By Jan Elman Stout, PsyD
Reprinted from Family Building magazine, Spring 2006
You’ve spent months or years trying to conceive your biological child. You’ve managed to cope while undergoing every imaginable procedure to diagnose your infertility. You’ve been poked and prodded, and survived the treatment process.
You’ve dealt with all kinds of personal questions and insensitive remarks from friends, family and acquaintances. You’ve attended one baby shower after another and received countless birth announcements. It seems everyone you know has a child, many two children, but you’ve handled all this.
And now, you and your partner are at a crossroads. Your doctor has told you that he’s done everything he can to help you become pregnant with your genetic child. Where will you turn? And when?
Couples face all kinds of challenges in coping with infertility and the treatment process, and two of the most stressful decisions they might face are when to stop treatment and where to go from there. If treatment fails, couples must consider whether to live without parenting or become parents through alternate means. If determined to parent, you must choose between collaborative reproduction (i.e., sperm, egg or embryo donation or a surrogacy arrangement) and adoption. These can be difficult decisions to make when couples agree and are on the same timetable. However, when partners disagree about their choices and are on different timetables, the impact of these differences may feel overwhelming.
If you and your partner disagree or are on different timetables, how can you reach agreement? Unfortunately, there is no clear answer, much less a step-by-step manual for reaching consensus and readiness. However, I often counsel couples facing this predicament and will share some of my advice here.
Know that it is not uncommon to feel at odds or out of synch with your partner while actively making a decision. Couples are comprised of two people with different life experiences, family backgrounds, personalities and ways of coping. Individuals have different needs, priorities and timetables, so be realistic about the likelihood you’ll experience tension in the process. Tell yourselves that just because you currently disagree does not mean that you will always disagree—couples ultimately find resolution. Remind yourselves that because this is a process you will sometimes feel that you are making progress, but sometimes feel stalled. Keep in mind that there are common gender differences in coping styles. Women tend to seek support, want to talk and express their emotions when facing a challenge or crisis. Men tend to be stoic, withdraw or isolate themselves and take a problem-solving approach in discussions. These differences can lead men to feel that women are overreacting and lead women to feel that men are uncaring or unaffected.
The first step in decision making is to learn as much as you can about all your options with an open mind. There is a great deal of myth and misinformation available; make it your goal to dispel it. Gather information as if on a fact-finding mission. Read about the various options. Attend workshops that address these choices. Consciously try to back away from conclusions you previously drew and avoid coming to new conclusions just yet. Talk to couples you know who have faced these choices and try to understand how they made their decisions. Attend support groups focused on decision making or specific options.
Once you’ve both gathered a substantial amount of information, begin evaluating it together. Try to identify what your priorities and needs are and why. Once you have completed these tasks, you’re ready to begin communicating about your findings, attitudes, feelings, needs and preferences.
Be attentive to the context in which you try make a decision with your partner. Most couples find it difficult to discuss emotional issues in public places, so try to find private settings for your talks, and schedule them ahead of time. Beginning a discussion when your partner has just walked in the door after a hard day at the office, or has had an argument with a sibling, tends to heighten emotions and complicate decision making. Couples often find it optimal to discuss options after they’ve enjoyed a pleasurable recreational activity together that has nothing to do with infertility, or if one promises to follow their talk. You should set ground rules for your talks, including how long to talk at any given time and how heated a discussion can become before abandoning it, with interrupting, criticizing and blaming forbidden.
You should attempt to use active listening skills when trying to reconcile your differences. Try to be very attentive to your partner and pay attention to nonverbal cues. Try to summarize your partner’s points and reflect his/her feeling before sharing your own thoughts and feelings. Good communication is impeded by being out of touch with your own feelings and/or being unable to communicate them honestly and directly, being insensitive to your partner’s feelings, jumping to conclusions, being on the attack, or trying to dictate, control or manipulate.
In deciding which course to take, couples must try to assess whether their differences are fundamental or a function of having different timetables. If one partner wants to adopt and the other doesn’t, it might reflect a real difference in their views or it might instead reflect a difference in readiness to proceed. Obviously, the implications are different. When a couple’s timetables are different, the “slower” partner must be given time to catch up, which may be difficult for the partner who feels ready to forge ahead. Ironically, planning vacations from treatment and breaks from decision making can help the “slower” partner reach resolution. The emotional impact of differing timetables can be minimized if couples establish timeframes for their decision making, such as agreeing to undergo one more in vitro fertilization (IVF) cycle; waiting three months before moving on to egg donation, or waiting two months before pursuing adoption. Agree to reevaluate and modify this decision if necessary.
If you feel that your discussions are unproductive, counterproductive, damaging to your relationship or excessively stressful, consult with an infertility counselor who can guide you through the decision-making process and toward resolution. A mental health professional can help you better understand your options, attitudes and feelings, improve your communication skills, feel less distress and reach resolution more quickly and comfortably.