How to Make a Family: The Blog

Never Mind The Menopause. There's A Tsunami of Children.

I ran across this synopsis of fun facts about reproductive stuff via the headline "6,000 Women A Day Hit Menopause" -- and believe me, that's definitely not the most entertaining tidbit in the piece by Leslie Mann on the Baltimore Sun. In fact, I'm not sure why they chose to pull that one data point from the American Congress of Obstetricians and Gynecologists' "2011Women's Health Stats and Facts" to highlight, except that the editors might think it's alarming. 

Why do we think menopause is alarming?? Tons of reasons. Don't get me started. But for the record, I don't think the absolutely natural and normal cessation of menstruation and fertility warrants headlines. If it were up to me, I'd have pulled this fact to head up the article:

"Assisted-reproductive therapy, or ART, an infertility treatment, is on the increase, catering to women with an average age of 36, and resulting in more than 600,000 babies a year."

600,000 babies a year. From ART. 

Y'all know me. An earlier sentence in the piece ("Only 12 percent of women suffer from infertility.") had me grumbling and mumbling about how 12% isn't nearly as high as the industry likes you to think and how it all depends on your definition of the terms. I'm up to here with other headlines that shriek about infertility being "on the rise", while The Roommate (a much real-er scientist than I) says 12% is indeed pretty impressive.

When I got to the paragraph about offspring and read that aloud to The Roommate, he exclaimed, "600,000?!"

Me: "Yep. Crazy, huh?"

Roomie: "Yeah! That's like, like, like a..."

Me: "A tsunami?"

Roomie: "Yeah! A tsunami of wanted children!"

And I smiled. 

And that, my friends, is how perspective adds up to everything. And, fortunately, how quickly mine can change on a good day.

 

Quick Hit: Pioneers Have More Babies

While you're wondering and worrying about why you and yours are having trouble disseminating your DNA, here's a short blogpost about an interesting population study, kindly passed on by my scientific Roomie.

It's not so helpful in terms of your own fertility struggles to know things like "Pioneers tend to have more babies" -- but data about unassisted fertility in populations might give you pause to think.

I wonder all the time about long-term consequences of reproductive medicine success in terms of the species. Part of that's the influence of my roommate, the mathematical biologist, but related notions have been bumping around in my head since way back when I was trying to force my own DNA to descend. 

Do you ever wonder what the Big Picture will look like for humans once we've truly nailed this whole "I want a baby, therefore, I will have one" thing? I ponder it constantly. Beyond the concept of "rights" -- the umbrella question is how will we wind up once we're decades past adherence to "laws of nature"?

If you're not up to reading the blogpost or study, here are a couple of snippets:

The study analyzed marriage and birth records in Canada’s Charlevoix Saguenay Lac-Saint-Jean region (northeast of Quebec City) and found that “families living on the edges of the expansions had 20 percent more children than families living at the settlement’s core. They also married one year earlier, on average, and contributed up to four times more genes to the region’s current population.”

and

Pioneering ancestors with high fertility had children who also eventually had high fertility...

And Always Let Your Conscience Be Your Guide

You grew up thinking all doctors were devoted altruists, right? That they go into the medical profession to devote their energy to helping people -- not to make money. Okay, maybe if you grew up in the 80's or later, not so much, but a whole lot of us had those crazy thoughts, which explains the fussing and fretting when docs became legally allowed to market their services.

You didn't know there was a time when that was illegal, huh? (You know, it kinda sucks when I can no longer refer to myself as prematurely gray...)

But yes: Prior to a 1977 U.S. Supreme Court case (Bates v State Bar of Arizona), it was illegal for certain professionals (like doctors) to advertise or market their services or fees. Ah, those were the days.

Granted, most docs were slow on the uptake of selling themselves. That might be a little proof that, indeed, most physicians consider the practice of medicine to be a privilege bound by an ethical oath. But I don't know.

Today I learned that the Association of Reproductive Managers who attend the annual ASRM gathering will be taught the secrets that Disney knows for making happy customers. 

Reproductive Managers go by a few other similar names, too -- for example, Practice Manager or even Executive Director -- but they all share in common the tasks of running the business end of medical practices. RMs are all about keeping the lights on so your fertility specialist can see during exams, and about keeping those nurses paid. 

They're also about managing the creation of more business. After all, even though some of us unlucky infertile souls spend years and years cycling in and out of the clinic doors, most of us are only there for a year or so before moving on, one way or another. And let's face it: reproductive medicine is elective medicine. (You may want to die if you can't have a baby, but you won't really meet your Maker just because you're infertile.) So no matter how many people are struggling to get pregnant, there's always going to be a need to replenish the supply of patients. Kind of hard to believe, isn't it?

Speaking of make-believe: Who better than Disney, American marketing royalty, to impart inspired techniques for bringing both a dreamily hopeful smile and a poignant tear to the faces of millions?

