, and the next I would. We're in a much better place with our s.e.x lives than before we began counseling. We still feel the emptiness of not having a baby, but at least we have the kind of s.e.xual closeness that means so much."

95.

Therapeutic Tips In earlier chapters I've emphasized the importance of taking care of yourself as you deal with the stress caused by infertility diagnosis and treatment. In this chapter I have looked at s.e.xual distancing as an especially unwelcome price that you pay while you try to conceive. And, at the risk of sounding like a broken record, I will gently remind you that taking care of yourself and your relationship must include careful attention to your love life.

Why is it especially vulnerable? It takes time when you have no time; it takes energy when yours is waning or depleted; it takes initiative when your focus is on following doctors' orders; it takes self-esteem when yours may be low; and it takes a joyful antic.i.p.ation when you feel the only source of joy would be a baby in your arms.

Now that you understand the psychological factors that can contribute to the s.e.xual distance you're experiencing, here are some suggestions for lighting a fire (or at least a warm glow!) in your love life: * Talk to your partner about the changes in your s.e.xual intimacy since you began trying to conceive. Use this conversation as a way of blaming infertility for your lack of s.e.xual spontaneity. Affirm how erotic you still find your partner; how much you cherish the closeness, comfort, and joy of good s.e.x; and how you want to think of ways to recapture and reinvigorate your love life.

* Once you are openly communicating about your wish to welcome lovemaking back into your lives, see if you can pinpoint the deterrents and figure out how to work around them. Some of the examples in this chapter may give you ideas of how other couples have given their s.e.x lives a jump 96 Scheduled s.e.x: When Making Love Becomes Hard Work When Making Love Becomes Hard Work start, and you'll undoubtedly be able to build on those ideas for your own relationship. start, and you'll undoubtedly be able to build on those ideas for your own relationship.

* Be kind to yourselves. Start out slowly, celebrate small s.e.xual pleasures, and don't be deterred by inevitable missteps and disappointments. Keep the lines of communication open so you stay on the same page about what brings you joy and what you need to rethink. Be sure to give positive feedback to each other.

* Experiment with new s.e.xual strategies. Rent DVDs, read books, buy some s.e.xy lingerie - and remember that this is not a scientific experiment! Laugh, be tender, be goofy, be loving. There's always time to create s.e.xual closeness.

* And remember: no pressure! s.e.xual expression needn't involve intercourse if this reminds you too much of baby making. You can even forget o.r.g.a.s.ms if you're not in the mood. Kissing, licking, caressing, snuggling, touching - the list of ways you can pleasure one another to reaffirm your s.e.xual joy is endless. Don't wait!

97.

Six.

Celebrations and Special Events: Coping with Gatherings There's no question that infertility alters your perspective on life. Now more than ever, your attention is devoted to your body, your doctors, your medical procedures, your test results, and your hypothetical future plans. Scheduling medical appointments and procedures around work and other obligations requires a fine-tuned sense of organization, as well as patience, politeness, and cooperation.

And then, all of a sudden, you find yourself thrown off balance by an invitation to a baby shower, a christening, a family holiday celebration, or any event filled with children. You and your partner find it hard enough to be celebratory these days, but when such events are focused on children, the pain is even more acute. What to do? This chapter explores various situations that you may encounter and how some women have chosen to deal with them.Baby Showers Baby showers are probably one of the most difficult events you may be asked to attend. In this case, the entire focus of the party is on the expectant mother and her baby, which is exactly the position you want to be in but can't. Here are a few stories that may resonate with your own experiences: "You know, I haven't told many people that Jason and I have been trying for two years to conceive. So, as far as our friends are concerned, we've just decided not to begin our family yet.

The last few baby showers I managed to drag myself to were filled with comments like 'You shouldn't wait too much longer at your age,' and 'Surely you can hear your biological clock ticking by now!' and 'What are you waiting for?' It's n.o.body's business but ours whether or when we decide to have children, but now that we have been trying so hard, these remarks really sting. Since I'm such a private person and I'm not ready to be open about our infertility, I've just decided to decline invitations to showers."

