Lifting the Veil

Last Friday Michelle Obama shared her struggles to conceive her daughters Malia and Sasha. As someone who has also experienced miscarriage, infertility, and IVF before conceiving, I am so grateful to the former First Lady for telling her personal story to the nation in her memoir Becoming. It is a story I needed to hear desperately years ago, as I felt so alone, ashamed, and stuck. Before I went through IVF, I had only known one other person who had gone through the process.

Having Michelle Obama as a visible face and powerful voice of infertility and assisted reproductive technologies means women and men who endure infertility and pregnancy loss may better understand they are most certainly not alone. In fact, one in eight American couples have trouble getting pregnant or sustaining a pregnancy. This statistic includes men, who also go through infertility and loss (up to a third of infertility is due to male-factor issues, a third due to female-factor issues, and a third of infertility cases have no clear cause and go unexplained).

Many assume infertility will not affect them, yet it often does. Trust me, someone you know has been affected by infertility, but you likely have no idea. I taught college women whose health conditions made having a child exceedingly dangerous or improbable, who wrote about knowing from an early age they may not have biological children—survivors of childhood cancer, brutal sexual assault, endometriosis, polycystic ovarian syndrome, or a host of other medical conditions. These same women often expressed feelings of shame, wrestled with how to tell future partners of their health status, and were worried the life they dreamed of might pass them by.

When I shared our struggles publicly after getting pregnant, work colleagues told me of their IUIs (intrauterine inseminations), of their miscarriages, of children they wanted but never conceived, of the fertility medications they took to stay pregnant, and so much more. In a society where so many say so much, it is still difficult to discuss infertility, pregnancy loss, and the treatments and alternative paths to parenthood.

Michelle Obama “coming out” to share her story might help others realize how to, first and foremost, not assume that all people are able or want to have a child, and secondly, to consider alternatives and not feel ashamed in asking for help.

I often think about how hard it was for me to make the first phone call to a reproductive endocrinologist. How hard it was to tell trusted family and friends what we were going through. To educate myself and others about the facts and feelings of infertility and to slowly throw off the veil of unwarranted shame.

During that first call to my first reproductive endocrinologist’s office, my voice shook and I almost hung up when the receptionist simply said, “Hello.” While perhaps it makes sense to logically know that infertility is no one’s “fault” or “shortcoming,” so many women have been taught by our culture that our worth is intrinsically linked to reproduction. We give young girls dolls and babies to nurture from the very beginning (at a much higher rate than boys). We groom young women to become mothers—we babysit more than men, we are our mothers’ helpers. Of course, a woman’s worth is inherent and whole, with or without a child or society’s expectations of what a woman should do. However, in pronatalist cultures such as ours, a woman’s worth is often called into question when she cannot get pregnant naturally, does not wish to be pregnant ever, or rejects heteronormative ways of becoming a parent.

Obama’s generosity in sharing how she and her husband conceived their daughters is a gift beyond measure. Infertility is a medical condition, yet only 15 states require insurers to either cover or offer coverage for infertility diagnosis and treatment. Had my mother not helped us pay for much of our first IVF treatment, we would have had to make difficult financial decisions—a second mortgage on our home, liquidate or severely reduce retirement accounts, take out thousands of dollars in loans, or realize we could not afford to pay for the care that ultimately resulted in our 19-month-old daughter.

Michelle Obama helps all of us better discuss a topic that may feel uncomfortable and taboo, even though infertility and pregnancy loss are more commonplace than our culture acknowledges. Thanks to Obama’s courage, perhaps others will not be asked this Thanksgiving when they are going to have children, why they should just adopt (which is wonderful, but also quite expensive), or to “simply” relax. The best support to give someone going through infertility and pregnancy loss is your compassion, active listening, and a refrain from unsolicited advice.