Why don't you have children?
What does unwanted childlessness mean?Why don't you have children?
Who should read this brochure?
Nearly everyone knows someone who wants to have children, but has difficulty conceiving. For individuals who will not see their desire to have children fulfilled, it is sometimes not easy to convey to others what this means to them. Freya, the infertility support association, has written this brochure to assist them. In this brochure, we attempt to explain the extent to which this unfulfilled desire to have children influences their lives.
Fertility problems are quite common: approximately one in six couples are confronted with infertility. Naturally, these individuals require the support of their family and friends.
INTRODUCTION
Unwanted childlessness, how does that affect your everyday life? Everyone can imagine that it is a difficult situation to bear, but you cannot imagine how it feels unless you are confronted with it yourself. You may have received this brochure from someone you know who faces fertility problems and who hopes that you may come to understand the hold this problem has on her or his life after reading it. The feelings associated with it are difficult to describe. With this brochure, Freya intends to give you a glimpse of the ramifications fertility problems have on everyday life. A bit of understanding for those confronted with this situation can aid relations with the childless couple while respecting their feelings. Ideally, this brochure can also serve to initiate discussions on this difficult topic. The italicized sections have been taken from letters from couples facing unwanted childlessness.
THE WISH TO HAVE A CHILD
In our society, we are accustomed to organizing everything to fit our needs. For instance, we delay realizing the wish to have a child until we are ready for the responsibility. Until then, we use birth control to prevent pregnancy. The ubiquity of this gives us the impression that we can determine when we will have a child. As such, when you cease practicing birth control, you expect to become pregnant within a few months. Unfortunately, this is not always the case, which in itself is a disappointment. You become aware that you are not entirely in control of your body. Every month begins with the hope that now is the time for it to happen and you start to keep a close eye on the ovulation date - when you are most fertile. And every month you must once again work through the disappointment because yet another attempt has failed. Many couples turn to the physician after about a year of trying and failing to conceive. The first step into the network of medically-assisted pregnancy.
[Approximately 1 in 6 couples have fertility problems]
EXAMINATION
The gynecologist is consulted after several simple examinations by the physician. Possible causes are sought and treatment can be initiated. People are often relieved if a possible cause has been revealed. At the same time, it can cause considerable sadness since pregnancy is not possible without medical intervention.
It is also possible that no reason is discovered for the inability to conceive. This complicates the process even more. As long as no cause is known, the uncertainty and hope return with each month. Furthermore, you sometimes have to wait several years before you are eligible for a treatment such as IVF (In Vitro Fertilization).
People often vacillate between hope and despair during the examination and treatment phases. The couple is often extremely focused on their wish to have a child and often have a great need to discuss it.
[1 of every 100 children was conceived by means of IVF]
THE ROLE OF THE MEDIA
Fertility treatments receive a lot of media attention. As a result, most people have heard something about the options available and generally have an opinion of the limits and of the risks and chances for success. There has been a great deal of publicity surrounding IVF in particular. But unwanted childlessness involves much more than (IVF) treatment. It is a long and tiresome road from examination to treatment, from hope to disappointment. As mentioned earlier, one in six couples are confronted with fertility problems and of those who are eligible for IVF treatments, only about half will have successfully conceived a child after three treatment attempts. Of all those with fertility problems, about 10% will ultimately remain childless. You cannot just decide to have a child with the assistance of IVF, but if you're lucky, you might get one!
YOUR OWN CHOICE
Everyone makes choices in their lives. When it comes to infertility, these choices can be far-reaching and at times difficult for those around you to understand. If a couple opts to not undergo treatment or to stop altogether, they can expect to hear that it's their own fault that they don't have children, otherwise they should have gone ahead with treatment. The reasons to not undergo or discontinue treatment are numerous and wide-ranging in nature. Ethical objections, the inability to handle the psychological pressure of the treatments any longer or decreased chances of success are just a few examples. Every couple must determine their limits and everyone wants to have their choice respected. Keep in mind, however, that no method of treatment guarantees a 100% success rate, so you can also choose to no longer grasp at straws. Furthermore, adoption is not always a logical step for everyone either. But this does not mean that you are choosing to remain childless! Regardless, the sadness remains as omnipresent as ever.
[Medical treatment or adoption are not necessarily logical steps for everyone.]
[People with fertility problems have not opted for a life without children.]
UNCERTAINTIES
The question 'Do you have children?' can be asked in any number of situations. If the response is 'no', the person asking the question may pursue the issue further. It is during moments like this that the individual with fertility problems may be at a loss as to how to respond. What do you say? Do you change the subject? Do you play down your situation, for instance, by saying 'It's taking a bit longer than we expected?' Or do you pursue a more involved discussion? Some people may simply be glad to have the opportunity to talk about it, particularly if they sense that the question is being asked out of genuine interest. Finally, the person asking the question may also coincidentally be someone facing similar problems. In any case, how to handle this will depend largely on the situation.
AT WORK
Not every couple opts to share their problem with co-workers. After all, the issue is extremely personal. Nonetheless, the couple may face a situation when they are forced to say something about it, for instance, when asked about the reason for all the hospital visits. Co-workers may be able to respond in a more understanding manner if they know the truth, otherwise they may believe that the man or woman with fertility problems is simply pretending.
"Rumors about me were circulating at work: after all, there was nothing wrong with me, yet I continued to go to the hospital. My co-workers believed I was just staying away from work for no reason at all!"
However, (male) co-workers may make jokes, for instance, by saying 'You want me to pay your wife a visit sometime?' Dealing with such insensitive comments is always trying and you never get used to them. Some people arm themselves against such thoughtlessness with well-worded responses that they've thought out in advance.
DIFFICULT PERIODS OF TIME
The couple facing unwanted childlessness faces a roller coaster of emotions. There are times when things go well, and others when it's more difficult. There are times when they will want to discuss it and times when avoidance is the order of the day. They will feel encouraged sometimes and sometimes sit in the midst of despair. As a friend, acquaintance or family member, you can provide support by asking how they are doing and offering them the opportunity to discuss the problem, but be certain to respect their decision to not want to talk about it. Try not to overdramatize the situation, but also take care not to avoid the subject altogether. Most people appreciate it if someone genuinely asks how they are doing and do not attempt to avoid discussing the problem. This applies even if they are not inclined to talk about it at that moment because, for instance, it would involve an overwhelming release of emotions.
"What hurts the most is when people say and do nothing."
PAINFUL COMMENTS
Every couple with fertility problems is familiar with such painful clichés as 'You know, children are not all that wonderful. You shouldn't idealize having a child,' 'You can do whatever you want without having to figure out what to do with the kids' and 'You can go on vacation three times a year, have a beautiful house, enough money, two cars, etc.' These are without a doubt well-intended, but many couples are hurt by such comments.
Every couple facing unwanted childlessness is also aware of well-intended advice, which can come across quite harshly. Such comments include 'Don't focus so much on it. Pregnancy will come if you just stop thinking about it,' 'You just have to arrange your life differently' or 'Why don't you adopt a child?' Finally, there are also the humorously intended, but extremely insensitive comments such as, 'You can get a dog to cuddle' and 'Should I come over and show you how to do it?'
POSITIVE APPROACH
But what does a couple dealing with unwanted childlessness want to hear? Most people appreciate it if others are willing to listen to their stories - this can do wonders. In general, genuine interest shown by others is greatly appreciated. A condition of this, however, is that the couple has told these individuals directly about the difficulties they face with having children, otherwise the interest may be viewed as interference.
"A girlfriend once started a conversation at a party by asking if I wanted to discuss it right away or at a later time. A great way to begin, actually; it was open-ended and I was able to respond in the way I felt most comfortable."
If you are yourself a parent, trying to imagine how you would miss your children - who you as a rule enjoy greatly and love very much - will help you gain an idea of what they are experiencing.
People with fertility problems generally appreciate it when others are prepared to learn more about the subject, for instance, by reading a book about unwanted childlessness.
"I truly appreciate simply being asked how we are doing. It's a sign that people are sympathizing with us."
Why don't you have children?
FAMILY CELEBRATIONS
Nearly every couple with fertility problems, particularly women, have a difficult time attending family celebrations. The reasons are that, at these types of celebrations and birthdays, pregnancy, birth and children are often central topics of conversation. Obviously, it is unnecessary and all but impossible to avoid such situations, but the degree of difficulty can be reduced.
"A normal conversation is impossible. You don't feel part of it at all. You often receive negative reactions for feeling this way. People say that you should try to put it behind you. Not everyone understands it if you decide not to answer and you're left in a defensive position. It's just uncomfortable."
Also confrontational is when someone announces that they are pregnant during such occasions. This can completely spoil the festivities for the couple dealing with unwanted childlessness. A better approach would be to personally inform the couple in advance of the news to give them opportunity to deal with the surprise. Because the couple would also love to have a child, they wouldn't begrudge this of anyone, but it is nonetheless difficult to hear that someone else has achieved (sometimes within a short period of time) what they have been attempting for years. Unfortunately, news of a pregnant sister, sister-in-law or friend is sometimes kept secret until the couple facing unwanted childlessness hears of the news from someone else. Even though the secret is not meant to shut the couple out, it can certainly feel this way.