"The baby shower bit is pretty painful to attend, but shopping for a gift is what's really hard for me. Here I'm standing in a store devoted to darling little outfits, fun little toys, and books for babies and toddlers, and all I can think is 'I want to buy these for my my baby! Why does it always have to be someone else's baby getting these cute presents?' Finally, one day I just decided to buy a whole huge bunch of baby books. baby! Why does it always have to be someone else's baby getting these cute presents?' Finally, one day I just decided to buy a whole huge bunch of baby books.

That way whenever I get a baby shower invitation or a birth announcement I'll never have to step foot into a baby store again. Books are fine for boys or girls, and if I'm lucky enough to have a baby of my own, we'll already have started the library!"

100.Celebrations and Special Events: Coping with Gatherings Coping with Gatherings "I'm finished with baby showers. It's bad enough that they come at the end of eight or nine months of ultrasound pictures, swollen bellies, swollen ankles, maternity outfits, and mounting excitement. What's worse is that women at the shower just a.s.sume that this happy event for the mother-to-be strikes a responsive chord for everybody - not for me. Enough is enough. I know I can find enough 'previous commitments' to get out of attending. My real challenge is how to avoid all the excitement when the baby is actually born and brought into the office to be admired. Disappearing for a couple of hours at a time will take some real creativity on my part, but I think I'm up to that challenge too."

"It seems as if my entire circle of girlfriends is pregnant. And, what's worse, some of these pregnancies are not even planned.

So with four close friends whose bellies are starting to swell, I finally decided to be clear about our infertility. One afternoon when we were all together, I just blurted it out. I told them that, although I was happy for them, I just ached inside that I couldn't be pregnant too. I said that the doctors don't know what the problem is, and that it could take a long time to go through all the tests and procedures available, and even then I might not get pregnant. I told them I didn't want my infertility to put a wedge between us at a time that they are so involved in getting ready for their babies, but that I would really appreciate if they wouldn't talk about their pregnancies when I'm around. I told them not to invite me to their baby showers. And I told them that the most painful thing of all for me right now is to be around little babies, so please not to expect me to visit after their baby is born. You could have heard a pin drop. I had tears in my eyes and so did they as they gave me big hugs and told me they had no idea I was going through such a struggle.

101.We talked a lot that day, as I told them that I knew this would be a challenge to our friendship. But, after all the conversation died down, we agreed that they could get together for baby-and-mom events without me feeling rejected, and those who are already moms said they know they will welcome the chance to get out and not talk about parenthood after the baby is born. Frankly, I feel lucky to have such good friends. I don't know how things will play out, but at least I raised the subject, I told them what I needed from them, and I can always go back to that if they forget and start to wax poetic about their infants when I'm around."

Religious Rituals The religious rituals a.s.sociated with infants may vary, but their effect on infertile women is often predictable. Here is an event with the focus on a darling little one, with proud parents, grandparents, and other family members gathered in a house of worship for a familiar ritual. Except that you find yourself wishing to be anywhere but focusing on this adorable baby who brings you sadness in the midst of everyone else's happiness. Able as you might have been to remove yourself from pregnant friends and their newborns, the family expectations for your attendance at a religious ritual are often not easy to negotiate. And, to make it worse, this ritual may have been preceded by the request that you be the G.o.dmother of this child, and your need to decline that request. You may find that you identify with the emotions of the women in this chapter who feel trapped by their loved ones' expectations: "When my brother and his wife asked my husband and me to be the G.o.dparents of their baby, I know they were confused 102 Celebrations and Special Events: Coping with Gatherings Coping with Gatherings by our silence and our request to talk it over. Although they knew about our infertility, it turns out that they thought the next best thing would be for us to have a G.o.dchild. Well, maybe that would work for some people, but for my husband and me, being G.o.dparents would just be a constant reminder of the baby we may never have. Both of us had agreed even before my brother's invitation that we would keep our distance from that baby for the first year or two, and then see how painful it was to be around it. So we thanked them for the honor of the invitation and explained that we just weren't emotionally ready to become close to a baby when we couldn't have one of our own. I don't think that my brother and his wife 'got it,' but at least they weren't offended, and fortunately I come from a large family so there are lots of other siblings he can approach." by our silence and our request to talk it over. Although they knew about our infertility, it turns out that they thought the next best thing would be for us to have a G.o.dchild. Well, maybe that would work for some people, but for my husband and me, being G.o.dparents would just be a constant reminder of the baby we may never have. Both of us had agreed even before my brother's invitation that we would keep our distance from that baby for the first year or two, and then see how painful it was to be around it. So we thanked them for the honor of the invitation and explained that we just weren't emotionally ready to become close to a baby when we couldn't have one of our own. I don't think that my brother and his wife 'got it,' but at least they weren't offended, and fortunately I come from a large family so there are lots of other siblings he can approach."

