From IVF To Miscarriages: 5 Ways We Can Talk About Infertility

By opening up about her struggles with pregnancy, former First Lady Michelle Obama launches a public conversation about something many women suffer in private.


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After two miscarriages at age 41, Amy Klein decided to visit a fertility clinic. It took her five clinics and four years to finally carry a pregnancy to term. And recognizing a void in conversations around fertility and information about it, she began to chronicle her experiences.

She wrote about it in a regular New York Times column, addressing her private concerns in a public way. She became the person people went to for online advice about infertility and in vitro fertilization. But Klein found that the more she wrote and talked about it, the more obvious the need for guidance and support appeared.

The reality is that despite being relatively common, infertility and the use of aids to address it are not something people talk openly about—whether out of embarrassment, lack of education, or society’s expectations of “natural conception.”

“I realized that although people are much more open about infertility, miscarriage, and IVF, women still struggle with getting through the process, from ‘Oh shoot, am I infertile?’ to … ‘How will I pay for all this?’ she says.

 So Klein is writing a book, which she describes as the “A to Z Guide to Infertility.”

The emotional impact of miscarriage and infertility runs deep. And it affects all walks of life, from the woman sitting on the bus beside you to some of our most beloved figures, such as former First Lady Michelle Obama.

In her new book, Becoming, Obama lets readers into some of the darkest and most intimate moments of her life by telling about her struggles with infertility.

By sharing her experience with IVF and the role it played in the conception of daughters Malia and Sasha, Obama is helping start important national conversations about a condition many women suffer in silence.

With the launch of Obama’s book, more women are talking about IVF and infertility. Admitting it openly—in public. The result has been a recognition of how little time we allocate for those who have experienced this arduous yet life-changing procedure to share their stories.

Here are five ways we can continue these conversations.

1. Remove the stigma around infertility

Infertility is still a taboo subject. A woman’s value is deeply intertwined and connected with reproductive expectations. And the stigma surrounding it can magnify its emotional and physical consequences.

After a year of trying when she was 31, Rachael Rifkin went to see a reproductive endocrinologist. She was diagnosed with unexplained infertility. After three rounds of intrauterine insemination and one failed round of IVF, she was implanted with two fertilized eggs, resulting in her son, born in 2015.

A year later, she and her husband got pregnant, unassisted. Rifkin vividly remembers the journey. “I felt like I should have been able to become pregnant with no issues,” she says. “Fertility issues happened to other people. [I felt like] something was wrong with me and my body because I couldn’t conceive.”

The taxing IVF experience coupled with social narratives that fertility and motherhood are negotiable aspects of womanhood, can lead to frustration and self-doubt. For Rifkin, those feelings of ineptitude were the hardest part.

“It could be physically uncomfortable, and the cost was stress-inducing at times,” she says. “But the emotional aspect was the worst: Feeling like something was wrong with me and/or my spouse and not believing it would ever happen.”

2. Address the physical and emotional consequences of IVF

IVF is very invasive. Egg retrievals, embryo transfers, pregnancy testing, and regular hormonal injections, which present their own challenges considering most people hate needles, can aggravate not just the body, but the mind.

Going through that process with no guarantee of success can be so grueling that many begin to wonder if it’s worth it. For women of all ages, the odds of a live birth using IVF are between 34 and 42 percent, over three cycles. The success rate for women using her own eggs declines with age.

“I think everyone gets to the point where they feel, ‘Maybe I’m not meant to be a mother, maybe I waited too long,’” Klein says. “There’s a lot of judgment against women for being selfish and focusing on their career [when] maybe they just weren’t ready to get pregnant.”

Klein recommends getting a head start on the process by not waiting too long to evaluate your reproductive status. “There are many things that can be done before starting IVF—you need to make sure you have a thorough health workup of your hormones, uterus, and tubes, sperm [if partnered], to see if you can get pregnant naturally, before starting treatment,” she explains.

3. Discuss the undue financial burden of IVF

Infertility can be expensive. Not all treatment are covered by insurance.

“Between doctor visits, the procedure to extract eggs and then fertilize them, and fertility medicine, it was around $20,000,” Rifkin says. “We were able to pay for the IUIs and some of the IVF and got help from family for the rest.”

