Transcript | Ep. 145: Childfree After Infertility

Sarah: I had read a couple of books in a row that were all thrillers and it just ended up that in each case, whoever the the kidnapper was, the murderer was, it was an infertile woman who just could not mentally get a handle on her situation. And would, you know, kidnap a pregnant woman and steal her baby or had some sort of bitterness that would show up in villainy. Sort of like, obviously, infertile women are unhinged monsters who are going to commit crimes, which as an infertile person myself, I have never had that inclination. We do have other things going on besides thinking about kidnapping babies.

[theme music]

Caroline: Hey y'all, and welcome to Unladylike. I'm Caroline.

Cristen: I’m Cristen. Last week on the podcast, we talked about being childfree by choice and all of the assumptions that come with it. That you're too selfish or materialistic or surely you must hate kids. And today, we're looking at the flipside of being childfree: being childfree not by choice. Or at least not first choice.

Caroline: We’re talking about infertility — something that affects 15 percent of couples. And it comes with its own boatload of stigmas and stereotypes, too. Unladylike listener Sarah, whom you just heard, has noticed it in books - and her own personal experience.

Sarah: There are definitely people who were in my life at that time we were sort of at the peak of our infertility journey who had gotten pregnant and had known that we were trying and sort of failing who purposely distanced themselves. I think they weren't sure what place they had in my life or what place I had in their life. I did actually have a very close friend who broke up with me via email, telling me that now that she was having a baby, you know, I didn't understand her life anymore. So we were going to part ways.

Caroline: Do you feel like that friend who broke up with you was making the decision for you? Like, do you think she just felt weird and she assumed you must feel weird?

Sarah: Yes, definitely. It was right after I had thrown her a baby shower, too, so I had really kind of tried to show that I was in support of what she was going through. I think it's hard for people, especially in our society and our culture, to understand that I can be sad for me and what I'm going through, but I can still be happy for you. I think people really struggle to understand those two things can exist together.

Cristen: We're going to hear more from Sarah later in the episode. And as for her ex-friend? We shall never speak of her again, Caroline!

Caroline: Nope!

Cristen: Sarah is one of a number of listeners who've reached out to us about infertility and how taboo it is even to just talk about.

Caroline: Taboo — and emotionally fraught. One listener named Jessica told us: “It seemed everywhere I turned, women my age and even younger were getting pregnant merely by thinking the word and I became incredibly angry and judgmental.”

Cristen: Other folks we heard from felt betrayed by how little they knew about infertility until it happened to them. A listener named Candice said, “there’s nothing worse than hearing ‘We don’t know why’ when you find out you’ve lost yet another pregnancy."

Caroline: So this episode, we're getting real about what happens when you want to stop trying to have kids.

[stinger]

Emily: When you are faced with infertility, it's either you pursue adoption or you do fertility treatments. There's no third option, which I feel like we’ve picked that third option, which is just to do nothing about it and just see what happens. And I feel like a lot of people don't understand that, they can't wrap their mind around why you would do that.

Cristen: Emily is a longtime listener who emailed us back in June about infertility and the pressure to just keep on trying. The medical benchmark for infertility is one year of unsuccessfully trying to get pregnant. Emily and her husband are now at year seven.

Caroline: We wanted to talk to Emily because she and her husband have chosen to go with that third option she mentioned. They are NOT trying to adopt and NOT pursuing fertility treatments. But they are still grappling with the decision to completely stop trying.

Emily: So at the beginning, you know whenever anyone starts on that journey to try and have kids, it's fun and you're kind of like cut loose and fancy free kind of vibe. But then after it hit, like the one year and, like nothing happened. We went and we did the doctor's visits and stuff to see what the issue was. So we found out we're dealing with male infertility.

Cristen: Was that surprising at all? Like, did you all have any expectations or thoughts about what might be going on like before you got that kind of prognosis?

Emily: At that point, we kind of expected to hear something was wrong because, you know, they always say, you try for a year, you know, and then if nothing's happening, you go and see the doctor. So I think I was expecting some sort of diagnosis. So in a way, it was kind of validating, I guess, to hear that there was something wrong. I kind of wish it was me that had the issue because I feel bad that my husband has to bear that burden, that it's kind of I guess kind of his fault if you want to look at it that way and I don't want him to have to bear that alone. But I guess there's nothing we can do about what our bodies want to do and how they want to, you know, perform. So, you know, we’ve just kind of been like, you know, it is what it is. These are the cards we've been dealt, so we just have to move forward from here.

