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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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In the US, we pride ourselves on the American dream of working hard and earning based on our merit. Our economy today, however, shows that many people who work hard are earning less and are not as well off as their parents. Truth be told, the real old fashioned way of earning money still works – inherit it. In addition to younger generations earning less, another difference that is becoming more evident is when having babies the old fashioned way doesn’t work either.  People are now turning to their parents to pay for infertility treatment.

The Future Grandparents Club

In vitro fertilization (IVF), which now accounts for a percentage of births in the US, is becoming more common. However, its affordability is not. The average out of pocket expenses for a round of IVF exceeds $24,000 and the average spent on treatment over all exceeds $60,000. So where are people turning to get this kind of cash to fund their IVF? Hopeful grandparents. 

One of the remaining stigmas of infertility is that it is mostly older wealthier women who are likely to have infertility treatment. However,  at least half of the women seeking IVF are under 35. Infertility has many causes. Hasidah has had clients facing PCOS (Polycystic Ovarian Syndrome), premature ovarian failure (at age 27), genetic diseases, cancer, recurrent pregnancy loss, and one of the most frustrating situations, unexplained infertility. Infertility affects young and more mature, rich and poor alike.

What’s A Parent to Do?

Hopeful grandparents seem motivated regardless of the situation. When it is a late bloomer, they want to help. When the couple is young or maybe doesn’t have any savings yet, the future grandparents are often there. One hopeful grandparent called Hasidah for help because she had already dipped into her retirement savings to help her daughter and still wanted to find additional ways to help. Not all parents have the financial capacity to help their children, and not all children are comfortable or able to turn to their parents. However, the vast majority of people Hasidah has seen that have spoken to their parents get some funding from them. When it is their own child looking for help to have the same blessing of having a child, it is a pretty sensitive heart string to pull.

To be sure, funding from grandparents has it draw backs. It is complicated to have financial ties to family members and IVF has no guarantee. However, one thing is for sure. More and more grandparents are going to have earned their title the new old fashioned way. They will have paid for it. 

Check out this article in Fast Company for more about IVF funding from grandparents featuring Rabbi Idit Solomon.

 

 

 

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As part of  Passover preparation – removing chametz from our lives and planning to leave the narrow places – Hasidah invited several guest bloggers to provide support for dealing with Infertility during the holiday and beyond.
Erin Schlozman is a licensed professional counselor specializing in women’s reproductive health at Mama Wellness Co. in Colorado

In Judaism, we are told to “be fruitful and multiply.” We come from a tradition steeped heavily in a narrative filled with the promise of creating new life. How many of you were asked as soon as you broke the glass under the Chuppah: when are you going to start trying for a baby? This question seems earnest and innocent, however the reality is that 1 in 8 couples will have a difficult time getting or staying pregnant. For couples that are facing infertility questions like “are you trying to get pregnant?” and “what are you waiting for?” can feel intensely personal and also crushing. Below are ways you can empower yourself, or help support the people you love once a person or couple has been referred to a fertility specialist.

Most fertility specialists will begin with a detailed intake that will gather you and your partner’s information including medical history, social history and the history of your reproductive health. Additionally, ultrasounds and labs may be ordered for the medical team to get an idea of a baseline and to begin identifying the source of what is going on. I always suggest bringing a list of questions to this first appointment that touch on the concerns you have. Suggestions for things you may want to ask:

  1. What is the process for identifying my diagnosis and how will this diagnosis inform my treatment?
  2. How long do you think the initial workup will take and when do you estimate we will be able to move forward with treatment?
  3. What courses of treatment do you recommend/are most commonly successful in your practice? Additionally, what are my treatment options?
  4. How long do we focus on each treatment and at what point do we move to a new treatment? For example: if we start with IUI how long before we discuss IVF.
  5. Is there anything I can do to improve my chances of becoming and staying pregnant during the course of treatment?
  6. Are there any lifestyle changes you recommend?

Infertility brings a landslide of emotions including immense vulnerability, feelings that you have no control and moments of intense sadness. When we think about growing our families we think about future homes, communities, holidays, birthdays and milestones. Experiencing infertility can feel like the biggest threat to those things. When you take your journey to have a baby from the bedroom to a doctor’s office it’s only natural that floods of emotion will come with you. Stress, sadness, excitement, grief and fear all bundled together. Here are a few tips on how to provide yourself self-care during this time.

