Monday, March 15, 2010

ControverSunday: The Culture of Pregnancy

This week's topic is "The Culture of Pregnancy", and there have been some great posts so far! I am a little late, clearly, as it is Monday night, but bear with me. I'm getting back on track.

There were many good options as far as I was concerned, regarding this topic, but I decided to start at the beginning, so to speak, and talk about my experience with infertility.

I would almost rather not, because it was a very dark time in my life, and I have regrets. Lots of regrets, about how I handled the whole situation. But, best to get it out there, and move on, right?

I was 23. I know, what a perfectly ridiculous age to be panicking over not being able to get pregnant. We decided around January that we were ready to start trying. By Easter, I was convinced I was infertile. I thought due to my age and general health that I would get pregnant right away. Even though I knew it could take a long time for normal, healthy couples to conceive, I was impatient and genuinely scared. See, I'm a very highly strung individual, and I've had anxiety issues since I was a kid. But, that's an (equally ridiculous) story for another time.

In the interest of brevity (not my strong suit, admittedly) I'll just draw up a laundry list of all the steps it took us to get here: I started charting my ovulation, realized this was impossible due to my irregular cycles, saw my OB, got put on Clomid, had a very painful procedure done called an HSG where they inflate a balloon of dye inside your cervix in order to provide contrast to view the fallopian tubes, began to see a fertility doctor, tried insemination (IUI) with Clomid, tried IUI with injections,tried ANOTHER IUI with injections, had another painful procedure known as a saline ultrasound were they fill the uterus with saline (again for contrast), underwent my first IVF cycle, was on moderate bed rest for four days, continued injections, got a positive pregnancy test, miscarried, and finally had a failed IVF cycle before we ran out of insurance money, patience, and sanity.

I guess that was a rather long list, but then again, it was a rather long two years. The shots became part of our daily lives; Chris always did them for me, but there were a few occasions where he just wasn't available. Once I tried to convince a friend to do it for me. She was game until I handed her the syringe She looked at it, looked at my exposed and sanitized patch of skin, and chickened out. So, I plunged the needle into my stomach myself, much to her horror. Those weren't so bad. It was the progesterone shots that had to be administered into my hip that hurt the most. I sported big purple and yellow bruises for months. Luckily, they were hidden by my clothing, but the stains from when the fluid would leak out of my skin and through my pants, were not.

Of course, all the physical pain and discomfort were nothing compared to what was going on in my head. Ugly, regretful feelings, every time I saw a pregnant woman or stroller-pushing mom. It was worse when they were teenagers, which is quite a common sight in my town. Being what I presumed to be "infertile" made me hyper-judgmental of other parents. No one was doing it right, in my book, and therefore no one deserved to be parents as much as Chris and I did. Baby showers filled me with panic and resentment. I could barely sit through one without crying or feeling ill. I hated having to pretend to be happy for my friends when they announced their pregnancies or those of their wives. I WANTED to be happy for them, but lurking at the back of my mind was the fear of never having my turn, and I couldn't shake it.

So, when I say that I have regrets, I mean that there is very little I DON'T regret about those two years. I wish I had been able to shut off the crazy and realize that I was young, and give my body a chance to figure it out before I resorted to such invasive measures. I wish I hadn't dragged my poor husband down with me. After his many failed attempts to reassure me that it would happen for us, he began to believe that perhaps I was right. I regret not being strong enough to revel in the reproductive triumphs of my friends. I regret not visiting my friend in the hospital after she gave birth to her twins because I was too devastated by my recent miscarriage. I regret the countless $30 copays, the gas we wasted on those trips to the clinic, the fees we encountered upon ordering box after box of injectable medication. I REALLY regret all the cocktails I passed up during each one of my cycles.

I suppose it's pointless to get bogged down in the past. And, what I do not regret is the incredible bond that Chris and I developed over going through something so painful together. Even though we looked perfectly ludicrous sitting in that fertility doctor's office amongst all the women in their forties, women who REALLY had it hard. Even though after two years of pumping me full of hormones and draining our bank account, all it took to get me pregnant was a couple of whiskey and Cokes and the backseat of my car. Even though I will always wonder about the baby we lost. I can never truly regret the road that led up to Charlotte, no matter how many syringes and tears were lining it.

Me at the Hollywood Forever cemetery, the night before I found out I was pregnant

But, what I can do is ask a question. And here is where I (finally) get to the controversy: Were the doctors who treated me doing the right thing? When test after invasive test showed that there was nothing really wrong with me, nothing that suggested I would be unable to get pregnant unassisted, were they justified in performing a procedure on me that ultimately cost my insurance company about twenty grand to pull off? Or are they allowed to poke, prod, and inseminate anyone so long as they get paid?

Don't get me wrong. I'm not misplacing the blame. It was my own psychotic willfulness that lobbied for these procedures. But, I am genuinely curious about the line between helping and extorting. I remember pondering this issue when Octomom gave birth to those babies. People were discussing the doctor that implanted those embryos, wondering if he was ethically obligated to refuse to implant so many, especially knowing how many children she had already. Is it his place to refuse, or should a person be given a carte blanche to make irresponsible decisions because it is their body?

I definitely do not have the answer to this one. I guess I feel like a doctor shouldn't be forced to perform a procedure he or she can't reconcile, just like we should not be forced or denied to do something to our bodies we wouldn't choose to do. In my situation, I sincerely wonder if the doctors were only doing what they thought I wanted, trying to appease a customer. Or, were they taking us for a ride, squeezing out every last penny? I know that if they had refused to treat me, I would have been livid. And if they had kept recommending hormone therapy, and never suggested moving on to the next level, we would have stopped going to them. So, maybe they just did what they had to do to keep us coming back for more. But, I am having a hard time coming to terms with it, especially since they suggested the in-vitro. In my mind, that was way too far. Too unnecessary for a 25-year old who had only been trying for less than two years.

So, what do we think? Where do we draw the line between treating a patient and taking advantage of their paranoia and insecurity?

Also, here are the links to the other ControverSunday posts. All done by wonderful bloggers who I am loving getting a chance to read and interact with. Please check them out!

Our Lady of Perpetual Breadcrumbs (Special shout-out to the host!)

Accidents will happen (Special shout-out for the awesome badge!)


I Know Why You're Single (This post offers a pretty good counterpoint to the one I am tiptoeing around. If I elect to have a procedure done, I have to suck it and own the consequences. But does that mean docs should exploit our fears and perform unnecessary procedures just to shut us up and make some money?)

Allison @ Partial Disclosures



  1. Jeremy and I were just talking about doctors and money earlier today, as I was told when I booked a re-check for Olivia's ear, that she couldn't have her 16-month check up at the same time -- the time slot was booked only for sick-child visits. Even though she's going to be there anyway. WTF?!

    Totally different than infertility, but bear with me. See, Jer's response was to point out that the goal is to make me have to come back so that I can be charged more money. Why? Because even though doctors take that whole "I won't harm anyone" oath, they are ultimately trying to run a business. Lame, I know.

    So, yeah. If there was nothing wrong with you, they should have sat you down and just said, "Look..."

    Shiiit. I just lost my train of thought. Making sense late at night is hard, okay? But I reckon you understand the point I'm trying to make... right?

  2. I <3 your writing!! I like that you took the advice from the show and added a picture to break up the blog. ;) I was totally listening!!

  3. This is an interesting post for a lot of reasons. Apparently there are a lot of women who have infertility issues not otherwise specified. (And actually, apparently it's pretty common for it to be the man's issue, but he's not diagnosed until the woman has gone through a bunch of treatments already.)

    Your story was another example of the pre-pregnancy culture in this country, I think. Why do I say that? I think that you probably wouldn't have been as hyper-vigilant about your possible infertility if not for all the scare-mongering stories about women being unable to get pregnant that have become ubiquitous. I mean, just yesterday my mother said to me, "You'd better hurry up and have a baby! You'll be 30 soon and then all your eggs will be rotten!"

    (Additionally, I don't know if you watch Teen Mom (it's on tonight!) but SOOOOO many of those girls/guys say they didn't use protection because they thought they were infertile! At 16!!! What is causing them to think that? The pre-pregnancy culture, I believe.

    Additionally-- I think Kate Gosslin (of Jon & Kate + 8)thought she was infertile at your age too.... and she ended up with 8 kids.