Cristen: Emily and her husband live in Akron, Ohio. They got married when Emily was 25 and started trying to get pregnant a couple years later. After they found out they were dealing with infertility, Emily’s doctor told her the odds of conceiving naturally were very low. To get pregnant, the doctor recommended using IUI or IVF. Emily and her husband had a decision to make.

Emily: Once she told me that I went home, kind of explained the situation to him, and we both kind of said at the same time, that it was just not something we wanted to do, which just we just know fertility treatments are just so draining on not only your body, but your emotions and just financially. It's really expensive. So. We just didn't feel like that was something we wanted to pursue. It's just we're both kind of anxious people, me in particular, and I think just everything surrounding what goes into fertility treatments is just it was just too much for us.

Cristen: I'm also curious if, in deciding to forgo fertility treatments. Was that effectively deciding to stop actively trying to conceive or was or were those kind of like two different decision points?

Emily: I guess they're two different decisions because we still even to this day, we're still trying. I did all of the at-home like ovulation tests and things like that. We did all kind of like the over-the-counter stuff that you can buy to kind of maybe help things along. It’s just none of that stuff has ended up working for us. So we haven't officially thrown in the towel yet.

Caroline: Where do you think the line is or what what do you think the deciding factor will be if and when y'all finally say, All right, we're going to, we're going to move on.

Emily: Really I think it will just be time. So I don't know if it'll be next year or the year after that. But I think just it's just so hard living with uncertainty as an anxious person like myself and someone who likes to plan and like, have my life laid out. I think it'll just slowly boil down to how much longer can we do this?

Cristen: Yeah, I mean, in your your email, you wrote at some point I just want to go back on birth control and start planning for the rest of my life, which is, I mean, a very understandable sentiment. And you then ask, like, is it normal to feel this way? And my question back to you — well, first of all, I'll just go ahead and say, like, yes, of course, it's totally normal. And my question to you is, does it feel abnormal?

Emily: It does. One hundred percent. It feels really weird. Because I feel like I mean, no one's ever said this to me or made comments or anything, but like I feel like when I tell people that like we want to go back on birth control, I feel like there's that moment in their brain where they're like, well, if you can't get pregnant, why would you go back on birth control? And I'm just like, there's still the chance that we could get pregnant, and I just can't live with the uncertainty if that's going to happen next month or nine years from now. I just would need to take back some control of my life so I can move forward.

Cristen: And that is such a relatable sentiment! Like, living in day to day month to month uncertainty has to be a difficult space to occupy.

Caroline: Oh yeah! And I mean, that desire for control echoes what we’ve heard from so many listeners about feeling powerless over their infertility. Like, a lot of times, there aren’t any clear cut answers, so you just get told from doctors, from friends to just keep on keeping on …..

Cristen: So one listener we heard from highlighted this myth that, if you aren’t getting pregnant, you just aren't trying hard enough or like you don't want it badly enough. And I wonder if that’s been something you’ve also had to contend with?

Emily: Oh, 100 percent. A hundred percent. It makes me feel feel so much better that you said that because I do feel like. I'm very much a people pleaser, and I feel like when I tell people we're just going to go back on birth control and stop trying I feel like people look at me and then think, you must not want kids bad enough or you must be selfish or you want to, you know you care about your money more than you care about trying to have actual children and a family. And it's just like it's. It's just definitely hard trying to juggle what you think people are thinking about you when you make these personal decisions.

Cristen: How do people tend to respond when you bring up infertility?

Emily: I feel like the main thing I get from people when I when I tell them we're experiencing infertility, it's it's a lot of pity, but also I feel like people don't ask me. Like, my friend, my closest best friends, they all know our situation. They're all very supportive. But like, you know, the wives of my husband's friends, they don't ask me about it. So it's just this like cloud that kind of hangs over me whenever I'm around them because it's like, I know, you know, so we'll just going to ignore it and just pretend it's not there.

