Secondary Infertility is a grief that knows no bounds.
This is her story:
We started trying to get pregnant after a pregnancy scare.
My now-husband and I were newly engaged, my period was late, we were both convinced I was pregnant. Finally, I took a pregnancy test and discovered I wasn't pregnant. We were both disappointed, and decided to start actively trying to get pregnant. Our wedding was a year away, so we figured if we got pregnant within the next two months, the dates would work out.
It didn't happen
Three months before our wedding, we started trying to get pregnant again. A year later (ironically the month we'd stopped trying as I'd just started a new job), I finally got a positive pregnancy test.
I spent the first half of my pregnancy nauseous and vomiting. By the time I'd started to feel better, I was diagnosed with pre-eclampsia and spent the remainder of my pregnancy on bedrest. It didn't help that my OB was an idiot, however, my daughter was born at 38 weeks via c-section - we are both very lucky to be alive.
When she was four months old, I started to develop extremely familiar symptoms. I took a dozen pregnancy tests, all of which said I was pregnant. I hadn't even had my period yet - I was breastfeeding. My husband and I were absolutely shocked as it'd taken so long to get pregnant with our first.
My second pregnancy was much easier until week 30 when I, once again, developed pre-eclampsia Thankfully, I had an amazing doctor and while we were preparing for a very premature baby, I was placed on hospital bedrest and given medications to manage the preeclampsia. I was then able to go home (no bedrest).
My second daughter was born at 37 weeks via repeat C-section.
That was five years ago next month.
We've been trying to get pregnant for the last four years. I'd taken two rounds of the birth control shot after my second daughter was born. When I stopped the shot, my always normal and dependable cycle went crazy.
Sometimes it would be 28 days long, others 32 days. Once, I had a 40-day cycle. Every once in awhile, I'd miss a period altogether. My periods themselves have been fairly normal but that's the only normal thing about my cycle now.
Two months ago, after more negative pregnancy tests than I care to count - that's what happens when you never know when to expect your period - my husband and I decided to go see my gynecologist.
She sent him for a sperm analysis while I underwent blood tests and an ultrasound.
We'll be seeing her soon to find out the result of the tests, and likely begin to take Clomid to help induce ovulation. We can try two or three cycles with Clomid before she sends us into the city to a fertility specialist.
Today is day 34 of my cycle; two days past my longest average cycle. As usual, I was certain I was pregnant.
I tested today.
It was negative.
I don't know how much more heartbreak I can take.
We badly want another baby, it just doesn't seem like it's going to happen. I know that with treatment, we'll have a better shot at getting pregnant, that next month I could become pregnant, but today, I'm scared I won't have another baby.
My husband's work benefits will cover up to $15,000 in fertility drugs but no procedures, so if we want to get really aggressive, we foot the bill. We're not willing to spend thousands of dollars to maybe get pregnant. We have two kids to support, our futures to plan, so that isn't going to happen.
Nobody knows we've been trying to conceive.
We keep hearing "When are you going to have another?" or "Are you going to try for a boy?" It's knife to the heart every. single. time. We usually shrug it off and say "We'll see."
My mom has made it clear that due to my pregnancy complications, she doesn't think we should have another baby (even though it was only poor medical management of my first pregnancy that put us in danger). Knowing she's against this adds more stress - we don't want to hear her say that we shouldn't be trying, or that it's a sign I shouldn't get pregnant.
I know we already have two kids and I am so thankful, so blessed to have them, but that doesn't mean it doesn't hurt that we can't seem to add another child into our family. I want a big family; I want my kids to have lots of siblings to lean on, to grow up with, to support each other when my husband and I are gone.
This all feels so unfair.
…a panic attack did.
My daughter's name (I was always meant to have had a daughter) would've been Willa or India or Savannah or Charlie or Lee or Harper or Nuala or Fiona or Maggie or Izzy.
I'd have had a long childbirth, full of curses and complications but, ultimately, successful. She'd have had Ram’s full lips, black hair and love of music and my hazel eyes, long legs and love of books.
I'd have stayed home from work to care for her until preschool and we'd have had adventures - road trips without destinations, scavenger hunts on beaches, skipping school to go sledding, sneaking out on dark summer nights to light sparklers, skinny-dipping in closed community pools.
She'd have been raised in the city, with Central Park, museums and people from all over the world to teach her. She'd have been a sharp student, excelling in Art, English and surprisingly, Science. She'd have taught me names of constellations and insisted on completing her science fair projects without assistance. She'd have won ribbons for her work.
