Thursday, September 8, 2011

How To Make A Baby

This guest post was written by a friend who is frustrated, angry and tired over a process this is supposedly there to help her. She wanted a platform to share her story and I was more than willing to do what I could. While creating a baby for some is as easy as one fun night, for others it's not as simple. And for other's yet, it's a painstaking journey...

We have been going through this crazy process to try to make a baby—build our family. We are two thirty-something women, who have been together for over 11 years, married for over 5 years, own our own house (or at least the bank does for another 20+ years), live in semi-rural New England with our two cats, have post-graduate degrees, and a huge community of loving friends and family that support us from one mile down the road to the West Coast, across the globe, and many places in between. We are financially stable, have good professions, physically healthy, and emotionally (in general) stable. We are culturally Jewish and identify with spiritual teachings from many religions, including Judaism. We have a garden that can sometimes successfully group tomatoes and squash, and we often forget, or simply don’t make the time, to weed.

Our lives have included their fair share of strife and difficulties, just like many, if not most, other people; and at times we have dealt with it better than others. But trying to make a baby has been no small feat. First off- we had to decide on where we would get our sperm. After debating known versus anonymous donor, we opted for a cousin, so that our child would be biologically related to both of us. I am going to be the birth mother with my partner’s cousin’s sperm. We had only the most positive experience and response when discussing this with her cousin- him wanting nothing more than to help us have children. I am ever so grateful for his loving kindness. Now to get the sperm to my egg… he lives out of town, so if he isn’t in town, we have it shipped, overnight, in a kit that keeps it viable for 24-48 hours (thank you gayspermbank.com).

Either we inseminate at home, or I go to my midwife who washes it, spins it, and inserts it past my cervix [Intrauterine Insemination (IUI)]. We know the timing, or hope we get the timing right, because I chart my temperatures and cycles daily, pee on ovulation predictor kits (OPKs) every so often, and sometime I even go and get an ultrasound to quadruple check. This is all because I am blessed with irregular cycles, for which they have found no known direct cause other than possibly Polycystic Ovarian Syndrome (PCOS), although blood tests do not confirm this diagnosis.

So we have been doing this for 20+ months. Friends I was trying to get pregnant with are celebrating their babies’ one-year birthdays. Please, don’t hear that as complaining- it is wonderful to celebrate their lives and it is also a reminder of how long and difficult this has all been.

We started with one midwifery clinic and had an awful, unprofessional experience there. One midwife reprimanded me (for what I still don’t understand), while I was in the stirrups butt naked. She ended up taking a leave and has retired early—something that validates my experience and saddens me for her difficulties. We switched to another midwife center and have received loving, compassionate, and accepting care. I text my midwife when I get a positive OPK and we schedule via texting. We share 1-2 hours a month while she cleans the sperm and I warm the wash.

After six months of trying on our own and 14 months of IUIs, we decided to consult a the local hospital’s reproductive medicine center to see what our next options were. Having completed one cycle of clomid that made me feel so crazy that I thought I was going to jump off a bridge, I needed to know other options. We met with Dr. L, who immediately told us what my health insurance would cover before laying an eye on me. We told her we had a known donor who had been tested for STIs and HIV and with whom I had been inseminating with for 20 months. She commented, “You know we don’t like that here.” She did not look at my charts, my cycles, my medical history, or my wife in the eye. She told us to go right to IVF (In Vitro Fertilization) and switch to an anonymous donor because it would be more efficient. As if our donor decision has not been well thought out and emotionally involved.

Dr. L stated numerous excuses as to why they would not work with us with a known donor unless we quarantined the sperm ($) at a sperm bank ($$) for six months to test it twice ($$$) for STIs, and then freeze the sperm and ship it ($$$$) to their facility. She said it was a waste to do it that way because it would cost over $5,000. [Which at this point in time I would pay $5k for a child in a heartbeat.] I will comment that the actual cost of this is more like $3,000, but the fact that it is put off for six months just because I am not married to him feels ridiculous. Dr. L explained that due to the guidelines that the hospital follows, while a heterosexual couple could move immediately to IVF, a lesbian couple has to quarantine the sperm for six months, even if the individual has been exposed to the sperm prior to IVF. Basically, if I had to come to the clinic with just the donor and we said we wanted to have a child I would have moved to IVF IMMEDIATELY without having to pay any such sperm bank costs.