Personally, I'm glad RMs exist. I like the thought that physicians can go about their healing activities without having to worry about (at least on a day-to-day basis) whether the janitorial staff was paid. And now they'll come back from ASRM whistling, "When you wish upon a star..."

I Just Want You All To Have Plain Ol' Health Insurance

At the risk of sounding like a crabby old mama who finally got hers and has no memory left, I feel compelled to finally say what I think about the notion of insurance for infertility treatment. 

Okay, it's not exactly the first time. But it's been awhile, and I don't think I've ever approached the touchy topic from this angle.

"Touchy?" you ask. What could be sensitive about insurance coverage for medical treatments that help men and women achieve what's supposed to be a natural life event, namely, procreation?

Most readers of this blog already know that most people have no insurance coverage for infertility treatment. It feels unfair to those who want that coverage. Even people with huge policies can't get their fertility treatment paid for. It's an old story and one that's been hammered on for decades now by advocates and patients and, sometimes, physicians who each year encourage legislation at different levels that will presumably, one fine day, make all things equal.

So what nudged me over the edge today?

An innocent Facebook post by RESOLVE, echoing the sentiment of Parents Magazine in wishing that all states would mandate fertility insurance coverage. (For those of my friends not in know, some states already do...)

Anybody ever vote for elected officials here?
Ever heard of "divide and conquer" as a strategy to defeat a group's ideas?

Folks. Are you aware of the current situation in this country regarding plain ol' ordinary health insurance?

From CNN's The Chart, March 23, 2011:

"Almost 50 million Americans are without health insurance– 3 million more than a year ago, according to a report from the Centers for Disease Control and Prevention.  The report finds one in five people were uninsured during some portion of the last 12 months."

You know, I was going to rant on and on like I tend to do, but really, I don't think I need to say anything else. Pretty sure you're all smart enough to figure this point out on your own.

Infertiles Speak Bigger Truths Than They Realize

Melanie Notkin writes about her truth as a woman who wants to be in a loving partnership before making a baby, and about how that truth is keeping her from that baby. She calls is "circumstantial infertility," a term that once applied to me. I like it a lot, that term. 

Most importantly, Melanie is writing about how life's circumstances are requiring her to re-write her personal story.

That's pretty much all our lives are -- stories we tell ourselves. Even documentable events can be spun and twisted to match our comfort level. The Infertility Chapter for most of us is one that we'd rather skip over. But here we are. And so we share it in hopes of "getting over" it. How selfish of us, no? Blathering on and on about our misery...

Here's the upside: I think it's possible, given how public conversations can be broadly influential over time, that all this infertility talk out in the open might actually benefit far more than just those who are struggling to get pregnant.

In a follow-up piece about being invisible, Melanie refers to the incredible viral nature of that first blogpost and to the many insensitive responses she received from readers. 

She hit a nerve.

I think it's possible that our discussions about parenthood and biological drives and obstacles in the mix might promote talk within the larger society about really tough ideas, concepts that are bigger in a way than just "who 'gets to' have a baby".

My own infertility struggle brought me face-to-face with myself, or at least the person I thought I was. I've seen countless others echo that experience. Many of us believed without even thinking the thoughts out loud in our heads that parenthood was It, The Pinnacle, The Reason We Are Here (both as individuals and as a species). We still find a lot of reasons to hang on to that notion.

But maybe all this talk about struggling to do something (get pregnant/have a baby) deemed by everyone from "Society" to our own tortured psyches to be the raison d'être to such an extent that we believe if we cannot clear those hurdles, we are doomed... maybe the conversation will finally take us beyond that singular drive.

I don't mean to minimize the emotions. I believe wholeheartedly in the impact of biological drives on virtually everything we think, feel, and do. But I think I'm hearing the winds of change, or maybe I should call it a breeze at this point, in online conversations as people start to think more deeply beyond the initial "OMG I can't have a baby! What do I do now?!"

Most people are not so lucky as to have life present them with opportunities to truly delve into their motivations. Infertility -- if used well -- will make you wonder why you want kids in the first place. And not just in that off-hand, silly way that haggard parents wonder ("What was I thinking?!" the mom said as the children climbed the walls.) But in a way that, for me and some others, required dredging the depths of my soul, murky and smelly, and bringing that muck and mire up to the surface to show it some light. And of course, as those of us who've done it know, once you see that stuff more clearly, it's easier to move on, whether that means keepin' on that TTC path or choosing a different truth about yourself.
I don't think the "infertiles" of the world should keep that life-changing exercise to themselves. 

For a second, just ponder what a world would be like if everyone of us clearly understood this drive to parent -- not as a species, but as individuals. And then imagine if that same world offered no societal bias about whether or not individuals became parents, so that each person could truly make that personal choice without fear of being judged or ostracized. Now, think about the children who might be created in such a world. 

It's a tough thing to do, re-writing our stories. Some of us find ourselves in circumstances that make those revisions essential to our existence here. Bringing it up out there in "the Fertile World" is our way of offering what we've learned, not about infertility, but about living life.