Just the two of us

‘I’m sorry, I can’t see anything.’ Not words you want to hear when you’re lying on a hospital bed in what can only be considered a most unladylike position. On two occasions I’ve been told this, when the giddy excitement of seeing two blue lines came crashing down upon learning that the embryo had lost its way and implanted in my fallopian tube. It seems that my eggs need some sort of Sat Nav to avoid winding up lost on my body’s equivalent of the A406.

After two ectopic pregnancies the hospital consultant was pretty frank with my husband and me: ‘You could have a spontaneous pregnancy…’ (which sounds terrifying, as if a baby could suddenly materialise in my womb without warning) ‘…but I think you should consider IVF.’

Before my own experience I was largely unaware of how widespread infertility and pregnancy loss actually are. According to the Human Fertilisation and Embryology Authority (HFEA), it is estimated to affect about one in seven UK couples at some point. Of those who do conceive, around one in four pregnancies ends in miscarriage. It is a huge issue, and there will no doubt be people in your church and mine going through it, often in silence.

Not every experience of childlessness is the same, of course. A couple could be facing medical struggles (such as absent ovaries, low sperm count or blocked fallopian tubes), or they could have been given the rather frustrating diagnosis of unexplained infertility or secondary infertility (you’ve had one child but fail to conceive after that). Other individuals are single and are longing for children of their own. These stories are unique but they have something in common ? they are all painful.

Aside from a sense of personal loss or grief, infertility raises wider issues. It can leave you questioning your identity and your faith, as well as asking big ethical questions such as where life begins and how much we can ‘interfere’ with natural processes. For Christians, the church community becomes an essential place to work some of these things through.

Pressure to Procreate

For women particularly, the longing for children can be felt as early as childhood, when pretending to be a grown-up, playing with dolls and keeping a house was almost a practise run. I loved singing lullabies to my Holly Hobby doll, and dreamed of one day doing it for real. And what started out as a simple childhood aspiration grew significantly when I got married and settled down. As you get older and the biological ticking gets louder, the pressure begins to mount.

This pressure isn’t just personal; it can also come from friends, family, Church and society. After a few years of marriage, you face the inevitable question from well-meaning people. Nick Welford, who writes about his experience of infertility, IVF and adoption on his blog, Ebs and Flows (deliberate misspelling) (nwelford.wordpress.com) and on Threads (threadsuk.com/you-can-keep-yourhealing), says: ‘People were starting to ask us about children. So if I thought we’d have a relationship longer than a short meeting I’d tell them about it upfront ? to save any later embarrassment.’ The questions from people who don’t know of your situation are tricky to answer, says Rosemary Morgan, author of Living with Infertility (BRF): ‘It’s not something you want to explain to people you don’t know very well. It can be quite difficult.’

There are particular pressures which come from the Christian community, which vary depending on the theology and culture of the church you belong to. ‘When people get married, if they don’t produce children quickly, people wonder why and start asking questions, thinking that you’ve not fulfilled your role,’ says prominent Churches Together in England leader, Dr Joe Aldred. ‘The black majority Church has a very deep grounding in the Bible and is very much linked to the Old Testament. That tends to conjure up famous women like Sarah, Rebekah and others, whose barrenness we’re told about, along with the miracle of God changing their situation. That presents barrenness, which is implicit in the term itself, as a problem: a social problem and a cultural problem. Back then, it rendered women in a pretty dire place. That was the purpose to which you were born, and if you were not able to fulfil that, you’d be seen as unfulfilled.’ 

Identity Crisis

Infertility can feel like no-man’s land. I began to feel as if I didn’t fit in with my childless friends, as I was going out less and attempting to be teetotal, but I felt that I didn’t fit in with my friends who had kids, either. ‘I noticed that I dressed differently,’ says Rachel Gardner, director of Romance Academy, who with her husband, Jason, has recently adopted after years of trying to conceive. ‘I didn’t look like them [other mothers] and I felt different because I didn’t understand the things they were talking about, like breastfeeding.’

It’s easy to feel adrift, especially as churches and society value family so highly. ‘I definitely struggled with my identity,’ says Rebecca Stewart, co-founder of the Waiting for Children course at Holy Trinity Brompton. ‘I assumed a large part of my life’s purpose was to be a parent; when it appeared that it would no longer [be] an option, it threw up some big questions.’ It’s not just women who experience this. Her husband, Alex, says: ‘It [becoming a parent] is a big part of your own sense of gender identity and it applies as much to men as to women. To be told you can’t be a father is a big blow and it makes you question what you’ve previously taken for granted.’