Cristen: What would you like to be asked about it kind of how in your ideal, your ideal world, sort of how would it be be raised?

Emily: I guess I would, I would like people to ask like how you're doing. Just simple. Right to the point, because then I can take that and be like, “We're doing fine, like it's OK,” or I can be like, “It's awful. You know this it sucks because of X, Y and Z.” I can kind of explain because I feel like just just saying, how are you doing? It's right to the point.

Caroline: Yeah, there's like no small talk script for it, right? Like if I run into you at a party and, you know, we don't know each other very well, but I know you have kids or whatever I can be like, Oh, how's little Timmy doing with baseball or whatever? Like small talk that we are just so accustomed to participating in. But like, there really is no script for “Oh so do you have kids?” “No, we're dealing with infertility.” “Well, fuck.”

Emily: Right! That just shut down the conversation.

Caroline: Right? And it and it shouldn't. I mean, ideally, it should not shut down the conversation because this is not uncommon.

Emily: No, it's not. And whenever I feel like whenever we meet a couple who has infertility issues, these like wonderful conversations blossom out of it and it makes you feel validated and that you're not alone. And it just you wish it was so much more normalized.

Cristen: Well, at least based on the sample population of our inbox, you are not alone. But one reason we we did especially want to talk to you in particular Emily is just because that third option - of basically seeing what happens and NOT pursuing adoption or surrogacy or fertility treatments - that is something that we don't really hear talked about. Like it's not something that we've seen sort of in the in the conversations and also it seems like the you've got kind of like the child free by choice community and then you have the community of people who are dealing with infertility and then you have people with kids. And all of those communities end up getting like really siloed off from one another when in fact, there's there's probably a lot more.

Emily: There’s a lot more overlap.

Cristen: Yeah, a lot more. It's more of a Venn diagram. Yeah. Than we might think it is.

Emily: Yeah. Yeah, exactly. For us, just the choice to like not do anything about it does seem very foreign to me and I feel like society because like you see on Facebook, you know, people writing these loving stories about how they've gone through their struggle of infertility, how they overcame it and then maybe got the child in the end. And you see those stories and they're heartbreaking but also heartfelt and, you know, courageous women going through this. And it's like no one's writing up about my story because I feel like there's not much pizzazz to it. It's just the choice to really do nothing and just see what happens. And I just didn't know if that was normal.

Cristen: I do think it's interesting, though, the way that you even frame it of “us not doing anything about it” because what I hear is a couple who is doing something about it. You're making the choice that best fits each of you in this moment and you're giving each other room and space for that. To me, that sounds like a lot of doing.

Emily: Well, thank you. That makes me feel better.

Caroline: I am curious if there is anything about your experience or infertility or being child free that we haven't asked you about yet, that you would want listeners to know.

Emily: I just hope people know that no matter what decision you make, it's a very personal one and it's no matter what you choose, it's OK. Like, I hope people aren't like me, and I hope people don't worry about what everyone else is thinking about their choice. And as long as it's what's best for you, that's what matters most. And that you as a couple are in it together, no matter what lies ahead for you. So I would just hope people, I guess, just hold on to that. Just whatever you decide, you're going to be OK.

Cristen: We’re gonna take a quick break. When we come back, we’re getting into alllll the bad advice to expect when you’re still not expecting.

Caroline: Stick around

[stinger]

Cristen: We’re back. Caroline, one of the things that you and I have learned from our Unladylike listeners is just how exhausting and confusing infertility can be. One listener wrote, ‘It feels like a tightrope, and the only answer is to be the perfect woman.” Like, there is just so much infertility baggage to wade through.

Caroline: Yeah, girl - there isn’t a baggage claim carousel big enough! For starters, like we mentioned earlier, infertility is medically defined as not getting pregnant after one year of unprotected penis-in-vagina sex. Which overlooks most queer couples from the jump! In the rare cases that insurance covers fertility treatments, they often don’t meet the baseline criteria to qualify.

Cristen: Then there are all the myths about how infertility happens. Because a lot of times we assume that it must be the eggs’ and/or uteruses’ fault. But in fact, infertility among opposite sex couples is kind of a toss up. A third of the time, it’s due to the partner with the uterus. Another third of the time, it’s due to the partner with the sperm. And the other third of the time, it’s either both partners or unclear.