She'd have been socially awkward, shy and uncomfortable in groups. She would've preferred one or two close friends instead of a larger clique. She would have been prone to heartbreak at the hands of cruel boys, but Ram would've gotten her involved in jujitsu which would have boosted her confidence.
She and I would have had a rough patch when she was in high school. I'd no longer understand how to relate to her as she no longer wanted to tell me her secrets. We'd have caught her smoking pot, and would've had to decide if we should lie about our own experiences with drugs (mainly Ram’s, as I would've been quick to point out – I'd only smoked pot one-and-a-half times and had not enjoyed it).
It'd have been a rough year but we'd have figured out how to be friends again over the summer after her freshman year. We'd have instituted a mother-daughter trip every year, closing our eyes and picking a place on the map, exploring the unknown together.
I was 29.
I was finishing up the last semester of my Masters in Psychology, taking two night classes, completing an internship at a partial care center for the mentally ill while working full-time. I'd been off of antidepressants for over a year, lost 40 of the 60 pounds I'd gained and ended my ten-year love affair with Camel Lights.
It was time to make a baby.
We had no real money, a tiny railroad apartment but we would make it work.
I felt strong and healthy. I hadn’t had a panic attack in many months and depression was a distant ship on the horizon.
I was about to turn 30 - the age my mother had birthed me - a good omen. My 20’s had been turbulent and lonely. Life, I was sure, would begin in earnest once I hit 30.
We tried to get pregnant for six months with no luck. I became impatient - too much of life had passed by as I waited for depression and anxiety to release their stranglehold. I was done waiting.
I went to my gynecologist.
"Six months isn't a long time," he said. I couldn’t explain the urgency. It wasn’t how long we had been trying, it was how long I felt I had left. What I couldn’t tell my doctor (or even Ram), was that I feared The Crazy was stalking me and would return before I could get pregnant.
Somehow, I thought, a baby would be my talisman - I had to get pregnant before The Crazy snared me.
The doctor prescribed Clomid to make me ovulate, but, he warned I could only take Clomid for three months - doubling the dose each month. Anything longer than three months was dangerous, as the fertility drug could cause ovarian cysts and... I didn’t hear the rest. Didn’t care. All I needed to know was that this would knock me up.
"There's an increased possibility," the doctor said, "of twins."
Twins! How wonderful - one pregnancy, two babies. A set. This was really going to happen - my life would start! I was going to be a mother.
I didn’t tell my coworkers we were trying to get pregnant at first. Several knew about My Crazy, and it felt too raw, too recent to say that I was ready to be a Mama. Part of me wondered if they'd call child protective services and put my uterus on lock-down: A crazy woman's trying to have a baby! Someone sew her shut!
I couldn’t keep the secret long.
Clomid mimics many symptoms of pregnancy: hot flashes, nausea, headaches. Face flushed with sweat, I ran for the bathroom whenever someone ate anything more aromatic than a cracker nearby. I lost another ten pounds. These were not the most telling signs.
My hormones were the main event at Wrestlemania - body slamming and clothes-lining each other, cracking folding chairs over heads.
I dared cars to cut me off in traffic, itching to sideswipe an SUV or rear-end a BMW. A permanent scowl took residence upon my face, eyes beady and forehead furrowed. I was a one-woman street gang armed with chains and broken bottles, ready to shiv the first old nun who cut in line at the supermarket.
Is this what pregnancy would look like?
Two months on Clomid resulted in two negative pregnancy tests. For the third and final month, the dosage tripled, the side effects quadrupled.
The Crazy slowly began to creep back in.
“No, you’re not.”
“Yes I am! Look at my belly.”
“Ashley, we’ve talked about this. You heard what the doctor said.”
“The doctor is wrong. I’m having a baby.”
“Remember? The doctor said you had to have sex to get pregnant. Have you had sex?”
“No, but TJ held my hand. He touched his penis before that - he told me he did. The baby traveled from his hand to my stomach and now we’re having a baby. Give me my prenatal vitamins!”
I had some variation of this conversation with Ashley during my internship at the partial care unit. It was a day care for the mentally ill, a supervised place to spend their days, receive counseling and interact with similarly affected patients. At the end of each day, they went home to their families or studio apartments or group homes, maintaining a semblance of independent living.
Ashley was my age, a schizophrenic who suffered from pseudocyesis – hysterical pregnancy. It was easy to believe she might actually be pregnant. Her belly was swollen, she kept her hands on her stomach, caressing the baby she believed was inside her.
The thing was, Ashley was a virgin; the doctor had confirmed it. Ashley admitted she'd never had sex, but felt it was possible to become pregnant by talking to a man, touching a man's arm.
