Correspondence and reprint requests: Walter W. Benjamin, Hamline University, 1536 Hewitt Avenue, Saint Paul, Minnesota 55104-1284, U.S.A.
"I have had four miscarriages. My husband and I were devastated by each one." The body of the well-groomed woman in her mid 30s shook and tears streamed down her face as she said, "We would do almost anything to have our own child."
I had been speaking to a state meeting of RESOLVE on the moral ambiguity of in vitro fertilization, embryo transfer, and surrogate mothering. Her outburst gave me a glimpse into the personal purgatory that many infertile couples experience. RESOLVE, a rapidly growing, nationwide organization, offers counseling, referral, and support services to infertile couples. Presently, infertility affects 15% of all couples and it is estimated that by the 21st century, about one couple out of every five may be unable to have their own biological children.
Infertility may be due to many factors: postponing childbirth, environmental hazards (radiation, etc.), stress, genetic or somatic abnormality, sterility induced by improper contraceptives, permissive sexual mores, gonorrhea, and others. Also, some conservatives suggest that the women's liberation movement might be responsible for increasing male sexual dysfunction. Whatever its etiology, infertility--defined as the inability to achieve pregnancy after trying for one year--is a devastating experience. The term, a dreadful one for those so affected, often affects every phase of a couple's existence.
In spite of the reproductive rights brought about by the decision in Roe vs. Wade (1) and the increasing acceptance of fertile partners who remain childless by choice, infertile couples still have difficulty fitting into the American model of families. Often they are made to feel isolated. With dread they approach Christmas, birthdays, and other culture rituals where babies and children are at center stage. Physically, women may have such psychosomatic complaints as headaches, gastrointestinal dysfunction, or such cognitive difficulties as an inability to concentration and poor job performance.
Psychologically, infertile couples may have a "premorbid" view of the self and the world. Spiritually, there is a form of "cosmic shock": "How could a good God allow this to happen to us?" Their grief often follows the five steps set out by Elizabeth Kubler-Ross:
Denial: "We just need to relax more" or "Take a second honeymoon;"
Anger: "Why is God tormenting us? Certainly we would make better parents than those promiscuous teenagers who can get pregnant at the drop of a hat;"
Bargaining: "I promise to leave my job and stay at home if I get pregnant;"
Withdrawal: "I just can't face people anymore; it hurts too much;" and finally,
Acceptance: "We have not failed over that which we have no control."
Couples experience a variety of conflicting emotions: they ricochet from one feeling to another--envy, cynicism, self-pity, pessimism, hopelessness, depression, jealousy, isolation. Each month there is the "yo-yo" experience. Started with hope, the onset of menses brings devastation. Baby-making becomes an obsession; intercourse turns into a ritual of timing, temperature, and technology. The world is viewed solely through the prism of pregnancy. After months of failure, there may be emotional flattening. To see an unwed, teenage expectant mother in a T-shirt decorated by a downward arrow pointing to "BABY" stimulates anger... and it's not nice to be angry. Alcoholism, divorce and suicide may threaten. Friends offer advice that varies from novel positions for sex to pills, exotic foods and far away "miracle" clinics. They mean well, but they hurt.
In the best-case scenario, the couple passes through the grief process with counseling and bonding with other infertile couples. They give up the "dream child" myth, recognizing that there are no "dream" children or "dream" father/husbands or mother/wives. …