Thalia's fertility journey

The end of the fertility journey

I will never be pregnant again.

Really. We have decided that we don't want any more children. The newborn stage with Junior has persuaded me that no matter how much I love my children, I don't need to be that sleep deprived again. Nor do I really want that emotional struggle with breast feeding again. If we'd started earlier, if I had that much more energy, if we even had the option of conceiving easily, when we wanted to, then it would be on the cards. But two children is perfect for us, and I can't help thinking that having three would start to get very complicated in the parenting stakes - speaking as one of three children.

Just because we don't want them, doesn't mean we wouldn't have a surprise. It's very unlikely, but it has happened to others in our community. Well, we are taking steps to remove that option. H has had the preliminary consult for a vasectomy, and has said he will make the appointment before the end of the week. He said, very forcefully, when I pushed him on whether he was happy with permanently ending his fertility, that even if he ended up in another relationship because I had died, he would have enough on his hands with his two children and would not want more. He is committed to the family we have.

We also have several frozen embryos. I can't actually remember how many, somewhere between 6-8. But they were never the best embryos from any cycle, and if we wanted to use them it would be a long and probably painful process of suppression, estrogen, trigger, progesterone, transfer, and possibly a chemical pregnancy or two before we were done. And besides, we don't want any more children. We don't want any more children.

As others have written, though, it's hard to let frozen potential children go even when you know a pregnancy might kill you, let alone because having more children just isn't right for you and your family. Nevertheless, I am psyching myself up to remove our frozen embryos as an option. We will donate them to research. There is no option that I know of to donate them to another family, and even if there was, I'm too old to be an egg donor in the UK so fairly sure that would rule us out. I'll make that call tomorrow. Or the next day. Or after the weekend, perhaps. Well, we have mentally let them go, at least.

With the vasectomy/donation double hit, we will have no other chances to be pregnant again. And I am sad about that, no matter how I think through the misery of sleep deprivation and the pain of failing again to breastfeed my children successfully. I am sad that Pob will not have a sister. I am sad that I will never again use the little white Egyptian cotton babygro with the two little embroidered silver feet on the breast, the babygro which was the first thing I ever bought for Pob. I am sad that I'll never again have that newborn on my chest, conked out between one suck and the next. I have fallen in love so hard with my babies, both times. I fell in love at different points, and it didn't preclude moments of despair and frustration at the screaming infant at a later point. But I won't get to fall in love like that again.

It's sad, but it's wonderful, too. Wonderful that I got to experience that at all. Five and a half years ago we started trying to conceive, and four and a half years ago I started writing about it. There were moments on the journey when I was convinced it would never happen for us. And then moments where I thought Pob would be an only, and mourned for her and for us that sibling relationship. But now here we are, a family of four, and those who meet us now assume it was all smooth sailing - after all, our children are only 21 months apart, and who would 'choose' that? And we have the boy and the girl that people assume must be what we wanted. We have been so incredibly lucky.

And yes, some of that luck is because I pressured and argued, researched and fought for the best treatment, the best treatment as soon as it was possible, fast, no waiting. But that's just a small part of how we got here. An important part, but a small part. Others argue and fight and research and it doesn't happen for them. I have no rationale for why it happened to us other than the weird quirks of my biology, the randomness of that sperm and that egg, and that sperm and that egg and that test tube and that embryologist and that catheter and that drug and the resulting embryo happening to hit the uterine lining just so, and find just the right blood vessel to colonise, and...

So the fertility journey is done. So what, pray, am I doing with this blog, with this blog title? Not writing much, that's for sure. But this isn't goodbye. It's my space, it's our community even if the community I am truly part of now is more naturally those parenting after infertility, with a strong emotional connection on my part, if not on theirs, to those who were in the trenches with me but who didn't make it out, whose embryos never quite found the right bit of the uterine lining. I will try to change the title to more accurately reflect my life now, but I will remain here until they consign Typepad to the dust. The blog got me through, you got me through, through infertility and pregnancy and breastfeeding and the start of parenting.

Junior is stirring. This post didn't end up being what I thought it was going to be. But it is what it is. And I am here, now. A parent.

Yet another study showing IUI doesn't help

After the last time I posted about this, a lot of you commented about how IUI had been the right treatment for you, and how at least it was affordable in the US, unlike IVF for many people. Also, a couple of you had diagnoses where IUI was the appropriate treatment - medium-level sperm issues, a lack of cervical mucous, etc. I am fairly sure that this study excludes those factors so read on.

A study published today shows that for those with UNEXPLAINED infertility, treatment with either IUI or clomid had no discernable effect. The doctor on the BBC news this morning pointed out that if you aren't ovulating, then clomid is an appropriate treatment. If you are, it has no effect on your chances of becoming pregnant. Here are the details:

In the six-month study, participants had all suffered unexplained fertility problems for more than two years.

Overall, 101 women ended up having a successful pregnancy.

Of those who tried to conceive naturally, 17% became pregnant and gave birth to a live baby.

For clomid, the birth rate was 14%, and insemination 23% - not significantly different from the chances of success with no intervention.

However, the women undergoing active treatment were more reassured.

The last sentence tells you why doctors keep on prescribing clomid and IUI when they are not specifically indicated. It's very hard to tell a patient to go away and do nothing, or that they are better off with IVF when, in most places in the UK, the local health authority will have a 2-3 year waiting list for IVF and lots of restrictions about who can be enrolled on the list. Or in the US because the patient may not be able or willing to take on the huge cost of IVF before they've "tried everything," or at all.

I'd like to look at the statistics for countries like Israel, where IVF is readily available and paid for by the state. Do more couples go straight to IVF, bypassing these intermediate and less effective treatments?

The thing to be careful about is asserting - IUI is the right treatment because it worked for me. This study shows that you are just as likely to have become pregnant by being sent away to keep going for six months as you are to have conceived with IUI, even if you've already been trying with no success for two years before that. It's just a probability game, and you happened to have hit the one month with IUI when you most likely would have achieved pregnancy without it. However, this is only true if you have unexplained infertility, not if you have a specific condition where IUI can help.

It makes sense if you say - I couldn't bear doing nothing any more, and IUI was the affordable option. That's a personal choice, not about the statistics. It's of course fine to say, we couldn't afford IVF so we went for IUI, but it actually is probably not a good use of your money - you could have saved the money you spent on IUI and spent it on something unrelated to fertility treatment.

Clomid is a bit of a different story - most people hate taking it and it can actively inhibit fertility by drying up cervical mucous. If you are ovulating, it really really should not be given to you. It's just a nonsense treatment.

