SWEET GRAPES
How to Stop Being Infertile And Start Living Again
Jean W. Carter and Michael Carter
Perspectives Press
Indianapolis, IN
Smashwords Edition License Notes: This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person with whom you share it. If you’re reading this book and did not purchase it, or it was not purchase for your use only, then you should return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this and all author
Copyright © 1998 by Michael Carter and Jean W. Carter All rights reserved. No part of this book may be reproduced in any manner or form whatsoever, electrical or mechanical, including photocopying, recording, internet or information storage and retrieval systems, without written permission, except in the case of brief quotations embodied in critical articles and reviews. For information address the publisher:
Perspectives Press
P.O. Box 90318
Indianapolis, IN 46290-0318
USA
(317)872-3055
http://www.perspectivespress.com
Book design by
Wade Smola, T-Square Design, Fort Wayne, IN
Manufactured in the United States of America
Softcover ISBN 0-944934-23-4
ebook ISBN 0-9449344-40-4
Library of Congress Cataloging in Publication Data:
Carter, Jean W., 1951-
Sweet Grapes : how to stop being infertile and start living again / Jean W. Carter and Michael Carter — rev.
p. cm.
Bibliography : p.
Hardcover, ISBN 0-9609504-9-4
Paperback, ISBN 0-944934-01-3
Paperback, revised, ISBN 0-944934-23-4
1. Infertility — Popular works. 2. Childlessness
I. Carter, Michael, 1950- . II. Title
RC889.C37 1998
155.9' 16—de20
97-34135
CIP
To Janice Wheater Cowen, who inspired, encouraged, nudged, pushed, and nagged this book into existence.
“The Fox and the Grapes” from Aesop's Fables
One hot summer's day a fox was strolling through an orchard when he came to a bunch of grapes just ripening on a vine which had been trained over a lofty branch. “Just the thing to quench my thirst,” quoth he. Drawing back a few paces, he took a run and a jump and just missed the bunch. Turning round again with a One, Two, Three, he jumped up, but with no greater success. Again and again he tried after the tempting morsel, but at last had to give it up and walked away with his nose in the air, saying: “I am sure they are sour.”
Preface
This is a book about hope, the hope that you can stop being infertile and start living again. However, we want to make it clear from the beginning that we're not talking about techniques for getting pregnant. Our subject is how to stop being infertile even if you can't get pregnant, either by living a happy and meaningful life without children or by adopting a child.
In other words, this is a book about changing the sour grapes of Aesop's fable into sweet grapes.
We have written this book primarily for people who are infertile and could use some hope to get them through their infertility crisis. Some of you may be just beginning that crisis. Perhaps you have recently been diagnosed as infertile and are trying to find out what to expect, what your future could be. The good news is that your chances of getting pregnant and having a child of your own genetic structure are very good. But right now you just don't know. We recognize that you may feel uncomfortable with the topic of this book because it makes you think about the possibility that you might not be able to give birth to a child after all. That could be a scary thought, one that you might not want to consider. In fact, you might not even want to pick up a book like this because of the fears that it may raise.
We're glad you have picked it up anyway. One of the purposes of this book is to help you see that there is life after infertility—and it can be a good life. And we think that it's important, even at your stage, to be at least aware of what is before you. If, by some chance, you are among the relatively small percentage of infertile couples who cannot conceive, then we hope to demonstrate that the potential exists for something good to come out of your infertility.
Or perhaps you are well along in your infertility treatment and find yourself thinking about whether or not you should stop treatment and what to do if you do stop. You may be considering traditional adoption or artificial insemination or surrogacy. You may have heard people talk casually about “living childfree” and want to find out more about what that means. Our purpose is to help you make your decisions—to go to an adoption agency, to find out more about artificial insemination or surrogacy, to try further medical treatment, or to live happily without children. We are by no means recommending one option over any other. That is your choice. Our message is that it's important that you make a choice, whatever that choice may be.
Or maybe you have already stopped treatment but are still unsatisfied with your childless life. You are probably unsatisfied because you have drifted along in your infertility. You haven't adopted—and have no plans to adopt—but you also haven't, as a couple, put your infertility behind you and moved on to a better life. Maybe you are even still vaguely hoping that the next month will bring a miracle, only to have that hope turn against you once again. The likely scenario is that one of you is reasonably satisfied with the status quo or is simply not talking about your infertility, thinking that it's all over. The other one, however, is still in turmoil—stewing quietly but still stewing.
