Taking Baby Steps. Jody Lyneé Madeira
from the Expedition changed.
Marriages can also be wellsprings of support. Most often, infertility simultaneously stresses and bolsters romantic relations: “It’s very straining on a relationship … ; in another way you’re forced to find strength in each other” (April Baldwin). Men often become emotional anchors for their wives and try to “to be strong for my partner” (Christopher Franklin). As Aaron Schneider explained, “[O]ne of us has to be the level-headed person… . I couldn’t just sit there, and [lie] on the pillow and cry with her all the time about it because it wasn’t going to be helping either one of us, so I had to be … the strong shoulder, … [reassuring her] it’s going to get better, things are going to happen… . it was taking a toll on her; it was taking a toll on me.”
And as old relationships sour, individuals often find solace with new friends who have undergone similar experiences. Danielle Greene recalled, “I had a lot of depression, anxiety, and feeling very alone until I got to a support group to find out that other people were feeling that way.” These new friends model new ways of negotiating infertility and exchange advice on coping strategies. “I was in the support group with other women that were going through infertility as well that probably showed a lot more emotion and had a lot more difficulty,” said Maggie Copeland. “I would say it wasn’t as bad for me.”
Thus, old relationships and routines are stretched and sometimes broken under infertility-related stresses and schedules, and new patterns and partnerships emerge, for better or for worse. However an individual’s Infertility Expedition unravels, it always leaves its mark. If individuals’ remarks communicate nothing else, they convey that infertility is an arduous experience—but perhaps not always an intolerable one. Those diagnosed with infertility choose next steps while mired in an emotional swamp, but the vast majority somehow manage to find their way to solid ground.
CONCLUSION: “ARE WE THERE YET?”
Patients’ and providers’ comments reveal two separate layers of emotional experience: Expeditions, or long-term adaptive periods lasting from suspected infertility to either successful conception or treatment cessation, and Attempts, shorter segments when individuals try to conceive. This model illustrates how emotions change both over monthly cycles and throughout the course of an infertility career, documenting the stages of descent from the precipice and revealing otherwise hidden positive emotions. Emotions play fundamental roles in treatment decisions and personal relationships, spurring their growth, death, and change. Eventually, for individuals who seek fertility treatment, these relationships grow to encompass doctors, nurses, and clinic staff, and they set in motion family-building efforts that trigger the informed consent project.
As of yet, however, we haven’t heard much about desperation, the emotion popularly thought to be most problematic. In reproductive contexts, desperation is a politicized cluster of other emotions—sorrow, preoccupation, restlessness, heedlessness, intense motivation to act, and so on—that critics strategically use in ways that fuel infertility-related stereotypes of individuals who can’t make good choices. These stereotypes exert real influence over individuals’ infertility experiences. But are they accurate?
CHAPTER 2
“The Heart Wants What
the Heart Wants”
Patients’ and Providers’ Reflections on Desperation
I would define desperation the same way the Supreme Court did when ruling on obscenity back in the ’60s: I know it when I see it. Or, rather, when I feel it. It’s when I have no other options, or when none of the options available to me are realistic or helpful. It’s when things seem impossibly tough, but I know that there’s no cavalry coming to save the day, so I pin all my hopes on something that might have low odds of success. It’s when there’s no Plan B—or when Plan B has been exhausted in favor of Plans C, D, E, and F and I’m wondering how far down the alphabet I can go before I give up… . I’ve been desperate for a crystal ball to find out whether this story would have a happy ending, for my baby’s health and life and for my own mental and physical well-being… . I’ve been desperate for time to pass so I can put miles between where I’m now and where I started this process, and I’ve been desperate for time to slow down since I fear that the worst is yet to come.
—Jade Jones
In 1978, the birth of a baby girl named Louise Brown produced a seismic shift in reproductive medicine. Louise was no ordinary baby, but the first child to be born through IVF. No longer was infertility an automatic life sentence to involuntary childlessness, to be negotiated only through adoption or donor sperm and IUI. For those with resources, like insurance, savings, credit cards, and generous relatives, IVF offered new opportunities to get pregnant. Intervening decades have brought new technological breakthroughs, but fairly stable (and high) prices. But with these reproductive medical advances come the emotional, psychological, and financial realities of unequal access. Others who can afford such treatment may find it’s not successful. For many, the dream of a biologically related child still shimmers on the horizon, seemingly just out of reach.
For decades, many have used the term “desperate” to describe individuals caught up in conceiving.1 If emotions like anger, frustration, and sadness are thought to warp decision making, then desperation is allegedly the worst of the lot, ostensibly robbing individuals of rationality and even competency. The “desperate” label has become highly politicized, used to create (or have the effect of creating) a power relationship, in which individuals experiencing infertility are subordinate to others, most often medical professionals. “Desperation” signals unease with emotion’s role in decision making—and with reproductive decision makers. Unsurprisingly, it is a label almost exclusively applied to females, like the “hysteria” diagnosis used to marginalize women in the nineteenth and early twentieth centuries.2
Legislators, policymakers, and the entertainment media frequently use a discourse of desperation and emotional extremism to justify proposals for ART regulation. As Dr. Stefanie Burgstaller observed, “it seems like movie stars and people in People magazine are frequently conceiving by infertility treatments, and they’re kind of portrayed as being devastated if it’s not happening and ecstatic if it does.” It gets to the point where it’s hard for clinics to get magazines for their waiting rooms, since “patients … complain that … almost every cover is about whether or not someone’s pregnant” (Dr. Burgstaller). Other critics use the term “desperation” as shorthand for concern about infertility’s emotional repercussions, the commodification of reproductive processes and products, and the potential for coercion and exploitation. Meanwhile, this characterization has fueled negative stereotypes of women experiencing infertility, who appear selfish, obsessed, and rude on the one hand or helpless or pathologically depressed on the other. Perhaps the most desperate of desperate women are those, like Lisa Montgomery or Korena Roberts,3 who murder other women who are pregnant and nearly full-term, cutting the babies from their dead mothers’ wombs.
These arguments also come into play in related contexts like abortion.4 Here, advocates champion women’s right to choose to terminate a pregnancy—an option that, like trying to create a pregnancy through IVF, is a reproductive decision. Sometimes, women undergoing IVF are labeled desperate, and those choosing abortion are not. But why should we trust women’s decisions in one context, but not in another? Shouldn’t we trust all such choices, without good reason to believe such trust is misplaced? Why are emotion-related rationales necessary for regulating reproductive technologies in the first place, when such calls could logically come from IVF’s scientific, medical, and ethical risks, like multiple births?
DESPERATE MEASURES, MEASURING DESPERATION
“Desperation” might not even be an identity that many women actually own in conventional ways. When interviewed, several were surprised when asked whether they felt desperate, and instantly denied that it (or related stereotypes) applied to them. For instance, Jackie Carson would’ve gone to great lengths to conceive, but she found “desperation” offensive: “Anything legal I would’ve done, probably, … if you had given me herbs, I would’ve taken them; I would’ve stood on my head for 20 minutes. But … I don’t