Others like Klein had an even more costly experience. “I’d say it cost nearly $50,000—and we even went abroad for free IVF, though that cost us in work lost and travel,” she explains.

When we discuss reproductive assistance, it’s vital that we highlight the cost as well. According to the CDC, only 15 states have enacted legislation requiring private insurance pay all or some of the cost of infertility treatments and only eight require reimbursement.

However, in most circumstances, IVF is not covered by insurance. That lack of coverage can make infertility seem like a personal deficit, which reinforces the shame.

By discussing the cost, we can address the undue financial burden fertility assistance places on families and look at the way class can be a barrier to family planning for more disadvantaged groups.

4. Acknowledge race-related disparities

Infertility narratives regularly highlight the experiences of wealthy, White straight couples. But while our depictions of infertility and IVF may discriminate, infertility does not. Like most things, race must be considered when discussing outcomes.

“There are a number of obstacles that stand between Black women and IVF usage such as stereotyped beliefs, cultural expectations about strong, self-reliant Black women, religion/theological interpretations, cost, mistrust of physicians and medical institutions, access, awareness, and acceptance,” says the Rev. Dr. Stacey Edwards-Dunn, founder and president of Fertility for Colored Girls.

Fertility for Colored Girls is one of few culturally tailored organizations seeking to improve outcomes with infertility issues by providing education, awareness, support, and encouragement for African American women and couples struggling with infertility.

Organizations such as Fertility for Colored Girls are important because research suggests Black women have lower rates of success with IVF than White women. According to a study presented in October at the American Society for Reproductive Medicine conference in Denver, Black women had a 14 percent lower live birth rate than White women.

“I think in order for Black women, in particular, to experience greater success with IVF, clinical trials and research will have to be focused not only on the unique experiences of Black women, but also focus on the implications of our physiological and genetic uniqueness as well,” Edwards-Dunn says.

5. Consider the political implications

Reproduction is a complicated process and assistive reproductive technology should be a core aspect of comprehensive sex education

Various factors—age, health, and orientation—all affect the likelihood of a woman becoming pregnant. Not discussing the social politics related to reproductive assistance increases access issues.

Monica is a Black woman who is in a same-sex marriage and lives in a conservative part of the country. (For that reason she asked that her real name not be used.) She found the IVF experience to be marginalizing as one fertility clinic after another rejected her and spouse, until they finally found one willing to work with them.

Even though she was an organizer for a national reproductive freedom organization at the time, her employer did not provide coverage for same-sex couples obtaining support for reproductive choices. She and her partner were told that their choice to be in same-sex relationship was the reason for their conception problem.

The couple paid for two rounds of IVF with a sperm donor, using their health savings account until the money ran out.

“It was emotionally taxing and shame-inducing to constantly meet barriers to care and experience direct financial and medical discrimination as a result of systemic homophobia,” Monica says. “We also face intense racism because I am Black and my wife is White and nonbinary,” she says.

When we stop oversimplifying the process of reproduction, we will reduce the deficit-based narratives around individuals and couples who need help. We need to start seeing challenges as a natural and normal part of the journey to parenthood.

Rochaun Meadows-Fernandez wrote this article for YES! Magazine. Rochaun is a Wyoming-based writer. She is passionate about breastfeeding, social justice, and her family. To read more from Rochaun, see her writer’s page on Facebook, and check out her website.

This article was republished from YES! Magazine.

See also:
It’s Her Choice
Nine Tips to Increase your Odds of Getting Pregnant

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November 15, 2019

We’re off to the races before sunrise. The Gemini Moon is inspired by Jupiter and fired up by Mars. Early birds are eager to embrace the new day. However, the Moon is void of course by dawn. The morning then grows tentative, lacking verve and clear …
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November 2019

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Cost: $20 each session

Where:
YogaLife Institute of NH
6 Chestnut Street
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Exeter, NH  03833
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Sponsor: YogaLife Institute of NH
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VFW Post 2597
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Sponsor: The Spiritualist Fellowship Church Of New England
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Cost: $25 per class

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Heart and Soul Holistic Healing Center
130 Massapoag Avenue
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Cost: Free

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176 Jackson Rd
Devens, MA  01432
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Sponsor: Yoga Anita
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2nd and 4th Monday of every month This psychic message circle is for anyone wishing to raise their connection using their psychic centers known as the “clairs.” Learn how to use...