It's a painful situation because the trauma of your infertility has never been put to rest. We hope that this book may encourage you to take the issue of your infertility off the back burner and deal with it again. The payoff is that you may be able to transform yourself from childless to childfree, from a life defined by what you don't have to a life defined by the opportunities that living without children can bring. It's something that only you (and maybe a counselor for some guidance) can do for yourselves.
At whatever stage you are, there is hope that your infertility crisis can be resolved and you can get on with your life, even if you don't end up with a child.
As we have been writing and talking to others, we have realized that there are also other readers who might be interested in this book, readers who aren't themselves infertile. Some of these are counselors who work with infertile people. Others are relatives and friends of infertile couples who have chosen to live happily without children. There are many books on adoption, but we have found none on living childfree after infertility. If you choose to live childfree, you may want to send this book to people you care about so that they can better understand what your decision means.
And there is another group who is often left out of discussions of living without children because they are not actually medically infertile. These are people who are not able to have children for other reasons. A therapist friend of ours calls these the “forced childless.” Perhaps you are unmarried, have gotten married too late, or have been widowed or divorced before having children. You, too, can change childless into childfree. Though our main audience in this book is infertile couples, we are also talking to you.
Over the years, we have developed a lot of expertise in how to stop being infertile. We want to make it clear, though, that in spite of the fact that we have letters after our names, we are not experts in the usual sense. That is to say, we are not counselors or social workers or therapists who would treat the issue as professionals. Mike is an English professor and Jean is an obstetrician-gynecologist. Jean, of course, has worked extensively with infertile people in her medical practice, but this book is not about the medical aspects of infertility.
In fact, it's not a medical book at all. And it's not a legal or scientific book, either. This is because no longer being infertile is not a medical, legal, or scientific issue. It is a human issue. About loss and the way people respond to it and the positive potential that it offers. And our treatment of the loss of infertility and the gain that can come of it has important ramifications for other losses in our lives.
Our knowledge about the possibilities of getting beyond infertility comes from three sources. The first is our own experience. We were infertile and understand what it is like to be infertile. We have come out of our infertility by choosing to live childfree, so much of what we write comes out of our personal knowledge.
What we lacked in experience we found elsewhere. One of those other sources was research. To find out more about what it means to no longer be infertile, we hit the books. We read psychological and sociological studies, histories, advice from counselors, and all sorts of articles.
But perhaps the most valuable source was the experience of other infertile couples. We have listened to them at the many talks we have given on living childfree. We have read their letters, solicited through the newsletters of RESOLVE, the national infertility support group. And we have read their articles and books. We have learned a lot from all these articulate and sensitive infertile people, from the questions they asked, from the answers they offered, and from the stories they told.
We are particularly indebted to all the people who wrote to us when we asked for their insights into childfree living. Replies came from all parts of the country, from people with many different stories to tell. Some of these stories were written, we are sure, at the cost of great pain. We learned something valuable from each one.
We would like to be able to acknowledge the contribution each of these people made to this book, but we will honor their privacy by using their material anonymously. When we have quoted from their letters, we have used only a fictitious first name. When we cite sources in the public domain or sources who did not request anonymity, we have used the full name.
We are also grateful to RESOLVE, Inc., and all the wonderful people connected with it. Without RESOLVE we probably would never have found our way out of our own infertility crisis. And in the writing of this book, RESOLVE enabled us to meet, correspond with, and read articles by many who had something to teach us.
We want to give special thanks to Janice W Cowen, Carol Frost Vercollone, and Carol Hallenbeck who gave us careful, insightful, and very helpful readings of earlier versions of the book, readings that resulted in significant improvements to the style and substance of the book. They all understand the difference between what writers want to hear and what they need to hear. And to this group we add Patricia Irwin Johnston—far more patient, understanding, and constructive than the average editor.
One last thank you—to Purcy and Jean Carter and Jack and Susie Whitmore, our parents—for their unfailing love and support and the courage to go with us wherever our choices take us.
Introduction Fertile, Infertile and No Longer Interfile
1. An Alternative to Fertile and Infertile
How many times have you wished that you were not infertile? Maybe you have had dreams in which you were no longer infertile. In the dream, your doctor comes out of her office and says that it's all been a terrible mistake: you aren't infertile after all. She is very sorry to have put you through so much trouble, but you aren't listening to her apology because you are so happy that you are no longer infertile. But then you wake up.