  4. I think the most important thing is to have a great relationship with your doctor. I really think that is the problem today, most of them don't know their patients or if they say something that might offend the patient they are worried about a lawsuit. It took me awhile to have my baby girl witch was so surprising because the boys came so easily but doctors, family and friends said stop thinking about it and it will happen. I hate to admit it but they were right! Doctors should be there for their patients and should be able to talk to them about how they feel, what would be the best way to do something or treat something. These days I think everyone including doctors go a little nuts, but that is their right to do so. It is the same thing as parenting, what may work for one family isn't going to work for other family. I personally don't agree with starting a family at 40 but who am I to say they can't?

  5. This is such an interesting discussion- especially when looking at the ethics of doctors. While I am not sure that the doctor should have refused any treatment if you asked for it, I do think a responsible doctor would have sat you down and said "look." I know just before my husband and I got married my doctor warned me that because I have PCOS (FYI- the same thing that Kate Gosslin has that had her struggling to get pregnant) it could take quite a few years for us to get pregnant. She said she recommended us trying for 2-3 years before we considered even looking into any fertility treatments. (Ironically, we took this that we should start trying right after we were married and we ended up pregnant within a month of our wedding date- so PCOS didn't impact our pregnancy, just breastfeeding.) Anyway, back to my point-- I can't speak for the doctors in the US and I do think you guys have an insane system- but I do think a good doctor who knows you can make all the difference. And I do think there are doctors in Canada who would have taken advantage in the same way. Unfortunately. But could you imagine the uproar if they refused someone and took away their right of choice to choose their medical options?! Tricky subject.

  6. Okay, first of all, I want to say that I am not suggesting the doctor should have refused me treatment. Not, me specifically. I wonder if they should have refused Octomom or that D-list celebrity that just got a plastic surgery overhaul. But, I admitted in my post that if they had refused ME, I would have stopped seeing them. I know they only did what they had to do to keep me as a patient, and I know that they thought they were helping.

    BUT, not only did my doctor not sit me down and have the "Look..." conversation, he SUGGESTED the in-vitro! That's where it gets a little iffy for me.

    I really don't know what the answer is. I know that I take full responsibility for my decisions. It wasn't my doctor's job to fix my crazy head. I just wonder at the lengths to which he was willing to take my treatment considering my undiagnosed issues, age, and how briefly we had been trying.

    You guys bring up some great points about doctors. I received an email from a friend who worked in the field, and she had some really interesting things to say in their defense, but I won't share it on here without her permission. :)

  7. Okay, on the subject of "did the doctors do the wrong thing?" I walk a fine line between "don't trust 'em!" and "They know a LOT I don't know." It's a fairly common experience, from what I've heard, for a woman to be diagnosed as infertile with no known cause (I think it's about 20% of infertility cases). So by doing the crazy invasive tests, they were most likely following a testing procedure that, for some women, gives no answers but doesn't mean that they're "healthy." It means they are infertile for some god-knows-what reason.

    Where I am, you start getting tested after six months of unprotected sex with no pregnancy. I don't know if that's a rule of thumb, though.

    To Hypatia's point about the culture of pre-pregnancy making women crazy, I agree and disagree. Yes, I think that all the talk of infertility makes us worry more. But I also think that it's good that we talk about it, because it's important to remove the stigma, and I also think that the more knowledge we have, the better.

    In our particular case, it was male-factor that worried us (an illness as a kid left hubby with sperm that are sometimes first-rate and sometimes not.) We got pregnant without planning, and with no trouble. But was our doctor wrong to tell us to freeze a good sample, just in case? Nope. Because if he hadn't, and if we were left without options, we would have been devastated.

    I also wanted to address this: "I regret not being strong enough to revel in the reproductive triumphs of my friends." You shouldn't regret this. I really doubt your friends hold this against you. If anything, they felt guilty for having kids while you struggled.

  8. Thanks for the last sentiment. I do hope that's the case.

    Oh, and I totally agree about talking about infertility. I find that it is like miscarriage. People are hesitant to talk about it at first, but once they do, they realize that SO many people have been through it, too. And it makes you feel so much less alone, you know?

  9. i have a friend who's best friend is thoroughly depressed at her inability to get pregnant after two years of trying with her husband. i am constantly telling them your story in hopes that they will find comfort and faith in it.

    love your writing, love how you handle difficult subject matter with delicacy and humor, and, of course, love the picture of you with its caption.

    your baby is the cutest.

    miss you x