According to her, she'd had several miscarriages, always near her due date. She grieved each phantom baby as her belly shrunk until, a few weeks or months later, she again announced she was pregnant.
A few of our patients were elderly but most were around my age, suffering from depression, bipolar disorder, schizophrenia and various forms of psychosis.
At the beginning of my internship, I looked forward to Wednesday's, the interaction with these needy, (mostly) gentle patients, leading group sessions and activities. I worked my eight-hour-shift and left my patients and their problems at the door.
As the Clomid cast its spell, I found it more difficult to disconnect. I began to take my patients home with me, mulling their symptoms and comparing them to mine.
Chen was a student from China, who'd come to the US to study engineering. At one time, he had been brilliant. He had no family or friends here and was said to have been a loner. One day in class, he began screaming and throwing books. He had to be restrained and was hospitalized for several months, diagnosed as schizophrenic.
Hearing of his illness, his parents in China refused to let him come home. They sent him a meager allowance each month, supplemented by Medicaid and food stamps.
Chen was rail thin and harmless. He'd sometimes follow me for blocks if he spotted me on the street. He was not a threat and I could've lost him at any time, as he had what we referred to as the "Depakote shuffle," the stoned gait of heavily-medicated patients - feet dragging, arms dangling lifeless.
Chen trailed me like a ghost, the ghost I'd been - or who I feared I would become – a castaway lost in psychosis subsisting in a world that had no place or patience for the mentally ill.
Ana was barely five feet tall and spoke no English. The patients had a choice between arts and crafts or preparing lunch - Ana always chose the kitchen. She seemed calmest when cutting vegetables or making pasta, humming and smiling.
I had very little interaction with Ana, as she spent most of her time in the Spanish-speaking groups. One day, while I was supervising patients in the kitchen, Ana took a boiling pot of water off the stove and walked toward me. She spoke Spanish softly and smiled as she came closer and closer.
I understood two words – water and God.
“I’m sorry,” I said. "I don’t understand - No comprendo.”
“Get out of here! Now,” said another staff member, standing in front of Ana and shoving me towards the door.
I left amidst a barrage of rapid-fire Spanish. When I turned to look, Ana was still staring at me, smiling and holding the boiling pot out like an offering.
“What was that?” I asked when the staffer found me a few minutes later.
“She was about to throw boiling water in your face. God told her to do it.”
“Oh,” I said calmly, as if that explained everything, which, in this environment, it usually did.
“Ana seems harmless,” I said, shocked that this tiny, quiet woman had an ounce of violence in her.
“She was until she tried to drown her baby. Postpartum psychosis. Watch yourself around her.”
It was as if someone had bashed cymbals on either side of my head. The shock was that jarring. Had Ana been normal before she had had a baby? Was psychosis lurking inside of her (me!) waiting for the proper conditions to steal her (my!) sanity?
What separated us (the healthy) from them (the unhealthy)? Was I an us or a them? If I worked too hard, took on too much, played with my hormones like a chemistry set, would I create a hormonal bomb that would explode and forever sever the tenuous thread keeping me this side of sane?
I thought of my father’s mother who, at the age of 40, refused a life-saving surgery and died unnecessarily. She'd spent most of her adult life enduring repeated electric shock therapy, in and out of psychiatric wards suffering from, what we now know, was severe postpartum depression. She never tried to hurt her babies or herself, but depression and panic kept her home-bound, unable to leave the apartment for weeks or months for fear of what lurked outside the door.
I thought of my aunt, who, after the birth of her sixth child, feared she was going to throw the baby out of a window. She, too, underwent shock treatment and claimed to be better afterward. But she often looked miles away, making me wonder if she really was better or faking it to avoid further treatment.
I researched psychosis, asked professors and supervisors... for purely academic reasons, of course. That a wire could snap in my brain, leaving me forever divorced from reality, was a thought more terrifying than a world without children.
What was said time and again was that the first psychotic break rarely occurred after the age of 25.
What I heard was – rarely? As in rare but possible. People suffering from run-of-the-mill anxiety and depression do not typically exhibit signs of psychosis.
So, I could have a psychotic break? That’s what you’re saying? That I’ll probably have a psychotic break? That I’ll be a rare late-onset psychotic?
I'd always been a late bloomer. What if my psychosis was late showing up to the dinner table?
Once again, my brain became infected with what ifs.
What if the hormonal imbalances of pregnancy make me crazy? What if I have a psychotic break? What if I’m schizophrenic? What if I have a baby and try to hurt her? What if I can’t function and leave her in the crib to cry all day, every day? What if I abandon her? What if I can’t handle the pressures of motherhood? What if I change my mind after she’s born? What if crazy skips a generation and I’m okay but my baby isn’t? What if I make my baby psychotic?
