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Going outside helps me journey inside my mind and soul. The stillness of nature allows me to tune in and listen to the thoughts and feelings that are buried under the chaos of everyday life. Several months ago I had the blessing to spend a few quiet moments in a nature reserve with majestic redwood trees. I expected to be overcome with awe while witnessing these tremendous trees, but was caught off guard by what the trees brought out in me.

The gigantic redwood trees invited me in, protected me and made me feel small and humble. In particular, I was called to the large cavities that exist at the core of some of these ancient trees. I climbed inside one tree’s cavernous hole and noticed the temperature drop slightly. The silence inside the hole was noticeable since the wooden trunk surrounding me prevented echoes from journeying into the forest. I felt the bark inside the tree, some parts smooth and some parts rough,different layers from different generations of the tree’s lengthy life. I noticed the parts of the tree that had been scorched by fire into a deeper shade of brown than the rest of the tree.

“She is a tree of life for those who grasp her…” (Proverbs 3:18)

I sat within the stillness of that tree, grasping the wisdom of life it had to offer. I identified strongly with this tree in all of her majesty and strength, in all of her presence, and all that she lacked. Deeply rooted, yet with a gaping hole at her core. I sat in the core of the tree and felt my own empty core, the space that remained after an excruciatingly long and drawn out miscarriage. A miscarriage that came after an intense year of appointments, injections, and procedures. A miscarriage of our last existing frozen embryo. A miscarriage process that began the day we found out we would soon be sheltering in place due to the pandemic raging around the globe.

I am not a stranger to grief, pain, and trauma. This was not the first time the fires of the universe scorched me at my core. And yet as time passed, this particular loss expanded, and the space that was supposed to nurture the newest member of our family instead became a cavernous hole that grew inside me. The lack was immensely present and I questioned what to do with the Empty Space. While inside this tree, I wondered how it continued to grow even while its core was empty.

After spending some time within the Empty Space, I crept out of the redwood tree and noticed a sign that read, “Due to their remarkable fire resistance, most redwoods are able to survive fires…When a fire does reach the heartwood (core) of the tree, it creates a cavity….the tree adapts to its hollowed trunk by strengthening its base on either side of the cavity. This additional growth is referred to as a buttress and provides the tree with additional stability.”

This sign reminded me that comfort isn’t about filling the emptiness. Comfort is allowing myself the space to feel the lack at my core and to integrate that loss into my identity as time goes on. But the emptiness doesn’t go away. I just keep growing.

“Hamakom yenachem etchem” (May the Space comfort you)…

I turned to the redwood tree for one last time. I took in her beauty and her pain. I admired that even with her scars, she continues to grow, and becomes stronger. I thanked her for comforting me. For providing a Space for me to be present in my own emptiness. For reminding me that strength, beauty, and rootedness can all coexist with emptiness.

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Yom Kippur, Hawaii and Infertility

Self-blame is often an uninvited guest at an infertility experience. It sometimes tags along with curiosity. Is this because I was on birth control pills? Sometimes it just walks in the front door. I waited too long. I didn’t take care of my body. I didn’t eat well. Other times you don’t see it come in and it is just there. I must deserve this.

Yom Kippur is an entire day for the Jewish people to confess all their mistakes to God, make amends, and return to better ways. The Hebrew word for this is teshuvah, which means return. This return is meant to be a return to God and Godly ways. The process traditionally includes stopping the offending behaviors or thoughts, regretting them, asking forgiveness from the person you wronged, and committing to not repeating the mistakes. Regret followed by asking another for forgiveness, however, skips over a crucial step: self-forgiveness.

Forgiveness requires relationship. One does not ask their sister for forgiveness for breaking their neighbor’s power tool. You ask your neighbor. One does not ask forgiveness of God for arguing with another person. You ask that person. In turn, we turn to God for sins that are an affront to God: being jealous, haughty and xenophobia. Yet feelings of untrustworthiness or being a bad friend may remain in one’s own heart. One can do the steps of teshuva and still harbor self-blame.