  1. Educate yourself on the medical components of infertility. ​Gathering information and education can help you feel empowered and whittle away at the feelings of powerlessness that come with the process.
  2. Identify your support system, both individually and as a couple. ​Finding a therapist that specializes in infertility or a group for families going through fertility treatments will help you build your tribe and a support system that knows exactly what you are going through. Also, social media outlets have support groups that many women find helpful.
  3. Try your best to focus in the moment. ​Be your own best advocate and don’t get caught up in future worries and anxieties: what if this happens, what if this doesn’t work, what if what if what if. Do your best to live in the moment and don’t give too much power to the what if’s.
  4. Feel your feelings. ​You may wake up feeling great one morning and incredibly sad the next. You may feel you don’t recognize yourself, like you have changed forever and wonder if you’ll ever return to the person you were before you started trying to get pregnant. This is ok. Allow yourself the moment to honor however you are feeling and remember that all feelings pass.
  5. Engage in regular check-ins with your partner. ​Infertility is a partners experience. Make sure you keep up your communication, try to make time for fun and to connect to one another in some way. Given the stringent requirements surrounding treatment, sex may be off the table at certain times- practice other ways of sharing intimate moments outside of intercourse.

As the primary focus of fertility treatments is medical, I can’t stress enough the importance of tapping into your community to help support your emotional, spiritual and physical needs. While you work toward parenthood, know that your tradition and community stand behind you with great force, fierce love and an intense commitment to support you. Whether you yourself are going through fertility treatments, or someone you know and love is, it is important to always remember that no two journeys are the same and that a foundation of loving support and community can help ease the silence and pain of the experience of infertility.

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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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Many find mikveh to be a place of healing and rejuvenation. Being part of the practice of for married women to immerse in a mikvah after menstruation before have relations with her husband, mikveh is intimately tied to fertility. However, for those experiencing fertility challenges, it can be a painful reminder that conception has not occurred.

Our partners at Yesh Tikvah have recently worked with the Eden Center to produce a booklet called “Birkat Emunah: A Mikvah Resource” (the title means “Blessing of Faith”), which provides prayers (in Hebrew and English), practical suggestions and personal stories to help women gain more control over their mikveh experience while facing infertility or pregnancy loss. Read more about the launch as published in the Forward or download the booklet.

 

 

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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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When couples struggle with fertility challenges, things can feel more unhinged. We are told by our faith to “go forth and multiply” or that sex on the Sabbath is a mitzvah. The frustration and self-doubt that creeps in when couples try to honor these teachings, and are unable to create new life can be deep. Inherently, there is a sense of shame that many couples experience when they are unable to fulfill their dreams of parenthood, and often times, this struggle is kept silent.

Infertility is not something that a member of a couple ever forgets, especially during their road to parenthood. Seemingly innocuous questions like, “when are you going to have kids?” or “have you tried to just relax?” add salt to an already open wound, despite those that ask them being well-meaning in their intentions. Since reminders of fertility are all around us (in the form children playing, commercials for baby products, and pregnant women) one doesn’t have to go far to feel that twinge of jealousy and longing as well as the reminder of the uncertainty about when it is their time to be parents.

Having a medical professional enter into the sacred space of childbearing changes the dynamic between a couple. An act that was supposed to have occurred in the sacred space of a couple’s bedroom has now shifted to a medical building.  Here is another place where the push and pull between having faith (that things will work out and a baby will be created) and experiencing fear (such as the doubts that can creep in) creates a tension in both individuals and between a couple. Many partners have different coping styles, and when it comes to experiencing something hard, few couples have had the history together to give them insight around what coping together looks like rather than coping separately.  Managing the emotions around infertility call for couples to increase their communication, particularly around what each might need. It also indicates that couples might need to allow for some space for one or both members.