I didn’t sleep at all the night before I'd find out if the third, final, round of Clomid had been effective, if I were pregnant.
For the first time ever, it occurred to me just how permanent a thing motherhood is; motherhood is forever. It wasn’t something that I could take back like an ill-fitting dress; it wasn’t like being a wife, which could be undone with a court appearance; it wasn’t a job that I could quit in favor of another, with shorter hours and better health insurance.
A baby was permanent.
A baby was forever.
Being a mother might make me lose my mind.
Being pregnant might make me lose my mind.
I didn’t want permanent.
I didn’t want forever.
I didn’t want to lose my mind. I didn’t want to be pregnant.
I didn’t want a baby.
I didn’t want to be a mother.
I didn’t want to be a mother.
But I did, didn’t I?
Hadn’t I dreamed of teaching my daughter to swim, taking her to the Museum of Natural History? Didn’t I want a sleeping baby on my chest? The late nights of homework, the finger paintings on the refrigerator, the singular smell of baby on my clothes?
The answer was yes.
Yes, I wanted a baby. Yes, I wanted to be a mother. But I didn’t want a baby at the expense of my health, my sanity, my life. If I had to choose between a healthy me and the prospect of an unborn baby, I chose me.
I shook and sweated and cried all night.
Not at the realization that I could not - should not - have a baby, which was a relief, but at the prospect that I might actually be pregnant. I researched abortion clinics, wondering if I could tell Ram the truth. Maybe I could say the test was negative and sneak off in a week or two for the abortion, blaming ensuing cramps and bleeding on a terrible period.
In the following months, I could come home one day after an imaginary doctor’s appointment with the sad truth for Ram – I could not have a baby.
Even if it wasn’t medically true, and it might be for all I knew. It was true in the truest sense, having a baby would be detrimental to my mental health, that having a baby would rob me of a chance at a healthy life.
There was no need for an abortion. The test was negative. I was not pregnant. I would not be a mother.
“I need a break from the baby making,” I said to Ram.
“Okay. How long a break?”
“I don’t know. Let’s not talk about it for a while, okay?”
“Okay. But you still want to have a baby, don’t you?”
“Yeah yeah yeah. Of course. Just not now, okay?”
“No problem,” Ram said.
And so, back with the condoms.
I started making jokes when we saw families out in public.
“Reason 235 not to have a baby,” I’d say, pointing to a toddler having a meltdown in a restaurant.
“Reason 947 not to have a baby,” I’d say as a family tried to board a plane with three kids, strollers, diaper bags and Sponge Bob Square Pants.
“Reason 58,306 not to have a baby,” I’d say when a mother cradled a frail baby attached to an oxygen tank at the park.
After several months of sex with condoms, Ram asked if we would start trying for a baby again.
“No,” I said much too emphatically. “I’m not ready.”
A cold sweat broke out all over my body. How could I tell Ram that I never wanted to get pregnant? Could I lose my husband over this? After all, we'd always talked about having a family. This could be a deal-breaker. Was I willing to lose my husband over this?
The answer was yes.
“I don’t want to get pregnant,” I confessed.
“What do you mean? Now?”
“I’m sorry. I just don’t think I could handle it. I honestly think having a baby would kill me.”
Ram looked skeptical.
He’s always believed in me, even at my craziest; he’s never doubted that I could do anything. He thought I was having the normal fears facing the prospect of motherhood. I had to convince him otherwise.
“I am afraid that I'll hurt the baby; that the pregnancy hormones will make me crazy. That I'll wait until I’m alone with the baby and I will hurt her.”
“So you don’t want to have a baby. Can we adopt at some point?”
“Sure. We can talk about it. Just not now.”
After that, the subject of kids came up less and less frequently. I continued to joke about the thousands of reasons not to have kids. Ram started to add his own. There was no defining conversation in which we sat down and agreed that it would never happen. Our plan for kids passed like a cloud over the sun, a temporary darkness that lifted and let us play in the sun again.
Just the two of us.
No kids allowed.
I don’t know if Ram jumped off the baby bandwagon or if I mule-kicked him off. We've never left it to chance to see if I could get pregnant.
In fact, two years ago when I was 36, the age most women crave babies, a condom broke, which could have been a wait-and-see moment. Before that thought could formulate in our brains, I kicked Ram out of bed and sent him to the pharmacy for the morning after pill.
He’s lucky I let him get dressed before I shoved him out the door. It was the best 50 bucks I've ever spent.
It’s not easy to be a childless mother.
