In August 2017 we heard a wonderful “Family Matters” interview on 702 Talk Show between Eusebius McKaizer and Clinical Psychologist, Stephanie Bove, regarding infertility, and how fertility issues not only affect us as individuals, but how these problems can affect relationships with our spouse, our family members, our friends and the connection we have to our communities. Society can put an enormous amount of pressure on women to bear children, so it is so important for us all to truly understanding the struggles and the psychology behind fertility, infertility and reasons behind egg donation.
We feel this message is so vitally important, for us all, as a community to rid ourselves of the taboos placed on women and men, regarding fertility. This message is vital to us as a community to help us rid ourselves of the taboos placed on women and men, regarding fertility. Stephanie Bove says it perfectly at the end of the interview when she says “that we truly are the agents of our own change”. And we agree! With that poignant message, we really do have the power to reshape our own futures.
So we have outlined the most important information below for you, and hope this answers any questions you may have regarding this very important discussion. If you have any comments or questions, please contact us here.
Eusebius McKaizer’s Family Matters: Interview with Stephanie Bove:
EM: We are talking about infertility, so before the impact on relationships, what IS infertility exactly?
SB: Fertility is interesting topic. It is very close to home. Infertility is not an inability to conceive – it’s a decrease in the ability to conceive. Sterility is the inability to conceive, and that is an entirely different story with its own host of issues. Infertility can be broken down into 4 groups (Male, Female, an issue with regards to both male & female and finally the last group, which is when infertility is unexplained).
EM: it’s interesting that we live in a society where sociologically we have this weird construction of what it means to be an adult. A mom / dad / a parent. And when adults don’t have children, in our society, it is deemed unnatural.
SB: I think it’s like any other right of passage and it’s a progressive process. You become a woman, you meet your first true love, you get married and you then have children. And if this process is not followed in that exact order, it is seen as dysfunctional.
Even though we are embracing a more feminist way of life, it is still in many cultures, and with many women, important that motherhood is an integral part of their identity and that cannot be separated. Especially in developing countries it is essential for a woman to bear a child to sustain their position in their communities and for their communities to back them up, and we are not going to get away from that very soon.
EM: That is very sad. And I guess that also has a huge psychological impact on males suffering from fertility issues too. Bearing with questions like, “What kind of a man are you, if you can’t give your wife children?”
SB: It is not just limited to feminist ideals, the masculine identity is equally in play here. What relationship have you embarked on when your wife cannot give you children? And then looking at the aspect where women are so insecure about being abandoned by their male partners when they cannot conceive naturally. In my practice, interestingly enough, I have seen a lot more men presenting this within their therapy process, as a result of equal levels of distress at having similar issues about not being able to conceive with their partner. People believe that only women go through these difficulties but it is more and more common to have men coming in to discuss fertility issues.
EM: You have come up with fascinating research. 40% of cases are in fact due to male fertility issues which is very interesting. Before we go to calls, I just want to unpack a bit more regarding the psychological impact that fertility has on relationships.
SB: In terms of impact on a couple – it can lead to serious disintegration of a relationship. When the entire marriage becomes focused on the time limitations of conception. When you begin to discuss what was initially a very intimate side of the relationship to stuff to your basal-temperature rate! And you start basing your sexual intercourse programme on a time-limit, it is extremely challenging when sex becomes on demand. This severely impacts not only on your sexual satisfaction but your marriage satisfaction too. And with the constant failures, this is when things start to disintegrate, and there is a disconnect and communication failure. This then snowballs into insecurities from both partners, distance and potentially one considering to leave the marriage.
On an individual basis when confronting infertility and fertility treatment there will be a lot of high anxiety and severe bouts of depression about how they are being anticipated and received by others. There could be cases of social exclusion and isolation from peers who have already embarked on their own families. So friends and families may distance themselves from you out of fear as they do not know how to deal with these anxieties.
EM: All of this must be exacerbated by the fact that when we look at medical interventions – either therapeutic or more invasive, that must also make it so much more difficult. We take for granted the right to privacy. And infertility is a deeply personal aspect that couple are now forced to share intimate details about their lives with doctors and psychologists, and this almost medicalises their sex lives, when sex is meant to be fun for couples.
