Childlessness and Pregnancy Loss

I listened to an interesting podcast the other day. Those of you who know me might be surprised - I definitely struggle with podcasts. In fact, I started to write an explanation, but have turned it into a post on A Separate Life this week. But this was one I had to hear. Because Loribeth featured on The Full Stop podcast, in a discussion that is very pertinent to me - Childlessness and Pregnancy Loss. Don't continue if you're not ready for this, or if you have difficult feelings around pregnancy and pregnancy loss. (Though I try to address these at the end.) You'll find the link here via  Loribeth's post about the podcast. And a warning: it's a tear-jerker!

As any regular reading of No Kidding in NZ knows, I had two pregnancy losses in my path to Otherhood, and then spent years participating in and moderating an ectopic pregnancy website, before I even thought of starting this blog. So I was interested to see what angle the discussion might take. Any limited time for four people to discuss a topic is, of necessity, going to limit the discussion itself. (In her post, Loribeth mentioned the "gazillion" things she wished she'd been able to say!)  We understand that. And there were some very interesting points. These are my comments on it.

First, the issue of silencing ourselves was raised. Loribeth has talked about this too, but I was thinking about it from my own perspective. Talking about loss seems to be largely taboo in our society. The whole "don't say you're pregnant until after the first trimester" really says "it doesn't count until you are properly pregnant." (I had someone say, "oh, it's still really early then" as if it didn't count, even though my nausea was very real. I'd announced my pregnancy early only to my family at Christmas, as they would have wanted to know why I wasn't drinking! But it was dismissed.) After a loss, the rule of no early announcement says, "we don't care about early pregnancy losses." People don't want to hear it. It's as if you're "not really pregnant" or, as a friend said to me, "you never had anything so there was nothing really to lose." So even when we have a loss, we are unable to talk about it. We are silenced. 

In ectopic terms, this too is incredibly dangerous, as it means a general lack of awareness by both family and friends, the women themselves, and their doctors. Women's early pregnancy pains or other symptoms are easily dismissed. I was lucky that I had a great GP, who wanted to monitor my HCG levels to ensure I was having a miscarriage. When my levels did not fall, but rose insufficiently, it was clear I was not - it was an ectopic pregnancy, which instantly means "danger." I've since seen many many women - one woman is too many - be told by their doctors not to worry, they're just having a miscarriage, only to end up in hospital with life-saving emergency surgery after internal bleeding, or needing emergency medication. I remember Bamberlamb telling me that, when presenting at hospital with symptoms of her third ectopic pregnancy, she had to ask the nurses/doctors for their names so her husband would know how to name if she died as a result of a ruptured ectopic pregnancy. It was only then that she got the help she needed. And it was only because she had been active on the Ectopic Pregnancy Trust Messageboard that she knew all the symptoms and what they meant - and knew them far better than the medical professionals at the emergency department.*

But, as the podcasters noted, we also silence ourselves. At first we do it out of self-protection, I think. I found I could talk about the mechanics of my ectopic pregnancies - the reality of the medical treatment, what implanted where, etc - more easily than the fact that I lost the future baby. Anything involving emotions would have set me off - I wasn't much of a crier before loss, but then the floodgates opened! So I preferred not to talk about it, except with a select few, or online, when you can type even when the screen is blurry through the tears. I also felt embarrassed and ashamed. I don't now. Not at all. But at the time, emotions are complicated. Protecting ourselves as we work through them is important self-care.

We also silence ourselves, trying to be sensitive to others. We don't want them to be uncomfortable, so we hide our own emotions and therefore our own experience. We don't want newly pregnant women to worry any more than they might. But in doing that, we are also not being honest about how it affects us, or the significant percentage of women who experience loss or childlessness. I find it interesting that it is often the grieving person who is forced to be the most sensitive to others. (Don't get me started!)

But all this silence is not entirely honest either. When we can cope, when we are ready, talking about loss openly is much more honest, both to our own experiences and our own relationships with others. It must help those who will come after us. Because there are always those who come after us, and knowledge is important, awareness is life-saving, and information is power. That's why I worked in the field (voluntarily) for years, and why I still try to talk about it openly when I feel it is appropriate and/or necessary.

