Judging a book by its cover is easy. I just did it. There was a title at my library last week, So When Are You Having Kids?, and I judged it. That’s a loaded question: Am I even able to have kids? Do I want kids? If I do, when is a good time, personally or professionally? Who could ever be ready? Yet, how many times a day do I ask it, whether directly or in a circumvallate way? As a private practice obstetrician-gynecologist, my day is filled with family planning, the will-theys-won’t-theys-can-theys-should-theys.
When you come to me to consider reproductive goals and discuss your ideal, I smile outwardly at you. Inwardly, I sigh. What your right time is different than what society might say. Luckily, everyone has an opinion. And I run through the what-if’s without letting you see my worries.
We talk and laugh through the exam about how tricky parenthood is. Then, we circle back to the logistics, of the menstrual cycle, process of trying to conceive, and when you need to come back to see me. My spiel involves your health optimization, a three to six month return to the office if you are not yet pregnant, and the next steps for your family goals. You’ve been avoiding pregnancy for so long, and you’ve been good at it. What will the next step look like?
You confide in me, your fears, your last pregnancy, and the three miscarriages that led you to my office, to a new start. We sit together, and we commiserate. You tell me about the tears you cried when the bleeding started a few days after the line showed the smiley face, that first positive. We talk about your fears of that “geriatric” label, and we discuss the what-ifs. You hope I never call to advocate to the maternal-fetal medicine specialist for an earlier consult or the family planning clinic for the unthinkable. You get excited, but your heart drops when I call you to discuss those genetic results.
Hopefully, we won’t ever discuss the confirmation tests for the chromosomal issues, that I never cry with you about your tragedy. Instead, we talk about the hashtags, the community that upholds you when it’s too scary to tell your loved ones. You leave.
Expectations are analyzed, from society, from your family, from caches of interviews and experts, and even still, there’s no right way or right answer. No amount of reading and scrolling can prepare you for the unexpected. And for those of you in the infertility spiral, the question downright hurts.
When we sit together some months later to recap the journey. We talk through the frustrations and separate on a hint of optimism. And we acknowledge your growth and your challenges, and we celebrate your success.
Yuliya Malayev is an obstetrician-gynecologist.