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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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Doctors and health care providers are not to blame for an “infertility industrial complex” and patients are not baby crazed. Wanting to provide people with medical care that will help them have a baby is a noble profession and wanting to be a parent is really deep desire. There are exceptions, but or every doctor who may take advantage of a patient who didn’t do their research, there are scores of doctors feeling tied up trying not to raise false hopes. And for every patient that is beyond their boundaries trying anything and everything, there are many more trying to be reasonable during an incredibly stressful and painful time.  The truth is that we are all vulnerable.
 
A recent article from the UK discussed the delicate balance attempted in the wellness industry that doesn’t always respect that vulnerability.  It can be quite easy to take advantage of people who want to improve their chances for having a baby and are willing to try  something that seems to be a viable option. In reality so much of the “wellness care” is stress reduction, which is legit, but not baby producing. A lot of add on’s in clinics just control for various factors, but may not increase chances of having a baby. Some treatments or “wellness care” may help certain conditions, but it isn’t necessarily a condition that you have.
 
So hold tight to your candy while focusing on having your own baby. Respect your own boundaries and vulnerabilities. Ask questions. Use your heart and your head.  Take care of yourself by keeping your body, soul, heart and mind in balance as best you can.
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They always talked about having children, yet three years of marriage brought no babies. She was pregnant last year, but it ended in loss. Infertility and other family building challenges are quite common yet hardly ever discussed.  When these situations happen to someone you love, what can you do to help?

Finding the balance of respecting privacy, breaking isolation and showing support can be a challenge. The best place to start is asking yourself some questions and checking assumptions. Below are some questions to guide your support for someone who is facing infertility or other family building challenges.

1) What business is it of yours?

If you are not sure how to answer that question, stop right here. If you feel vested in this matter, ask yourself: How close am I to this person? Do I talk about personal issues with him or her? Do we have a level of trust and are we in a context that invites such a conversation?

Being a relative or acquaintance does not entitle you to intimacy or information. An appropriate relationship does. Do you have it? If you are still unsure, consider the next question.

2) What are you hoping to accomplish?

Curiosity is not a good enough reason because it is about your interest and not helping the other person. What do you know about her/his/their plans or attempts to have a baby? Do you have an opinion on what they ought to be doing? What is your motivation for getting involved?

You cannot make a baby for someone. You cannot force someone to give up, move-on, seek treatment, lighten up or keep trying. You likely cannot change his/her desire to have or not have a child either. People need to do this for themselves. Only your care for their well-being will be appreciated. And if your motivation is to share your opinion, don’t do it.

3) What can you offer?

You cannot force help upon anyone. Infertility can be isolating and painful and some people do not want to open up, impose on others, or appear weak. However, if you are truly prepared to give support and flexible about when, here are a few ideas you can offer:

  • Distractions – processing the emotions and getting medical treatments are all necessary, but so is a full life. Offer to be there for the rest of their life too. Offer a movie, massage, lunch or whatever you would normally do. Keep offering it. Time together is invaluable.
  • Be involved – you can help find support groups, learn together, ride to an appointment, etc.
  • Learn on your own – Don’t know what IVF, ICSI, PGS vs PGD, PCOS, IUI or TTC mean? Look it up. Knowing what someone is going through shows them you care to understand their pain. Then you can spend more time focused on them rather than their diagnosis.
  • Listen – without advice. Reflect on what you hear. Or offer a set time for them to unload. Just be present.

4) What can you do?

You can help someone feel less isolated. You can help them understand themselves. You can nurture a sense of wholeness while he or she is in the process. What could that look like?

  • Email and text to stay connected. This gives them the space to answer when it is comfortable for them. If someone really is struggling with infertility, bringing up the topic may feel more like an ambush than support. Take advantage of technology when appropriate.
  • Tell them you care. “I’m sorry this is happening to you. It makes me sad and angry at times. I hate that you are going through this. You don’t deserve this. I care about you no matter what happens and I just want you to know that.”
  • If someone does share and says something like, “I don’t know what to do,” or asks what do to, resist answering with advice. Some of the hardest and most important work to be done when facing infertility is keeping priorities and boundaries. Each person has to set their own. How many months/treatments/dollars/medications are the limit for you? Is there only one way for you to become a parent ? Where in this process is your marriage, mental health, social life, finances, etc? Help someone find their own way, not yours.
  • Follow up on all of those offers above when they let you!

 

The most important way to show respect comes down to knowing your place, putting their interests in focus, staying connected and supporting them as they find what is important for them. May you be a source of strength and may those facing infertility and other family building challenges be strengthened!

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One of the hallmarks of a good decision is whether it takes into account all of the information available at the time it is made. Hindsight is always challenging when circumstances change or values change. Feeling good about a decision is not thinking you can know everything there is to know. Good decisions come when you know you did a reasonably appropriate job of considering the factors necessary and addressing them.

Why is this important in the fertility world? Because most people’s biggest decision for conception is if the it will involve red or white wine, or if the occasion will be planned or spontaneous, or other more salacious details. It is not statistics about a clinic or egg freezing rates or medication protocols or genetic testing or embryo transfer date implications.  When people are using medical technology to build their family, a lot of decisions have to be made and they can be overwhelming. The information available and research is constantly changing, unending and inconsistent. Dr. Google does not help matters when frantic yet hopeful parents have plenty of time at night to research procedures and their chances and the results of strangers on the internet and trying to find something to help salve the pain and frustration of… not having a baby.

