How to Cope with Fertility Problems

Emma Howard: Welcome back after the break. Now joining me is Christine Northam who is a Relate counselor and here to offer some emotional support and encouragement to parents like Chris and Kim who we have just been talking to who are troubled by fertility problems. Hello! Christine Northam: Hi there! Emma Howard: Thanks for coming in, and also let's talk about here because first of all so many couples when they get together don't expect that they are going to have fertility problems. It's not something you usually you talk about before you get married or you decide to go down that road. So it can be a huge shock, can’t it? Christine Northam: Absolutely. It's definitely not what you were expecting to happen, is it? We have all these sort of preconceived ideas of how it’s going to be. Emma Howard: I think it's a natural rite, don’t we? Having babies is what we are here to do. Christine Northam: Yeah. So you have to do sort of a quick double take if you like in order as a couple to accommodate this new problem. And think too about how you are going to approach it when it comes to the family and friends and your life together. Emma Howard: And when you decide it becomes a problem as well, we were talking to Kim earlier who started trying when she was 18 she got married she said, but she just kept canceling all those appointments. So it took her until 40 to actually have IVF that was successful. Do you think that a lot of women are so scared of hospitals or procedures or maybe admitting to the wide world as you suggested that that’s a problem that they are leaving it too late? Christine Northam: It could be that. Yes, I can understand people having such great fears if you like and apprehension about undertaking IVF treatment because it's a protracted and expensive experience, and not one to be taken lightly. So you would firstly talk. And I am guessing you would always carry that hope that maybe something will happen. Emma Howard: Yeah. Christine Northam: And it gets to a point perhaps where you then think, no, I can't keep on hoping, I must take some action. But reaching that is quite the turning point for most couples I would assume. Emma Howard: And that idea about this is a problem we don't want to own up to because people from the outside often say, who is it that can't have them, is it you or is it him? It’s this kind of apportioning of blame which is so unhelpful. Christine Northam: Yeah, it's very, very unhelpful indeed. Certainly couples I know have kept it completely to themselves and I think they find that that's the easiest way to deal with it. You get sort of anxious grandparents etcetera and friends who might ask you questions about it. I guess they are probably sort of wondering secretly whether you are trying or whether you are having problems. But perhaps they get -- they read signals from you that you actually don't want to talk about it and maybe it's best for couples to deal it themselves, but at the same time, I do feel there is a really good place for counseling in that whole process. Emma Howard: And of course that's the job you do, you counsel couples who have often had failed attempts at IVF and terrible place, terrible situation for them to be in. Christine Northam: It is. It's certainly a huge -- it has a big, big impact on couples and it's very much about loss. The loss of hope that they would be a family and whether or not they can actually envisage their life going forward but without having their own children. So that's a huge change for the couple to accommodate and sometimes they can't and the relationship will break down. Emma Howard: And do you see couples who are in the middle, so who are dealing with grieving but are going to carry on? Christine Northam: Yes, yes. And there -- I think when they can actually talk about it a lot more and allow themselves to have the feeling, because so often you keep it quiet, you -- there is an element of sort of disappointment and failure too. So you keep it quiet, so you don't perhaps get the support that you might get. Say you have an ulcer on your leg, everybody could see that and they talk about that -- Emma Howard: And you get the sympathy. Christine Northam: And you get the support and the sympathy but this is a different ball game. Emma Howard: This is totally different, isn't it? Because often your friends are having babies around you -- Christine Northam: Yeah. Emma Howard: And they want you to come and share in their joy and you are happy for them, it must be so painful. And the last thing you want to do is to go to somebody's house, there are little ones all over the place when it's exactly what you want. Easier for men in that situation, because they are not invited to those kind of environments as often as women are. Christine Northam: No. But I think for men they don't actually have permission to be fad, the man is supposed to be the strong ones and he is supporting his wife. Emma Howard: Do you not think we are becoming more understanding? Christine Northam: Oh yeah! Yes, thank goodness. Thank goodness! Nick Hornby and the other writers, the male writers, Steve Biddulph, etcetera, but the men can acknowledge their feelings but generally speaking in my experience, they still find it much harder to do than women. Emma Howard: So when you have the couple in front of you, do you find you have to almost more work with the man? Christine Northam: Try and include him in on conversation and ask him what it's like for him to see his wife turning into this different kind of person. Because it does get in the way of intimacy, unfortunately and unless the couple can really, really get out their feelings and support one another and understand why they have got those feelings and it's -- they don't go away, they are there simmering beneath the surface. Emma Howard: So much better out than in, as the old saying goes. Christine Northam: Yes. Absolutely. Emma Howard: What kind of practical work do you do with couples to help them? I mean I am thinking of people perhaps listening to you now, watching you now and thinking that's exactly where we are. What can they do to help and support each other really so that their relationship doesn't