Although infertility is widely acknowledged as a crisis for individuals and couples, it is less recognized as a trauma that impacts their families. Yet, involuntary childlessness is an intergenerational crisis that has the ability to strain, even damage, family relationships over time by impairing communications and interactions. Invisible losses, such as miscarriages, failed medical treatments, or adoptions gone awry, may highlight a family's inadequate means of dealing with problems. Old family issues, jealousies and resentments may resurface or other family struggles, such as parental illness or the pregnancy of a sibling, may take priority over reproductive difficulties, leaving the infertile couple feeling isolated and abandoned. The lack of acknowledgment of the losses associated with infertility may damage family interactions, particularly if family members use negative coping techniques such as blaming, side-taking, denial or avoidance. However, the family experience of infertility also has the potential to bring out the best in the family system, promoting growth and well-being for the members. This article will examine family dynamics impacting infertility and discuss ways to help deal with the demands infertility places on the family system.
Some families faced with infertility grow closer and find ways to provide support, compassion, and understanding in the midst of the maelstrom of profound loss and despair. These families are able to handle the myriad of negative emotions of infertility, and weather the pain of its many losses. They acknowledge the despair of this unique loss and its impact on the family as a whole, not simply on the individual or couple. Family members listen, openly communicate warmth and compassion, and ask for what the couple wants or needs during the infertility journey. And, they are willing to provide support in a variety of ways, including participation in rituals for commemorating losses as a family (e. g., attendance of service after a miscarriage) and a willingness to adjust family life to accommodate the realities of the infertile couple's situation (e.g., adapt gatherings to meet treatment plans or emotional needs). However, even strong, healthy families can find the challenges of infertility daunting and draining, particularly the pain of being an observer in a drama in which your loved one is suffering and there is little one can do to relieve that suffering.
Involuntary childlessness is an interruption of the family life cycle. Family building is a developmental stage that represents generativity or fostering the next generation. It is a life cycle stage in which each and every member of the family transitions from one developmental stage to another, and in the process assumes new roles and new role responsibilities: couples move from being spouses to parents; their parents become grandparents; their siblings become aunts or uncles; nieces and nephews become cousins, and so on. Infertility is the obstacle blocking these normal transitions and preventing family members from assuming new developmental roles.
Interruption of normal life cycle transitions can highlight a family's unique flaws, precipitating negative behaviors such as; parental favoritism; poor communication; and/or unhealthy coping strategies. Infertility may also require family members to re-examine some long-held family beliefs if they cause increased distress. For example, the belief that an offspring is not an adult until he/she is also a parent, or children owe parents grandchildren. In short, infertility has the ability to distress not only infertile couples but also, also, their families, resulting in 'collateral damage' that lingers long after the problem of childlessness has been resolved.
Very often parents of an infertile couple feel caught between their infertile child and their 'fertile', sometimes pregnant, child(ren). Naturally, both offspring may expect to rely on their parents for emotional support at this significant time in their lives. While this is a realistic expectation, many parents may, for a variety of reasons, end up providing more support to the 'pregnant' child than the infertile couple. Sometimes this happens when a parent is more knowledgeable about providing support around pregnancy and parenthood issues than about infertility. Other times, it may be that pregnancy and grandparenthood is a happier, more enjoyable experience, while infertility brings sadness, loss, and a variety of negative emotions. In addition, the infertile offspring may not have asked for parental help, keeping infertility a secret, or may have asked for assistance that is impossible to provide. Many parents become paralyzed by their child's pain and feel helpless to know what to do. Sometimes they feel trapped in the middle-or worse, their children demand they declare a specific loyalty or that they take sides. It is important to remember that parents still set the tone for family interactions and values, even in adulthood, and must refuse to take sides.
A significant challenge to parents of adult children is knowing when and how to provide feedback-particularly when it may not be wanted or appreciated. How does a parent say, "Telling me to support you by asking that I reject your sibling is inappropriate. I will support you in any way I can, but not by being hurtful to your sibling." Or "While it is wonderful that you are overjoyed with your new baby, I expect you to be compassionate of your sibling's feelings while they struggle to have children." Parents must be aware that watching a sibling move through the stages of pregnancy is typically most difficult for the infertile couple.
Parents faced with their children's infertility are often baffled by this crisis. It is an 'invisible' loss that involves private marital issues, complex medical treatments, and a rollercoaster of emotions. They may know how to support a fertile child, because of their own experience, and may be less clear about their role of support for infertile child. As with other experiences in parenting, they may have difficulty dealing with different children, with different needs, and coming from two very different life experiences.
Families dealing with infertility must find ways to help each member feel respected and acknowledge, despite their differences. It is important to define goals for strengthening the family which help to keep the group intact, communication open, and strengthening the functioning of all members.
The following suggestions are advice for family members and couples struggling with infertility and is based, in part, on Patricia Irwin Johnston's Understanding Infertility:Insights for Family and Friends: