We never talked much about children before we got married. They were 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 desire not 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 children.
The story of the next three years is familiar to most couples who have faced problems with their fertility. At first we felt foolish for the disappointment we felt when my period would come. We knew it 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 give 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 layman’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 snuck 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.
Early in our workup, we felt relieved when each test came back normal. But as more and more tests showed normal results, I began to worry. I knew that in about 10% of infertile couples, no cause for the problem is ever found. I also knew that this group has one of the poorest chances for ever achieving a pregnancy. You can’t fix what isn’t broken.
By the third year of trying to conceive, we were being offered very little encouragement by the specialists. And as our hopes for a biological child dimmed, we began to grieve in earnest. Each menstrual period touched off rage and depression. Every baby I saw made me acutely aware of the emptiness in my belly and in my arms. But the worst times were when a friend or relative would announce a pregnancy. And it seemed that all my friends from high school and college were having babies and sending baby pictures. The biggest depression came when Mike’s sister-in-law got pregnant, the first grandchild in Mike’s family. He kept the news to himself until he thought the time was right for a storm to break–and it did.
The full force of our infertility hit home, literally, when we made a special trip to tell our parents that we would probably not be giving them grandchildren. I found out several years later that Mike’s parents thought we were coming to announce that we were pregnant, since we had let on some time before that we were trying. So it was even more remarkable that they kept what must have been a great disappointment from showing. We all cried a little, and for the first time in a long time, Mike and I felt absolutely accepted–even though we were infertile.
The next day, however, has become famous in our family lore. Mike and I went to church with his parents and, wouldn’t you know it, they had scheduled an infant baptism. At Mike’s church, baptisms are a big deal. The minister takes the baby in his arms and carries her around the sanctuary, introducing the baby to her new church family. But on that occasion, this loving ritual was only a reminder of a blessing that I couldn’t have. I found myself crying. And I don’t mean just a few discrete tears, but boohooing. To make matters worse, we were sitting right in the front of the church, so I couldn’t just ease out. I sat there and cried–with people passing Kleenex and handkerchiefs to me–until the parents finally took their beautiful baby away.
Most infertile find that they are able to avoid babies and baby talk and occasions like that baptism. But not an obstetrician. I was never far from a swollen belly or a proud father. But even worse were those unhappily pregnant women wanting referral to an abortion center. And I found that I shared the pain of my infertility patients much too deeply. Looking back on it now, though, I can see that this daily dose of pain was actually a blessing. I knew I couldn’t go on living that way. Something had to change. I had to get either a new job or a new attitude.
That new attitude started to blossom in the spring of 1983 when Mike and I attended a day-long workshop for infertile people on the campus of Purdue University, sponsored by the Indiana chapter of RESOLVE, the national infertility support organization. I pushed and persuaded a reluctant Mike to go with me to the meeting, together as an infertile couple rather than by myself as a gynecologist–in disguise, so to speak. In fact, I remember promising to do dishes for two weeks if he would go. He gave in to the bribery and agreed to go but not to enjoy it. Going was enough for me.
When we arrived at the workshop, Mike tried his best to become invisible in the way that husbands sometimes do at gatherings. I had a professional excuse for being there, but for him, it was an open admission of failure, as if his masculinity had become tied up in his fertility. He joked that his name tag should have read, “Hi, I’m Mike Carter, and I’m infertile.” But as the day went on, he became more involved–and visible. He discovered that there were men there, some of whom he knew but hadn’t realized they were also infertile. But best of all, he discovered our infertility was a problem that we shared with many other nice, normal people and was nothing to be ashamed of.
The workshop consisted of a smorgasbord of hour-long discussions on topics of medical, emotional, and marital issues related to infertility, such as advice on pursuing adoption, scientific talks on the causes of infertility, and presentations about new treatments. One title, “Childless to Child-Free,” intrigued us, so we both attended. In retrospect, the couple who gave the talk was still carrying some anger and bitterness, but they were in the process of forging a new life for themselves. This was the first time that the concept of living child-free had even occurred to us.
We both feel that this seminar was a major turning point for us. We didn’t find an answer there, but it started us talking in a way we never had talked before. It was as though a taboo had been lifted. The main thing was that these were issues that could be talked about and dealt with as we did with other problems. After the meeting was over, I remember walking back and forth in the late evening sun over what seemed like miles of brick sidewalks on the Purdue campus–talking and talking.
Nothing was solved that day, but it did touch off months of discussing, negotiating, questioning, arguing–all of which allowed us to learn more about ourselves and each other. The wonderful thing was that we were talking. We were beginning to feel that we had some control over our lives again. We stopped seeing ourselves as victims, helpless in the hands of fate. There were decisions that we could make. The way we saw it, our choices were these: to keep on hoping and trying after medical means had been exhausted, to adopt, or to live child-free.
There was only one more test being offered to us, a diagnostic laparoscopy in which my pelvic organs would be examined in a minor surgical procedure under general anesthesia to look for any other physical causes of our infertility, such as endometriosis. We agreed to go ahead with that step, but in the weeks before it, we played, “what if.” What if, once again, nothing abnormal were found? What would we do? We knew that if the laparoscopy turned up nothing treatable, we were going to keep riding the 28-day cycle of hope, failure, and despair.