Some things in life, like infertility, are not as simple as a power tool. Infertility often leads to deeper and more complex guilt intertwined with loss and longing. The self-blame is sometimes subtle and sometimes overwhelming. However, the full process for addressing remains the same.

Two years ago I went to Hawaii to lead Yom Kippur services. Next year in Hawaii, I quipped as I flew home.  This past year, Hawaii came to me.  Someone taught me about a Hawaiian ritual that over time evolved – or perhaps was simplified – into the Ho’oponono prayer. It comes from a Hawaiian healing tradition. It is linked in part to Hala, the Hawaiian concept to miss the thing aimed for, or to err, to disobey. This is similar to the hebrew word het, which rather than sin, means to miss the mark. The prayer also fits beautifully into the process of teshuvah. More to the point, it allows space for forgiveness in all relationships, including with one’s self.

This prayer has the power to work for a broken tool and for self-blame. Assume for a moment that it makes no difference if you waited too long to have children or if you stayed in good enough physical condition to have children. Or whether or not the broken tool really was the result of an accident or not. It simply is the situation and that cannot be changed. What makes a difference is that you are blaming yourself. You feel you have done wrong.

If you are able, bring something to mind that is lingering with you. Then say this prayer in your heart:

I’m sorry
Please forgive me
Thank you
I love you

You may ask, to whom do I direct this? Direct it to whoever you need to say it. Psychologists have written about the power of this prayer, the power of its directness and simplicity (not to be confused with ease). We focus our view of situations around ourselves. We see ourselves as flawed. We see the world or some external force as preventing us from moving forward. Yet, it is okay to have made mistakes. More often it is our own minds that need changed. Our hearts need compassion. Our souls need to be cleansed.

I’m sorry
Please forgive me
Thank you
I love you

Keep saying it. Say it slowly. Say it quickly. Say it directed to another. Say it directed to yourself. Then say it again until you feel movement inside your heart or your body. It is a movement towards healing. And maybe you need to repeat this later today, or tomorrow, or next week and keep releasing it. Returning to ourselves is an ongoing process. Some make a practice of saying it every day.

Starting with yourself prepares you to ask others for forgiveness.  Or God. In your compassion for yourself, you are able to be open with others.  Either way the release will allow you to move forward in your life and your decisions. The change that is needed, the change within you, will happen.

On Yom Kippur, invite in the memories of all the mistakes, perceived or real. Or any time of year when the uninvited guests arrive – self-blame, doubt, guilt or regret – welcome them gently. Invite them on a trip with you. To Hawaii. Acknowledge your guests.

I’m sorry
Please forgive me
Thank you
I love you

Welcome yourself back. You are ready to reach to others and to God from your place of return.

 

https://blogs.timesofisrael.com/yom-kippur-hawaii-and-infertility/

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“Passover” is known by four names – the Festival of Freedom, Passover, the Festival of Matzah and the Spring Holiday. These four names are linked to four spiritual levels. The Feast of Freedom represents our physical freedom. Passover (sacrifice/shank bone) represents the ability to rise above our animal needs and do the right thing. The Festival of Matzah is about our intellectual freedom, our ability to let go and think expansively (think yeast that rises). The last and highest level is Hag HaAviv, the Spring Holiday when the earth comes back to life, which represents our freedom from fear leading to our renewal.

Experience with infertility, like many challenging experiences, can feel like slavery on some levels.  Bodies, minds, and spiritual connections can be tied up and feel out of control in many ways. Passover reminds us that opportunities are always available to free ourselves and ultimately that freedom comes from within.

May this Passover season help elevate you in freedom of body, mind and spirit and lead you away from your fears towards renewal.

Hag Kasher v’Sameach – Happy Passover!

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The term reproductive rights has too often become synonymous with abortion rights. “Reproductive rights” are not seen as such in Judaism. A more expansive view of reproductive rights is important for understanding Judaism’s stance on the issue. It is also essential because Jewish views include the painfully overlooked population of those facing infertility and other family building challenges.