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Cost: Donation

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Peaceful Creations LLC
382 Boston Turnpike
Suite 102
Shrewsbury, MA  01545
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Wilbraham, MA  01095
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Cost: $15

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Awaken Holistic Counseling Services
2 Liberty St., Unit 2L
Newburyport, MA  01950
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Center for Inner Wellness
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PO Box 98
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Sponsor: Center for Inner Wellness
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Cost: Reg includes supplies $40 per person or $35 more than one

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The Healing Power of Flowers - Heaven and Earth
68 Stiles Rd
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Salem , NH  03079
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Sponsor: The Healing Power of Flowers - Heaven and Earth
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Sponsor: Vesta: Redefining Divorce
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YogaLife Institute of NH
6 Chestnut Street
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Sponsor: YogaLife Institute of NH
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Cost: $35

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Peaceful Creations LLC
382 Boston Turnpike
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Telephone: 617-208-3333
Contact Name: Rebecca Resnik
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Facilitator: Peyton Pugmire Fridays, 9/20, 10/18, 11/15, 12/20, 9:30am–10:30am Everyone leaves with a powerful message to inspire their weekend!  Join Peyton Pugmire,...

Cost: Pay What You Wish

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Creative Spirit
80 Washington Street
Marblehead, MA  01945
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Telephone: 781-797-0389
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Cost: Series: $75; Drop in rate $20

Where:
YogaLife Institute of NH
6 Chestnut Street
Lower Level
Exeter, NH  03833
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Contact Name: Alice Bentley
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Learn the facts about Lyme Disease and how to protect yourself and your family! The Central Mass Lyme Foundation will host its 4th Lyme Disease Conference....

Cost: In advance: $30, at the door: $40

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Sturbridge Host Hotel & Conference Center
366 Main St.
Exit 9 off Mass Pike
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Sponsor: The Central Mass Lyme Foundation
Contact Name: Michele Miller
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With Ross J. Miller, psychic healer, medium, regression therapist. In this unique, experiential workshop you’ll learn how to identify your guardian angels and spirit guides by name and...

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Newton, MA


Telephone: (617) 527-3583
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Cost: $120 (includes all supplies)

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Creative Spirit
80 Washington Street
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Telephone: 781-797-0389
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Cost: $35 preregister; $40 at the door

Where:
Sohum Yoga and Medittaion Studio
30 Lyman Street
Suite 108b (next to hair salon)
Westborough, MA, MA  01581
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Sponsor: Pat Lebau Yoga
Telephone: 508-393-5581
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We welcome back Marcia Shaw of Goshen as she shares the beautiful energies of her Core Harmonizer. This portable unit, developed by Ross Newkirk (a former Chester resident), creates a blissful...

Cost: $10 suggested donation

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Center for Inner Wellness
26B Main street
Chester, MA  01011
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Sponsor: Center for Inner Wellness
Telephone: 413-315-1133
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Journey back into the experience of peace, harmony and inner power through this unique meditation practice. Explore the power of your thoughts and how they can bring you inner harmony and help you...

Cost: Free of charge as a community service, contributions welcome.

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Inner Space Meditation Center and Gallery
1110 Massachusetts Ave.
Cambridge, MA
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Sponsor: Brahma Kumaris
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Reiki Master Teacher Libby Barnett, M.S.W., integrates her healing skills with past experience as a medical social worker at Massachusetts General Hospital. 38 years experience. Reiki...

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Weston, MA


Telephone: 603-654-2787
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Psychics, mediums, angel readers, spirit art. Reiki, chair massage, IET, Gaiadon Heart, crystal healings, etc. Sign yourself up for a few appointments and bring your friends! Appointments...

Where:
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118 Washington Street
North Easton, MA
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Telephone: 508-230-3680
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Learn to overcome spinal tensions through therapeutic postures, designed to decompress your spine and relieve pain. Taught by a certified yoga therapist, classes bring you through poses...

Cost: 5/$50

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Bliss Through Yoga
484 Bedford St
East Bridgewater, MA  02333
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Telephone: 508-331-3564
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