We spent a lot of time wishing that we weren't infertile, and now we are happy to say that our wish has come true. But not in the way we expected. We never were able to have children biologically and we didn't adopt. But we definitely consider ourselves no longer infertile.
Is this a contradiction? We don't think so. The problem is that for most people, fertility and infertility are the only two alternatives. If you are not fertile, you must be infertile. And if you are not infertile, you must be fertile. That sounds logical. But in this book, we want to offer a third option, one that might not seem so logical at first. We think that you can stop being infertile even if you are not fertile.
If this is starting to sound like gibberish, let's try to make sense of the issue by looking at it from a different angle. Medically speaking, you are defined as infertile when you have been trying to get pregnant without success for a certain period of time, usually about a year. At that point you are labeled officially infertile and most doctors will advise some sort of medical investigation to determine the source of the problem. For most people, the elements of this medical definition that are most important are “without success” and “for about a year.” Thus, it seems that if you have ever been labeled as infertile and haven't been able to have children, you will always be infertile.
For us, however, the most important part of this definition is “trying to get pregnant.” If a couple never did try to get pregnant, then they would not be called infertile, whether or not they actually could, in theory, have children. And, following that logic, when a couple is no longer “trying to get pregnant,” they are no longer infertile. They no longer have the medical problem called infertility.
According to this medical definition, infertility is a very specific and limited condition. It doesn't mean that your marriage is infertile or that your life is infertile or that you are a general failure. But what is especially helpful about this view of infertility is that it suggests that there is more than one way to “cure” infertility. One is by becoming fertile, having a child of your own genetic structure. That's the cure we all hope for during our infertility workup and treatment. But there is another cure, too: by no longer wanting to get pregnant. One way to effect this second cure is by putting your dreams of a biological child behind you and deciding to adopt. Another way is by discovering that for you, life without children can be rich and satisfying, and thus you no longer want to have children.
Either way, there is hope that you can no longer be infertile without necessarily being fertile.
It is important to understand, though, that when we talk of no longer being infertile we do not mean some magic state in which your feelings of loss have completely disappeared. Perhaps the best way to understand this is to look at what infertile means. Infertility is a negative concept. Continuing with our medical perspective, infertility is a condition characterized by wanting what you don't have—a biological child, of course. Being infertile means defining your life according to the loss of your fertility.
But as the title of this book suggests, we believe that there is another way to define your life. This is why we offer the alternative of no longer infertile, or no longer actively infertile. We don't want to imply, however, that your loss simply vanishes. It will always be there. It is an important part of who you are. Instead, no longer infertile means that in the loss of your fertility you can find the potential for gain. The alternative to infertility— that is, the alternative to defining your life according to what you don't have—is to define your life according to what you do have and can have.
What you do have is the strength and resiliance that your marriage has developed as you have wrestled with your infertility. What you can have is the opportunity to live happily without children or to build an adoptive family. Thus, no longer infertile means that you can embrace both the loss and the gain that comes with infertility. Sometimes you will feel the loss more than the gain. But on the whole, it is the gain that becomes the theme of your life.
And it is this gain that is also the theme of this book.
2. Childfree and Adoption
Our route to no longer being infertile was deciding to make our lives good without children. We describe this as living childfree. We have found, however, that childfree is one of those words that people use (and misuse) in a lot of different ways. And that's one of the reasons we have written this book—to try to clear up some of the misunderstanding about what childfree is and how to become childfree. And because much of the focus of this book is on the concept of childfree, we won't talk about it anymore right here.
But it is important to talk more about the other route to no longer being infertile—putting your dreams of a biological child behind you and deciding to adopt. Adoption, however, is no longer as simple a term as it used to be. In the past, it meant that a couple would rear a child borne by someone else and having genetic structure from neither member of that couple. Because of newer technologies, though, a couple can now parent a child with the genes of only the mother or only the father (in combination with a donor's genes) such as in donor insemination (DI) or surrogacy. And embryo transplantation makes it possible for a mother to carry a fetus with whom she shares no genes or for a surrogate mother to carry a fetus with the genes of another couple who will become that child's parents. The possibilities are becoming more and more complex.
What unites all these methods is that they involve a process of adoption. But it's important to understand that when we use the word “adoption” this way, we are not referring just to its narrow legal definition. Rather, we are talking about the psychological process of claiming as your own a child that is not automatically yours by nature: a child who possesses the genetic material of someone other than the parents or a child whose birth mother or birth father is not a part of the couple who raises the child. And for the purposes of making decisions about how to become no longer infertile by adoption, it's important to make a distinction between these methods of adoption. We will discuss these distinctions in Chapter Eight. For now, though, we will lump them all together and refer to them simply as adoption.