Caroline: These days, we’re also led to believe there are plenty of simple solutions out there - like, worried about getting pregnant when you’re older? Just freeze your eggs! But as y’all might remember, we did a whole episode on egg freezing, so go listen to episode 78: How to Unscramble Egg Freezing to find out what you can — and can’t — expect from the process.

Cristen: That brings us to fertility treatments like IVF and IUI. And if you’re not familiar with the acronyms, IVF is in vitro fertilization — basically when sperm and eggs are fertilized in a test tube, then the embryo is implanted in the uterus. IUI is intrauterine insemination, where sperm are put directly in the uterus. - basically giving slow swimmers a jump on the whole thing

Caroline: And the out-of-pocket costs for those procedures can be staggering: Insurance typically doesn’t cover it, and if it does, it might cover just one or two rounds. Like a round of IUI will typically run you less than a thousand dollars, but IVF? That’s gonna start at around $10K.

Cristen: One 2011 study that we read pegged the average cost of IVF treatments that result in successful childbirth at more than $60K. Not to mention the time, hormone injections, and emotional ups and downs that can come along with it.

Caroline: An Unladylike listener named Jessica shared with us that when she and her husband were navigating their infertility diagnosis, “the outrageous costs of fertility treatments would simply not be manageable for us, especially given that there is no guarantee of pregnancy. That’s how we decided to adopt.”

Cristen: Adoption isn’t necessarily cheap either – costs can range from very affordable to tens of thousands of dollars. But Jessica’s experience circles us back to perhaps the biggest infertility myth of all – that you’re just not trying hard enough or want it badly enough. Because that bullshit pressure? It did not ease up after Jessica and her husband decided to adopt. Instead, she told us she got reactions like, “Don’t you want kids of your own?” and “you just need to be more patient, and you’ll get pregnant.”

Caroline: And no surprise, those pressures are reinforced all over the internet. Like just take a moment on Google and fall into a deep rage like we did. There are so many unhelpful articles. You find things like “Fertility Tricks (That Actually Worked!)” over on The Bump. Or “Try These Yoga Practices to Increase Fertility” on Healthline. Or the best one – “19 Foods That May Increase Fertility for the Ultimate Fertility Diet” on Glamour.

Cristen: That doesn't sound confusing at all! And ultimately, what all of these myths add up to is a mandate to pursue biological parenthood, no matter the emotional, physical and financial cost. And for folks who have that desire, that is totally fine! Choose your choices! But when facing infertility, you are often told to try fertility treatments or adopt. And that leaves Unladylike listeners like Emily feeling wrong and abnormal for simply taking a different path.

Caroline: We’re gonna take a quick break. When we come back, we're talking to Unladylike listener Sarah, who you heard at the top of the show. Sarah’s going to share what happened when she and her husband chose to move forward childfree.

Cristen: Don’t go away.

[stinger]

Sarah: So I actually did not at all want children until I met my husband. I had friends in high school who were like, I just can't wait to have babies, and I was actually not that person, and when I met my husband, I felt like, Oh, this is a person. Yes, I can see myself having children, raising children with this man.

Caroline: This is Unladylike listener Sarah, who we met at the top of the show. She lives in Massachusetts and is a non-profit fundraiser.

Cristen: When Sarah was 26, she and her husband got married. The plan was to settle in just the two of them for a few years then start trying to get pregnant when Sarah hit 30.

Sarah: I was really on top of it. I was like, We're starting today. That means if we don't get pregnant in a year, we're going to see my doctor, so I had a plan. I was a woman on a mission.

Caroline: So what happened next in the plan?

Sarah: So I did have a few miscarriages. They were very, very early. So the doctors weren't super concerned. I think it was 10 weeks, eight weeks and six weeks. I was concerned because it seemed to be. I was miscarrying earlier. They were like, No, no, you're young. It's fine. Just take the year. And then if you don't get pregnant, in a year, we'll figure out what's going on. And I had in my head an idea of what I thought it was. I thought it was PCOS. I have a number of friends who had struggled with that, and so I still in my head had a plan of, OK, if this doesn't work, I think I know what it is, and I think I have a plan for that too.