"I agreed to be my best friend's baby's G.o.dmother when both of us were a few months pregnant. Susan and I had both learned we were pregnant with girls, and we had so much fun wondering if they would grow up to be best friends too. Then, at four months, I had a miscarriage; I was devastated. Of course she came right over to the house when I came home from the hospital. We talked and we cried, because it was a loss that touched both of us. A few weeks later I realized that I could not be her baby's G.o.dmother. I knew that Susan's daughter would forever remind me of the baby I lost, and the pain would just be too great if I were her G.o.dmother. When I told this to Susan, it was as if she had antic.i.p.ated my decision - it just shows how well she knows me. And, bless her heart, she told me not to give it another thought, that the important thing is that she and I will always be close, and that it will be up to me to decide how her baby will fit into my life."

103."Christenings are a big thing in our family. They're not just religious occasions, they're an excuse for a family reunion, a chance for the siblings in the family to get together, and an opportunity for the grandparents to admire their brood. Since most of my siblings live nearby, and even those who live far away fly to town when their babies are to be christened, we see christenings as special family rituals. So with that as a backdrop, imagine my family's reaction when Bruce and I explained that we wouldn't be in town for the next christening. We've been struggling with infertility for five years, and in that time the four christenings we've attended have been progressively more painful. We resent that G.o.d hasn't blessed us with a baby, we have no interest in doting on any more family newborns, and I always feel as if I'm in a field of fertile rabbits when I'm around my sisters and sisters-in-law. Needless to say, my parents were floored. The family grapevine began to operate instantly, so I quickly got on the phone to my sister whose baby was to be christened and explained that I was happy for her baby's healthy birth, but being infertile has made both Bruce and me very sad around newborns. She said that she wished we would change our minds, and I said it would only increase our feelings of unhappiness to come to the christening when our hearts were aching. I explained that this had to do with taking care of ourselves at a stressful time, and that in no way did I want to take away from her joy of being a new mother. I think it helped to be direct about it, but it was one of the most difficult conversations I've ever had."

"I was raised in a Catholic family. So the Church was a big issue when I came out as a lesbian and had a commitment ceremony joining me to Janet five years later. My parents attended the ceremony reluctantly, more because they didn't want to lose me 104 Celebrations and Special Events: Coping with Gatherings Coping with Gatherings than because they accepted Janet into our family. So now that I'm going through donor insemination, my parents are raising the importance of having the baby baptized. Frankly, since I've been trying unsuccessfully to get pregnant for six months, I have no interest in a baptism. Especially a baptism in the Catholic Church, where being a lesbian is tons worse than being a lapsed Catholic. But this is going to be a big deal with my parents, who probably want to protect the baby against our 'lifestyle' and think that a baptism is a good start in that direction." than because they accepted Janet into our family. So now that I'm going through donor insemination, my parents are raising the importance of having the baby baptized. Frankly, since I've been trying unsuccessfully to get pregnant for six months, I have no interest in a baptism. Especially a baptism in the Catholic Church, where being a lesbian is tons worse than being a lapsed Catholic. But this is going to be a big deal with my parents, who probably want to protect the baby against our 'lifestyle' and think that a baptism is a good start in that direction."

"After my sister had a baby boy, the bris was scheduled at the temple and Jacob and I were expected to attend. I had concentrated so much on how I could minimize contact with this new baby that I'd completely forgotten about the bris, where everyone would be celebrating my nephew's healthy birth. I didn't have the courage to absent myself from the bris itself, but Jacob and I sat way in the back of the temple, and we left as soon as we could.