So the point here is that the numbers by no means tell the whole story. They don't tell the story of how bloody miserable it is to try every month to no avail. At least by taking clomid or doing an IUI you feel like you are taking action to deal with this horrible problem. They also don't tell the story of the money flows in infertility - the intense rationing of IVF in the UK, the extraordinary cost for those in the US whose insurance doesn't cover IVF. Numbers are powerful but not omnipotent. Everyone has to make the decision that's right for them. I just wish the doctors and the insurance companies and the NHS would review their standard procedures and at least start having these conversations with people.

Is the pain valuable?

About 12 years ago, my friend Girl Detective and I went to see a Chinese film at the Ritz Cinema in Philadelphia. I can't remember what it was now, perhaps 'Raise the red lantern'? We came out profoundly depressed, and agreed with each other on the way home that we didn't need to be that depressed by Art. We could go through the rest of our lives as good, caring, responsible citizens while avoiding other similar works of Art that were likely to upset us. I've mostly stuck by this decision.

Except with the news. H is very keen on watching the news, and so we often have it on in the evening while I'm catching up with work on the sofa. Mostly I'm fine with it on, but occasionally a story gets me angry or upset. Angry about the situation in Zimbabwe, for example, or desperately upset about the incipient famine in East Africa. I wear my emotions very close to the surface, I always have, and I find it hard to switch off when something touches me.

But worse than what I see on Channel 4 every evening, are the three stories I've read recently on the internet. I'm not going to link to them now because I don't want to inflict the pain on all of you, and I know the temptation to click is hard to resist. All three are stories of terrible things happening to children. In the first two examples, because their parents, otherwise entirely caring and loving, didn't realise the child was in their care rather than the other parent's. In the third case an extraordinary neglect case. The first two happened in Italy, the last in the USA.

The point here is not what happened to those children, although it's appalling and horrible, but what I choose to do to myself. I know that I am going to carry the awful knowledge, the awful pain of those stories around with me for weeks, if not months. The images of what it must have been like for those children rise to the surface, unbidden, at regular but unpredictable intervals. I'm left wondering two things about myself. First, why did I click through when I knew it would upset me? Second, do I have to know about these things? Would it be ok if I just closed my eyes and let those stories pass by me?

It's a tough one for me. I want to know about the holocaust, for example. I think it's important that everyone knows it happened, some of why it happened, what we might do to prevent it happening again. Everyone in the world should know. I think the world should be aware of what's happening in Zimbabwe, be aware of the extraordinary events that are commonplace there - a man's wife being murdered because he dared stand for election, for example. Not to mention the other places in the world where awful things are happening right now.

So where do I draw the line? Is it enough to know that child abuse happens, awful accidents happen to children when their parents aren't paying attention? To know in the theoretical sense and not have to know the details? Or is it important to know the details of the stories, to let them haunt me because in doing so I...what? Decrease the chances of it happening again? What impact can I have on similar stories? I'm not a social worker, or a child care worker, or a charity worker who might fund the right programme.

I don't know. It's messy. I have to know these things exist, I have to have empathy for those children, but do I have to carry those stories with me - to honour the children concerned, at least in memory? Does that help?

                                             ***

6dp3dt - none of the cramps and pullings I've had before when I've been pregnant, except for one sharp one yesterday. Resisted peeing on a stick this morning because I only had two expired ones, one digital and one cross-type, the latter being notoriously hard to read, and the former being unsatisfactory in the peering and twisting activities. Torn between hoping and being pretty sure that one doesn't get that lucky twice in one's life.

Well, that last post went down like a cup of cold sick, didn't it?

I've read a lot about BlogHer, both this year and the preceding years. I've never wanted to go, not since the first time I heard about it and the focus seemed to be on increasing traffic and making money from your blog. My blog is so far away from being a money-making venture, that the concept of discussing how to make it more commercial seemed utterly alienating. I do this to get my thoughts out there in a constructive way, I do it to be part of a community, I do it to keep in touch with people I love, even though I've never met most of them.

What also put me off was when Julie and Julia went, I think in 2006, and Julie reported back that this was not a happy place for the infertile. Fine, I thought, I'm sure yet again that this is not the place for me. And then there's the whole America-as-the-only-country-on-the-internet blinder which is guaranteed to drive me bananas, so that was the final nail in the coffin.

My impression has been both confirmed and confounded by the reports I've read this year. The American focus? Yes. The unfriendly place for the infertile? Yes, yes and yes again. The perhaps minor but still irritating lack of concern for some substantial minorities attending? Yes (Mel, you may think it's ok not to provide something you could eat in the building, but I don't).

The commercial thing? I'm less sure about. It is not my focus, and just won't be. I have an extremely well-paid job that I'm lucky enough to enjoy. Like most of us, I'd love to write a book someday, but I show no signs of getting on with it. My blog, however much I try to push it, market it, get it linked to by all and sundry, could never be an important source of revenue for me. However, I love the idea that here are a bunch of women, all together, with some shared goals and aspirations, figuring out ways to subvert standard business models and make money in a way that suits them. That I like, that speaks to the feminist in me. So while that focus may not be for me, I can see how it is a good thing.

The thing that has stayed with me, although I'm not sure what, if anything, to do about it, is Cecily's report back from the 'make something of your blog' section about deciding what you're about and sticking to it. Isn't that the critical problem all of us who went through infertility and loss but are now parenting? We were about one thing, now we're about another, although we might dip back into the first from time to time, and we certainly don't feel at home - and aren't connected to - the community on the second topic.

So what do my readers come here for? Yes, for a few people it's about continuing to follow the story. But for some people the story has changed so they aren't interested or can't bear to read the story any more. And right now I'm in the middle of being ultra-unfocused, since in one week I've written about Pob, about an IVF cycle, and about breastfeeding. No wonder no one left a comment yesterday (except Jenn!). it just wasn't what pretty much anyone came here wanting to read, and so no one had anything to add.

What do I do about it? The blog is really for me, although of course I'm also writing an extended letter to all the readers I know about and understand. I want to keep writing about what I want to keep writing about, but I also do want to continue to have a community of people who tell me what they think about what I've written. Should I write separate blogs for separate topics? I don't love that idea because it separates out the story. Should I edit out some topics partially or completely? Perhaps, although that affects the integrity of the story.

There are some obvious things to do to help bolster that sense of community. Keep leaving comments, that helps. Write more regularly, that helps a lot. Get more original content in rather than life updates. That helps but it's hard with limited time.

Or decide that the blog really is for me, and I should let go of needing the validation of the feedback and conversation with readers, and just write what the hell I like.

Hmm.

Thank you Mr Steptoe and Dr Edwards

In 11 days time, Louise Brown will be 30. She has her own son, Cameron, who was conceived spontaneously just over two years ago. She comes across as a nice, thoughtful, sensible and articulate woman, very aware of the role she's played but in no way starry because of it.