Many people assume that adopting a child will automatically make them stop feeling infertile. However, Michael Humphrey, in his study of adopting couples, says that adoption may solve the problem of a couple's childlessness but not the problem of their infertility. These are two different problems. He suggests that a couple can adopt a child and still feel infertile.
Other experts on adoption agree with Humphrey. Reuben Pannor of the Vista Del Mar Child-Care Services says, “First and foremost, the couple must work through the feelings of guilt and loss arising from the infertility of their marriage and come to a mature understanding and acceptance of it as a fact of life that cannot be altered by adopting a child or by any other means. Until this kind of emotional resolution is achieved, the couple really is not ready to adopt.” Pannor makes the point that adoptive families tend to run into trouble when they use adoption “to avoid resolving the sense of loss infertility brings” (quoted in Gilman). Infertility counselor Roselle Shubin puts it in a way that most infertile couples can easily understand. When she is counseling an infertile couple about their readiness for adoption, she will sometimes ask, “Can you give me your thermometer?” (also quoted in Gilman).
Others talk about the necessity of grieving for your lost biological child. Jacqueline Plumez and Barbara Eck Menning say that a couple must mourn that dream child and give up that dream before they should actively consider adoption.
What's important here is to recognize, as Humphrey says, that adopting a child may solve your childlessness but not necessarily your infertility. The way to resolve your infertility is by becoming no longer infertile—before you adopt! Not being infertile frees you to adopt a child because you want to adopt a child. Without this kind of freedom, Plumez says, the adopted child is likely to be “second best,” only a substitute for your biological child. We have a special name for this state of not being infertile so that you have the opportunity to adopt—being open to adoption.
The problem is that many couples who cannot be fertile continue to live their lives as infertile (as opposed to no longer infertile). If they remain childless, they define their lives in terms of the child they will never have. And even if they adopt they continue to define their lives by the biological child they don't have and continue to hope for. We say that there is another way. No longer being infertile focuses not on the loss but on the possibility for gain. It changes childless into childfree and adoption as second best into adoption as first best.
So childfree and open to adoption are both ways of becoming no longer infertile. We have discovered, though, that a lot of people see them as opposing options. Some think that deciding not to adopt means that they are automatically childfree, and others perceive of childfree as anti-adoption. We will talk in greater length about these misconceptions later, but let's consider them briefly now.
Living childfree and being open to adoption have a lot more in common than most people believe. First of all, both should be the result of a choice. If you think of adoption as simply the next logical step in the infertility process, then perhaps you haven't put your infertility behind you. And if childfree means simply that you don't want to adopt, perhaps you also have not been able to break out of your infertility. Indeed, being open to adoption may be considered “biological childfree.” If childfree is living with the advantages of not having children, then “biological childfree” might be defined as living with the advantage of not having a biological child—that advantage is that you can adopt a child and share in the experience of an adoptive family.
Also, the decision to adopt and the decision to live childfree are both positive choices. And a positive choice cannot be the result of a rejection of something else. A childfree life cannot be founded on a rejection of adoption. People who adopt should not perceive of childfree as a threat. And people who are childfree should not perceive of adoption as a threat. They should both be choices in favor of something, not against.
Finally, they are both an affirmation of a way of life, one an affirmation of a life without children and the other an affirmation of a life with an adopted child. Both depend on this affirmation. In both cases the affirmation leads to something good. In one case it is the possibility of a satisfying life without children, in the other case it is the ability to adopt a child with a different configuration of genes and love him or her as your own.
Childfree and adoption are not opposing positions. They are both indications that you are ready to get on with your life as no longer infertile.
3. The Focus of This Book
The main subject of this book is the childfree way of becoming no longer infertile. We have chosen this focus for several reasons. One is that we are childfree. That is the way we have made the transition from infertile to no longer infertile, so that is what we are most experienced with. Another reason is that childfree is so widely misunderstood. We feel that a large part of our task is to help people understand what childfree is and how to become childfree, an attempt to reduce the confusion about it.
A third reason is that of all the couples who cannot conceive, only about 25% of them even try to adopt (as reported in 1980), a percentage that seems to be dropping. And our experience tells us that many of the people who don't adopt are still focused on the child they don't have; they are still infertile. Because this is such a large group, we wanted to address the potential they possess for living childfree.