I know my mother felt we were being rude, and I suspect my sister did too, but I thought we fulfilled my family obligation by being there at all. I've resolved that if anyone in the family makes so much as a reference to our brief partic.i.p.ation, I'll remind them that our infertility feels like an open wound when we're around babies, and we did the best we could to honor our new nephew while still taking care of ourselves."

Holidays Holidays are times that families come together. They are times that people celebrate. And they are often symbolically linked with hopefulness, thanksgiving, and parenthood, none of which will be high on your list of topics close to your heart. To make the holidays even more toxic, this often is a time when the 105family gathering focuses on infants or young children, and where various relatives will be pregnant or nursing. We all know that holidays, joyful as they are expected to be, can be a source of stress for anyone trying to meet high expectations of these family events. But infertility introduces an additional stress for you if you are trying to keep your distance from babies and pregnant relatives. So see whether any of these scenarios strike a responsive chord (and make a mental note of some the creative solutions proposed for holiday dilemmas): "Thanksgiving is one of the toughest holidays for Jim and me.

The family tradition is to gather at his parents' house, and usually about 20 people are there. For sure at least one person will be pregnant or nursing, and there are always a handful of little kids. So on top of having to celebrate a holiday when I can't think of much to be thankful for, I'm besieged with fertility at every turn. Jim's mom is a dear, and she has been very concerned about us. So Jim and I decided that we would offer to come to the house early in the day and give her lots of help getting the turkey in the oven, getting the table set, bringing over extra chairs, and just having some time to talk to her and his dad without the whole family around. But we told his parents that after the meal, instead of hanging around watching the little kids and listening to his siblings talk about parent-stuff, we would help with the dishes and then leave early to have some quiet time for ourselves. And we explained why. Luckily for us, they understood. And in some ways I think our plan allows them to dote on the grandchildren without feeling hampered by our presence. This arrangement doesn't do anything to help me feel more thankful, but at least I'm not subjecting myself to an unnecessarily lengthy family get-together."

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Celebrations and Special Events: Coping with Gatherings Coping with Gatherings "The holiday I hate most is Mother's Day. For the longest time I was able to see that as a day when my siblings and I sent cards to our mother. Then as my sisters and girlfriends had babies, Mother's Day began to be a day celebrated by my own generation. And I was still able to keep the focus on my mother, so that was okay. But last Mother's Day in church I was floored when a person holding corsages asked if I were a mother. I said no, and the person nodded and didn't give me a corsage. Then it dawned on me that mothers were ent.i.tled to corsages and non-mothers weren't! But it got worse. The minister actually asked all mothers to stand up at one point in the service so that the congregation could pay special tribute to them. At that point I just lost it. I left the church in tears, with Allan close behind me. When I got home and got a grip on myself, I wrote the minister a letter explaining the pain that I had experienced that day in church as someone who wanted more than anything to be a mother. I explained that there were probably others in the congregation whose hearts were aching because of infertility, pregnancy loss, or the death of a child. And I ended by asking that he not make a special tribute to mothers on Mother's Day, since there are many non-mothers in the congregation who love children and who contribute to the lives of children. To my great satisfaction, he telephoned me at home to thank me.

He apologized for having been so shortsighted, and he asked my permission to share my letter, anonymously, with a group of local religious leaders whom he thought could learn from what I had written. So out of my misery did come some good, but I wonder how many other non-mothers have vowed never to go to church on Mother's Day again?"

"This year for Christmas, Art and I have decided to take a trip to the Caribbean. I know my entire family will be shocked 107that we're skipping the celebration, but honestly, each year is getting more painful than the last. My siblings are producing more and more babies, and I'm increasingly stressed out at the sight of the kids opening up their presents and their stockings with adults smiling all around. In my family, Christmas is really focused on the children, which is fine for the kids and their parents, but what about us? Where do we fit in, with no pregnancy for six years, no baby after two miscarriages, and no prospect of becoming parents by Christmas? So this year we'll try something new and see if we can have a soothing and relaxing time away from the reminders of parenthood and Santa Claus."

