She's color coded your calendar for the days you’re supposed to TTC. She’s taken up a diet of bone marrow broth and beets. She always seems to have an appointment but you can’t quite keep track of what for and are afraid to ask. Was it acupuncture? Reproductive Endowhatyoucallit? Therapy? She never drinks anymore, but wait, sometimes she does, you’re not sure. It was only a few months ago (it seems) that you both agreed to start trying, when did it get out of hand?
As much as I want everything to be equal in a marriage, when it comes to infertility, it’s not. The woman that plans to get pregnant is calling the shots (literally, because she’s taking them). Most of the work-up involves her body, and she is the one who has to get ultrasounds, dye tests, bloodwork, etc. Sometimes women I see are slightly worried that their partner will change their mind about having kids if it seems to be too complicated. So they don’t tell you about it. Or, they’ve started to feel so out of control with her inability to make it happen, that she’s tried to find relief in controlling all of the appointments, scheduling the sex, and trying not to talk about it to you too much lest you lose interest.
See, infertility is a disease that affects the very core of who a woman can see herself to be. She takes it personally. Some women have wanted to be moms their whole lives, and when they finally have the right job, the right spouse, and a nice place to raise a child, but the child doesn’t come. When women get cancer, they do not see it as their fault. If you take that into consideration, then it is not surprising that the data show that women respond to an infertility diagnosis with more psychological distress than a cancer diagnosis. Many women blame themselves for infertility, see themselves as being a lesser wife and a lesser woman because of it. And thinking those thoughts makes her feel terrible.
In the Ring Theory of emotional support, it describes how we can gather around a loved one when they are in pain. The idea is that the one afflicted is in the center, and each supportive person exists on rings outside - comfort flows in and discomfort flows out. The person in the middle (your spouse, the one who is trying and planning to carry the baby) gets to dump on you, and you get to dump on your friend (anyone but her). This is not exactly the way it goes in infertility though, because not being able to have a baby affects the non-baby-carrying spouse too - just differently. So your wife wants to be there for you, she wants to make space for your pain, and she’s even told me she secretly kind of likes it when you express your pain and sadness about not being able to have a baby - because it makes her feel less alone. Just don’t do it all the time. Sorry. It’s complicated.
So what do you do to support your spouse?
1. Ask her what she needs
She may not know what she needs, she may need different things on different days, and on different cycles she may feel more despair than others. Things I most often hear from my clients are:
“I want him to hold me while I cry.”
“I want him to get mad when a cycle doesn't work.”
“I want him to research what is going on so he can help problem solve too.”
“I want him to make dinner while we talk.”
“I want him to suggest we curl up together and watch a movie.”
Of course this is a time to ask her, “How can I best support you?” but being supported might be unfamiliar to her because she sees herself as a badass who hasn’t needed support in the past, (which is a misnomer because it’s actually MORE badass to ask for support). So this is a tough one for both of you, but the more you can talk to her about it, the better. Asking for help also happens to be a key lesson for new parents, so your wife is starting early.
2. Show your emotion.
Infertility is so lonely. Because our society so often defines womanhood simultaneously with motherhood, this is confusing place for a woman in her late thirties to be without children. It’s just not the same for men - it’s kind of like how men are defined by their jobs, and what a man goes through when he’s not working outside of the home, or is a stay at home dad.
3. Pay attention to the calendar.
Infertility doesn’t follow any rules, and order is craved. Planning procedures, appointments, attempts, and tracking cycles is all she has. Link your calendars, pay attention to the little hearts or color coordination she has. If an appointment competes with something at work, figure it out and be there. She does not want to be taking you away from work, but she also does not want to be infertile. Tell some of the people at work what you’re going through, and let them help you out. If there are times you absolutely cannot attend appointments, mark it on the shared calendar. Procedures like IUI and egg retrievals are time sensitive and cannot always be planned a week ahead of time.
4. Bring it up.
She is thinking about trying to conceive ALL THE TIME. She is probably making assumptions about how you don’t want to talk about it or that it doesn’t affect you the same way it affects her. By bringing it up, saying something like “How are you feeling today?” or “What have you been thinking about today?” you allow her to release the pressure valve with regular increments so that the emotion doesn’t build up so much and explode later. She may not want to talk about it at that moment, but it feels damn good to have someone else bring it up for once. Providing the outlet shows her you care and are in it with her.
5. Investigate a support group and offer to go with her.
Infertility is so isolating, and no one wants to become identified by it. it’s there, and the pain grows the more baby showers she’s invited to and the more pregnant women that seem to be popping up everywhere. Check out www.resolve.org for a local peer-led or professional led group in your area. It’s a great place to hear other’s stories, get tips and ask for guidance, and maybe even find a friend.
Infertility is stressful and lonely for both of you. Talk often and don’t forget to have fun too. And one more tip - research shows that bringing her flowers helps to reduce her stress.
Allison Ramsey is a licensed clinical mental health counselor and fertility counseling specialist in the Asheville area. She’s a member of Resolve, The Infertility Association and the American Society for Reproductive Medicine. Contact her to start feeling better.