For Eleanor Margesson, co-writer of Just the Two of Us? (IVP), the sense of an unfulfilled role as a mother was tangible. ‘I felt that I was only living life in a half-hearted way. What I really wanted was to have children, and the fact that I wasn’t meant that I wasn’t getting to where I wanted to be. God gave us that job to do, and when we can’t we feel something is missing. It’s not strange to feel incomplete or have a sense that you’re not fulfilling your job…The challenge is to know that our identity rests in who we are in Christ, rather than who we are in other people’s eyes.’

Grappling with issues which challenge our sense of identity can actually help us to embrace the truth of the gospel more fully. ‘We have to ground our identity in the truth that we are beloved children of the Father,’ says writer and broadcaster Sheridan Voysey, who with his wife went through ten years of dashed hope and failed IVF cycles. ‘This world is so temporal; you can lose your job, children, home. Your sense of worth, security, value, significance has got to be based in God ? which is easier said than done.’ Voysey writes about his and his wife’s journey and subsequent resolution in his book Resurrection Year (Thomas Nelson) that is out in May.

The Ethics of IVF

We spoke to John Wyatt, emeritus professor of neonatal paediatrics at University College London, about the ethics surrounding IVF

What is IVF and how does it work?

In a normal monthly cycle one egg is produced at a time. The egg passes down the fallopian tube and if it meets sperm fertilisation takes place there. The embryo then passes down tube and implants into the side of the womb. IVF is an artificial way of achieving the same outcome. To maximise the chances of success, the mother is given drugs which induces hyper-ovulation so a larger number of eggs are produced. The eggs are then harvested during a medical procedure and incubated. They are then mixed with the sperm in a petri dish. Fertilisation occurs in a few hours, the embryos are examined and the best quality ones are selected. Between one and three are inserted back into the womb. The hope is that these embryos will implant into the side of the womb and that the pregnancy will develop. 

What are the general concerns?

There is a much higher risk of multiple pregnancies and with this comes the higher risk of premature birth. There’s also a problem concerning what to do with the spare embryos. The options are to freeze them (the commonest thing that is done, as they can then be thawed out for subsequent use), donate them to another couple or for research or discard them.’ 

What are the ethical issues for Christians?

Once the embryo has been created, it’s possible to test for genetic abnormalities. In the UK sex selection screening is not allowed, but the embryos are sometimes screened for other genetic conditions, and this raises ethical debates. The psychological effect of this high-tech approach is also worth reflecting on. In sexual relationships human beings are at their most vulnerable, and IVF is the equivalent of Drs marching into your bedroom, turning on the lights. Then there are financial issues. A small number of cycles are allowed on the NHS, depending on where you live. Many private clinics offer a scheme called egg sharing, which offers reduced cost or free treatment if you agree to donate any remaining eggs to others. There may be financial pressure to agree to this, even if you’re not convinced that you wish to do so. A further issue is that of gamete donation; using a sperm or egg donor. The issue with this is the broken covenant link between a husband and wife, and the mixed genetic make-up of their child.

A Test of Faith

It’s not just identity that is tested; other aspects of faith are, too. We all have experiences of praying for things which don’t end up happening, and how we deal with this is a vital area of discipleship. Continuing to love and trust God in the face of hurt and disappointment is one of the hardest and most challenging lessons we can learn, and there are some approaches taken by churches which compound this.

Offering a word or picture, for example, that includes specific detail such as ‘I see you with a baby in 12 months’ can be risky. God does speak today through prophetic words, but when bringing a word it’s important to remember that it could be wrong or it could be your own subconscious longing for the couple. ‘I think they [those who offer a picture of you with a baby] are trying to be helpful, but it can be really heart-rending if it doesn’t come to pass,’ says Morgan.

Similarly, the notion that a baby will appear if you ‘just believe’ or if you ‘name it and claim it’ isn’t founded in scripture, and can add extra pressure in an already highly emotional situation. Stewart says: ‘I don’t think this [linking faith to prosperity] is very helpful; it is not for us to second guess God. For people who are experiencing sadness or loss, to then add to their burden saying it’s their lack of faith is pretty meanspirited.’ Voysey agrees: ‘It’s something that does rile me quite a bit. It takes passages where Jesus talks about faith and elevates them above all other scripture. When we look at the healing of the man at the pool of Bethesda [John 5], Jesus comes along and says, “Do you want to get well?” The man has no faith at all; if anything he’s got a superstitious faith, believing the stirred waters of the pool will heal him. Yet Jesus heals him anyway. In the Gospels, Jesus often responds to people with misshaped faith, not perfect faith.’