The first reason to expand beyond reproductive rights is because Judaism has historically focused on obligations above rights. The Jewish approach to the American focus on rights is almost always on how rights protect a Jewish person’s ability to perform their obligations, whether it’s the obligation to pay fair wages, to have access to kosher food, or to care for the earth. These issues are more often aligned with concepts of pursuing justice (economic, food or environmental justice). Justice includes a context and focuses on solutions and actions. Those actions being our obligations.  One of those actions/obligations is having children and having them safely.

The World Health Organization (WHO) has clear language when it discusses reproductive priorities and rights. People ought to have “the capability to reproduce and the freedom to decide if, when and how often to do so.” That would be inclusive of pregnancy prevention, abortion, and fertility support. They continue, “These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly on the number, spacing and timing of their children and to have the information and means.”  Again, this is the means to have children. It is inclusive of, yet far beyond, abortion.

Similar to the WHO view, Jews have a responsibility to their own health and wellbeing. Put them together and this makes pursuing the whole gamut of reproductive health care an issue of justice. This includes an obligation, yes obligation, to have an abortion when a women’s health is at risk. This also includes treatment for infertility and other family building challenges.

Focusing reproductive rights so heavily on abortion moves the narrative to its most restrictive and narrow view. “Life at conception” is not a Jewish view. Prioritizing an embryo over a woman’s life is not a Jewish view. Not supporting assisted reproductive technologies like in vitro fertilization and artificial insemination is not a Jewish view. When focused on abortion and life at conception, other important issues are ignored. For example, some forms of contraception can save lives and, of all ironies, are needed for the success of assisted reproductive technologies in order to have a baby.

One cannot be denied the access or means of planning their family and having a child. This is the Jewish view. God created humanity with the divine gift of reproduction. For sure, abortion is necessary and extremely important to fight for. Reproductive rights/freedom/justice also means fighting for people facing infertility and other family building challenges.

On this #ReproShabbat, stand up for reproductive rights. All of them. Prioritize maternal health and reproductive health in general. Create access to the means for all reproductive care. And protect those who want to have children too.

By Rabbi Idit Solomon
Founder, Hasidah

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#BabyLoss #PregnancyLoss #Miscarriage #Infertility

October is the month we remember, share and grieve. The public sharing of the struggles so many have with experienced pregnancy and infant loss  are important. Too often images of beautiful families make it look like it was all so easy to get there. A recent article about Mark Zuckerberg and Priscilla Chan bursts that myth and sheds light on reality. They too experienced multiple miscarriages and infertility fears along their path to parenthood.

Another important point is that the stories more often are told AFTER the family has received good news. Many people are right now in the midst of loss, may not get good news to follow up, and may not end up with the picture perfect reflection.

The Jewish Stork is sending love to all those who grieve from pregnancy and infant loss.

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The COVID19 pandemic came at an interesting time on the Jewish calendar. Something very important can be learned from this.

The period of time between Passover, celebrating the Exodus from Egypt, and Shavuot, celebrating receiving Torah at Mount Sinai, is a time of counting. Bundles of wheat were brought to the Temple. The portion was called an Omer. To count the seven weeks of seven days from Passover to Shavuot was also counting the Omer – the offerings brought as part of the harvest holidays.

Over time these seven weeks gained mystical significance. Each week was identified with a different attribute of God such as strength, beauty and loving-kindness (Hesed – one of our favorites at Hasidah!). We are in the fourth week of this counting and come to a timely attribute: endurance (Netzakh).

The Hebrew word netzakh also implies eternity and fortitude. We are currently experiencing a pandemic and if you are reading this you are likely facing infertility or other family building challenges, which can feel like a marathon of endurance, lasting forever and testing your fortitude.

The Hebrew Prophet Samuel refers to God as Netzakh Yisrael (Eternal of Israel – Samuel 1 15:29) to show that God is one who stands firm, not wavering. Who among us can say that during these times we do not waver? These are challenging times.  With a lot of alone time and the doors temporarily close, the doubts creep in. The sadness and the worry come too. Endurance is tested.

Yet, netzakh is an attribute that is essential to cultivate now. Endurance does not mean an adherence to an unrealistic stringency or standard and it also doesn’t mean to simply accept whatever comes. Endurance is to hold firm and steady to that which is important and essential.