The pain and frustration are real as is the need for good information and help for making decisions. What is really helpful when making all of these decisions is noting what most of them have in common. Here are some helpful considerations to use when approaching many of the difficult decisions:

1) Only you can make the decision. As much as it may feel like doctors are making the decisions or the data is telling us what to do, each one of us makes decisions about our care in the end.  Other people’s “should’s” can be taken under advisement, but they are not you.  If you accept a recommendation or follow someone else’s success, that is your decision. Remember that nobody else’s experience and circumstances are exactly like yours thought. You need to do what is best for you.

2) Your decisions mean your values. In the exact same situation, which people rarely are actually in the exact same situation, people make different decisions because they have different priorities. I have met couples who say finances are their biggest issues. Others are planning for not just the first baby, but with the hopes of more. Others are on a time limit of how much they can tolerate and then they want to move on. Another person chose her clinic and  treatment based on its proximate location to her home and whatever they could offer. These are not right or wrong. The simply match the priority of the decision maker. So know yours.

3) You have to have a relationship with your healthcare provider. If you don’t trust your doctor, then no amount of information is going to make you feel good about your decision. Work on that issue first. What about the doctor doesn’t match? Do you need to ask more questions to understand or do you need a new doctor? It is important when making decisions to be able to separate your beliefs about your doctor and your beliefs about what is the best next step for you. Confusing the two can lead to choices you don’t feel confident about, resentment or worse.

3) You can’t know it all. You will have to make a decision based on what you know at that moment. We cannot predict the future and results not in your favor alone are an unfair measure of the quality of your decision. You have to consider what you know, what your priorities are and go. If you really do want to understand more about procedures and risks and decision factors FertilityIQ has singularly changed the field for the better. (Disclosure – nothing to disclose. Hasidah gets no kickbacks. FertiltyIQ simply are a great resource). Your body is not a machine with exact operations and medical care is not mechanics. However, we be informed about important factors. Figure out what is worthwhile to know and accept what you cannot know.

Research for a decision works best, however, when you have already done the first two steps. It is up to you to make the decision, determine your priorities, and make sure you and your doctor are together on how to make these decision.

Wherever your quest for parenthood takes you,  you can bring more wholeness to the journey. Hopefully, these steps can help you as you navigate the many decisions along the way.

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Some things are just human and it doesn’t seem to matter much where you live. Facing challenges to building a family might be one of them.  A recent survey in England got the following stats from people struggling to become parents.

  • 90% say infertility feels like a trauma.
  • 94% don’t think their friends, family or colleagues really understand what they are going through
  • 55% feel hopeless and like a failure
  • 68% believe other people think less of them because they do not have a child.
  • 54% feel annoyed by other people’s comments
  • 37% feeling angered by what others say
Healthcare in England is different than in the US, but again, some things seem similar. The stats there revealed that 34% of those who paid privately for IVF put themselves in financial risk in doing so.
One third of people paying for IVF are putting themselves at financial risk.
So for those who didn’t put themselves “at financial risk,” what did they have to give up?  
What are you giving up to try to have a child?
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A recent article in the Atlantic gave a wonderful introduction about advice for grandparents who want to ask their children about their family planning activities. The summary was don’t ask.

It’s worth stopping here to read this if you are a hopeful future grandparent or are currently facing fertility challenges and thinking about your parents. Here is it again.

One premise of the article was that the would-be grandparents are wannabe grandparents and that the asking is therefore self serving. When am I getting grandchildren? In that circumstance, the asking amounts to pressure and of course is completely unwanted. However, maybe this is coming from a place of wanting to care and support your children too.  Maybe the grandparents-to-be have fertility losses and challenges in their own past, often which children don’t know. It’s eye opening for children to think their parents may have some awareness of what they are experiencing, but it still doesn’t make it welcome.  It’s worth thinking about if you have that kind of relationship about anything with your children before asking. It’s up to the kids if they want to talk about this or anything else.

To be sure, there is scientific evidence that no grandchild has been born as a result of a future grandparent asking. It doesn’t work that way.

Many grandparents are in the loop and do work out how to talk to their kids about it. Many people also know that future grandparents are a likely a percentage of the source of funding for IVF outside of patients. Hasidah is lucky to have support from many of them! Hasidah has also received called from grandparents looking to help their children. One such call was from a future grandparent that had already used her 401K and was looking for other ways to help her daughter. She had been through infertility herself and it was heartbreaking to watch her daughter’s experience. She sincerely wanted to help and that was one thing she could do. She wasn’t even so heart set on having a grandchild, but she was committed to supporting her daughter’s dreams of being a mother.

If you have the kind of open relationship with your children, then asking about grandchildren just needs a check – is it about you or about them? Consider the relationship you have with them. Some of that awareness of your relationship will guide you in how to approach the conversation.

Would love to hear your thoughts or experiences on talking with parents about fertility issues. Please feel free to share!

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So often fertility journeys are marked by the ups and downs in couple’s relationships. Coping with trials can strain even the best of relationships and fertility is far from an exception. Everyone copes differently and will be on different timelines.

What advice has helped you stay connected with your partner during fertility struggles?

Check out this article by one woman who recounts her story and what helped her manage some of the strain in her relationship.

 

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