This is actually one of the first ‘comics’ I drew when I decided to start blogging, but up until now, I haven’t been able to find the right words for it. Or maybe I always had the right words. They are just angry words, so I didn’t want to share them. But after reading my recent newsletter from Andrea Syrtash, Founder of Pregnantish, I decided it was time.
In her letter, Andrea mentions an AirBnB owner, who after hearing what she (Andrea) did for work, remarked that she (the owner) knows so many women having issues with pregnancy and wished that they took better care of their bodies and/or didn’t wait until 48 years old to start trying. [Loaded sigh.]
Unfortunately, this is a common characterization of the infertility/miscarriage community – older, stressed-out women who waited too long to have kids and are now turning to science to solve their problem. Sad, but it is their fault.
We all face this. About six months ago, I was telling one of my former business school professors about Recurrent Pregnancy Loss Association and the importance of research into miscarriage and infertility because there is so much still unknown and unexplained. He nodded along, then said it was “unfortunate” how many more people were dealing with infertility these days and posited that perhaps one of the reasons was because women are waiting to have their children until later in life. This was a smart man. An educated man. But a man completely ignorant to the realities of infertility.
It is true that rates of infertility and miscarriage are correlated with age. But it is not true that infertility rates themselves are increasing. A CDC National Health Statistics Report showed that the rate of “impaired fecundity” (difficulties getting pregnant or carrying a pregnancy to term) has remained nearly constant since 2002. But even if this were not the case, I desperately want to tell this man the following:
- Infertility is a multi-factorial, medical condition, please stop assuming age is the cause of our problems. Many of us started trying for a family at a much younger age than we are now and have been on our fertility journey for a long time.
- Male factor infertility is a cause for about a third of couples suffering from infertility, and multiple studies show that sperm count and quality decline with age, so don’t assume the problem is women waiting longer to have children.
- Some of us didn’t meet our partner until later in life and weren’t inclined to start trying to conceive before then, so don’t assume we waited because we wanted to.
- Some of us did make a deliberate decision to wait until we were older to start building a family, perhaps even knowing there were increased risks, but that doesn’t mean that our frustration, grief, or losses aren’t worthy of attention and compassion.
I am not ignorant of the science. I understand that statistics are not in our favor. Numerous medical articles detail the risk of aneuploid embryos (embryos with an abnormal number of chromosomes) by maternal age. The risk sits around 30% for women under 35, jumps to 60% by age 40, and +85% by age 45. A woman’s chances of naturally conceiving a chromosomally normal embryo are literally time stamped. But the belief that infertility or miscarriage is simply a function of age serves to stigmatize and minimize a very real health problem.
A similarly triggering phrase for the trying to conceive community (TTC) is “just relax.” All of us – and I mean ALL of us – have had someone tell us the story of their friend’s sister’s cousin who tried for years and then magically got pregnant once she quit trying and calmed down. “It’ll happen when you least expect it, if you’d only just try and relax.” Barf.
The LAST thing I wanted to hear when I was trying to get pregnant or stay pregnant, when I was feeling broken and traumatized, when I was hopped up on all manner of hormonal cocktails, when I was anxious and uncertain if I would ever be a mother was to relax.
I faced an impossible conundrum. Yes, of course I wanted to take a break from trying again after every miscarriage, but I also felt a terrible urgency to start up again as quickly as possible lest my chances slip away from me entirely. I felt older and less capable of success by the month. So, when an uninformed advice-giver then assumed that my family building struggles are my fault, because I was just stressing about it too much, I kind of wanted to punch them in the nose.
There are mountains of evidence to show that infertility and miscarriage cause stress, anxiety, and depression. In fact, a literature review cited in a 2018 article in Dialogues in Clinical Neuroscience showed that 25-60% of infertile individuals experience anxious and depressed psychological symptoms. What is NOT proved is that stress, anxiety, and depression cause infertility and miscarriage. Certainly, we are all healthier and better able to cope when we manage our mental health. But this isn’t the cause of our medical, fertility related problems. Would you tell a cancer patient to “just relax” or that their tumor will go away when they least expect it if only they stopped fighting so hard? Of course not. Cancer is disease that needs to be treated medically. Guess what? So is infertility.
Next time someone tells you about their struggle to build a family, rather than trying to identify or solve their problem simply try saying this: “I’m sorry that you have been dealing with that, but I want to thank you for sharing your story with me. It’s so important for people to talk about the challenges of infertility and miscarriage. Please let me know what I can do to support you through this process.”