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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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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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Reproductive rights have been hijacked. When someone mentions the phrase “reproductive rights,” the first things that usually come to mind are either birth control or abortion. However, the ability to prevent pregnancy is only part of reproductive rights. What about the right to have a child? This conversation has fallen by the wayside. Ironically, every year at Rosh Hashanah, Jews assert the centrality of having children, and we would do a great service to the world if we embrace that message a little more.

A married woman’s right to sex, which means access to fertility, was codified early in Jewish tradition. Initially included in the Torah’s injunction of a husband’s minimum obligations for food, clothing and sex (Exodus 21.10), the Talmud explains the women’s right to sex through an outline of the minimum sex a husband must provide for his wife (Ketubot 61b). For sure, mortality rates were influential in that process, but essentially Judaism has always been a pro-family, pro-child tradition. Early declarations of human rights spoke of enabling people to exercise their right to determine freely and responsibly the quantity and spacing of their children, along with the means for having them (see, e.g., the UN’s 1969 Declaration on Social Progress and Development, Part 1, Article 4). The language was not exclusive to birth prevention. It was inclusive of having children. The implied shift towards prevention has painful repercussions for millions who face fertility challenges.

Rabbi Daniel Polish, a contemporary leader on interfaith dialogue, wrote in that context in the 1980s, “The recognition of the importance of human life is at the same time both integral to the Jewish faith system and the first and necessary precondition for a belief in human rights.”

On Rosh Hashanah, God is coronated, and God’s rule is epitomized through opening the Book of Life and beginning to decide who shall live and who shall die. Fertility is the ultimate example of that synthesis and exemplifies the other themes of the holiday: the birth of the world, the beginning of humanity and its frailty, and God as ultimate ruler and source of life. The first words of the Torah reading for the first day of Rosh Hashanah (Genesis 21:1-34) describe God “remembering Sarah,” meaning opening her womb to pregnancy. The Haftarah text (1 Samuel 1:1-2:10) then introduces Hannah, who is loved yet barren. She tearfully pours out her heart, God remembers her, and she has a child.

God’s ultimate power is exemplified through fertility. The connection comes together directly in a Talmudic passage:

Three keys the Holy One, blessed be [God], has retained in [God’s] own hands and not entrusted to the hand of any messenger: these are the key of rain, the key of childbirth, and the key of the revival of the dead. (Taanit 2a)

While Jews remain a little skeptical about anyone’s ability to overcome death, most of us have come to recognize our ability to affect the rains. Environmental action is real, and can affect our planet for the better. The medical community enabled assistance for reproduction. When it comes to pregnancy prevention, modern Jews have spoken out. Are the steps leading to childbirth some exception that, unlike other areas of healthcare, we should stay out? Is assistance for conceiving a child exceptional and beyond our realm of action? The politicization of all things related to reproduction, the lack of insurance coverage, and the assumption that attempts to procreate will work whenever we want all seem to have silenced the topic.

Jews have almost always been open to intervention when our bodies have not performed as intended. The Torah states “Make sure he is healed” (verapo yerapei)( Exodus 21.19) in double (repetitive) language. The Talmud gleans from the double language that not only do doctors have permission to heal, but that healing is not considered to be an intervention counter to the will of God. (Baba Kamma 85a). Much of childbirth is out of our control, but bringing healing and relief to those facing infertility is something we can address.

I experienced years of infertility before becoming a parent. I have counseled hundreds of people dealing with a variety of fertility challenges. Wanting a child and then facing the prospect of not being able to have a child brings the importance of human life front and center. One of the ultimate expressions of our Judaism, of our faith in God and humanity, is through the creation of a new life.

Support, resources and advocacy are needed for people experiencing infertility and fertility challenges.

How can you help? Awareness is important and appreciated. As Rosh Hashanah’s messages of life, fertility, creation, and God’s power come upon us, remember those who feel isolated from that message. When we wish that others be inscribed in the Book of Life, include a prayer for those hoping and praying to be a part of creating life too.

Rabbi Idit Solomon is the founder and CEO of Hasidah, a Jewish nonprofit dedicated to building awareness about infertility in the Jewish community, connecting people to resources and providing financial support for treatment. She lives in Berkeley, California with her husband and three children.

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Is egg freezing a good thing? A recent article in the Forward by Amy Klein explores the personal stories of a growing number of Jewish women considering egg freezing. Egg freezing  is empowering for some, a relief for others and scary for others. For cancer patients it ought to be a given option.  For the general population, however, more questions are in order.

Egg freezing may add to the societal pressure on women’s bodies. We cannot treat women’s bodies as machines that can simply have parts temporarily preserved. As with all technologies that have the potential for good, society needs to change too. How we think about family building needs to change. The attitude of work versus family needs to change. The role of men in all of this needs to be discussed. How can we stop the I-never-thought-about-it, now-it-is-getting-late and we-can-control-it-all rat race and begin to have meaningful conversations with young people about the role of fertility and family?