"You know the holiday that b.u.ms me out the most? Halloween!

Can you believe it? But when I was a kid that was my favorite holiday, and even now the joy of kids getting ready to trick-or-treat can be heard up and down our block. Before we had to deal with infertility, we would decorate our front porch, and I'd get into a wacky costume. But I think this year we'll either hire a neighborhood teenager to answer the door or we'll just darken all our lights and leave town for the evening. It just makes me too sad to see so many little kids when I can't dress up any trick-or-treaters in my family!"

"Making New Year's resolutions has been a miserable challenge ever since we were diagnosed with infertility. It's bad enough that another year has pa.s.sed without a baby to share our lives.

The thought that I should focus on changing or improving something about myself is downright infuriating. Just getting through the year in one piece is an ordeal in itself. I was about at the point of chucking the idea of New Year's resolutions altogether when another infertile friend told me about how she approaches 108 Celebrations and Special Events: Coping with Gatherings Coping with Gatherings the New Year. She makes a commitment to do something for others - whether it's a little volunteer work each month, a good deed for an elderly neighbor, a financial contribution to a worthy cause . . . As she says, infertility is such a self-absorbing phenomenon that unselfish acts help her to focus on the needs of others. That works for me much better than anything that reeks of self-improvement." the New Year. She makes a commitment to do something for others - whether it's a little volunteer work each month, a good deed for an elderly neighbor, a financial contribution to a worthy cause . . . As she says, infertility is such a self-absorbing phenomenon that unselfish acts help her to focus on the needs of others. That works for me much better than anything that reeks of self-improvement."

"Hanukkah is a holiday that always has been lots of fun in our family. When we were little, my brothers and I felt lucky to be Jewish at a time of the year when we would be getting gifts for eight nights and our Christian friends only had Christmas as their gift-giving day. Anyway, now the shoe is on the other foot, as I've been sending gifts to my nieces and nephews year after year, wishing that I had a baby whose eyes would light up at the sight of the menorah candles. So this year I decided that rather than brave the holiday-shopping maze, with all the stressed-out parents and excited children, I would send checks to my nieces and nephews and let them each choose one gift that they know is from Jeff and me. We quietly celebrate Hanukkah at home with potato latkes and lighting the menorah, but the focus is much more on our being together as a couple than it is on making a big production of presents for the children in our extended family."

Family Celebrations Whether the family is just you and your partner, or it extends to other relatives, there are traditions that everyone a.s.sumes you will continue to celebrate, even as your infertility is causing you to re-evaluate whether you want to. How to communicate with family about your different plans "this year," or 109how to regroup and celebrate in a new way, may be challenges you are contemplating. Perhaps these scenarios will sound familiar: "My brother and his wife invite the whole family for their kids'

birthday parties. That usually adds up to about 12 people, most of whom are kids. It's pretty chaotic, not at all relaxing, and increasingly painful as we feel the sadness of being infertile.

So this year we told my brother and sister-in-law that being around that many children was just too much of a reminder of the family life we yearned for. We said that we'd stop by before the party to drop off our gift and give the birthday child a hug, but we wouldn't stay for the party. They seemed surprised, and I really think it never occurred to them that being around children is hard for us. Our plan worked just fine, and we expect we'll continue this way until we have some birthday celebrations that we can invite the cousins to attend."

"Early in our marriage our anniversary was a time that we tried to get away from work for a long weekend together. But the last couple of years we didn't make much of an effort, because one year our anniversary coincided with an infertility procedure, another year I got my period and was so depressed I cancelled our plans. When I mentioned this to the counselor I've been seeing, she reminded me that even when our greatest hopes are denied, we still have choices. She meant that even while we're still not able to have a baby, we can still make choices about creating positive experiences for ourselves. So Sean and I have decided that we'll time our anniversary celebration so it won't conflict with either my ovulation or my period - is that crazy or what? And we've vowed not to raise the topic of our infertility or future options - just to enjoy the anniversary time for 110 Celebrations and Special Events: Coping with Gatherings Coping with Gatherings what it is. With both of us concentrating on making this a special time together, perhaps it will bring some of the comfort back into our marriage after all the stress." what it is. With both of us concentrating on making this a special time together, perhaps it will bring some of the comfort back into our marriage after all the stress."