Endurance requires patience. It requires that we can sometimes look past the small stuff and keep our eye on that which is truly important. It also means caring for ourselves to make sure we can continue to endure.

If becoming a parent is truly important, the shelter in place, the closing of clinics, the stopping of treatment might be one of the hardest tests of your patience.  It is time to nurture your endurance. Connect to that which is eternal to you. Connect to the Eternal.

A short meditation. Find a quiet space and sit comfortably:

  • Give yourself a few moments to remember the essential goodness of who you are that will endure no matter what.
  • Take another moment to connect to your body. As long as you are alive, you are in it together with that body and you need to endure together.
  • One more moment to hear your breath. Your source of life. Your source of connection to The Eternal. That connection endures. You can endure.

May we all continue to endure and reach Sinai together.

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COVID -19 RESPONSE

Dealing with uncertainly, unknowns and lack of control is familiar to people facing infertility and family building challenges. Many other medical conditions and life circumstances also can put us in this state of unknown uncertainty. However, having it experienced on a global level, being sheltered at home, and having limited access to healthcare is something very new.

While the lack of information is confusing and stressful, one way we can help ourselves move forward is recognizing that sometimes the best we can do is to make decisions based on what we know now. We cannot always wait for certainty.

Hasidah set forth some questions to help those facing infertility and family building challenges to take steps forward.

  • What do we know about the situation right now?
  • What are the issues involved with medical care for infertility clinics?
  • What are the important things to consider when making decisions (medically and emotionally)
  • What can people facing infertility do to take care of themselves through all of this?

Hasidah is very proud to have a robust healthcare advisory board to provide guidance at times like these and beyond. We were blessed to have reproductive endocrinologist Dr. Peter Klatsky and psychotherapist and spiritual director Karen Erlichman, D. Min, LCSW, to help us answer these questions. The video is available for you to see. Please feel free to share with others. It is very informative and comforting.

 

SPIRITUAL CARE DURING COVID-19

Hasidah also has spiritual care practices that are even more essential now. We will post them throughout the following weeks to help with coping through these challenging times. Our first one is the most basic and most common issue now: Relationship

Relationships are key to our spiritual health. Infertility can be isolating as it is. For many people social distancing was a very real coping mechanism before it became a common phrase.  Having and nurturing relationships are essential to our human and spiritual existence. Infertility can strain relationships with family, spouses, parts of our self, our friend, our community and even God. Experiencing such a painful, personal and private trial can keep us feeling separated from others. Judaism teaches, however, that people are not meant to be alone (Gen 2.18). We are meant to live in relationships with others.

During this COVID-19 situation we are actually physically distancing and not necessarily “socially distancing.” We can nurture relationships in many ways even when we are not physically together. We can emotionally, mentally and, with the use of technology at least, visually make connections with others. The distinction is not just semantic. Feeling connected, thinking of others, taking stock of people in our lives, praying or focusing on a divine presence in our lives, and reaching out in any way opens us up to powerful healing.

In whatever way you are able, nurture relationships that nurture you. At least once a day, take a moment to recognize the relationships in your life. If you are able to reach out to just one or two people to share what you are experiencing, you are blessed. If you can just stay connected in any way, that is a blessing too. You are not alone.

Wishing you all health and safety during these times of uncertainty.

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See ASRM press release on managing infertility therapy. Infertility is isolating and traumatizing on its own. With the COVID-19 spread now a pandemic, people dealing with infertility and other family building challenges face new questions. Read on for some answers:

COVID-19: Suggestions On Managing Patients Who Are Undergoing Infertility Therapy Or Desiring Pregnancy

As the novel coronavirus disease (COVID-19) spreads around the world and throughout the USA, our professional community and policymakers, and the public in general, are seeking advice regarding how to manage patients who are undergoing or who are planning to undergo infertility treatment.