SM: Absolutely. And to construct the whole intimacy in the sexual scene, becomes immediately contaminated by all the emotional issues which plays a massive part when you are trying to be intimate with one another. Couples are dealing with massive dynamics in the relationship apart from the stress of the physiological treatment of infertility that they are going through. Never mind the costs that both couples need to absorb, and whether one partner is on the same page as the other with regards to the treatment options which can cause further stress on a relationship.
SB in response to a caller who called in regarding her own struggles with falling pregnant. Although they have only been trying for three months, there is still a large amount of anxiety attached to the wait
SB: There is anxiety and despair when months go by and a mother-to-be just isn’t falling pregnant and the anxiety comes in when people offer sentiments or some sort of support that doesn’t really help. Socially, people don’t know what is correct to say, we feel obliged to tell hopeful parents not to worry or think about it, and that is extremely difficult to do. But it is really about not giving up and to keep going and to rely on our support system.
EM: On a practical level, what is step one? And when do we take that step?
SB: The actual definition of infertility is when you cannot fall pregnant after 12 months of unprotected intercourse. I guess it’s ironic because in initial stages of a relationship you are so careful with protection and then when you are ready to try to conceive and nothing happens, it is hugely stressful. And of course the older the couple is, the less likely it is to fall pregnant immediately.
It is therefore important that when you and your partner are ready to try for a baby that you go to your gynaecologist, explain your need to want to conceive, rule out any abnormalities upfront and explain to your doctor that you have not fallen pregnant in the expected time since trying.
EM: what are some of the stresses that you have experienced with your clients, especially male clients?
SB: Sex on demand is a major issue. I have had male clients saying that on may occasion, they would be in a social situation where they are having fun, with the wife tapping on her watch to leave as she is ovulating and they need to go back home immediately!
SB in response to a caller with regards to his wife, who is a carrier of genetic disease (ALD) which affects boys where that boy will not live a very long life.
SB: Step one would be to really look at the specialists involved – you must get a second opinion. And it is a very intimate discussion with all specialists to find out the best options for the couple. In any pregnancy, even without any difficulties there will always be huge levels of stress anyway. Then you add technical difficulties or genetic difficulties and these anxieties multiply! So you definitely need specialists opinions, a fetal specialist’s opinion as well as genetic counselling options. A holistic approach and process is also definitely important for you and your wife during this journey. You must not ignore the that the distress must be confronted.
Part of becoming pregnant is facilitating an emotional space ready to embark on parenthood. So you want to alleviate as many anxieties as possible.
SB in response to caller – a woman who couldn’t fall pregnant even going through IVF and her husband’s decision to stop due to the emotional stress that was being put onto the family from friends and family and their own feelings of failure when they couldn’t conceive. The caller mentioned that they recently adopted a little girl and they are blissfully happy and so in love with their daughter.
SB: That is amazing. Your daughter is a lucky little girl because she now has so much love through you! And that is what causes so much distress because a hopeful mother doesn’t only want to experience pregnancy, but they are desperate to love a child. In my therapy sessions I always mention to my clients that starting a family is about transferring hope to a different outcome, and finding a different meaning to the life that they thought they were going to have!
EM: You have spoken before about a grieving process. Are there couples, even if they choose adoption, that may need to deal with leftover feelings of shame, because they couldn’t have a biological child?
SB: I think the process of adoption is just as much as diagnosing and treating infertility. As parents you will take a massive emotional knock when experiencing consistent or multiple loss when dealing with failures whilst going through fertility treatment. And you will need to stabilise the ego as well as work through the process of loss and bereavement in a way.
EM: And why do you use the language of loss?
SB: One can observe there is a bereavement process when confronting the diagnosis and the possible failures of treatment. And it is all about confronting your failures and loss. So it almost mimics the stages of loss in mourning the death of a loved one. And in some cases there will be miscarriages and that is a huge loss in itself. So you will get your five stages: denial, anger, bargaining, your depression and eventually acceptance.
EM: That is liberating! And I feel part of what you are presumably saying to couples who are going through fertility issues, that they must be kind to themselves through the process and to allow themselves to be vulnerable through the stages?
SB: Yes, It is important to allow yourself to grieve and to mourn – to look at what the loss means and internalise it and to understand what that means for your future. And how you create coping mechanisms through that grieving process. And it is important to confront your feelings of failure, betrayal and anger.
We need to understand that we are the agents of our own change. There is nothing in the books that states you must stick with one specialist so if I can leave you with anything, it is to seek the opinions of a number of specialists, not just one.
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Love EDSA x