Support, as Lori mentioned on the podcast, is something we take when we can get it. But often that support drops away, especially if people go on to have children and drop off the radar. She found that in her support group, and I found it also at the ectopic messageboards, as more and more of my friends went off and had their families, and disappeared. I didn't really belong there except in the anonymous moderator role. But my presence, like Lori's as a leader of her support group, was important visually, just to let people know we were okay. And then I found blogging, where I do belong, even if I live on the other side of the world from most of you. That's why I love this community so much!

Michael, of the Full Stop podcast, also talked about how "the ghost (of his and his wife's losses) continues to be with us." Their losses are around birthdays and Mother's Day, and that is hard to ignore. I can relate to that. I learned I would never have children at a scan on my birthday, and both my ectopics took place over Christmas and New Year. Others I know remember the dates of their last IVFs, or when they decided not to look at assisted reproduction, or adoptions fell through or they had no choice but to opt out.Though I'd like to give some hope. After over 20 years, I can think of those dates and losses with love and compassion for the woman I was, but largely without the pain. (Although I admit that the Mother's Day reminder is an unkind double whammy.) I've written about this here, and here, amongst other places.

His perspective on how a man grieves, whilst at the same time wanting to help his wife, is complicated too. He had nowhere to find support. I remember my husband saying that his GP asked "if his wife was over it yet." I don't recall him saying the GP asked how HE was handling it. And I remember how, when I was feeling better recovered and stronger, that my husband felt he could finally open up to me more about his feelings. 

Finally, there was a really interesting discussion around envy amongst the childless community. Even though we are all living lives without children now, the speakers felt the envy of those who never got the joy of that positive pregnancy test, or who felt the losses of the children they never had but don't feel they can talk them as losses, or those who never had their losses recognised, or those who never named their losses or had those names recognised by family and friends, or those who never held their lost babies, or those who never saw them take a breath, etc. And those who are envied might also envy - it's only natural, I think. They might envy those who never felt the fear of an emergency hospital intervention, who never felt the grief of a late-term or full-term loss, who never had to take medication or have a D&C to end an incomplete miscarriage, who never had to tell family/friends/colleagues of their loss. 

Envy is, of course, for what the other person had, not what they lost. It's a blindness, and is only about the loss felt by the envious person (eg. the lack of a pregnancy positive, or a good scan, or heartbeat, etc). And that is real. But we also need to know the existence of that envy can feel like we are negating what the subject of that envy has lost. That the magnitude of their loss feels cancelled out by the moments they had that we might not have. 

That's where compassion comes in. And sometimes, compassion can only come with time, when we are less self-centred, and our envy can morph into true compassion and empathy for another's loss. I think, I hope, that the childless community is good at that, ultimately. Most of us recognise that everyone's grief is different, and there's no better or worse.

* I know all this is wordy and perhaps repetitive. If one woman finds this information about ectopic pregnancy, and it helps her or someone she knows, it is worth noting.

 

Thinking about life when you're childless

In recent conversations over the last few weeks, I have been reminded how readily my husband and I think and talk about ageing, about the natural progression of life (and death), about infirmity and about dying. And I have been surprised by how others do not do this.

In particular, we know we have been forced to think about this in two ways. Firstly, we couldn’t ignore the realities of ageing because we did the bulk of the elder care of his parents, watched their decline week by week by week over 20-30 years, and inevitably recognised that we too would be largely unable to avoid this. It always surprises me how many people aren’t willing to confront this, who think by exercising and keeping healthy they will avoid all the health problems that may crop up in their 70s and 80s, if not earlier. They are in denial, because they don’t want to face the fact that almost all of us will, if we’re lucky enough to survive to old age, have to deal with physical or mental decline. Of course, one of the reasons we were responsible for so much of the elder care was our No Kidding situation. We had no excuses for not visiting, for “not having the time” to care for the elderly parents, to think that a letter or Skype call once a month was sufficient to keep the relationship going.

Secondly, we can’t ignore the realities of ageing because if we don’t plan for our future, no-one will. We can’t rely on children, or even nearby nieces or nephews, because we don’t have any close by. We can’t ignore these issues, of not thinking about where we might want to end up, especially not if we want any sort of choice in the matter, and if we want to avoid the distress and fear we have observed in other elderly people who leave everything too late. Yet our guest seemed to be more concerned about where we would end up when we are dead (ie our ashes), than when we are still alive but in need of help. It is bizarre.