Currently, very little is known about the impact of COVID-19 on reproduction and pregnancy. There are reports of women who have tested positive for COVID-19 delivering babies free of the disease. (1,2) This data is reassuring but must be interpreted with caution given the small numbers. Other forms of coronavirus (3, 4) have been linked to increased adverse outcomes during pregnancy, but data specific to COVID-19 is not yet available. It should be emphasized, however, that coronaviruses are unrelated to the ZIKA virus, which had very clear implications for pregnancy and fetal development. Given the information we do have, while it would be wise for individuals with confirmed or presumed COVID-19 infection to avoid pregnancy, there appears to be no cause for alarm for those already pregnant.

Nonetheless, out of an abundance of caution, patients who have high likelihood of having COVID-19 (fever and/or cough, shortness of breath, and either exposure within 6 feet of a confirmed COVID-19 patient and within 14 days of onset of symptoms, or a positive COVID-19 test result), including those planning to use oocyte donors, sperm donors, or gestational carriers, should strive to avoid a pregnancy. If these patients are undergoing active infertility treatment, we suggest that they consider freezing all oocytes or embryos and avoid an embryo transfer until they are disease-free. Please note this recommendation does not necessarily apply when there solely is a suspicion of COVID-19, because symptoms of COVID-19 are very similar to other more common forms of respiratory illnesses.ASRM/SART recommends that all its members and their staff be familiar with the travel guidance on a daily basis as provided by the CDC as it is anticipated to change frequently.   (https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html)  This advice applies to both men and women. Patients who have been traveling long distances for their care should also consider obtaining copies of their medical records in case they need to transfer their care to a local provider.

ASRM and SART remain concerned that travel restrictions due to the virus may cause intended parents who are using a gestational carrier not to be able to join their newborn in a timely manner. Consequently, we strongly encourage all intended parents and the legal professionals, organizations, and programs that facilitate these arrangements to promptly take the necessary steps to identify families that may be so affected and develop contingencies in the event that these babies need to be cared for following their birth. ASRM/SART member clinics who work with gestational carriers and intended parents are requested to reach out to their patients and those organizations and programs who facilitate gestational carrier arrangements to encourage them to ensure that these steps are taken.

Finally, all reproductive health care professionals and their patients are encouraged to follow instructions from state and local health departments and stay abreast of the latest guidelines and updates issued by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) websites regarding evolving developments concerning the COVID-19 pandemic.

Additional information can be obtained at:

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By guest columnist Dr. Karen Wasserstein

What to do with another New Year? Being Jewish, I celebrate two New Years. Is it lucky to have two New Years or is it unlucky?

My family and I fully celebrate Rosh Hashanah as the Jewish New Year. We spend the month ahead of time talking about it, shopping and cooking for it, wishing everyone we see a Happy New Year. We greet each other with hopes for a year of growth, prosperity and blessing and readily accept those blessings in return. We wish each other a Shana Tova Umtukah, that we should have a sweet new year.

And then, about three and a half months later, as January rolls around, we bring in the New Year — again. We wind down the previous year and watch retrospectives on tv of the year in review. We watch as father time becomes an old man (with a sash with last year’s date) and turns into a newborn (with a sash with the new year date). We watch a ball drop in Times Square, get together with friends, wish each other a “Happy New Year!” and hope for a new year of promise, of potential and of hope for all of our dreams.

What both New Years have in common is a looking back on the last year and a look forward into the New Year. How was the last year? Did our dreams and hopes get fulfilled? Did we have a year of health? Of growth? How did our relationships weather last year and are they ready for the next one?

When one is facing fertility challenges, the New Year can powerfully remind us of all that has happened in the last year– and all that has not happened. Has another week, month, year gone by where there was no pregnancy? Was there loss? How many New Years will I face without knowing what my family will look like? How am I (or we) weathering this time? Am I ready to start another New Year plowing ahead on my fertility journey? This is when having two New Years can feel difficult, not so lucky. Another year gone by without having the family I am dreaming of and working so hard to build.

But on the other hand, maybe I have hope, even cautious hope. Maybe as I can turn the page, the last year which had its share of pain and disappointment can come to completion, and I can move into the next year with the potential for more, even as I know that I have no answers and no guarantees. I can take the lessons of last year as I move ahead. Maybe my partner and I have learned how to cope together in a way that we had not had a year ago. Maybe I have developed a network of others, or I attend a support group where I feel held up and able to face another day. This is when having two New Years can feel lucky; two opportunities to turn the page, to start again.