To be sure this is not about blaming women for taking the opportunity to utilize this amazing technology to help them preserve their chances of motherhood. For sure, egg freezing has benefits and women absolutely deserve and have the right to control their bodies and their fertility. However, most technologies have unintended consequences as well as negative effects and it is important to consider them. Some of those are the issues about careers, fertility, family building, parenting, gender roles, and the politics of women’s bodies that are not being addressed. Let us not utilize this technology to prevent these conversations from happening.  These conversations are needed – early, openly and often – to empower women from the start. Not just to justify looking at the the freezer for a back up.

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Hasidah’s name which means “stork” comes from the Hebrew word hesed, which means loving-kindness. Loving-kindness is showing support when people need it in the way they need it. Loving-kindness is maintaining their dignity while they are in need and in the process of helping them. Loving-kindness is helping them without making them beg for it. 

Every one of these baby crowd funding campaigns is a lost opportunity for the Jewish community to show loving-kindness, something we do so well for many other circumstances. Wanting to have a child is a basic desire that most of us understand without much explanation. Yet, we let people beg: Help me fund a chance to have a baby!

Thanks to the Forward for highlighting this issue. Let us know what you think – if the Jewish community will spend billions on trips to Israel in the name of the birthright, how can we direct support for the birthrate?

 

 

 

 

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Ever see that headline that addresses a question that’s been nagging at you? When you are struggling with infertility, a lot of things are nagging at you. Is there something I could be doing differently to resolve this? Did I forget to ask a question? Is there a treatment or method I don’t know that could help? And headlines can answer questions – or create questions – you never knew you had.

Here is a sample of some (not all) headlines that came out about a recent study. I took the liberty to highlight what I learned just by reading enough headlines (and share some of my reactions).

  • This over-the-counter painkiller has been linked to male infertility (what is it?!? I have to click, right???)
  • Study Links Ibuprofen with Male Infertility (oh)
  • Study: Ibuprofen may lead to male infertility (may lead?)
  • Ibuprofen use linked to male infertility, study finds (linked or leads?)
  • Ibuprofen linked to Male Infertility in Small Study (how small?)
  • New study suggests ibuprofen could be linked to male infertility (getting vague now)
  • Ibuprofen use may be linked to male infertility (back to links and maybes. But there is a lot of headlines. Maybe there is something here)
  • Taking a lot of ibuprofen could mess with men’s fertility – here’s what you should know (Wait, how much? And what does mess mean?)
  • Regular Ibuprofen Use May Contribute to Male infertility, Study Says (how often is regular?)
  • Daily Ibuprofen usage associated with infertility (that’s pretty regular, but how much? And what is associated? for what kind of infertility? Nothing male here!)
  • Should you worry about new study linking ibuprofen to male infertility? (Why are you asking me this?)
  • Ibuprofen could cause male infertility? (Cause? How come you can’t decide if this is a question or a statement?)

Did you want to click? Did you want to know more? If there is a male involved with your fertility struggles, did it make you think about perhaps switching to acetaminophen? Did you consider past use? Did you wonder if maybe it effects women too?

Here is a question I have for you now: Do you trust your doctor? If you do, tell him or her about any medications you take and ask questions. If the doctor is not sure, ask your doctor where you can learn more. Stay away from the random newspaper or internet site that gives quick quotes about research. Because here is what you really need to know:

  • Infertility is complex
  • There are more causes and possible scenarios for fertility challenges than any one article could ever address
  • It is not your fault. There is rarely a quick “fix”
  • The news is not meant to make you feel better or address your situation. A lot of news is meant to sell, and fear sells
  • The last thing someone experiencing infertility or fertility challenges needs is another reason to worry.

In case you were curious, the study is with 31 men. The test was only for six weeks. The results were not causal and they were reversible. So to the last question, does Ibuprofen cause infertility (was that really a question?). No. Ibuprofen maybe, could be linked to “messing” with men’s fertility if he is taking a lot, daily.

Summary: Talk to your doctor about any medications you and your partner are taking.

And read a good book, have a cup of tea or take a walk outside to give you a break from the stress of reading the news.

 

Update: Ransom paid here (Headline: The truth about ibuprofen and male infertility)

 

 

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Traditionally called the Season of Joy, Sukkot is inherently wrapped in fertility. Historically and religiously associated with agriculture, Sukkot is a harvest festival celebrating the fertility of the earth. Living in booths (Sukkot) commemorates the Israelite’s wanderings in the desert. Their temporary and unstable nature also reminds of of how fragile our lives and the world is.

