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Past Article of the Month
Originally Published 06/04/2011
What Do We Do Next and How Do We Get on the Same Page?
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Craig and Susan have been fighting. Over everything, it seems. Whose turn it is to do the dishes, where to go for dinner, if they should plan a vacation. Oh, and also about whether or not to do another IVF. Susan wants to try again, but Craig is freaking out about the money.
Sound familiar? When a couple is struggling under the weight of a reproductive trauma, it can be exceedingly difficult to know how to proceed. Reproductive technology allows so many options, but none of them are guaranteed, most are physically invasive, and they all cost a tremendous amount. And often, people disagree on what they should do, or do next. The conflicts that arise can leave people feeling confused, alone and angry.
It is terribly important that couples know that such conflicts are very normal and are a direct response to the reproductive trauma; they are not caused by some fundamental flaw in the relationship. Just as an individuals self-esteem suffers in the face of reproductive difficulties, so can a couples shared self-esteem be shaken. Their sense of themselves as a couple no longer seems to fit; couples who felt compatible and supportive prior to their infertility, now find themselves fighting and at odds. Couples who shared dreams and plans now view the future differently. Couples who felt financially secure now worry, to different degrees, about money. They no longer recognize themselves. It can even evoke a disconcerting sense of ambivalence about their partner: Why do I even want to have a child with him/her if s/he is so rigid and/or angry and/or un-understanding? In addition, the person who carries the medical problem may struggle under the added burden of guilt, shame and insecurity, worrying that their partner will not love themor will even leave them--if they cannot provide them with a child. Most often, this fear is completely ungrounded, but can trigger misunderstanding and defensiveness fueling the conflicts between them.
But what to do? How do couples navigate the complex decision-making process and stay connected and true to themselves? The answer to this question lies in one word: compromise. Just as with any difference within a relationship, people must be able to identify their needs, clarify their wishes, and then compromise on areas of disagreement. If Susan wants to do another IVF and Craig is afraid they will run out of money, maybe Susan can sit down with him and go over their finances together. Maybe they can budget a little differently, or consider borrowing some of the funds. Or maybe Craig can agree to one IVF, if Susan assures him that it will be the last one. Or if Craig wants to adopt, perhaps Susan can agree to begin researching adoption even while they embark on an IVF.
Reproductive decision-making is complicated because with each new decision, another piece of the reproductive story must be edited, relinquished and grieved. People will often start the process of baby-making with the proclamation that They would NEVER consider IVFor egg donationor surrogacy or adoption. It is only when prior options are proven unviable, that people will open themselves to other possibilities, and suddenly realize that they are not people who would never but in fact, are people who would, in fact, must consider all sorts of alternative ways of becoming parents.
We often advise couples to spend some time identifying their own reproductive stories, and listening to their partners stories to facilitate the decision-making process. In so doing, they can identify which aspects of parenthood are the most important to each of them, and which they can relinquish. We encourage them to try on the different scenarios, really visualize themselves in each circumstance, before they commit to a single path. We suggest doing this not only for the near term, but to imagine how each experience would feel five, ten, 20 years down the road. For example, if the experience of pregnancy and birth are paramount, then the use of donor technology may be considered. If a biological connection to the child is most important, then surrogacy may be an option. If the goal is to become parents and raise a child no matter what, then adoption comes to the table. If none of these scenarios fit, then remaining a family of two may be the solution. But it is crucial that each option be given full consideration by each member of the couple, without prior judgment. Couples need to agree that they each can verbalize all of their ideas and hopes and that it will not be interpreted by the other as a decision or fact; people need to be free to fantasize without having to feel defensive. This can be challenging, because we all tend to presume that if a person says something, then that must be what they really want, when in fact, they may just be thinking out loud and turning ideas over in their minds. This is part of the process of coming to a decision, not the decision itself.
Finally, it is the rare couple who can gracefully process all the emotions and decisions that they face when enduring reproductive difficulties. We strongly advise all couples to consult with a therapist or other professional to help them maintain their footing as they traverse this all-too-slippery path.
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