Cristen: It wasn’t polycystic ovarian syndrome, or PCOS. Sarah was diagnosed with Graves disease. It's an autoimmune disorder that affects your thyroid and hormones. Sarah's doctor started her on medication and advised her to hit pause on trying to conceive for at least the next six months.

Caroline: Six months turned into a year, and Sarah was still in treatment. She tried not to panic.

Sarah: I did sort of feel the clock ticking at that point because it had been it had been a year and I'm thinking, OK, if it does take the longest end I'll be this age, it does put you in a different headspace of trying to figure out like, what is the plan now? And I think my husband had a different idea, too. I think a lot of men dream of like, we're going to have a boy and it's like, OK, we just want a baby at this point. Like, we just - you sort of manage your expectations a little bit like we thought we were having two, you know what, we’ll take the one, you know, and you just kind of - you try to, I guess, accommodate what's going on with the plan.

Cristen: Sarah’s body didn’t respond well to the medication. She was tired all the time and had all sorts of aches and pains. And her thyroid problems persisted.

Sarah: I had a doctor who basically told me, you know, it's not like you ever run a marathon or anything, but like, eventually you'll get used to this fatigue. And I was just like, That is not how I want to live my life.

Caroline: Sarah ditched that doctor and found one she actually liked — and then an ultrasound revealed four tiny nodules on her thyroid. They were too small to biopsy, so Sarah's waiting game continued.

Cristen: Sarah started to question whether children really were in her future. Her husband, meanwhile, kept his hopes up. In the early years of their marriage, they lived in the house he grew up in, and he'd always imagined that this was going to be the home where he raised his children.

Sarah: I was much more focused on what is our Plan B? Like, what do we want our life to look like? But at the same time, it was also, I think, really isolating for both of us as we had friends who, you know, when we when we got married, were single and then they were meeting people and getting married and having kids. And it felt like we were really on pause and everyone else was moving on with their life. So I think that had been really difficult too. And just really isolating feeling like, you know, we've been together for like 10 years now and the people, these other people, they've been together half that time and they now are married and have three kids. And you know, what are we doing? So I think there's a lot of angst around that too. Like, are we hitting these, I'm putting like air quotes, are we hitting these milestones that are sort of expected when you get married and express an interest in having a family?

Caroline: Finally, one of Sarah’s thyroid nodules was big enough to biopsy. They found that it was cancerous, and her thyroid needed to come out.

Cristen: After that operation, Sarah's doctor told her she could try to conceive again, but it wouldn’t be safe. She’d have to up her dose of thyroid-replacement meds, which would also increase her risk of the cancer returning.

Caroline: By that point, Sarah had spent more than SIX YEARS in pregnancy limbo. She and her husband had gotten some dogs and moved into a new house with a shorter commute. It was time for them to decide if they were going to keep trying.

Sarah: It was almost easier at that point to say, you know, this is the thing we can do. Are we willing to do it? Are we… And I think the way that I phrased it was that we chose me instead of moving forward, that the risk of me having cancer again and having to have surgery again or having to do radiation was just too great and that the choice was that we were going to choose my life instead of this potential for a new life.

Cristen: How did reaching that decision feel, like, did it take any weight off in a way?

Sarah: It did, and I think I was really grateful that my husband was on board with that. I think we really wanted to have a strong relationship to bring a child into, and for me, it was almost a relief that he was on board to say, like, “Yes, I choose you, too, like you are more important in a way like your life, your health and your safety is more important to me than this dream that we had.” So it was almost a relief to be able to say, like, “OK, we are on the same page. We're on the same team. We've got this together.”

Cristen: Sarah and her husband looked into adoption and decided it wasn’t for them. The path forward was clear. They’d be childfree.

Caroline: Was there any sort of grieving process that you and your husband went through? Like what was that like for you?