"My birthday is getting harder and harder to bear. When I was 28 and trying to get pregnant, having a birthday just seemed like another year had gone by. But now that I'm 36, not only have lots lots of years gone by, but with each one I'm losing the likelihood of being able to conceive. So each birthday is now a bitter reminder of diminishing possibilities for a pregnancy. of years gone by, but with each one I'm losing the likelihood of being able to conceive. So each birthday is now a bitter reminder of diminishing possibilities for a pregnancy.

And of course with that perspective, who even wants to celebrate? Not me. I've told everyone in the family that birthdays aren't happy occasions for me, but I've also made some suggestions for those family members who want to give me a gift. Some of them have arranged to send me a lovely bouquet twice a month; another family member knows how much I love fresh oranges and grapefruit in the winter, so she sends me a huge citrus carton every January; and a dear friend who lives in New York uses her frequent-flier miles to send me an airline ticket for a long weekend every spring, and we have a lovely time together. Spreading out my birthday gifts over the year is so much better than being reminded on my birthday that I'm a year older."

Dealing with Gatherings on Your Own Terms Holidays and family celebrations are emotionally loaded, even without infertility as a backdrop. Since so many family events focus on children, you will need to decide whether the familiar and traditional ways of celebrating continue to bring you pleasure. If not, remember that no one should make you feel compelled to partic.i.p.ate in events that are stressful.

111.Often friends and family believe that holidays and family celebrations are a cushion against the stresses of life, that rituals are comforting, and that children are a reminder of the future of the family. But in truth, celebrations often have expectations a.s.sociated with them that are too difficult to fill. The stress of a holiday season can leave the celebrants more exhausted than exhilarated, and the large gathering of family members often precludes any meaningful one-on-one conversations. Individuals trying to conceive are not alone in feeling shortchanged and short-tempered at holiday time; however, at least you are more clear than most about the source of your lingering sadness. That knowledge can empower you to make constructive changes in the familiar rituals that have acquired sharp edges.

In addition, you can choose to take the opportunity to enlighten friends and family members about your reasons for changing your partic.i.p.ation in celebrations. Infertility is not an invisible force in your life, and your loved ones need to know that you are working hard to make constructive decisions. You will want to emphasize that your decision has to do with taking care of yourself at a difficult time and you are not upset with them in any way. Even though the effect of your decision is to change familiar rituals, you need to ask your friends and family to be understanding and supportive.

Therapeutic Tips We begin by a.s.suming that because your loved ones believe family traditions are joyful, they are blind to the pain they may cause for you. Your loved ones look forward to rituals as the glue that holds the family together; you, on the other hand, know that some of these rituals are an increasing source of alienation and sadness as you yearn for motherhood.

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Celebrations and Special Events: Coping with Gatherings Coping with Gatherings So it's time to clarify your needs around how to avoid or redefine painful rituals; it's time to be clear with loved ones about your new decisions; it's time to emphasize that your focus is on taking care of yourself; and it's time, hopefully, to express to loved ones how they can be supportive and how much you appreciate their understanding: So it's time to clarify your needs around how to avoid or redefine painful rituals; it's time to be clear with loved ones about your new decisions; it's time to emphasize that your focus is on taking care of yourself; and it's time, hopefully, to express to loved ones how they can be supportive and how much you appreciate their understanding: * Suggest new family rituals.

* Redefine the ways in which you partic.i.p.ate in seasonal celebrations.

* Include your infertile friends in your lives at times of the year that are filled with children.

* Focus on yourself and your partner as a family in your own right - stop trying to "fit in" to celebrations and instead define your own form of celebration.

* Emphasize the enduring love that you and your partner share, your readiness to honor both sadness and joy, and your commitment to those friends and family members who understand how infertility is shaping your life.

* Above all, be kind to yourself. Learn what leisure activities you enjoy most, what friends and relatives are most understanding, and what new rituals bring you the most comfort - and then indulge yourself!

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