This photo was taken during the first hour of a seven-hour car ride that was as crazy and stressful as you can imagine it would be. My kids couldn’t seem to coordinate their bathroom breaks, there was bad traffic, and many, many squabbles in the car where I threatened some unmentionable actions and said things that I regret.
But you would never know just by looking at this picture. What would have been real and accurate is if I took a before and after photo, the ‘after’ taking place in the throes of crazy, when I was sweating and talking to myself. In fact, if I’m being honest, even though they start off well-intentioned, most of my long car trips end like this one, where we are all fighting and fussing. But we don’t show that stuff, those unvarnished emotions, to the world because they are deemed unacceptable. Instead, we process them, suppress them or package them up in a nice little box or, in this case, an acceptable picture. There’s a stigma, still, attached to being authentic and admitting that you are struggling.
In my role as an infertility nurse and nurse educator, I often function as a patient concierge, counseling people during their fertility journey. Some formally, but many people informally. I can’t tell you how many times I am approached by a friend who has read one of my blogs and asks me to talk to their daughter, family member or friend about what they should do when they are ready to conceive. I do talk to them, and I actually cherish these interactions, being able to demystify or explain complex processes.
Lately, I’ve been speaking to those who are not actively trying yet, and we discuss what they can do prior to pregnancy. I go over the basics, taking vitamins, getting immunized, achieving a healthy weight, but what I really want them to know is that preparing for pregnancy (whatever that path looks like for them) is an inside job.
Here is the irony about female fertility: You don’t know if you can conceive unless you try and you can’t try until you are ready to have a baby. There are no previews or glimpses into the important machinery that is the female reproductive system, so we can’t ‘prep’ for it until we are ready to ‘use’ it. This is a foreign and uncomfortable concept to most of us.
Think about our past experiences which form the context for this current one: we have an important test, we study for it. We are running a race, we train for it. You decide to start a family and you, well, go for it. Fertility (within reason and depending on age) follows a bell curve, like many processes in life, so that the majority of people get pregnant in a few months. Some get pregnant right away, and we know this because we are often inundated with these stories, like folklore. Most take a few months, and some need assistance from a fertility clinic to conceive. I can tell you, though, that I review lots of pregnancy records for my clients and a women might ‘remember’ that she got pregnant in a month, but the OB/GYN records state 3-4 months. It’s just all about perception.
Many of my friend’s daughters are reluctant to call me, either because they are embarrassed, or just don’t want to label that they are trying-because then, if it doesn’t work, they have failed at something. Many of them are ‘not not trying’, which I assume means not using birth control and having sex for fun instead of on certain days of the month.
Why do we, as women, feel ashamed or embarrassed to talk about this kind of stuff? Social media doesn’t help as it perpetuates a myth that everyone is happy, that situations are under our control most of the time and, when they aren’t, they are handled with humor and grace. If we are being authentic, we know this isn’t true and I am guilty of perpetuating this as well. I post pictures of my kids and my life (like the one above) that don’t truly reflect the fissures in it, posed pictures while everyone is smiling or funny ones where it seems like I’m laughing at something when I wanted to yell or cry. I still felt the frustration that the situation generated, but took the picture once it was over and processed. So, it probably never really got resolved, just repressed and reframed.
Why do we correlate importance with what’s visible?
This is what happens to young women who are struggling with infertility. They feel the anxiety of trying or wondering when to try, how to try, but then internally compartmentalize it so that they can seem ‘normal’ to their OB/GYN or family members. This is the snapshot that we see on social media, not the real person with real feelings. I talk about this with my patients.
One in particular is so incredibly put-together while she is on the phone, regardless of whether it’s good or bad news. But once, in an unguarded moment, she revealed to me that she is a ‘mess’ after she hangs up the phone. She’s not a mess. She’s a deeply feeling person in a messy situation. There is a difference. But I can reassure her many times and the message might be received but not heard, or heard but not absorbed.
I am working on a venture to develop strategies for nurses to help them find joy in their jobs. I am helping to write protocols, educate them and refine their systems so that they are more efficient. What I can’t emphasize enough, though, is that the women need to do the inner work.
External factors and stressors will always be present. We need to feel that we are good enough, strong enough, just ‘enough’ regardless of our path or outcome. I’m not an expert in this field, and am just beginning to study it. But I have spoken to a few who are well-versed in it, and here are some of the activities that they recommend for developing inner strength:
- Journaling or writing. I started writing my blog posts as a form of stress release after a difficult patient conversation and find that they are just as helpful to me as they are to others. It was difficult for me to reveal how I felt on that car trip, and allow myself to be vulnerable, but vulnerability is a powerful tool, for more on this, read this excellent book by Brene Brown.
- Going outside for a walk or exercise. It’s not just about the aerobic activity, it’s about the contact with nature and invoking your senses to try to get you to focus on the present moment. If the weather precludes outside activity, go to the gym to move, but smelling the leaves or feeling the sun on your face or putting your feet in the sand brings you back to the present. Nature can stop, if even only for a few moments, your mind from going down the well-worn path of would-haves and should- haves and endless ruminating and thought-looping in which we have a tendency to engage.
- Meditation. This one is tough for me, but I highly recommend the work by Dan Harris on this subject. He became interested in happiness and meditation after having an on-air panic attack that millions witnessed. As a result, he became interested in the healing powers of meditation, writing a book and developing an app, both of which I’ve found incredibly helpful. It’s easy reading and he somehow manages to be both informed and self-deprecating.
- Reading. I love to read, but need to be picky about the tone and subject matter of the book depending on my mood. Sometimes I want to learn, sometimes I want to laugh, sometimes I want to escape. If you need ideas for good books, check Pinterest or go to the GoodReads app to see what your friends recommend.
- Talk to a friend. Most likely your friends have struggled with some issue in their life, maybe not infertility, but something that they needed to manage. It’s ok to share your challenges with them. Most are grateful that you are willing to open up to them. Your job, in return, is to cultivate your listening skills. This book by Celeste Headlee really helped me with this and I recommend it to all of my clients and friends.
I am happy to talk to you or your daughters about their fertility. Honored, actually. But some of you ask me what you can do, besides refer them to me. In this situation, you don’t have to be an infertility nurse to make a difference. Encourage them to develop inner strength. If you think they are struggling, ask them, as their Facebook posts aren’t always a reliable reflection of their inner psyche. Support them in the knowledge that it’s ok to allow external events to affect you, without defining you.
“A healer is not someone that you go to for healing. A healer is someone that triggers within you, your own ability to heal yourself.” –Unknown