I confronted him about it, mentioning that his inaction might limit his choices when he does need help, that by not thinking about things he was – consciously or unconsciously – deciding to leave the burden on his children, and that it was quite selfish to do so. I also pointed out we didn’t have the luxury of doing this. And now that he knows, it is no longer an unconscious choice he is making to ignore his old age.

He does not even have a Will – can you believe that? He must think he is immortal! We’re not perfect. We know we need to update our Will. And after these conversations, I’m keen to do that early in the New Year.

Ultimately, being childless has forced us to think about these things. Ectopic pregnancies forced me to confront my own mortality, and doing so has brought me some peace. Accepting the randomness of life has made me accepting of whatever may befall us. And the ease of having compassion for others, knowing how easily misfortune can occur to anyone, and knowing that judgement often comes through ignorance and an inability to put  ourselves in other people’s shoes.

Learning to enjoy the little things in life, to feel gratitude, to continue to learn, to try to improve myself, all these things will make my life easier as I age, as they make my life easier now, and as they were a result of infertility and loss and survival. I am not kidding about any of life’s inevitabilities. I’m glad about that. I’m at peace. Whereas this person who wants for nothing materially, who has children and a wife and friends, is uncharacteristically ill at ease with his age and afraid of the future. Maybe, the grass is not always greener on the other side.

"What if there isn't a plan?"

Yael Wolfe posed this question in her recent piece about Why Childless Women Inspire Superstitious Sentiment. "What if there isn't a plan?" Perhaps because I don't come from a religious background, and I'm not surrounded by religious people or even in a religious society, as I mentioned back in World Childless Week, I don't think about "God's Plan" or believe that there is one. But as I wrote then, the "it wasn't meant to be" sentiment is still strong. Yael Wolfe's articles echoes a lot of the sentiments in my post, but was perhaps kinder to people who say these things than I was! It's worth reading. Or see Loribeth's excellent synopsis and selected quotes here.

I highlight it again here because the idea that there is no plan, and that everything is random, does not worry me as Wolfe concludes it worries so many others who just want certainty in their lives. When I accepted that everything was random, that nothing "happens for a reason" it was a moment of true relief and a lifting of the burden of guilt. Because I did feel guilt that I must have done something wrong to not be able to have children, an accomplishment that so many others - less deserving others as I know now - manage, or perhaps have imposed on them against their will. 

Realising that that guilt was so misplaced, and dispensing with it, gave me a freedom and lightness and yes, uncertainty, that I would always take over the assurance that everything happened to me for a reason. It is so much easier to show compassion to myself and acceptance of others, to try not to judge, and to be the best that I can be within my power and circumstances. Uncertainty and randomness has taught me gratitude, mindfulness, and appreciation for the little things (as well as the big). It has helped me stop worrying as much about future events. It has stopped me focusing on the what-ifs, because that is so pointless, and given me a clarity that has made life better, and easier. 

Embrace the uncertainty! It will set you free.

What we share

A week or so ago, a friend posted a pic of her eldest son, moving into his university halls accommodation. Between my two ectopics, my friend invited me to lunch, and told me she was pregnant, and would be telling our bookclub the following week. I appreciated that so much. At the time, I was hopeful I too was pregnant, but it took a few more months until I was, this time with my second ectopic. When I was in hospital for a week, waiting to see whether my ectopic pregnancy was a trophoblastic cancer or not, and not being allowed home in case it burst and killed me, she visited, heavily pregnant, joking that she thought that alarms might have gone off at the door to stop her getting in in “her condition.” I appreciated that joke, and the visit. 

When she had her son a few months later, I popped up upstairs in the women’s hospital to leave her some magazines and a note, after I had yet another consultant’s appointment downstairs to see how to resolve my ectopic. And afterwards, I remember walking with her along the beach, pushing the pram, as she asked about ectopics and IVF. She was there for me when I needed her, and was always easy to talk to when we did get together, despite a gap in ages, her easy fertility, and her always active social life. I’ve been lucky, because she made things easier. (Not all my friends were able to do that.) When I’ve visited her house I’ve seen the boys grow up, and knew that her son was going to university this year (though I didn’t know he was leaving home and going to another city), so the passage of time itself wasn’t a shock to me.