implode, because as you say, it all becomes about sex for a reason rather than intimacy for its own sake. Christine Northam: Yes, absolutely. Well, I guess -- actually if they come to counseling that's the first positive move, because they are acknowledging that they would like some help. So once they get there, I would be working with them to -- encouraging them to talk easily with one another. Now lots of couples say, oh, we talk all the time. But actually you are not talking about what you really need to be talking about. Emma Howard: Talking about shopping and how tired you are – Christine Northam: Exactly. So my question to them very often is what is it that you are not talking about? Emma Howard: Alright. Christine Northam: And then we start down the track. And it's very, very uncomfortable and prickly and they have to actually get to know the counselor. They are going to walk in and suddenly start telling me everything, so building up a relationship with the couple is important and then it would be down to some really basic communication work. Very often, I give couples sort of the basic communication exercise to practice at home where they each talk for 5 minutes about their feelings without interrupting each other. Emma Howard: Alright. Christine Northam: Like being on air here, you just tell each other what you are feeling but you don't do it in a blaming way, you acknowledge it. And that could be tremendously helpful. Emma Howard: Fantastic. Yes. How often do we not interrupt each other? Christine Northam: Exactly. Emma Howard: So that in itself -- Christine Northam: And why do we interrupt? It's very often because you know someone is going to say something that you don't actually want to hear. Emma Howard: Yes. I am sure that, that is absolutely right. Yes. And a exercise, probably we can get for all us to try at times. Is there a problem do you think with couples not really understanding how invasive the whole fertility procedure is. And so they can be quite shocked about really what they have gone through, an abuse almost. Christine Northam: Yeah. Emma Howard: Their being prepared is a huge part of it. What would you say? Christine Northam: I would, I think you are spot on there. Someone described it to me as an assault on the body, IVF treatment, because if you think in the preamble, you have to – a woman has to take various hormone preparations to make or produce the eggs. That’s like having PMT for a long time because your normal hormone balance is upset, that you would be moody and perhaps moody and perhaps it difficult then. Then you have actually got the surgical procedures to undertake. Now you can -- I would imagine you could have your partner in with you but it's not like having a baby. When women sort of get used to exposing their rear ends to the medical world, it's because you know that you are actually going to have a lovely baby, or you hope that you are going to have a lovely baby at the end of it. Emma Howard: And often forgotten about once the baby is in your arms, isn’t it? Christine Northam: Exactly. Emma Howard: The trauma of what happened before kind of fades away quite quickly. Christine Northam: Exactly, exactly. But this isn't -- this doesn't have a result immediately and from a statistical point of view, it might well not be working. So you have to -- Emma Howard: So you are saying, you go in loaded anyway with all these emotions and medical staff like anybody, some are nurturing and caring, some are having bad days, and I hear women talk a lot about the fact that they would treat it like a number and because there isn't that lovely baby right at the end, well, hopefully that maybe further down the line, that's part of the abuse, isn’t it, if they feel they weren’t being nurtured during that procedure. Christine Northam: Exactly, exactly. But the -- I would imagine there are always financial problems within the NHS, even if you take private treatment. But probably the priority when it comes to a spend would be on the technical treatment rather than say employing a counselor and suggesting to couples that they go to counseling while they are going through the treatment. Emma Howard: So how do you see couples then? The couples that -- Christine Northam: Well, couples who come to me might come to Relate because they are having drastic relationship problems and then when you start to then pick it with them and tell you their stories, then you realize that perhaps the IVF treatment was a trigger for their current problems. Emma Howard: So hopefully, this kind of discussion that we are having is very useful to people in the procedure thinking, yeah, talking would be good, it would help. Maybe not let's just get to that dramatic stage where you see couples who might be absolutely desperate, probably one of the last things might be before they split out. Christine Northam: Yes. Talking and actually informing also to about how it's going to be so that when you go along, you are not surprised. I mean I am sure that there are leaflets given out and all the rest of it, but you can read about them, but you can never quite know how you are going to be when you are in that little room, and you are all set to leap, hop on to the couch, and the clatter of instruments and here we go sort of thing, it's quite different. Emma Howard: And what about couples’ dynamic. How does it change when it's one of them? We talked earlier about this apportioning blame, who is it that can't have children? Is it him, is it her? Sometimes its couple together, the chemistry between them doesn't work, but often between them they have apportioned the blame very clearly, she can’t have the children, that he was him; all he is hideous kind of phrases that come out. You sit with them, how do you get them to become a team when they have clearly blamed each other? Christine Northam: Well, blame and attack is really a huge defense. So once they can start talking about the problem, they very often find -- I find that their defense is reduced, they come down. And we talk about how constructive it is to actually use blame and attack? Because blame and attack is like a glass wall between, you can't get through it. Emma Howard: Yeah. Christine Northam: So all you do is you are stuck in that position. So I would be working with a couple to try and get the glass wall down by exploring their feelings and also then perhaps to looking at how they have dealt with problems in the past. So was it being like when you have been in the jam before? How have you worked as a couple to overcome that jam? And they might then draw on their past experience and use that to cope with the present one that they are dealing with and then the blame and attack mechanisms might reduce. Emma Howard: And what about carrying on when they know they can't have children and they have decided that they do want to adopt and that, this is it, this is them together going forward. What are little kind of triggers, maybe not triggers, devices I should say that you use to get them to remember who they were before they were in that position? Christine Northam: Exactly. Well, I would go back to what it was like when they were first together, what attracted them to each other when they first met? What did they do that was fun, was good? And then I would remind them that even if you have children, you are going to be a couple on your own after the children have fled the nest. But then I would kind of do some sort of forward thinking if you like imagining how you want your life to be. So, okay, we haven't got children in this picture, but nevertheless what kind of life would you like to have as a couple? What will your priorities be and how will you enjoy yourself and enrich your couple relationship in the future? So it's very much looking forward. Emma Howard: And do you find that it really works? Do you find that couples have -- you turn them around completely that children aren't in the picture for them anymore, do you see that? Christine Northam: It's not as dramatic as that, I think the counseling process will sort of start them down the track of imaging how it's going to be without children. What they are going to say, what they are going to think, how they will be feeling about their -- and the meaning of their couple relationship in the future. I don't think six or eight weeks counseling is going to help you to completely come to terms with it, that would be very nice, but it might start the whole process -- Emma Howard: Do you get see them then for that short amount of time? Christine Northam: Well, it depends really on what contract you have with the couple. But sometimes they might stay for six months. But generally speaking they would probably be in counseling for say six to eight weeks, something like that. Emma Howard: Yeah, and that is quite a short amount of time. Christine Northam: It is, it is to get over a big loss. But sometimes couples come for counseling, then take a break and they think we are in a new place but we still need to have a bit more objective help, so then they might return to counseling then. Emma Howard: And of course we have been talking in that very fine or dramatic way, we are talking about couple who have for whatever reasons thought that they can't have them, they are not going to have them. But you see lots of people as I said earlier, who are just in the middle. It's being a struggle but they are carrying on, they are going forward. It just is something that needs to be prepared for on every level, isn't it, I think emotionally as well physically. There are a lot of women and men who are getting themselves fit and cutting on alcohol and caffeine and eating food and taking exercise, it all helps in that fertility process. But mentally, what do you think that they need to do to prepare themselves for the whole hospital invasive procedure thing? Christine Northam: Well, inform yourself about what's actually going to happen, go and have a look around the premises beforehand so you are familiar with -- Emma Howard: Yes, we do with babies. Christine Northam: Yes, exactly. Emma Howard: Yes, why not do it for -- Christine Northam: If you can, if you can. Talk about it to as many people as you feel comfortably talking or feel that you can comfortably talk to because it's not always an easy thing to do. There are lots of help groups, if you go on to the Internet, there are support groups out there that you might gain an awful lot of information and they would lead you to think about things that you might not have considered before. So do research it and then spend loads of time as a couple talking it through. Because actually, if you think that it's a really big challenge that you are meeting and if couples do get through the other side of big challenge, it's very often they have a better relationship than they might have had without that challenge. Try and see it as positively as you possibly can, but be aware that you might not get the result that you want. Emma Howard: And that's it really isn’t it? Christine Northam: It's tough. Emma Howard: Christine, it's absolutely fascinating. And so the key and we have heard it before is get couples to talk to each other. Very, very hard for women who have married men who are stoic and strong in every way but just kind of not emotionally matured, that's very difficult. Christine Northam: It is, it is and it could -- they both might feel very isolated and lonely. They really might, because the women might know that it's just not safe to do that with him. He is feeling bad about it anyway because it hasn't all worked out. So if she then starts to talk to him about it, he might back off and that then in turn would make her feel even more lonely than she might -- Emma Howard: Which is where think about you. You can really come and make a difference. Christine Northam: Yeah, I think counseling has a really important to play but I don't think enough people seek it easily. Emma Howard: Well, I am hoping, after listening to you talking Christine that they will. Actually it’d be much more fascinating. Now after the break we will be taking a look at what problems facing an older mother attempting to conceive plus we will have the author of the book, ‘How to Get Pregnant’, Harriet Griffey in the studio with her tips on how to increase your chances of getting pregnant. But before that here is a look at some of your baby photos and art gallery of beautiful babies.