That’s what I am - a childless mother. I mother everyone around me – my family, friends and patients, children whose laces come undone, old ladies who need help with bags, homeless men who need a sandwich. I sing children’s songs. I carry a balloon rocket in my bag to entertain children I meet. I make quarters magically appear from little ears. I am magic around children.
I was meant to be a mother. It will be my biggest regret and my biggest relief that I will never have a child. How can I explain that to people who ask (and they always ask) why we do not have children?
Sometimes I say we don’t want children. The responses to that are strong and swift:
You will regret it.
You want a baby. You just don’t know it yet. And when you realize it, it will be too late.
Every woman wants a baby.
Who will take care of you when you get old?
Shame on you!
You’re going to be very lonely.
Other times I look sorrowful, touch my belly and say, I can’t have children. I am vague when asked what treatments we have tried, hinting that it is just too painful to talk about. The responses to this are sympathetic but no less urgent:
I know a doctor who…
Did you try IUI, IVF, artificial insemination, donor eggs...
My daughter got pregnant with acupuncture and Chinese herbs.
You can’t just give up.
It’s God’s plan.
You’ll get pregnant when you least expect it.
Babies from China are very expensive but so smart!
South America is cheap but unreliable.
If you really wanted a baby, you’d adopt.
Other times I make jokes:
We prefer to borrow, not buy.
There’s nothing but moon rock in my womb.
I did have a kid once. I dropped her off in the ball pit at Ikea and never heard from her again.
We have a cat. She can’t demand an iPhone or $100 skinny jeans and we won’t have to put her through college.
What I don’t tell people is that, when I take my friend’s two young daughters out to the park and a stranger says – your girls are so beautiful, I don’t always correct them.
In the introduction to her grandmother’s decades-old cookbook, At Home on the Range, Elizabeth Gilbert writes of her grandmother:
"…her passions have outlived her, still manifesting themselves quite firmly, four generations later, through the pursuits and aspirations of her female descendants. Among her six great-granddaughters, three of us write for a living, one of us runs a restaurant, one of us is a hostess worthy of any recipe in this book, two of us are wizards at cards, two of us are trained historians and three of us found a way to live overseas. All of us love a good party. Gima also has two preteen great-great granddaughters, who are not only charismatic and literary, but in whom the ‘prime requisites’ of – yes! – ‘hearty appetite and sense of humor’ have come down the pike utterly intact.
“What I’m saying is, if you are influential enough and beloved enough, it turns out you can stick around for quite a while after you die.”
What does this mean to me, truly?
The melancholy part of me grieves that I will leave no legacy behind, no children or grandchildren to carry on my sarcasm or kindness, to delight in sunsets and books, to enjoy solitude and movies, to have a strong left-handed curve ball and no culinary ability whatsoever.
The people I have had the most impact on – my elderly patients – will be gone long before me.
Who will remember me when I am gone?
The other part of me, the less sentimental me, feels that a legacy is unimportant. Living in the moment, being grateful, helping those I can, making the most of this life – that’s what matters to me. But I can’t deny the beauty of my patients with children, grandchildren, great-grandchildren, even great-great-grandchildren, how so much life and love and potential can come from just one person.
When we meet up with old friends who have children, there is an undeniable physical aspect to the progress of their lives. "We had a baby!" becomes "We had another!"
Those babies learn to walk and talk.
They play soccer and take karate and start kindergarten. All of these milestones are recognizable in cultures the world over.
What are my milestones?
Where are my markers?
Old friends look at me and see the same me as ten years ago. A little thinner or heavier, longer or shorter hair, more wrinkles and grays. But still just a wife. Not a mother. Nothing new to report, no way to know the lyrics to their secret mommy songs. So when they ask what’s new (perhaps not wanting an answer) and I shrug and say not much, I smile to myself.
Because I have a secret. Lots of them.
I have this whole life to explore and challenge and question and change. I am the singular force driving my life. I alone contain the promise of my future, my passions, my plans, my failures – past, present and future – that make me who I am.
Did you know it is possible to miss something you’ve never had? Someone you’ve never met? I do. I miss my daughter. It’s an physical ache; dull but real. I miss her as if she'd actually been born. As if we'd shared a secret language only the two of us had known. As if we'd played in the waves together. As if we'd celebrated a lifetime of Christmases and birthdays and Halloweens.
I miss the daughter I never carried; the daughter I never had. What is equally and possibly more true is that, had I actually had that daughter, I would have missed myself a lot more.
Some days, the non-mommy ache is so big and hard it’s like a sledgehammer against my breast-bone.
Other days, however, my ribs open up like the door of a birdcage and let me know that I am free.