We owe a lot to her parents, to Mr Steptoe and Dr Edwards, and I'm sure a lot of unsung nurses, embryologists, researchers and other doctors without whom the good gentlemen would not have been able to treat Mrs Brown, who had blocked fallopian tubes. It's hard with scientific progress to disentangle the multiple threads that come together into the tapestry which is an individual breakthrough, but these articles give you a sense of the long line of clinical and scientific progress without which IVF would not have been possible. I did not previously know that the first IVF pregnancy ended in an ectopic, for example, although I was aware that Mrs Brown's pregnancy resulted from harvesting a single egg, caught just after ovulation, since the drugs to produce controlled ovarian hyperstimulation and to control ovulation were not yet well developed (hyperstim was already in use, just not put together into the edwards/steptoe protocol).

If we think back to all those many pieces of work, the century (at least) of work on human fertility which led to Louise's birth, we can marvel all the more at what's been developed since. The drugs to help us to produce multiple eggs in one go. Agonists, antagonists and recombinant chorionic gonadotropin (hcg) to control when ovulation happens. ICSI. The understanding that many women need progesterone support after artificial induction of ovulation to support a pregnancy. The use of trans-vaginal needle aspiration rather than laparoscopy to retrieve eggs. Laser surgery for endometriosis. Hysteroscopies to remove fibroids. The ability to freeze embryos. The use of estrogen therapy to support frozen cycles. Progesterone suppositories to replace nasty intra-muscular injections. Automatic dispensing pens for FSH rather than having to mix powders. The understanding of the role of blood clotting in recurrent miscarriage. And so on.

It is extraordinarily difficult to deal with the fact that - and oh so much more so to experience - after all that progress there are still some of us for whom the technology doesn't work, and some of us whose infertility has no apparent cause. In the next 30 years I believe many of those situations will be treatable. Probably not all, but more than today. Roll on progress.

Until more of the causes of our infertility are treatable - and until women's fertility is no longer over at 42 or so - thank you for all that progress has already given us. Thank you to Mr Steptoe and Dr Edwards. Thank you to Mr and Mrs Brown. To Louise and to her sister Natalie - the first IVF-conceived woman to bear a child. Thank you to all those couples who participated in early work on IVF, who agreed to be guinea pigs. Thank you to those who agree to be experimented on today - trying new drug protocols, participating in randomised trials. Many of our children would not be here without you. Thank you.

Hillary and Feminism

So I owe you all a response to those very thoughtful comments on my Hillary post. I'll let you know where I ended up, but I'm a little worried that (i) I remain not terribly well informed on this, and (ii) not terribly well informed on up-to-date feminist theory - it's a long time since I read any. So please forgive any errors.

I think at least part of the reason that Hillary lost is due to misogyny. And I think that being a feminist means voting for/selecting/appointing a female candidate wherever possible - yes, even if the male candidate may, in some ways, look more qualified (although no, of course not if the woman candidate is clearly unqualified). You have to dissect why he looks more qualified and bear that against generations of prejudice. And no, I don't believe this weakens women and their cause. If you look at it the other way round, for hundreds, if not thousands of years in most positions, people (men) have believed they have a good reason for appointing a man. Of course he is better qualified. He is more rational. He has greater vision. His experience goes beyond hearth and home and raising children to issues of state. He is more intelligent. And so on. Some of these world views persist into today, almost without our noticing them. So we have to work to redress the balance, and only then we can go into a contest and not worry about gender, because we'll know that there is no aspect of our gender biases biasing our decision. But until women are 50% of the decision-makers in any particular institution, we are not equal, we are not being judged equally, and we should be aware of that and make decisions accordingly.

Let me tell you a story. My mother is an academic. In the late 1970s and 1980s she was a lecturer at a UK university. In early 1980 she was up for a promotion to senior lecturer in her department. She didn't get the job. When she asked for feedback, she was told that although she had been one of the two strongest candidates, they gave the job to the man concerned because after all, he had a family to feed. At the time my mother had 3 children. In 1983 she acted as head of department for a year while the existing head of department took a sabbatical. But she wasn't given the title head of department. The assistant to the old head of department told her she had taken minutes in the meeting where this was discussed, and the powers that be had decided not to formally appoint her interim head of department because if they had, she would have had to be appointed to the university's guiding council, and she would have been the first woman there and they didn't want to set a precedent. In 1983. In 1986 she applied for a year's sabbatical and was denied as her teaching contribution was thought to be too important. Despite the fact that her direct contemporaries had both had a sabbatical in the last 3 years.

Yes, that was 25 years ago, but that's just one generation of university graduates, do you think we have removed ALL those attitudes just yet? I deal with sexism every day at work, in little ways. Much much less so than my mother, but present nonetheless. When one of my colleagues calls me 'strident', do you think he would make the same comment about a man? Have you looked at the composition of the boards of the Fortune 500 recently? At the composition of the US Senate? Of the UK House of Commons? Until those attitudes are all gone, I do think it is our responsibility to do whatever we can to redress the balance.

And yes, black men were often not included in that power base, so I quite see that this applies to discrimination against blacks as well. But in this case, I think the comments made against Obama (mostly) did not come from the world view that he had fewer of the qualities required for the job because he was black - almost the opposite. Whereas the concerns raised about Hillary did come from that world view. She's too aggressive. She's too political. She's not warm enough (aka, I don't like her enough), - not to mention those which were obviously sexist - calling her 'Mrs Clinton' where the other candidates were referred to as 'Firstname Lastname', jeers at debates of 'iron my shirt'. As this article at MSNBC points out, a jeer of 'shine my shoes' was never made at Obama. Racism is perhaps easier to spot, these days. None of those concerns would have been raised about a man. Yes, some of the concerns about her - particularly her earlier vote on the Iraq war and how she spoke about that subsequently, and the comment on the last post about how Hillary hadn't responded to a constituent - seemed quite gender-free. But many were not.

I also didn't think the comments about a Clinton dynasty were fair. She's married to the man, not descended from him. She's established a political career in her own right, using her own skills. I imagine that for some voters, the fact she had Bill on her side was a bonus, but for many others I imagine it wasn't - so I don't think it's reasonable to not vote for her because she is married to a politician.

So while I agree that misogyny wasn't solely responsible for her defeat, I absolutely believe that it was a contributor. Obama has clearly touched something that Americans need right now - a vision, an inspiration. But 'more qualified'? No, he simply isn't. He has less experience, and getting stuff done in politics takes experience. Many of his policies have less thinking behind them than Hillary's. I understand voting for the inspiration. I just don't know what a woman - any woman - would have had to have done to be seen as that kind of leader. It may be that Hillary just doesn't have the right skills to touch that nerve, but I also believe that as a woman, she had her work cut out for her to be seen in the role of visionary leader. People didn't want to see her in that role, they wanted the nurturing, emotionally open, vulnerable woman who displayed her feelings near the end of the campaign - and her numbers went up. But I don't think that's the whole story of who she is, she didn't maintain it and it was probably too late anyway.