We argued these points, but to no avail. We were met with even more blatant discrimination (oh did you know, by the way, that sperm banks certified by the ASRM [American Society of Reproductive Medicine]- which this clinic only accepted sperm from- you can’t be a gay male—or rather you can’t have had sex with a male in the past 5 years. There are hundreds of other rules too about being out of the country, so on and so forth, but having sex with a male was #1). Then there was Dr. L’s comment about how we needed to go to counseling (I’m a psychologist) to deal with our “issue.” I inquired about the subject of “issue”—my infertility or the way we are choosing to make our family and was told the latter. And don’t let me forget the moment where my wife told the doctor that we knew it was not her intention exactly, but we felt discriminated against by her actions. She replied, “It’s okay for you to feel that way.”

Dr. L claimed that they could not separate the social (my state-recognized marriage) from the medical (my inseminations with the donor) because they had a “moral obligation.” She explained this with an example of a family in which children had been removed from the home and how the hospital would have a moral obligation not to offer that couple IVF. We, as two women with a known donor, were being compared to a family in which children were removed from the home for abuse and/or neglect. This was Dr. L’s attempt to have a “mutual agreement” as to why the hospital would eventually deny us equal services that would have been offered had I been a married heterosexual woman, a single woman with a male partner, or had I simply just come in with the donor and said that we wanted to have a child (a.k.a. lied—kind of like we are forced to do on our federal tax forms, but I digress…).

Needless to say, they denied us services for what we believe is discrimination based on how we are choosing to create a family. She neglected to send us her policies as we requested and it took over four weeks for me to get a copy of the records I requested and testing I had done there. They charged me $3.25 for the copies after billing my insurance company over $1,000 for the two 30-minute visits and even more for testing. (I had a Hysterosalpingogram [HSG] done and while they gave me a time to arrive, they took me 90 minutes later than my scheduled time. When I inquired, I was told to take deep breaths and relax (have I mentioned I am also a trained yoga instructor?), even though a sign in the waiting room stated “if you are not taken within 15 minutes of your scheduled appointment, please inquire with the receptionist.” Oh, and I was told to take 800 mg of Ibprofen 30-minutes before the procedure which I was now concerned was beginning to wear off.)

Finally we are done with this clinic, and while we are considering letter writing or letters to the editor, we cannot expend our energy on it until we have a child. We really just want a baby - one that is of both of our genetics, and for some reason this is so confusing to the reproductive medicine center at our local hospital.

So we try a second reproductive clinic. This one is two hours away with a satellite office one hour away. We don’t hesitate to go. We are treated with significantly more respect—find out that the owner/medical director is an out gay male—and are allowed to more forward with IVF, with just a few stipulations. 1) We need a contract by a lawyer, reviewed by my wife’s cousin’s lawyer, stating the financial/parental responsibility of the to be child; 2) the donor needs to attend one session of counseling to prove that he knows he is making this decision (have I mentioned that he is a scientist, his father a lawyer and his mother a psychologist?); 3) he needs to have blood tests, again, within 7 days of depositing his sample or “donation” if you will- he has to freeze his donation ($) so that they can ship it ($$) to our facility; 4) I need to have additional genetic testing and infectious disease screening, as well as proof that I have been vaccinated and/or exposed to a host of childhood diseases. I have already had 2 rounds of genetic testing, 3 rounds of hormonal panels, 2 rounds of thyroid panels, 2 rounds of glucose screening, 3 rounds of infectious disease screening, and 2 rounds of blood type screening; 5) I need to have a physical within one year of IVF- apparently they only really need to listen to my lungs and heart, and even though all the reproductive doctors are physicians (and wear stethoscopes around their necks), none can listen to my heart and lungs without a separate appointment; 6) pap smear within a year (thankfully I did that!); 7) hormonal panel on day three of cycle (done!); 8) uterus cavity examination (I have had not just one but two of these) and… screeching halt… 12 cycles of IUI with three cycles using follicular stimulating hormones. Well, even though I have been trying for 20 months, thus exposed to sperm for 20 months, there is a chance that my health insurance company won’t accept that and that they will only count IUIs and unfortunately I have only had 10. (Again, if I were hetero- no problemo!). Oh, and even though I ovulate on my own without difficulty (irregularly, but only 1 out of 18 cycles have been anovulatory), they want to stimulate the heck out of my ovaries so that my hormones are out of whack for the two months BEFORE IVF. I was recently put on an anti-diabetes drug (metformin) for the PCOS. I am hoping that the insurance company will count that because I start a new job next month and the following month my wife has ACL surgery, so I really don’t want to go crazy for all of that. (By the way, my mom has breast cancer and went through surgery, chemotherapy, and now radiation while I was going through all this, finishing a doctoral program, writing and defending a dissertation, my wife had her ski accident, and more people in my life died than I can easily count.) It has been a year of trauma, topped off with disappointment, frustrations, stress, and discrimination.