Sarah: I think potentially it was harder for me. I remember very distinctly we were coming back from a long weekend when he got a call because they do, you know, the male fertility workup as well. And he got the call, and I think I took the call because I was talking to the nurse, and nothing was wrong with him. You know, she went through all the things like, this is perfect. This is perfect. This is perfect. And I hung up the phone and I burst into tears, and he was like, “It's really bad news, isn't it?” And I was like, “No, it's great news. You're fucking perfect, and it's all my fault.” And he was just like, “Oh, I don't know what to do with that.” And so I think it was really hard for me to feel like, you know, this is all me. This is my fault. This is, you know, I'm - something in me is broken. And I think, you know, this is like a very long like is it is it religion that, like women are meant to do this. Is it in our society, like “you’re made to do this.” So it was it was really hard for me to feel like me personally, I was not made to do this. This is not what I’m made to do. It's a lot of just messaging all around that like this is the highest calling, right. It's the most important job you can have. It's the best job you can have. You don't know love until you have children, and to really get beyond that is like through the grief process of like, you know what, that's that's for those people and they can feel that way. But that doesn't have to be how I feel. I don't have to take that messaging and take on that burden.

Cristen: Where do you think the kind of messaging of like, “It will happen for you. Just give it time. Try harder, etc.” Where do you think that messaging comes from? What do you think really drives that?

Sarah: There's just a lot of toxic positivity around it. I think people don't know what to do with another person's grief, so they want to say, you know, Oh, don't worry, like, you know, the next month will work out or the next the next cycle will work out. And I think as a society, we just need to embrace that there are many ways for something to work out. And just because you didn't end up with a child at the end, it doesn't mean that you you didn't work out, right? So you can have a happy life otherwise. So I think a lot of people just don't know how to say, You know what? It's OK to stop. If you're exhausted and you are tapped out emotionally or physically or financially like it's OK to stop at any time. And instead, people really just like to push that, you know, it's going to be OK — and it is going to be OK. But that OK might look different than you thought it did.

Cristen: What has been the most helpful or healing as you moved through that? Not only like the processing, the grief, but also kinda how your identity shifted?

Sarah: Finding a different community was really helpful. I mentioned my endocrinologist earlier who said, you know, you'll never run a marathon or anything, but. And so I took up running actually out of spite. And one of my really good friends, the year that I got diagnosed, she had done her first 5K, and I kind of thought to myself, like, you know what, if she can do it, I mean, maybe I can do that. And I had some friends and we did our first 5K together, and I just sort of got hooked on it. And so the friend that had introduced me to running initially, she ran my first marathon with me. She was super inspirational and running is a really great community that I found that was like, OK, you know what? I'm not going to be in moms’ groups, but this is my community. And my husband too, he plays in a softball league through work, and so I think just creating a new identity for yourself and exploring that and it could be maybe you try one thing and maybe that's not who you are, so you try something different. And for me, running really worked out.

Cristen: I hope that you sent your first marathon bib to that endocrinologist.

Sarah: Well, interestingly, my second marathon was the Boston Marathon, which is a big bucket list item for a lot of runners. So I did take a picture of myself holding my medal and sent it to her.

Cristen: Yes!

Caroline: Oh yes!

Sarah: I did not get a response.

Caroline: Oh man, that was my next question.

Cristen: Oh, I love that.

Caroline: Wow.

Cristen Huge thanks to all of the unladies who shared their childfree by choice and infertility stories with us for this series - we so, so appreciate it. Y’all can find us at instagram, facebook and Twitter @unladylikemedia. You can also drop us a line at hello@unladylike.co. And you can support Caroline & me directly by joining our Patreon; over there, you’ll get instant access to more than 70 existing bonus episodes, and a new bonus episode every week, including last week’s extended conversation on being childfree by choice and specifically how contentious childfree reddit ist. It is juicy, y’all, and you can find it all over at patreon.com/unladylikemedia.

Caroline: Nora Ritchie is the senior producer of Unladylike. Michele O’Brien is our associate producer. Gianna Palmer is our story editor. Special thanks to Abigail Keel for her help on this episode. Shruti Marathe transcribes our tape. Our music is by Flamingo Shadow, Amit May Cohen and Sarah Tudzin. Mixing is by Andi Kristins. Sound design and additional music is by Casey Holford and Andi Kristins. Executive producers are Peter Clowney, Daisy Rosario and Unladylike Media.

Cristen: This podcast was created by your hosts, Cristen Conger

Caroline: And Caroline Ervin of Unladylike Media.

Cristen: Next week…

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