So that's what I think. You all helped clarify my thoughts a lot, so thank you. I hope this won't be seen as an attack on any of your comments, you all voted thoughtfully, with concern for your country and the world as a whole. I'm someone who is watching from the outside, someone with a particular world view, and this is just my opinion.

Staying with the stories

I have 311 feeds in bloglines. Currently there are 876 unread posts. That's down on over 1100 when I returned from 2 weeks away. About 30 of the feeds are food blogs which I can take or leave. Five are infertility information feeds which I read very seldom now. Three are information feeds regarding work stuff which I also look at only on an irregular basis. Probably 30-40 are blogs which are no longer updated (like that of Grrl of blessed memory). The rest are your stories. And then there are about five or so blogs that don't publish feeds which I also try and look in on on a regular basis. I also check for news on a couple of message boards, and occasionally read a UK parenting forum. That's a lot of stories.

Other than the few information feeds and food blogs, all those feeds represent stories I care about. In some instances I've read those stories right from the beginning - either because I read through the archives when I first found the blog (Julie, Tertia, Cecily, Millie etc.) or because I've been reading since the blog started - particularly when we started around the same time (DD, Ovagirl, Nico, Amy, Clover, Alexa, Flicka to name but a few). I can no longer remember the exact order I found your stories. I used to have a great resource for this because the typepad lists went in order of when I added each blog. Then I got clever and deleted those lists to replace them with the bloglines feeds and lost an important archeological artefact.

When I started I often found stories by clicking through from comments on mine or other's posts, only to find a story I empathised with and wanted to continue to follow. More recently I've found stories through cyclesista or lost and found. Often now, although I may empathise with the story, I don't feel the need to continue to follow it. Maybe I don't like the writing much, maybe I just can't get back into the story of someone just starting clomid or injectibles. Often I'm outraged by a doctor who is recommending an IUI with five follicles ready to go and just can't face writing a comment that I know will probably upset the person concerned. But also, I am committed to the stories I already follow, and it takes a lot of time to follow them.

This is particularly true for me because I feel horribly guilty if I read without commenting. I know how much comments always have meant to me, and if I read without visiting I know the person concerned has no way of knowing that I care about her story. But reading at least a few blogs without commenting is clearly the only way for me to at least know how things are going across all these blogs. Which is better? For me to know what's happening but not to offer real support to the author? Or for me to stop following some stories and do a better job of commenting and being a visible part of that author's support network?

In either case, I'm not sure I can continue to follow all these stories. I'm going back to work. I need to try and find the time to go back to the gym, and I need to spend more time with Pob and not with the computer. But I'm finding the pruning very hard. There are some blogs I will never stop reading. No matter if you haven't posted in months or years (Bugs I'm thinking of you), I'll keep you in the feed just in case. No matter if all the posts are about sleeping challenges or your child's new wardrobe, or your latest walking holiday I'll keep reading just so I still know how you are (no names mentioned to protect the innocent). But there are others where I've followed them through the tough part of the story, they are out the other side, they don't post much, and when they do it's not stuff that I feel a strong need to comment on. They seem fine and I'm not sure they need me so much any more. Then I remember how much I still love getting comments, even on seemingly happy and contented posts, and I feel bad, but I then i think about the others still in the trenches, or with whom I have a stronger emotional connection, and I feel ok about letting go of a few of the stories.

Ok, let me be really honest. I've deleted a grand total of five blogs from my feed over the last week. One was a work-related news feed. Two were food blogs. One was a blog which used to be about infertility but hasn't been for a while, written by someone who never comments here and with whom I've only had a weak emotional connection. The other was a blog previously about infertility, where the author has just recently reached the other side, and who again I've never had a very strong connection with. Every other blog I thought about deleting, I've paused over the delete button, hesitated and moved on.

I don't know how this will play out. I'm connected to all your stories, even those blogs I drop in on just occasionally and rarely comment. I don't want to lose that connection, and I want to continue to support those I care about. There will no doubt be a middle ground. I've yet to find it. In the meantime I'll muddle through, commenting a little less than I used to, being grateful for everyone who stays connected with my story, and hoping I can offer just a little of that support in return.

A rant, feel free to ignore

This has been brewing for ages, but I'm afraid that this post from Mel just sent me over the edge. It all started a couple of years ago, when I noted that NaNoWriMo was rather exclusionary in its title. It continued when people took up the cause of NaBloPoMo. It intensified each year as I noted that American bloggers would casually write things suggesting: "Along with everyone else, we celebrated thanksgiving last night," and when people suggested "I have this sense of solidarity with everyone as we celebrate the 4th of July." It even niggled at me when people posted this weekend about the universality of mothers day. So when Mel suggested we have a NaComLeavMo, I was a little disappointed, to say the least.

Dear Americans. Especially dear American bloggers. Let me let you in to a secret. You aren't the only bloggers in the world. You are a majority, but it's not just you. And the rest of the world is perfectly capable of writing a novel, writing a blog post a day, or commenting every day. To that end, what's wrong with GloBloPoMo or GloComLeavMo? While we're at it, the rest of the world doesn't celebrate the 4th of July or Thanksgiving, although we certainly understand those traditions well based on what you have shared. Some of the rest of the world celebrates mothers day in the spring, when it was a Lenten tradition. (and btw, no it wasn't invented by an American. The way you celebrate it might have been, but it's been going a lot longer than that). We have different traditions, and different festivals, and contribute to our community nonetheless.

Let me quickly point out that I love you all individually, and remember that Mel was very careful to point out UK mothers day earlier in the year, so this is not all about her and it's not all about any individual. It's perhaps just a teensy reminder to be aware of other traditions, and, most importantly, other contributions to our community and the interweb in particular.

/rant.

Grrl

Does anyone else regularly visit Chez Miscarriage just to see if by any chance Grrl has posted something and bloglines didn't pick it up, or if, quelle horreur, she's finally taken the site down, the "next bloggy idea" having never materialised? No? Just me then?

Why I'm angry

I feel a tremendous amount of joy. Even while Pob screamed at me this afternoon in her anger at me allowing her to be hurt with injections, even as I slog through a bedtime routine on my own, as she shouts in irritation as I put her vest on after her bath, I am awed by how lucky I have been. And when I return from ensuring the bathwater is the right temperature to find she has rolled off her mat and onto the carpet, and is grinning at her own cleverness, well then I am overwhelmed.

