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The debate about questions and their stupidity is on-going. Dumb is subjective. Thoughtless or insensitive is a little more precise. Questions about people’s family planning are often in that category. In the Jewish tradition, the Talmud guides a lot of our behavior and provides guidelines for prioritizing situations. However,  Rav Abby, sister of Rabbi Landers, who might have been a cousin of Rabbi Manners have words of wisdom on this topic too.  They had a consistent approach which almost always applied to these questions: you are not required to answer someone else’s question.

How do I answer when someone (fill in the blank question that reflects someone else’s curiosity or possible good intentions but is a raging trigger for you and you are just trying to get your copies made already!)? Or even from a friend, how do I respond when (fill in the blank question that you have no intention whatsoever of answering at that moment regardless of your relationship to the person asking).

A recent NYTimes Social Q’s answer summed it up beautifully. Their fill-in-the-blank-question was a curious friend who wanted to know whose fault was causing the infertility for a couple (!?!). “Rather than bringing a useful talk to a screeching halt because of one dumb question, how about redirecting it (“That’s not what I was talking about”) or brushing it off (“Oh, that doesn’t matter”) and returning to the valuable part of the discussion?”  Besides that this does bring us back to the issue of “dumb questions” (there are two sides to that debate), they further point out that sometimes you are entitled to end a conversation and make others squirm. This is accomplished by one of my favorite responses, and tone is everything in this one, “Why do you ask?” That could be stated with chin downward looking out of the tops of your eyes, or with lips pursed and an icy tone, or a head tilt and furrowed brow and a dramatic forefinger and thumb around the chin for effect. All of these squarely place the issue into the hands of the person asking the question – to whom attention ought to be directed – rather than on you or your partner’s reproductive organs and private life.

The first attempts to redirect or brush off, however, are useful when we know or are hopeful that the other person really does have good intentions or is a good friend and just fumbled the attempt to open a conversation. As noted above, this is still accomplished without answering the question.

So here is your mantra. Repeat after me: “I am not required to answer someone else’s questions.”

And here are your multiple choice stock answers to keep at the ready:

a) “That’s not what I was talking about”

b) “Oh, that doesn’t matter”

c) “Why do you ask?”

d) “Interesting that you ask. What’s really on my mind is…” (To talk about it or to change the subject)

d) “That reminds me, I have always wanted to ask you and I know it’s not really any of my business… ” Silence. Blank stare. (Okay. Maybe not, but I’ve always wanted to do that).

Happy not answering!

 

 

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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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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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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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Many articles are written about what to say and what not to say to someone experiencing infertility. Sadly so many of the “what to say” lists get it mostly right and then there is that one piece of advice that just does not fly.  Here is one list that holds strong because it is nuanced and recognizes that each person’s experience can differ. Please read for yourself if you are experiencing infertility or for someone else if you have a support role. It comes from BabyCenter.com.

Therapists’ top ten tips for coping with fertility problems

The pressure to raise a family can be enormous, and the thought of not being able to have children can make many people feel something is wrong with them. We talked to respected psychologists who work with couples with fertility problems to find out which coping strategies really work.

Recognize that a fertility problem is a crisis. A fertility problem may be one of the most difficult challenges you’ll ever face. Acknowledging this is a key to coping, says Kate Marosek, who’s counseled couples with fertility complications in the Washington, D.C., area for more than ten years.

“It’s normal to feel a monumental sense of loss, to feel stressed, sad, or overwhelmed,” says Marosek. “Don’t chastise yourself for feeling this way.” Facing and accepting your emotions can help you move beyond them.

Don’t blame yourself. Resist the temptation to get angry at yourself or to listen to the little voice in your head that’s saying, “I shouldn’t have waited; I’m being punished for having that abortion; I should have lost more weight or taken better care of my health; I shouldn’t have assumed that I could have children when I wanted” or whatever negative thoughts you may be having.

People can get caught in negative thinking patterns that only make matters worse, says Yakov M. Epstein, a psychologist at Rutgers University and co-author of Getting Pregnant When You Thought You Couldn’t: “Instead of berating yourself, look forward to how you and your partner are going to manage the situation.”

When you start feeling like you “should have” or “could have,” remind yourself that your fertility problem is not your fault. Even if you could have made different decisions in the past, they’re behind you. Concentrate on your future.

Work as a team with your partner. You and your mate should help each other through this time (and definitely not blame each other for your difficulty getting pregnant).