People who in the meantime have become parents should, for that matter, not try to spare the feelings of the couple confronted with unwanted childlessness by not inviting them to children's birthdays and christening parties. More appropriate would be to simply invite them with a note saying that they are welcome and that you will understand if they choose not to come.
"Announcements from brothers or sisters that they were expecting a child were always difficult. One announcement was even disguised in the form of a poem in a card given during a celebration. That was quite unpleasant for us since the rest of the evening was pretty much ruined because everything revolved around the pregnancy. Furthermore, we were expected to react enthusiastically, which was difficult as you have to get used to the idea before such a reaction is possible."
[Children enrich your life. The inability to experience this is the root of a great deal of pain.]
MOVING ON TOGETHER
If having children isn't an option despite all the medical and technological possibilities, the couple will have to learn to deal with this. This involves a grieving period, during which they will have to finally accept the impossibility of realizing their wish to have a child. Because this is unimaginably painful - parting with a child that was never born - this is often associated with many problems. Some couples are able to work through this on their own, with the support of the people around them or people in the same situation. Sometimes, however, they require professional assistance to guide them through the grieving process. Obviously, it's possible to live without children, but it's not the life that people had laid out for themselves. It is also important to remember that the unwanted childlessness remains with you for the rest of your life. You will never be a father or mother, but you will also never become a grandfather or grandmother. Time and time again, the sadness can flare up. Regardless, support from family and friends is essential.
"Receiving a card that says 'chin up' or 'our thoughts are with you' is a source of comfort. It shows that people are sympathizing with you."
"When we told my mother that we would not be able to have grandchildren for her, she reacted by saying, 'What a shame! You wanted children so badly."
ALREADY HAVE A CHILD AND STILL FACING SADNESS?
Even couples who already have a child - whether or not the pregnancy was assisted by IVF or another technique - can experience an unfulfilled wish for a child when a second pregnancy is difficult to achieve. After all, it is quite common for people who do not have fertility problems to want more than one child. Quite often, people facing this situation have nowhere to turn with their grief. They know all too well that they are fortunate to already have a child and are often reminded of this. But the lack of a little brother or sister for their child often overshadows this fortune. The sadness that comes with the impossibility of a second pregnancy cannot be disregarded. As such, most of the problem areas identified in this brochure also apply to them.
"By expressing my sadness, I make room for more happy feelings.' 'That it's possible to feel the joy of having a child and still face an issue of childlessness!"
IN CLOSING
As we have already mentioned, the problems of couples facing unwanted childlessness are nearly unbearable without the support of others. In short, individuals in this situation are faced with a burden that cannot be trivialized. Every man and woman will deal with it in their own way and there is obviously no standard formula outlining how you as a friend or family member can support them. In any event, we hope that this brochure gives you sufficient food for thought to maintain, and possibly even strengthen, good relations between the couple facing unwanted childlessness and those around them.
ADDITIONAL READING:
R. van Walbeek, Ongewenst kinderloos. Brieven over een leven zonder kinderen. (Unwanted childlessness. Letters about life without children.) ISBN 90 6523 091 2
M. Disseldorp, Stil Verdriet. (Silent Grief) ISBN 90 6523 084 X
WHAT DOES FREYA DO?
As an infertility support association, we work to assist couples with fertility problems to cope with their situation. To this end, we provide information covering a wide range of topics associated with infertility. An important section of this information comes in the form of printed materials, which can either be ordered directly from us or viewed on our web site.
In addition, Freya has a network of contact persons who provide answers to questions and lend an ear over the telephone. Evenings are also planned for individuals with fertility problems to give them an opportunity to share their experiences.
Board members and contact persons are all volunteers who are (or were) confronted with fertility problems. Freya publishes 'Freya Magazine', which appears 4 times a year and contains the latest news, a medical column, important addresses and telephone numbers, and many personal stories.
With Freya membership, individuals are entitled to the Freya Magazine, access to meetings and assistance with insurance matters. Membership can be requested by transferring € 38 per calendar year to giro number 598005 (in the name of Freya in Wijchen, the Netherlands), with the indication 'new member' on the transfer form. Please indicate your address if you pay via online banking.
Donations are always welcome!
This brochure is made possible thanks to a grant from the Stichting Patiëntenfonds Foundation.
For more information:
FREYA
infertility support association
P.O. Box 476
6600 AL WIJCHEN
The Netherlands
Tel./Fax: +31 (0)24-6451088
Web site: www.freya.nl
E-mail: secretariaat@freya.nl