In the middle of feeling that joy and that sense of good fortune, I am still very angry about infertility. I am angry that it took us three years to conceive Pob, even though I know if we had conceived our take-home baby any earlier, that that baby would not have been her, and she's perfect, so how can I regret the three years?  But I am angry about those three years nonetheless because it means that if we want to try for another baby (and just how greedy does that make us) we need to start pretty much NOW. Well, my OB made us promise to wait at least six months, which is five weeks away. But at that point we really should start trying, at least trying without intervention if not gearing up for an IVF cycle or an FET.

Trying NOW is difficult. It's difficult to start again. It's dificult to know I need to stop breastfeeding to give my body a chance to ovulate again, let alone start pumping it with puregon, baby aspirin, clexane etc. It's difficult to be putting H in the position of needing to perform again. It's frightening to think of engaging in those painful emotions again. It's worrying to think about the unlikely but possible scenario of having two children 15-20 months apart. I worry what we'll do to Pob if we introduce a sibling so early. I worry what it will be like for her if we can never give her a sibling. I worry about managing my emotions around her as we go through the pain of trying to conceive again.

But we are going to try. It's always been important to me to avoid having an only child. I know it can be fantastic but I've seen and thought about too many bad scenarios to be happy with not trying. The first scenario was when one of my university friends died of cancer when we were 23. He was an only child and both his parents were only children. I watched them at the funeral, and I've never seen two people more alone. There were no cousins, no siblings there to comfort them, it was just them and then the rest of us. I know that losing a child to cancer would be a disaster whatever your family situation, but somehow to me the pain seemed magnified because they were lacking any family support.

The second scenario was one presented to me by - I think - a New Yorker article about 15 years ago. In it a woman described returning to her family home to pack it up after both her parents had died within a few weeks of each other. She told how she had a sister, a sister she'd barely spoken to in the last 5 years. They'd gone different ways, didn't have much in common. But her sister was the only person she wanted to be there with her. She wanted someone who had a shared memory of her parents, who knew what her family looked like from the inside.

The third is a concern that the weight of parental expectations is awfully heavy for an only child. No matter how cool we try to be, both H and I have expectations of what we thought our child would be like, of what we wanted her to be. If she isn't a book lover, I will survive. If she doesn't like sport, H will cope. But at some point Pob will know how much we wanted certain futures for her and she will have to cope with that. She might rebel utterly. She might try desparately to please us but not be true to herself in the process. Yes, I know we can try our hardest to avoid this, but my own childhood tells me it's not always possible.

So I feel a strong obligation to try to provide a sibling for Pob. And it will be a biological sibling or none at all, at least given how H is feeling at the moment. No donor eggs, no adoption. We'll try naturally. We might do a fresh IVF cycle to see if I can still produce any eggs. We will use up our frozen embryos. And then we will be done. We'll see if we can stick to this plan but this is where we are right now. We have an appointment with Dr Candour set up for next Tuesday. We'll see what he says.

So I'm angry. I'm angry that we have to think about this now rather than simply enjoying Pob's babyhood. I'm angry that it might not work and that Pob will never have a sibling to love, to support her. I'm angry and I'm happy all at one.

Why the pain never goes away

Since Pob was born, the pain of infertility has dissipated somewhat. It hasn't gone completely, partly because in our community the pain is always present so there are constant reminders of how hard it was to get here. Others are still enduring the trenches. Pain similar to the pain we have endured, or tortures worse than we can imagine. There are constant reminders that it hurts, of how much it hurts, of the constant threat that joy can be taken away in an instant. It doesn't take away my joy, it simply keeps me connected to the pain I have felt and the anger I still feel about what infertility took away from us.

I have felt that hurt very profoundly over the last few weeks as the losses mounted up, and as usual I haven't known what to say, known what I can do, what any of us can do except stand by silently and form a virtual circle around those suffering those losses. An author I admire has used language that has stayed with me to describe what I think this community does. It's Christian language, but I get it, I think, anyway. She says that what we do in this situation - all we can do - is to stand by the foot of the cross as someone goes through their own personal Good Friday. Mary Ellen, Steve, Alexa, Scott, I hope you knew how many people were and are standing there with you.

Not a baby at all

My fake baby was a program on Channel 4, Britain's 'alternative' channel, last week. Others have already written about this, but I'm feeling a need to process my feelings about it, so be prepared for some wandering around the topic.

These fake babies are dolls which are unbelievably realistic. Some even have breathing mechanisms inside, and heaters so that they feel warm. In the memorable words of one woman profiled on the programme, however, "They don't soil themselves." For some women (and I limit this to women advisedly, there were no men seen who were keen on the dolls), therefore, they are the perfect baby. They never grow up, they never make a mess, they never cry, they just look adorable and you can cuddle them to your hearts content. Or take them out in the pram.

One such woman explained that she and her husband had not wanted to have children earlier as they enjoyed their no-children lifestyle too much. They delayed and delayed and eventually realised they were never going to want to give up that lifestyle. I checked my infertile radar and decided that they probably weren't covering up difficulties in conceiving, they genuinely didn't want real, messy children. As evidenced by the scene of this woman cleaning the wheels of her pram. She had about 4-5 of the dolls, and about 4 prams, all white with white wheels. She likes to keep everything clean, so she has inside wheels and outside wheels, and washes them in between trips. To take the dolls out in the pram, to the park or to the shops. She saw the dolls as better than real children. They were no trouble, and they never grow out of their clothes. In one memorable scene she spent nearly £300 ($600) on 4 items of Roberto Cavalli clothing to create a 'coming home outfit' for the new doll she was expecting. She explained that it made more sense for her to spend that money on dressing a fake baby than a real one as at least this way the clothes would never get soiled.

For other women, these dolls fill an emotional void. In one disturbing scene, a woman collected the doll that had been made to look like her grandson when he was a baby. The grandson had gone to live in New Zealand, and this woman was bereft, so the doll was made to help her satisfy her craving for her grandson, but it was also her grandson at a stage when he needed her the the most, it wasn't just about her loss. To take this doll home, she buckled it into a car seat. A car seat. Later, she was seen walking the doll in a pram. For this woman, clearly, the doll was someone to love. She showed it over a webcam to the grandson, who insisted it was a doll, while she insisted it was a baby. He sounded confused.

Yet another woman has a whole nursery filled with the dolls, about 50 from what I could see. Most upsettingly, one of them was "the smallest size which can survive", a tiny micro-preemie sized doll, but without the lanugo and the red colouring of the micro preemies I have seen. Why if you are going to spend money on these dolls, do you buy one designed to mimic a baby that would have a hard time staying alive?

As with many others, I found the programme disturbing. I didn't want to watch, but I was fascinated. H refused to watch, echoing the comment of the woman with the grandson's husband, who told her he "didn't like it, it looks like something on a mortuary slab". Why did I want to watch?