Still, it gave me food for thought. In some ways that time in hospital seems like another life. But in other ways, it doesn’t feel that long ago. 17 years went in a flash! In a year or two, her youngest son will be away too. Then she’ll be an empty nester, along with all the rest of us from that bookclub. Her day-to-day life will be, essentially, the same as mine. (Except it will be far busier, because that’s just who she is!) Of course, long term she will probably become a grandparent, and (barring a tragedy) her boys will be there for her when she’s elderly, or needs them. I’m not forgetting that. But there will be a period of time – maybe 10, maybe 20, maybe even 30 years, when her life won’t be all that different to mine. It’s useful to reflect on that. Sometimes it really helps to focus on the similarities between us. There are far more than we might think.

No Kidding 2020 Project: Day 5 - Love

Growing up, the idea that you might love or even like yourself was anathema to me, and I suspect most New Zealanders my age. We didn’t think about ourselves in that way – we were taught to focus outwards, not inwards. In some ways that is helpful, but in so many ways it is not. So when I first experienced loss, I didn’t know how to feel compassion for myself. 

But what I read, and who I talked to (mainly online), always came up with the same message. Be kind to yourself, be compassionate, love yourself. I never really got it, as instantly – when I would think about loving myself or showing compassion – my inner dialogue would counter with a long list of why I didn’t deserve love or compassion. Sound familiar? Too many of us do that. Just this last week, in a different blogging project, a friend wrote her “Things I like about myself” post which was really a litany of what she didn’t like about herself.

But then, in a book a friend recommended, there was a simple exercise about how to love yourself, and how to show compassion. It didn’t mean you had to love everything about yourself, or even like it or approve of it. But it did mean that you were worthy of love and understanding. I’ve written about it before here (in the Gifts of Infertility series), but I’ll repeat it because I think it is useful.

When we’re grieving, or angry, or simply feeling down, we should try not to self-recriminate. Instead, imagine that grieving, ranting, or sobbing person as the child we once were, clearly in pain, clearly needing love and understanding. Who better to understand them but us? Embrace the child, send all the love and understanding we can, because their pain is our pain. Let them know that pain is heard with empathy, it is understood, and they are loved nonetheless. I’ve done this exercise, and it always helps when I’m in pain. Sometimes years go by without needing it, then something pops up, and I remember how important it is to just express and feel that love.

Ultimately, isn’t this also how we would react to someone we loved who was in pain? Wouldn’t we would hold them, comfort them, listen to them, love them? Don’t we deserve the same compassion? Yes. Yes. Yes.

It makes life easier. It helps us begin to change what we don't like, or to accept what we can't change. It makes us better people too, more able to exercise compassion and extend love towards others. But it all starts with loving ourselves.

Finding acceptance and compassion

Several blog posts over the last few weeks have all come together in my mind, as well as observations of a Fbk group focused on ageing without children. And so I had to put some thoughts down.

I read a post of a woman who was struggling with the fact that it was unlikely that she will have the third child she so desperately wants. I read Fbk posts from people who seem to reside permanently in grief over the children they were not able to have. They seem unable to be able to move on, and I feel for them. I read their comments wishing that they could join this community, and feel the hope and compassion and understanding that I try to offer, and that is offered by my readers and fellow bloggers. And I read Léa’s post here about the difficulty of acceptance, referring to a study (one that I had quoted after Loribeth had referenced it about five years ago) that found that acceptance is vital for happiness. 

Then I read responses to the people who were stuck in their grief from a person who berated them for that. Just because this person was able to move forward and embrace their life, and embrace the children of friends and family, they seemed to think that everyone should be able to do that. And they weren’t particularly kind. They didn’t think that maybe their circumstances were different, maybe their friends and family were more inclusive, maybe they had children in their lives they could influence, or maybe they had the mental and physical wellbeing to be able to cope with their lives. So they were judgemental of the grief-stricken for not moving on. Which is, as we know, exceedingly unhelpful.

“Get over it,” or words to that effect, are never going to work. I am cautious even when I tell people that it gets easier, because I know many will resist and resent that message until, one day, they realise they can start to believe it. Over 15 years, I’ve seen this pattern over and over again. Over one, two or three years, the large majority of us learn to accept our lives. We first learn to let go of the yearning. Then eventually, the mourning turns into remembering. And we learn not only to accept our lives, but to love them. We learn to look to the future.

But what of those who don’t? Decades on, they are still grieving, or worse, still yearning. I don’t know if they are stuck in their grief simply because they have never received help and encouragement to find a way to stop their yearning that will never be fulfilled. Or maybe they’ve never had to face and overcome their emotions, their fears, and now don’t know how to even start to do that. Or maybe, perhaps, they were just having a bad day (as we all do), and needed some understanding and compassion.

