One of the most difficult challenges of infertility is communicating with the people around you about what may be a devastating crisis. Often, the reactions and well-meaning advice of loved ones can cause more distress than comfort. This is especially the case if the topic of infertility is culturally taboo. In some cultures, producing an heir is important and when this doesn’t happen the wife may be blamed and have to accept her husband having a child with another woman. Frequently women are also shamed for the inability to produce offspring, whereas the reality is that it is often a couple problem, with male infertility accounting for 20-30% of infertility cases.
Some fertility patients choose not to tell anyone about their journey, and may end up feeling isolated and alone. Others are forced to tell family or friends, even employers or colleagues, out of necessity so as to take time off work or to miss significant events. Others choose to share their sadness with those closest to them but sometimes find that the support they long for is not forthcoming. This is not from heartless disinterest or a deliberate attempt to make one feel worse. Rather, it stems from not knowing what to say or how to broach the subject, naivety about the subject, or simply incorrect timing in addressing the subject. Even the most loving relative or friend may offer a “helpful” suggestion that lands in a painfully insensitive and hurtful way.
There is also the problem of the financial cost of fertility treatment, and the implications of this for a couple. Unlike some overseas countries, African countries have very few government-funded fertility clinics, and private medical aids often do not cover fertility-related conditions, even though infertility affects one in six couples and is recognised as a disease by the World Health Organization. Thus for the majority of couples there is little hope of access to intensive fertility treatments.
When someone we care about has a problem, it is natural to try help. We often draw on our past experience or that of people we know, for instance, when someone has a car in need of repair the first thing we do is recommend the place we took our car to. Generally, though, baby-making advice isn’t transferable. What you or your first cousin did will usually not help the person you are talking to. Not only can’t your friend use your advice, the sound of it will probably upset her greatly. She is, in fact, inundated with this sort of advice at every turn. To the couple undergoing infertility treatments, making love and conceiving a child have very little to do with one another. Your well-meaning advice is an attempt to transform a complex medical condition into a simple one. However, simplifying the problem has the effect of invalidating the couple’s emotions.
How loved ones can help
The best thing you can do for your friend is to listen and be sensitive. Think clearly before you speak and before you address topics like reproduction, baby showers and pregnancy. If your friend needs to avoid baby showers or children’s parties for a while, don’t take this personally. It is not jealousy. She is happy for you, but these occasions are a painful reminder of what she doesn’t have. Sometimes it is too painful to deal with so she has to take some “time-out” for a while in order to allow you to enjoy your special time without feeling guilty or ill at ease.
Don’t give blanket advice (going on holiday will not cure or fix the problem), and avoid saying things like “you’re trying too hard”, “relax and you will get pregnant”, or “what about considering adoption?” These well-meaning solutions all discount the medical condition and imply that your friend is defective or unable to figure out procreation without your help. In the same way, do not criticise your friend’s medical choices. Medical options are plentiful but they aren’t for everyone. Not only that, but people need different time spans to make important decisions. Just because it seems an easy decision from the outside, does not mean that your friend can process what’s happening quickly. Don’t ask how it’s going. No news is always bad news. Let your friend open up and share how her cycle is going. It’s better to let your friend decide how and when to share this information. Don’t suggest miracle cures or third-party options like “just adopt”. The insinuation is that infertility isn’t so bad, and that adoption is second best.
Support groups and platforms
Joining an online fertility support group or attending Africa’s essential fertility event, Fertility Show Africa, can go a long way towards helping couples cope and access accurate and credible information.
Support sessions at Fertility Show Africa are guided by a professional counselling and support team. Many of these facilitators have travelled the infertility road themselves, and they understand the struggles and grief people experience on their journey. Hence they are in the perfect position to offer help, advice, and support to those in need.
Online support groups include the Infertility Awareness Association of South Africa, the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy, Hannah – You_Are Not_Alone, the Fertility Conversations Foundation, Vessel is Me, the Waiting Wombs Trust, the Zurin Zilani Foundation, and the Empower Mama Foundation. Generally, people are unlikely to want to sit in a room full of people and disclose their challenges. Fortunately, these groups offer support online, and Fertility Show Africa offers both an in-person and a virtual platform where you are not placed on the spot; you can sit in an audience and engage, or not, with experts in the field. These platforms give unbiased support and recommendations based on your individual needs, and can help you choose the fertility specialist best suited to your personality, marriage, family, and community.
This text was adapted from RESOLVE (an American Infertility Support Group) by Mandy Rodriques, a Johannesburg clinical psychologist working with couples and individuals on the fertility journey. Mandy underwent two early miscarriages, along with three IVFs, to have her family. She will be exhibiting at Fertility Show Africa on 9 & 10 October 2021 in the Focus Rooms, Sandton Johannesburg, and online.