So here we are, I’m in weekly acupuncture, taking herbs, trying to prepare my body for an onslaught of hormones, waiting to hear what my insurance company, not my doctor or midwife, will dictate about my treatment. I have to get permission from more adults in power for making a wanted child and yet 16 year olds are not taught about protected intercourse and find themselves unknowingly and unwittingly pregnant with little support from anyone, let alone the FDA, ASRM, or any other institution. Why is the government so interested in making this so difficult for us but not in preventing children from mistakes that can’t be undone?

Yes, I am frustrated. I’m sure it is partially a mask for the sadness and monthly disappointment. I don’t know how much longer I can do this and yet I can’t imagine not having children. Three ideally, although I can’t see myself doing this part again. My new mom and pregnant friends have told me that the nine months feels like forever. At this point, it doesn’t feel so long.

I’m not saying that it should be perfectly easy for two women to have children. I’m the first to admit that this isn’t supposed to be simple. I chose to marry a woman (note language here) but I didn’t choose to be discriminated for it. I just think that Dr. L could have been kinder. It was so clear we made her uncomfortable—but I’m a human and like many others that she has helped get pregnant, I want a child. She wasn’t thinking of what my experience was because she was too stuck in her own discomfort to see past it to ours.

I never expected it to take this long and yet somehow I trust that when we finally have a child, it will all feel right that we had to wait this long. I know that there are children out there, whether born yet or just in spirit, that will choose us as parents. I just wish that institutions didn’t get in the way quite so much.

At this point, I would happily take twins because it would mean we were done with this process. Happily.

In closing, it has been emotionally tolling and draining—but it will all be worth it when we hold that child in our arms for the first time.

Abigail Levy, a pseudonym used by the author to protect her identity, is a psychotherapist and has been married to her spouse for 5 years. They reside in New England. A shorter version of Abigail's story originally appeared in The Rainbow Times

5 comments:

lifeversiontwo said...

My heart breaks for you, and others who have been discriminated against this way. And I get ragey thinking about Dr. L and the hundreds of other health care professionals (and people) just like her, who are happy to impose their discomfort on people they feel deserve it.

Thank you for sharing this story, and I wish you great strength and much luck in your future baby making journey.

Kelly Deneen said...

Wow, I am tearing up reading of the struggles you have gone through. It is certainly not fair at ALL that you need to go through so much. Yes, it will be worth it, but wow. I don't even have words. I hope your journey to motherhood becomes easier and more fruitful.

Thanks, Avi, for sharing this.

conceptionquestions said...

I have tears in my eyes, too. It sounds like you put so much thought into this decision to become parents; if only more people did that. Instead, the people who get paid to help couples have babies have adopted scary language that, frankly, smacks of eugenics. They're not just judging you; these are doctors placing obstacles between patients and care. Thank you for sharing this; don't give up. If only all children had such thoughtful parents!

Nicole said...

My heart goes out to you and your wife! What an incredible gift of her cousin to be the donor. How unjust and completely selfish of Dr. L and others who "didn't approve and therefore were not willing to help"

Parenthood is an amazing journey ... you have had quite the start

Good luck to you! I would love to read an update in time.
Avi, thank you for sharing!

Linda said...

That is such a sad story. You sound like you two would make ideal parents, have family and community support. But,the stress of trying and deaths and accidents may be a large part of the problem. I remember my cousin tried for over ten years to get pregnant. But, when she quit her high-stress job and started baby-sitting the toddler next door, she was pregnant within the month.

I am not blaming you at all. But, your burning desire and all the tests may have your body telling you this is no time for a child. The medical profession has discriminated against you. All the stress is not within you.

This may not please you, but can you just omit facts, leave your wife at home and take the cousin to whatever it takes to please others and get what you want?

People have had their own agendas and forced rules on you unfairly. So, play their game and give them what they want. At least, now you know how to play the game.

Please forgive me if this is offensive to you.