That left adoption to consider. This question was much more difficult for us to answer. We went through times of strong feelings both ways, usually out of sync with each other. We finally came to the mutual conclusion that adoption was not for us. Our choice was based on an unequal mixture of logical, realistic concerns–such as the very short supply of adoptable babies and doubts about our suitability as adoptive parents–and completely irrational considerations. The important thing is that we talked about it and kept talking. Neither of us allowed the other to play the role of dictator. And as we talked, we were able to bring to light some deep-seated fears, doubts, and needs that may have nothing to do with logic or the way life really is but are no less strong for that.
So we began to ask ourselves some questions. Could we be happy without children? Could we accept a life as non-parents? Could we choose it and affirm it? Could we change childless to child-free?
Soon, in the fall of 1983, it was time for the laparoscopy, and once again my being a doctor was both an advantage and disadvantage. I was able to get the surgery done by the best person in the area, but I had done the procedure many times myself and knew precisely what to expect. Sometimes a little ignorance could be relatively blissful. My position as doctor-patient became especially pronounced as Mike and I were waiting nervously before the operation in the pre-surgical holding area. First an I.V. technician came in to put the preoperative I.V. line into my vein, but when the nurse introduced me as a doctor, he blanched slightly and eased out of the room. Then the resident came in and the same thing happened. Then the chief resident. I thought for a moment that I was going to have to talk an unwilling Mike through another medical procedure, but finally the attending anesthesiologist came to do the job. Fortunately, he had no trouble.
I woke up in the recovery room with the surgeons face blurring in and out saying, “Everything looks fine in there.” My immediate reaction was relief that I was well and would not have to undergo treatment for endometriosis. My second reaction was relief also, but for a different reason. I knew that I was getting off the infertility roller coaster at last. All our talking had led us to the place where we could make a choice to live child-free. Of course, there was still some final grieving to do. Hope is hard to give up, even when it has become more painful than helpful.
Finally, there came a day that winter when after so many weeks of talking about living child-free, we finally decided to choose it–to take it and live it. We didn’t know exactly what it meant, but we were willing to figure it out day by day and build the rest of our lives on it. The most important thing was that we realized that we did have a choice. We could be childless, defining our lives by what we lack, or we could be child-free, affirming the potential gain that comes of living without children. We chose the latter.
Things really did begin to get better from that moment as one small part of our lives after another underwent redefinition. The future nursery turned into a music room. The dolls we had been saving for our daughters were set aside for our nieces. The money we had been putting away as a college fund became our opportunity to travel. After dozens of these little transformations, we realized that we had made a major change in our lives. Instead of being unsuccessful parents-to-be, we were very successful non-parents. Failure was no longer the major theme of our lives.
Neither of us had realized how much of our lives had been consumed by infertility until we chose to live child-free. Suddenly we found energy for doing things. I began quilting, and Mike began to work in earnest on his dissertation. We became more active in community and church activities. We felt that once more we were in control of our lives–and could do something with them.
There were two more important milestones on our road to a child-free resolution. The first occurred almost a year after we made our decision. One Friday night, at the beginning of what promised to be a romantic weekend, I came home with a package of contraceptive sponges. And Mike’s reaction was, “Yes, that’s a good idea.” We seemed to have arrived together at the point where it was time to exert that final bit of control over our reproductive lives. We know that Mother Nature’s sense of humor is just bizarre enough to wait until my fortieth birthday to grant the wish we long ago stopped wishing for, and we didn’t intend to let her do that. We also realized that even though we had decided to live child-free, there was always that little bit of hope each month that I would not get my period, enough hope, though to hurt. Contraception was our declaration of independence from the cycle of hope and despair and for us, the final step in being child-free.
The second milestone came shortly after the first, when we were asked to speak at a RESOLVE chapter meeting about the child-free alternative. Preparing for the talk forced us to go back over our journey, step by step, which was a painful process. But it was only through that process that we began to understand what we had done, and we discovered that it seemed to make sense. We realized that choosing to live child-free is just as “successful” a way of resolving an infertility crisis as having a biological child or adopting. It is not a failure or resignation to fate; instead, it is an affirmation of who we are and of our ability to live full, productive, happy lives because of who we are. We discovered that we don’t need children to be a family.
We also discovered that this is a very difficult concept, especially for people who have spent much of their recent lives trying to have children. It sounds like giving up or taking second best. One woman asked us, in a rather accusing tone, whether we were offered an easy medical cure for our infertility problem, wouldn’t we take the cure and have children? We both responded, without hesitation, that we wouldn’t. That part of our lives is over. We like who we are now, and our plans for our lives do not include children of our own.
But our lives do include other children. One especially pleasing consequence of our choice to live child-free was that children came back into our lives. We had avoided them as much as possible during the struggle with our infertility because of the pain they caused us. But we found ourselves opening our hearts to children once again. We no longer perceive them as reminders of what we don’t have, ready evidence of our inadequacy. At this writing, we are enriched by two god-daughters, three nieces, and two nephews. And we love birthday parties.
This transformation has probably meant more to me than to Mike. One of the reasons I became an obstetrician was the joy of watching a mother’s belly grow and of bringing a baby into a loving family. When I was infertile, though, all this changed. The joy was replaced by jealousy and pain; the baby business was no longer a happy one for me. Deciding to live child-free brought the joy back. I no longer look at pregnant women as a threat. I still may cry a little at a birth, but it’s not because of jealousy any more. Now, the tears are once again tears of happiness for the baby and for its mother and parent. This baby and their love for this baby are my hope for the future, my legacy, my joy.
If you found this excerpt from Sweet Grapes provocative or enlightening, you’ll love the book!