Well, there was the car-crash tv element of it. I wanted to see odd people behaving oddly, and perhaps give myself a pat on the back for being that much more normal. I also wanted to watch for the infertility angle. Were these women looking for replacements for babies they couldn't have? Not really from what I saw, but perhaps in other instances? But would such a baby ever be satisfying to an infertile? Perhaps even more so than women who can pop babies out at the drop of a hat, aren't we very sure that we want the whole puking, shitting, laughing, growing, crying, unique package? Wouldn't one of these dolls be almost worse than not having anything at all, a constant reminder of what you don't have? Never to get a reaction to your hugs and kisses, why would that be a satisfying way to parent? Clearly, the dolls are being used as child substitutes, but they equally clearly don't fulfil the women who buy them - why else would someone have a whole nursery full and regularly buy more?

Another angle was the need to feel special. A woman who makes these dolls explained that when you have a newborn, everyone is interested, everyone comments and pays you attention. As the baby grows that stops, but with one of the dolls you never lose that specialness of being the mother to a new born. Only you're not. Would that attention feel wrong somehow, knowing you are misleading people? I can empathise with this, I'm feeling a distinct lack of special-ness right now as the task of looking after a 16.5-weeker starts to be routine and sometimes rather dull. But nothing can compare to the smiles and talking I get when she is in a good mood, something I would never get from one of the dolls.

I don't want to be cruel. As the women in the programme said several times, they aren't hurting anyone. They aren't hurting anyone else, I agree, but aren't they hurting themselves? The dolls are very far from being adequate substitutes for a real baby, they are dolls and could be satisfying as dolls, but as babies they are never going to be anything more than a very pale imitation of the real thing. Thus the least emotionally unsettling part was perhaps the woman with the white prams who wanted perfect babies who didn't cry. She wasn't very emotional about the dolls, they were genuinely possessions to be showed off, not babies to love. She is better off with a doll than a real baby who clearly would disturb the way she lives her life.

For some of the women profiled, these fake babies seemed to be relatively harmless. If they want to spend money on Roberto Cavalli or white prams, then it's their money. For others it seemed to be a displacement for feelings they no longer had an outlet for. Is this the healthiest way for them to deal with their losses? For another group it was a way of stopping themselves from being invisible, the woman who is not a parent, who doesn't attract attention of any kind - not young enough to get a wolf whistle, not a mother who gets attention reflected from her children. It felt sad. It felt wrong - the dolls are just that bit too close to looking like one of those death masks they used to make from guillotined heads. But for a few minutes, a few hours, perhaps longer, it made - makes - these women feel more fulfilled, feel more love(d). Who am I to question that?

The emotions, balanced they are not

I'm always an emotional person. What I feel is written on my face most of the time. If something touches me, I cry easily and often copiously. I still remember dissolving into uncontrollable sobs during a performance of Romeo and Juliet at the RSC when I was about 19 - it was something about the hollowness with which the Capulets and Montagues delivered the lines that vow that these deaths have changed the way they feel about each other that meant I was beyond comforting. My mother was rather embarassed, as I recall. I did the same thing at a performance of Billy Elliot 18 months ago, although of course at that point I was mourning the negative IVF cycle we'd just had as well as being empathetic with Billy's lost relationship with his mother. There are too many incidents to count. And it happened again last night.

I'm not entirely sure what set me off. In one sense, I'd had a good and productive day. My mother wanted to take me shopping for the baby, and the day our diaries meshed was yesterday. I arrived at Peter Jones and immediately felt very ambivalent about being there. My mother suggested we take a basket and start filling it, but I struggled to pick one up. "Ill just look around first," I said. This took a while and eventually she started to get impatient. I resigned myself to picking up at least a few things. I bought nipple pads and cream, barrier cream for the baby, a pack of muslins, 2 nightdresses (apparently easier to change nappies in the middle of the night), a pack of vests, a hooded towel. Stuff we need, stuff that isn't too personal, doesn't cost much. We looked at moses baskets, cribs and other furniture but nothing was terribly exciting. After a poor lunch we headed down the road to a shop that I knew carried some furniture a friend had recommended. It was totally worth it - fantastic service and great looking furniture. The choices were hard. We liked things from different ranges, and I couldn't decide on what kind of colouring I wanted. It took maybe 2 hours to decide and to buy some serious stuff, including a few more bits and pieces, like swaddling blankets and a baby healthcare kit with thermometer, nail scissors etc.. Mum kindly paid for the 2 big pieces of furniture, a crib and a wall storage unit including a wardrobe. I bought a glider that I had not known I wanted until I sat on one in the shop and immediately felt better, relaxed and comfortable.

I spent most of the time in that shop on the verge of tears. I didn't cry, but I kept wanting to. I tried to get H to come down as I was really struggling to make a decision. H wouldn't come, he was suffering from a hangover and probably couldn't face leaving the house. It felt like a big deal. It's not, I know it's not, but it felt like one.

Part of the problem was that three years ago, before any of the drama, I had come across some hand-made children's furniture while surfing the web, and set my heart on it. It costs a small fortune, and it seemed we would never need it so I put it out of my mind. Recently a friend whose baby is now a year old had recommended another brand and actually it looks remarkably similar to the hand-made stuff but at a fraction of the cost. So I'd had this image all through the journey of how the eventual nursery would look, and now perhaps I could create that look. But when I saw the stuff in the flesh it was quite big and chunky, and looked best in a very dark wood that I worry will overwhelm the room. So I dithered and paced and wished someone would just tell me what the right answer was. After much thought I decided to go with the dark colouring, but kept fretting about it. I still am. I may change my mind, who knows.

We capped off the day by visiting a third shop to comparison shop the furniture, desparately trying to find something to eat and failing, and then going back to Peter Jones to try and find curtain fabric and fabric for the chair. We were knackered by then and I was starting to feel a bit feeble I was so hungry. I tried to get mum into a taxi home but she wanted to come back with me. We walked in the door at 1900, to find H feeling a bit sheepish and worried about me. I downed a bit of cheese and a huge glass of water and started to recover slightly. We made mum a cup of tea and I started to really really wish she'd go home, I wanted to collapse on the sofa but didn't feel I could. I also felt emotionally tense. It was a huge deal, suddenly having all this baby stuff in the house, and I felt both stressed and ridiculous about being stressed that I'd bought the wrong furniture.

Eventually while mum was encouraging me to show her other bits of furniture on line, I snapped and said something along the lines of "I just can't make any more decisions about anything this evening, I've just had enough." At which point she stood up and said "well, I'll just go and wait outside for a taxi, then." So then I felt terrible and asked her to please stay, and she started telling me how awful I'd made her feel, and I just lost it. Started sobbing and couldn't stop. I tried to articulate why but I'm sure all that came out were snippets of stuff along the lines of "still don't know if we'll have a baby" and "don't have the right stuff" and "if you get upset by this, how are you going to be helpful after I give birth and am even more emotional and tired." (mum has promised to come and stay after the baby is born to help, and swore blind that she was the right person for us because I could be horrible to her with impunity and she wouldn't mind).