Instead, we should view times when God seems to be silent and when prayers remain unanswered as part of the Christian life, says Aldred. ‘Yes, God has called us to a life of prosperity; we are called to that fruitful life. However, the cross and the crown go hand in hand; it is a life of joy and a life of suffering. The life of a Christian has never meant that you’ll always have what you want.’ Morgan shares this view: ‘It [the prosperity gospel] is an inaccurate theology. We live in a fallen world. There are illnesses and sorrow ? I don’t think God promises to heal everything on this earth.’

It would be helpful for the whole Church to think through their theology on suffering, says Margesson’s co-author Sue McGowan, who was given the diagnosis of unexplained infertility and after a couple of cycles chose not to pursue further treatment or adoption. ‘We all experience suffering at some point, and in God’s sovereignty he helped me to think this through before I faced it,’ she says. ‘Asking questions like “What can I expect in this world?” and “What has God told me about himself?” [gives us a] chance to think through the issue, to develop a biblical view of Christian suffering and expectations, then this does give you good groundwork to support you when something awful happens.’

Support and Resolution

As infertility can be so easily hidden, it can be hard to even know if people in your church are going through it. For others, their infertility can become public property, with everyone having an opinion. It was pretty tricky to hide from my experience the moment that my fallopian tube began to rupture and I was rushed into hospital for emergency surgery. In our case, having our grief known by our church was absolutely the best thing. It meant that we saw the real benefits of the somewhat glib statement, ‘doing church together’ ? friends visited with chocolate and copious amounts of glossy magazines, our church leader came and prayed for us, everyone gave us space to laugh and cry.

As space and time is given to those longing for children, thoughts inevitably turn to the future, and to a hope for a resolution. I’m wrestling with this as I write. My strong longing to be a mum may be fulfilled in a way that I’d never even considered. Perhaps my kids will be born naturally as God heals my body, or perhaps I will pursue IVF and conceive twins, or maybe we’ll feel led to adopt, welcoming a child from afar into our family. The days ahead will no doubt be filled with ups and downs. Ultimately I do feel I will be a mum; somehow, someday. I’ll let you know how I get on.

Hopeful Help

Here are some suggestions for how you can address the issue of infertility with your friends and church family:

Sensitivity, sensitivity, sensitivity
Yes, it’s so important, I’ve written it three times.

Permission to pray
Rachel Gardner suggests: ‘Everybody is so different, and every situation is unique. Be led by the individual or couple and always ask permission to pray. Don’t assume anything.’ 

Every day is different
Sometimes the person or couple will want to carry on as normal and sometimes they’ll need to talk about it all. Give them the space to set the agenda.

Carry on as normal
Don’t automatically exclude those facing infertility from child focused activities such as baby showers, ‘I found it hard when people excluded us from things assuming it would be too painful for us to cope with,’ says Rebecca Stewart.

Family focus services
On services that celebrate families, such as mother’s day, ensure that the whole church family is celebrated. Offering flowers to every woman on mother’s day is a good way to include everyone.

Balance the message
Avoid over the top celebration of babies at the front of church. Rosemary Morgan, who also writes about living with infertility on her website (frogotter.net) says: ‘if you keep talking about babies as a blessing it leaves open the question that God isn’t blessing those couples who can’t conceive.’

Offer to investigate
Sheridan Voysey says: ‘if somebody within the church is available to help the couple wrestle through the ethics of reproductive techniques; that would be pastoral care at its optimum.’

Watch what you say

Try not to fall into the trap of trotting out these trite statements to your childless friends.

• ‘Have you tried [insert random titbit of pseudo health advice]?’ You name it, I’ve probably tried it.
• ‘It’ll happen if you just relax.’ And concentrating on relaxation is always a great success: must relax. Must relax. Must relax.
• ‘You can have my children!’ Undermining my pain with a joke isn’t very helpful.
• ‘Have you considered adoption?’ It isn’t a ‘solution’ to infertility, and deserves to be celebrated for its own merits.
• ‘You’re still young!’ Yes that’s true. But this is my present reality and it may not change any time soon.
• ‘Well, at least you got pregnant’ Yes, pregnancy was my goal, not a child.