This doesn’t mean you need to feel the same thing at the same time — that’s one of the most common pitfalls for couples facing fertility problems. It does mean paying attention to what your partner’s going through. “If you’re taking care of each other emotionally, you can unite to fight the problem,” says Marosek.

Work together to find practical ways to share the burden. If you’re undergoing treatment, he can take care of the insurance papers. Or if he needs injected therapy, you can administer the shots.

Educate yourself. Read as much as you can about fertility problems and ask questions of your doctor and other couples in your situation.

Staying educated is especially important when you’re dealing with a fertility problem because the technologies behind the treatments are complicated and change quickly. “You’ve got to understand what’s happening medically,” says Epstein, “or you won’t be able to make informed choices.”

See our resource guide for a list of books, Web sites, and organizations that can help. Learn the basics by starting at the beginning of our Fertility Problems area.

Set limits on how long you’re willing to try. Some couples decide from the get-go that they won’t go to extreme measures to have a baby. Others spend years and thousands of dollars exhausting all of their treatment options.

No one can tell you when to stop trying to conceive — that’s a decision you need to make with your partner and doctor — but you’ll feel more in control of your life if you start thinking in advance about how far you’re willing to go to get pregnant.

Start by discussing your medical odds of getting pregnant, which treatments you’re not willing to try, and your end goal. (For more help with this choice, read about making the decision to end fertility treatment.)

Decide how much you’re willing to pay. With in vitro fertilization (IVF) averaging $12,400 a cycle, it’s no wonder couples feel anxious about money, especially since women often need to go through multiple cycles before becoming pregnant.

To cope with the anxiety caused by the high costs of treatment, sit down and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn’t cover. If it covers some or all of your treatments, decide which one of you will monitor the paperwork and negotiate with the insurance company.

Then look at all your assets and determine how much you can spend and on which treatments. “You should always have a plan B,” says Alice Domar, a psychologist and assistant professor of obstetrics, gynecology, and reproductive biology at Harvard University Medical School who specializes in helping couples with fertility problems. “Because nothing, especially with fertility treatments, is certain.”

Get support from professionals and others with fertility problems. Society often fails to recognize the grief caused by infertility, so those denied parenthood tend to hide their sorrow, which only increases their feelings of shame and isolation.

“Finding other people who are going through the same thing can help you see that fertility problems are widespread and your disappointment is understandable,” says Linda Klempner, a clinical psychologist and mental health consultant at Women’s Health Counseling and Psychotherapy in Teaneck, New Jersey.

Share stories and advice about fertility Problems with others in the BabyCenter Community.

If you’d like to talk to a therapist, look for one who understands reproductive medicine. “Fertility problems are very complex, and if a therapist does not understand the medical issues, he or she won’t be able to help,” says Epstein. Look for a referral through RESOLVE, the American Society of Reproductive Medicine, or the InterNational Council on Infertility Information.

Just say no to baby-focused activities. If certain gatherings or celebrations are too painful for you — if all your siblings had babies in the last two years, say, or you keep getting invited to baby showers — give yourself permission to decline the invitation or at least to have a good cry afterward.

To avoid hurt feelings, send a gift but choose children’s books or an online gift certificate to save yourself a troubling trip to the toy store or baby boutique.

Balance optimism and realism. “You need to be optimistic to go through a procedure,” says Epstein, “but if you’re too hopeful — if your hope is unrealistic — you’ll be setting yourself up for a huge fall.” By keeping current on the technology and your diagnosis, you can get a good handle on what chance of success you have with each treatment.

The array of medical technologies available today leads many couples to keep trying month after month, year after year. But about a third of couples treated for fertility problems won’t go on to have a biological child, and often they must make peace with that before they can move on with their lives. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.

Take care of yourself by pursuing other interests. Being treated for a fertility problem can feel like a full- or at least part-time job, so it’s important to keep up with some of the activities or hobbies that bring you pleasure.

“It won’t be easy,” says Marosek, “especially if you’re doing something like going in for a blood test every other day, but look for ways to take care of yourself.” She recommends that people get a massage, have a manicure — anything that can give them relief from the focus on fertility treatment.

If your old activities are painful — maybe all your friends are parents now — look for new diversions. If hiking sounds appealing, do that. Or take a class — painting, dance, or something else that’s always tempted you.

And remember, laughter is one of the best healers. See a funny movie, head out to a comedy club, and reread your favorite funny novel.

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