It’s frustrating. I started this post to write about those who have been unable to move on, and who continue to feel their loss keenly. I end it with no helpful conclusion, other than that compassion and understanding and acceptance – our own, as well as that of others – is key to our well-being. As Léa said so beautifully (in translation), "it is essential for (our) mental health to mourn without continuing to hope in vain."

Celebrations vs Grief - a place for both

I've been thinking a lot about celebrations recently. It's part of the New Zealand culture that celebrations shouldn't be (too) over the top, and that we should pay tribute to, or at least be thoughtful of, the unlucky amongst us, whether it is a sporting event, career achievement, or anything else we might be celebrating. Fair play and humility are important to us.

Perhaps that's why I feel I am less willing to keep silent when it is perfectly legitimate to talk about my losses, or my situation. I've written about this before, four years ago, in Practising Self-Compassion. I don't think that we need to keep silent, for fear of upsetting other people or diminishing their happiness. Because our feelings are just as important as those of other people.

I'm writing this after reading Loribeth's post about wondering how to acknowledge the anniversary of losing Katie this year, because on the exact same date her nephew and wife are having an OB-GYN appointment for their pregnancy. She's a nice person - she doesn't want to upset them. Society tells us that we are supposed to put other people's happiness before our own grief. We feel it is unfair to ask others to ever-so-slightly subdue their own feelings about their good news, when their celebrations - sometimes gloating - can cut us to the core, or kick us when we are down. When actually, the fact that someone might think twice about celebrating, or how they celebrate, in front of us is not a bad thing. They can whoop and cheer behind closed doors, with other family and friends. They will have plenty of people celebrating with them. Their joy will not be diminished. But if it is, with an awareness of how bad it might make others feel, is that a bad thing? I personally don't think so. I think it can be a teaching moment, and contributes to a better, more thoughtful, world.

I think - as I said in the comments to Loribeth's post, and as I've said here before too - that this is one of the reasons why pregnancy loss and infertility are so misunderstood. We don't talk about it because we put other people's feelings before our own. That's what Loribeth is doing, because she is a lovely, thoughtful person, and because she adores her nephew. But her loss was huge, and deserves recognition. At the very least, she deserves to show herself self-compassion, and allow herself and her husband to honour Katie and their loss in the way that feels right for them.

The thing is, I often think that we worry that our news or situations or sometimes our very presence will bring people down. Whereas I think the reality is that, unless someone has been through what we have been through, they don't recognise the pain of individual days, or events, and they are easily able to dismiss our situations because "it won't happen to them."

The reality, I believe, is that if she posts about Katie, and her nephew and their wife see it, two things may happen:
a) they will feel compassion for Loribeth and her DH, I'm sure, and
b) they may feel increased anxiety about their pregnancy, for an hour or two.

If they get good news, as we all hope they will, they'll either
a) forget any small sliver of anxiety, and/or
b) feel even more grateful that they have a healthy pregnancy.

The one thing I'm confident of is that they will be surrounded by the good wishes and shared joy of family and friends, including Loribeth and her husband.

If the couple get bad news at their appointment:

a) they will worry, feel anxious or grieve regardless of what was said or not said earlier, and
b) they will have been reminded that they have an uncle and aunt who understand, and who will be there to support them.

Victory and defeat, joy and grief, celebration and commiseration don't have to be mutually exclusive. The bad things don't need to be hidden. The good things in life can be even more precious when the bad things are openly known, are talked about, and are mourned.

Of course, it's easy for me to say. I don't have this particular dilemma. But I'll admit that I'm tired of us always being the ones who have to tiptoe around others, who have to swallow the slights, the casual thoughtless remarks, who have to make allowances when we are hurt. I'm tired of squashing my feelings in the interests of "being polite," when it is not reciprocated.  I don't think an occasional, polite, diplomatic mention of my own circumstances is inappropriate. In fact, I will defend it strongly.

I hope that whatever any of us would decide to do in similar circumstances, we are reassured by the knowledge that this loving No Kidding community of women and men will give support and understanding, and that we will our needs - the needs of the minority - will always, in this space, come first. As I said above, there are plenty ready to be cheerleaders for the majority, and to celebrate the unbridled joy (we sincerely hope) of those lucky enough never to feel this particular loss.