Mum left after I calmed down somewhat, but she was clearly upset and I spent the whole of the rest of the evening on the verge of tears despite H's attempts to cheer me up. I don't entirely understand why I found the whole thing so stressful. Yes, buying stuff for the baby is hard, but it's also wonderful. It's exciting to be choosing curtains for a nursery, isn't it? Shouldn't I be excited and happy rather than stressed and freaked-out?

I wonder if my tension is because the nursery is a signifier of what we've gone through to get here. That I finally get the furniture I've always wanted but it's not really the right furniture - is that about my worries about being a mother? Some of the stress is undoubtedly because my relationship with my mother is always stressful, but most of the day was actually ok. I feel bad for ruining it. I feel stressed about whether it's really right for Mum to come and help after the baby is born. And most of all I wish I knew how to make it all better.

This was going to be a post about the emotions of infertility and how they've changed, but I think that will have to come in a follow-on post, this is enough already.

Communities, or what to do about pregnant blogging

I promised that I'd return to this topic, but haven't had the chance to do so. I've been thinking about this post a lot, which is a mistake because I had lots of interesting thoughts (I promise) but I didn't write them down and now they may be lost to posterity. No matter, I will do my best to recreate. Just bear in mind that there was another, much better post, written in some parallel universe.

It seems I touched a few nerves with the whole pregnant blogging thing. Poor Beth, for example, felt it was directed (at least partially) at her. So while it had the joyful effect of getting her to update us on how she was, it had the negative effect of making her feel got-at, and making me then feel guilty for having got-at her. What a fun cycle we do subject ourselves to.

My thoughts have led me to the conclusion that there are two angles to this. The angle of the pregnant after infertility blogger, and the angle of the continuing infertile blogger. And then there is the question about the combination of the two. Let's think about the newly pregnant first.

Several pregnant bloggers commented on why they slowed down or stopped once they get pregnant. The reasons seem to be:

• Guilt, often combined with Fear
• Boredom
• Just feeling too bloody ill to get to the computer
• All your readers go away so it's very hard to motivate yourself to post

The guilt one is the one that I do empathise with, although I don't buy it completely. I did feel guilty, and even have the post to prove it. Then my dear friend Ms Pamplemousse wrote me a 'get over it' email and I got the message. Apologising for being pregnant is not the point. None of us should apologise. Even our fertile friends shouldn't apologise. We all deserve it. Our fertile friends, I think, owe us a bit of sensitivity in how they break the news (but oh how so few of them manage that), but treating us as damaged people who cannot handle the information is so much worse - patronising and controlling. But for those of us who have struggled together, the blissful pregnancy announcement, accompanied by a picture of a peestick if appropriate, is entirely fine. You don't have to wind up to it or pitch it carefully, we've probably been reading along with breathless anticipation (although not as breathless as yours) for the last four weeks or so. And mostly, we don't wind up to it. We are not embarrassed to announce that pregnancy. It's what to say after that first post, or perhaps the first few posts, announcing rising betas, that we find hard. How can we rejoice when so many friends are left behind? Or, alternatively, how can we post about how bloody awful we are feeling when so many friends would give anything to be feeling this disastrous?

Then comes the fear. How can we rejoice when we are so scared? How can we not rejoice when others are desperate to be in our position? We're damned if we do, it feels, damned if we don't. And it's all very well saying that once we get to 13 weeks or so the fear should go away. This community has seen too many awful things happen after 13 weeks for most of us to relax, even then. And worse, we probably feel that we SHOULD be relaxing, but yet we can't. And we can't complain that we're so tense, because our friends would love to be where we are, yadda yadda yadda. So it must be incredibly hard to know how to pitch your posts. Joy/fear? Guilt/Joy? Happiness/Sadness? All so very complicated.

On the guilt and fear side, I am not going to tell anyone how to feel. The fear I think will never go away, goodness knows if I knew how to banish it I could make a million. But how about changing the guilt to empathy? You know that where you are is a great place to be, you wish all your internet friends could be here, but for now you are just going to remember how they feel, and connect with that in your writing. At a minimum, I would love it if more people felt able to write through it. Follow the advice I give a lot of my junior colleagues. Acknowledge the emotion you're feeling (I'm feeling so guilty, it's really hard to write about how happy I am), then figure out how to deal with it so it doesn't become a problem for the other person in your conversation (I wish you were all here too. I know that may never happen, but remember that I feel that way. At the same time I'm so happy for where I am/we are). So that's it for the guilt side...

The boredom one seems like a reasonable reason for struggling to write. Many of us struggle sometimes with what to post when the infertility stuff is taking a back seat for a while. So when a pregnancy gets past the 'oh wow, I'm pregnant, but I might lose it, oh wow, oh shit, oh great, oh shit' stage, and just goes on going, then I can see that it might be hard to post. Some people, like Jen, just keep posting regardless. Jen has shared about her family, how her pregnancy is progressing in great detail, and all about her preparations for the Beasties. And now she's even sharing from the labour suite! So it works for some people, but not for others. Perhaps it depends how good you were at just posting before you got pregnant. Some of us seem to be in the habit of updating regularly, regardless of whether big things are happening. Others take extended breaks from time to time. I guess writing regularly is one of those disciplines, like making time to exercise, that some of us are good at and some not. Not that I'm equating blogging with the health benefits of exercising, you understand. Oh, if only - but that's another post. So on the boredom front, just a little bit of telling us how you are will work wonders, even if you don't feel you have anything very exciting to say.

The too sick to come to the computer makes perfect sense and no one is ever going to hold that against you. Just let us know when you can how you are. That's all.

The demotivation of losing your audience is hard, too. I know that my audience has gone from about 800 a day when I was about to miscarry, to more like 350 a day now - just above where I was before this last cycle. It was hard looking at those dropping figures, but it doesn't stop me wanting to post. I understand that if you're getting down to the 1-2 comments per post level, perhaps it feels that you aren't appreciated any more. Your reading figures may be higher, but you're not getting any validation. You know why we aren't visiting as much as we did, you've been there too. And without validation, why keep posting? I'm going to come back to this point below. Hold on, another point has to come first.

Before that killer point, we need to look at things from the perspective of the infertiles left behind. As far as we are concerned, we are part of your support group. We helped you get here, emotionally. Not to mention that we are desperate to be where you are. So we are all a bit emotionally invested in you being happy, and in sharing that happiness with you. It's a little bit like when you think really carefully about a lovely present you want to give someone. Then you make the present, wrap it up, and present it, and they say: "Oh thanks." And put it to one side and get on with what they are doing.