Learning about how, as individuals, we process information can be vital in then teaching our partner.  An example might be a couple where the wife is an externalizer and likes to talk to others when things are hard but who is married to a man that is an internalizer, or someone who likes to keep his feelings close to the vest until he has figured out his next course of action. These are two styles that tend to be exhibited in many couples. The wife might be talking to whomever will listen about their fertility journey, while the husband keeps the information to himself. This can make his wife feel like she is alone within the couple on this journey whereas the husband might feel like his wife is broadcasting something personal to the entire world. Both are correct in their experiences, and through communication and knowing their styles of coping, they can manage their coping styles together while being respectful and responsive to the other’s differing style.

For some couples, struggling with infertility or another unforeseen challenge might turn one member towards their faith while the other member is turned away. Developing outside areas of interests can also be important in coping with the unknown, as a way of distracting and distancing people from the path they are on. Areas of interest can be faith based, sport based, or creatively based as just some arenas that couples might want to explore. Certainly, for many engaging in a variety of mindfulness practices assists with managing feelings of uncertainty. For others, finding a support group or a mental health provider is equally important in dealing with factors beyond one’s own control.

Infertility impacts one in eight couples, and can have a lasting impact on how individuals experience themselves, how a couple connects, and how a couple is able to cope.   Learning strategies to manage the unknown, whether it be faith based, therapy based, or developed on your own enables individuals and couples to have more of a sense of control around an area in their lives that is not within their bounds to always directly change. Additionally, learning how to communicate as a couple about what each individual member’s needs are is a skill that will last well beyond the initial challenge of infertility.

Dr. Julie Bindeman is a member of Hasidah’s healthcare advisory board. She is a reproductive psychologist and co-director of Integrative Therapy of Greater Washington outside of the Nation’s Capital.

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Just hosted the National Jewish Fertility Network video conference about adoption. Experts represented an amazing array of approaches – adoption agency, adoption support, law firm, and Jewish adoption advocacy. Indeed adoption is a very Jewish and beautiful pathway to parenthood. These experts helped educate Hasidah and others in the Jewish community supporting family building. We learned more about the benefits, issues, and challenges of adoption as well as how to support those considering adoption.

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Lots of news articles and social media posts say what to do to combat infertility, how to get pregnant, 5 ways to “fix” your infertility, or other simple solutions to painful, complex and difficult barriers to building your family. These articles may have some new research to share or possibly an intention to be helpful, but often thinking an easy solution exists leads us to more disappointment

Summary of the these answers: make healthy choices and seek support and advice. No silver bullet exists. Be skeptical of anyone who gives a simple “solution” or any advice without knowing a whole lot about what is happening in your situation.

To save you reading about the magical powers of walnuts, the new research on smoking, the ancient techniques that still work in the 21st century, the secrets to infinite fertility, and how you can take control of your womb/sperm/ovaries/reproductive health, here are the basics that summarize most of those articles:

Eat a healthy diet if you are not
Quit smoking if you are smoking
Lose weight if you have a lot of excess
Be kind to yourself if you are struggling
Find support if you are feeling alone

Notice that this doesn’t even begin to diagnose the majority of fertility issues or speak about treatment or other family building options. These basics alone take some effort to maintain.  No silver bullet can do them for you.

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On the last night of Passover, the participants at the retreat I attended shared reflections on Passover themes. What were our journeys? What made us feel liberated? One woman, while describing the diversity of participants in our newly formed community, referred to me as a nursing mother. Me? Ironically, moments earlier I had leaned over to my husband and recalled how the first of many IVF treatments in our fertility journey occurred the day before Passover Seder. Our Seder that year was minimal but hopeful as I lay on the couch on bed rest. The hope ended when I had a miscarriage several weeks later on Mother’s Day.  The experience was a hard one and my identity will always be connected to years of infertility. Nursing mother, even just mother, is not an identity I wear easily or take for granted.
 
On this Mother’s Day, if you are a mother, please take this day to appreciate the gift you have been given. Not everyone gets to share in the experience. Consider making a contribution to Hasidah (www.hasidah.org/donate) to help those who yearn for that identity and are struggling along the way.
 
If you are not a mother and are hoping to become one, please know you are not alone, that others have been on the journey, and that we care and want to support you along the way.
 
Wherever you are on the motherhood journey, may Mother’s Day come with blessings for you.
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