The special reading done for this holiday is from Kohelet, which begins, “To everything there is a season, and a time for every purpose under the heaven. A time to be born, a time to die…”

Fertility and the fragility are related. Those of us who have experienced fertility challenges know this all too well. But time plays a role as well. Most of it during a fertility journey seems to be spent waiting. A time to wait… and another time to wait. But Kohelet’s perspective can be helpful during fertility challenges. The verses continue that there is “A time to weep and a time to laugh; a time to mourn and a time to dance.” Indeed all things under heaven have a time and a purpose. While fertility can feel all consuming, we do have other purposes in life. And time will continue. The message of fragility at this season is also a reminder of what endures. Our choice to laugh or cry endures. Our ability to reach out to another for support when we mourn and to dance when there is joy endures.

So if this Season of Joy seems hard to reach for you, if you are intimately feeling the fragility of the fertility world, remember there is a purpose for you in this world. Feel the enduring presence of your self and your ability to laugh and cry. And if you are mourning, know too that there will be a time to dance.

Always, there will be time.

Chag Sukkot Sameach – Warm wishes for a joyous Sukkot Holiday

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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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The statistic for infertility of 1 in 8 does not really care about race, religion, gender, sexual orientation or political party. Fertility challenges can affect anyone and even those whose journey leads to children remember well the experience. See Melissa Langsam Braunstein’s interview with Second Lady Karen Pence about her experience with infertility.

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In today’s speak-up, tell-it-like-it-is, immediate response world, the power of what is not said and the context in which messages are delivered can sometimes be overlooked. This is especially true when someone is carrying a silent burden such as infertility. This week’s Torah portion (Toldot) provides a vivid example of how noticing those nuances reveal an incredibly moving story of a personal spiritual awakening.

The Torah portion begins with two brief lines introducing Isaac as Abraham’s son who married Rebecca at age 40 and then says, “And Isaac entreated God for his wife, because she was barren; and God let God’s self be entreated of him, and Rebekah his wife conceived.”

One little line about Isaac pleading with God to have a child and then the story moves to the topic of those children. But do not blink. That one little line about infertility is a defining moment in Isaac’s spiritual life.

The rabbinic texts explain that Isaac and Rebecca were trying to conceive for 20 years. I struggled with infertility for three interminable years before my first successful pregnancy. 20 years seems unimaginably painful. The other biblical matriarchs Sarah, Rachel and Leah speak about having children. Yet after 20 years, Rebecca is silent and the story gets one line.

The significance of Isaac being the one to speak up cannot be underestimated. The last time the Torah shared something Isaac said was when his father was taking him up a mountain to offer him as a sacrifice. Isaac asks, “Father, here is the firestone and the wood, where is the sheep for offering?” He asks his father and accepts the answer – God will provide. For the rest of the story on the mountaintop, when Abraham raises a knife above his son, when a ram is found in place of Isaac, when they walk back down the mountain, Isaac is silent.

Later Abraham sends a servant to find Rebekah and brings her to Isaac to be his wife. Rebekah is very involved in the process, being active and vocal. Yet Rebekah is chosen without Isaac’s input. The Torah says Isaac takes her as a wife and is comforted after his mother’s death. Yet Isaac remains silent.

In the midrashic text Pirkei de-Rabbi Eliezer, we learn: After twenty childless years, Isaac took Rebekah to Mount Moriah, which is where the Akedat Yitzhak/binding of Isaac took place. There Isaac prayed for Rebekah that she become pregnant, and God answered him.

At the place of the binding of Isaac – “Isaac entreated God for his wife, because she was barren” and God answered him.

This is Isaac’s story. This is Isaac’s awakening. Perhaps a childhood marked with a near sacrifice on a mountain understandably left Isaac silent and distant from God. Yet facing infertility, Isaac finally is shaken to the point of turning back to God. Years after the binding incident and 20 more years after marriage, Isaac is awakened and goes to the very same spot where he last encountered God. Isaac returns. He enters into relation with God once again to continue the covenant. Isaac petitions God. In turn, Rebekah, his wife, conceives. The story is relative to him. Infertility and turning to God is Isaac’s story.

This is not to say that infertility is punishment for turning away from God. That is a theology I cannot abide. However, this is to say that infertility can isolate someone from God. It can break a person to the core. Infertility can make continuing with the rest of life terribly difficult. It can leave a person isolated from loved ones and community too. Wholeness and healing in the face of infertility can come when we nurture those relationships, spiritual or otherwise.

Infertility caused Isaac to finally enter into relationship with God. Isaac reaches to God. Infertility is a yearning, beyond our own lives, beyond this world. Infertility can leave us utterly helpless. 20 years of helpless. It can also spiritually awaken us and make us act in ways we never thought possible.

That is the context of infertility. That is what is not said.

When Abraham takes Isaac to Mt. Moriah,
Abraham says: God will show us the sheep for offering.
Isaac goes along silently.
Abraham brings Rebekah to Isaac
And Isaac accepts her
And he is comforted.
20 years of infertility
And God waits
And Rebekah is silent.

And Isaac entreated God for his wife, because she was barren; and God let God’s self be entreated of him, and Rebekah his wife conceived.

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