Fourth, there are dozens of books on infertility and adoption, but we haven't found another one specifically on living childfree after infertility. We think that this subject demands special considerations that don't appear in books aimed at the voluntarily childfree. And finally, we believe it's important for couples who are considering adoption at least to understand the childfree alternative. We see ourselves as childfree advocates, but we certainly don't recommend it for everyone; however, we do think that adoption should be a choice that a couple makes, and part of making a choice is to consider the other possibilities. Otherwise it's not really a choice.
Though the focus of this book is mainly on childfree, we are also concerned with the larger issue of no longer being infertile. This means that much of what we say about childfree is also relevant to adoption, particularly Chapters Three, Four, Five, and Eight. In Chapter Three we discuss the potential that we all possess for turning the loss of infertility into a gain. In Chapters Four and Five we talk about the crucial role that choice plays in achieving that potential. And in Chapter Eight, we apply what we have said about no longer being infertile specifically to the diverse kinds of adoption.
But even though our emphasis is on no longer being infertile, it's possible to find an even broader focus in this book. It also has implications for other major losses that occur in our lives. It is a book about taking a major loss and finding in it the opportunity for a major gain. Indeed, this may be the greatest lesson of all because it gives us hope that all loss—such as losing a job, living with a less-than-perfect child, getting a divorce, or even dying—offers the potential for growth.
Jean Tells Our Story
We never talked much about children before we got married. They were a part of our distant future and we simply expected them to come, one of life's givens, as inevitable as aging. Our immediate concerns at that time were marriage, school, and managing two careers, in that order. But when we did mention children it was always in sentences that began, “When we have children...”
We got married when I was beginning my third year of medical school and Mike was beginning graduate school in English, so it was easy—necessary even—to postpone children. Five years later, though, as I began to hear the biological clock ticking louder and louder and with the physically most demanding years of a residency in obstetrics and gynecology behind me, we began to talk seriously about having children. To our surprise, we discovered that we felt some ambivalence about the issue. After concentrating so long on our professional lives, we found some self doubt in the face of this new responsibility. It wasn't that either one of us expressed any strong desire not to have children, but we both recognized the seriousness of the step. It wasn't long, though, before we decided yes, we want to have children. We wanted to affirm our belief in life and our love for each other. We may have begun with ambivalence, but we discovered that our desire for children was no less strong for it; in fact, wrestling with the issue may have strengthened that desire. We wanted a child.
The story of the next three years is familiar to most couples who have faced problems with their fertility. At first we felt foolish at the disappointment we felt when my period would come. We knew that it takes time. But when a few months became a year, we began to fear that something might be wrong. As an obstetrician I knew all the advice that doctors gave for getting pregnant, so even before we became infertility patients the basal temperature thermometer became a bedside fixture and sex became a routine dictated by the calendar.
When even these efforts produced no baby, we decided that the time had come to seek help from an infertility specialist. The fact that I was an OB/GYN resident made our infertility workup both easier and more difficult than most couples'. Because I worked with infertility patients myself, I knew where to go for the best care and had easy access to the doctors who could give me that care. But there were disadvantages, too. I had delayed going to see a doctor because of a professional pride that led me to believe that I could solve the problem myself. I also knew all about the difficult tests and procedures that come with an infertility workup and treatment. The worst thing about being an insider, though, was that I was often treated more like a colleague than a patient. I found myself wanting more specific explanations, more counseling, more comforting. And worse yet, I was the one who had to translate all the medical jargon into laymen's terms for Mike, outlining for him the risks and alternatives for tests and treatments. It was hard to do that objectively, particularly when I was the one being discussed!
Physician heal thyself had its humorous side, too. At one point in our workup we were asked to obtain some cervical mucus and mail it in dry ice to a lab in Michigan. Getting the dry ice and packaging was no problem, but getting the mucus was. At that time I was beginning private practice and was unwilling (for reasons of modesty?) to ask my new partners to get the mucus for me. So Mike and I decided to do it ourselves. When the right time of the month came around, we sneaked into my office late at night after everyone, including the janitor, had gone. We felt like comic thieves in a movie and even jumped like frightened deer when a water cooler abruptly turned on. I got into the stirrups and with a hand mirror directed Mike through his first gynecological exam. Mike, who doesn't even like for me to talk about what I do, was sweating awfully under the hot lights he was using to see through the speculum as I called out what to do: “It's that round thing in the middle. No, over there. Yes, that's it. Now take the...” We never did get the mucus but at least Mike no longer suffers from professional envy.