Every year builds on the one before. We are ever changed by the past and still try to live in the present. Overall, new beginnings are important. Some years, I would like to find even more New Years to celebrate– to help me pause and take a breath as I start a new beginning. But for now, I’ll stick with the two I’ve got.

A Happy New Year to all — may it bring you growth and fulfillment in all areas of your life.

Dr. Karen Wasserstein is a psychologist in Maryland and Virginia specializing in the area of fertility and family building. She can be reached at drkwasserstein@gmail.com

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This column originally appeared in The Jewish News of Northern California , November 12, 2019

 

Several months ago, I was asked to speak at an event for Hasidah, a Berkeley-based nonprofit that “raises awareness of infertility, connects people to support resources and reduces financial barriers to [fertility] treatment in the Jewish community,” according to its website.

I so wish my family had known about this agency’s work when we were struggling with these issues.

I care about helping build Jewish families. So many of us take for granted that when we are ready to build a family and have a child, it will happen. I know from my own family’s experience that it doesn’t always work so easily, or economically.

Topics such as infertility were rarely spoken about until recently.

Growing up, I knew our past generations had hard times, but my life and the future seemed simple. College, career, get married, have kids, be a mom, then a grandmother.

Fast forward. It was not so easy.

Seeing one’s children struggle with their health or struggle to create a family — it was not easy at all.

One of my daughter’s struggles began in high school with severe abdominal pain. Today we see commercials on TV about endometriosis, but 20 years ago I had never even heard the word. Many years went by — years of tests and surgeries and different doctors — with no diagnosis. Finally, one doctor was able to give her an experimental drug that took away her fertility for five years (ages 20 to 25) with the hope that it would just “pop back.”

Through all those appointments, shots and bone-density scans, the fear of “what if fertility doesn’t come back” was always looming, And there was no place to talk about it. Yes, her fertility returned, as UCSF had hoped, and she and her husband went on to have a family.

Then my other daughter married and learned she had issues getting pregnant. With her wonderful husband’s firm support, they tried many options, talked over all the possibilities, the what-ifs.

One day a friend of hers who knew the situation asked me, “How are you?” Seeing the dark cloud hanging over me and being a mental-health professional, she shared that the dark feeling isn’t just over the couple but over the whole family.

My husband and I were in a dark place, but we came to understand this was our daughter’s journey, and we were there to support her.

We tried not to show our pain to her when treatments failed and as she felt more and more isolated. Through many very expensive processes, a woman’s enormous generosity and modern technological miracles, we were granted two more beautiful grandchildren.

Every day we thank HaShem for those beautiful children.

I began to see how so many others could use this kind of support.

My daughters were fortunate that our family could help them financially. Not everyone is in a position to afford fertility treatment or to help their own children. There hasn’t been anything in the community to help.

I have since become involved with Hasidah, which provides “financial, spiritual and emotional support for people experiencing infertility or fertility challenges, and build[s] awareness about fertility,” according to its listing in the 2018 Slingshot Guide of outstanding Jewish organizations. Hasidah, which means “stork” in Hebrew, was founded in 2012 by Rabbi Idit Solomon.

Hasidah.org is packed with information, such as the average out-of-pocket cost for one in vitro fertilization treatment being $24,000, with a $61,000 total for “a successful outcome from IVF.”

People need so much support when they are facing infertility, which is why it was so important for me to step up and help. Not only for my own family, but I could help others overcome their fertility struggles, too.

It was imperative for me to help each of my daughters become a mother.  It is imperative upon all of us as a community to help others who are facing infertility and other family building challenges.

We need to replenish those lost during my parent’s generation. We need to support the mitzvah of being fruitful and multiplying. And it is the Jewish way to help others in need.

Jewish children are the future of the Jewish community. I have endless joy from each of my grandchildren. I hope our community can prioritize this issue for our sake, and for our future.

 

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