Let's be clear we KNOW that you are incredibly grateful for the support you've gotten. But it just doesn't FEEL that way when you immediately bugger off and don't tell us how things are going. And, as described above, we KNOW there are all sorts of good reasons why you might feel bad about continuing to share. But dude, we are the ones who are left here, still infertile, no happiness to share around without your input. See how that works?

So really, what this comes down to is whether or not we have any responsibility to each other or not. This argument has been had many times before, and from what I can gether from sideways comments, there was a big furore in blogland sometime in 2004 which touched on this point. The arguments seem to be that

1. A blog is your blog, and whether someone reads or not is up to them, so you say whatever you like.
2. A blog, particularly one with comments enabled, is everyone's blog. Yes, you are the author, and it's up to you what you write, but you are clearly writing with at least one eye on your audience. This has the upside that you get supportive and encouraging comments, but the downside that in return for the readership and the commenting, your audience expects something from you. A certain frequency of posting, or a certain kind of post, or a certain obligation to update. You are, of course, free to ignore these obligations, and then you might irritate or even anger people. In the pregnancy case, we'll just feel hurt but probably not say anything if you stop posting. In other cases, people have had to deal with angry comments about something they've said, because they've offended community sensibilities.

This second point of view assumes that we are a community. I've seen people debate this before, so I thought I'd go and get a definition so we've got something to debate from. Here is the Wikipedia point of view:

A community is a collection of living things that share an environment, so forming a recognizable group. These living things can be plants or animals; any species, any size. Communities are characterized by interaction in many ways. The definitive aspect of community is that each subject in the mix have something in common that allows an identification. ...[In] human communities, intent, belief, resources, preferences, needs, risks and a number of other conditions may be present and common, affecting the identity of the participants and their degree of adhesion.

The word ''community'' comes from the Latin ''communis,'' meaning "common, public, shared by all or many." German sociologist Ferdinand Tönnies presented a concise differentiation between the terms "community" (gemeinschaft) and "society" (gesellschaft). In his 1887 work, Gemeinschaft and Gesellschaft, Tönnies argued that "community" is perceived to be be a tighter and more cohesive social entity within the context of the larger society, due to the presence of a "unity of will." He added that family and kinship were the perfect expressions of community but that other shared characteristics, such as place or belief, could also result in gemeinschaft.

Sounds like us - no? "A tighter and more cohesive social entity, due to the presence of a unity of will". I'm buying it. So if we are a community, doesn't that mean we have some obligations to each other? I believe that in a healthy community, there is some sense of responsibility for each other, some give and take. Perhaps in any community there will always be free riders (I'm not going to divert into economics now, don't worry), but for a community to survive, those who form it have to have some sense of its value, and of their role within it, and to continue to contribute to it, although that contribution may vary over time.

So I'm coming down on the side that says

1. We are a community
2. When you write your blog, you are writing mostly for yourself, but also with your audience in mind
3. Your audience therefore has a vested interest in your story
4. And you therefore have some - perhaps minor - obligation to your audience
5. This means that when you get pregnant, we need to know how you are from time to time

I'm not entirely thrilled by where I've come out, since another way of saying the above is that you owe us something. Maybe you do. Just a little thing, the gift of sharing whatever it is you are going through, good or bad. If you are able. And you know, even if you can't or won't, we aren't going to forget you. Everyone leaves an imprint on this community. Some bigger than others. But the moment you hit 'save' on that first post, or left your first comment, you made your first step into the community. So whether you like it or not, you're part of us.

Hierarchies of loss

Do you all feel different levels of sorrow when you see different kinds of sad news on someone's blog? Do you, for example, feel less sad at my 11dpo post than you do when you see someone who has been through an IUI get a negative beta? And less sorrow for them than for someone who has been through a full IVF cycle and got their negative beta?

And extending into more controversial territory, do you feel less sorrow for someone whose pregnancy ends at 5 weeks than you do for someone whose pregnancy ends at 15 weeks? At 25 weeks? At 35 weeks with a stillborn baby or a baby who dies?

I'm not trying to be morbid with that last one, it's just that I've been sitting on the sofa reading this morning and wondering about how I feel. My answer to the first of the above two paragraphs is "yes". Sort of. I do feel more sadness for Julianna's last IVF cycle than I do for my own bad news this month. I feel terrible for Danae's horrific week, more so than I did to hear about Reprogirl's failed IUI. That doesn't mean that I sat there when I read Reprogirl's entry and thought, "get over it, sister." I felt bad for her. I wished it had worked. But somehow it doesn't seem so awful as when someone has been going through this for so long and it still doesn't work, like Julianna, or when someone gets that fantastic news and then something goes wrong.

The two first paragraphs above aren't really asking the same question, though, are they? The first asks about whether we feel more sympathy when someone has gone through more pain to get there. MsPrufrock was writing about this yesterday. The second paragraph is asking about if it is worse when pain comes after you've already started to feel joy, after you've already started to live a different life. I can only imagine that although many in this community write blogs saying: I won't believe it til the 12th week, I won't be excited until I know the baby is viable, there must be some part of you, surely, which is happy. Which in unguarded moments starts to think about and take joy in the potential baby. I read last week on someone's blog, I can't remember who's, sorry, that they had decided to let happiness reign early in their pregnancy even though something might go wrong. It's going to be awful if it does go wrong, they wrote, so we might as well be happy in the interim. That sounds a lot like the advice you guys gave me a few entries ago about hoping during the 2ww. Enjoy the hope, even if you have to mourn afterwards.

Given that, I do feel terribly sorry for someone who is losing their baby in the 5th week of pregnancy. You are already losing that potential child you had started to dream about, even if you hadn't really let yourself start dreaming. The news that someone has a stillborn baby does seem worse - you had no reason to think anything had gone wrong. But it is the same grief, surely. The grief of a lost child. Is grief worse when your child dies at the age of six than if he'd died at two? So why is it so much worse if he dies at two than if he dies before he left your body. Your image of him was still there, you had already started to think about him as your son...Indeed, I just found an article which shows that parents who have a premature baby also experience grief - grief for the loss of the full term pregnancy they expected, of the healthy baby that they didn't have to worry about...Grief seems to be the loss of an imagined future, more than it is about the loss itself.

I'm torn. Perhaps the point is that there is no hierarchy of grief. That what you feel when responding to someone else's loss depends on your own sense of loss, on eliciting that empathy in you that relates to the losses you have suffered, whether or not they were related to infertility. That no one can judge any one else's level of grief. That we should grieve and sympathise with each other because that is what makes this community worthwhile. I think that's what we do. That's what I will try to do.