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Abu Dhabi, UAEMonday 15 October 2018

The road to parenthood is paved with stories – of both love and loss

On Baby Loss Awareness Week, conversations about miscarriage and fertility issues are often fraught with guilt and embarrassment. But these issues affect more people than we imagine

Robert Edwards, the British scientist who developed IVF, with Louise Brown, who was the world's first IVF baby, with her son Cameron and her mother Lesley. AFP
Robert Edwards, the British scientist who developed IVF, with Louise Brown, who was the world's first IVF baby, with her son Cameron and her mother Lesley. AFP

The summer I had a miscarriage, it seemed as if every woman I passed on the street was pregnant, flaunting her fertility in my face. As miscarriages go, mine was not that dramatic. I was about 11 weeks pregnant, daydreaming that the little puddle of cells inside me would become my daughter, when my body decided to make other plans.

All I’d wanted was that everyday mammalian miracle, a child, and I’d failed. At least my doctor didn’t offer me the diagnosis that a friend’s sister received after hers: she was told that she had an “incompetent cervix”. What a lovely way to underscore the insidious idea that miscarriages are somehow things we can control, as if to suggest that if only this woman’s cervix had tried harder, the pregnancy would have gone to term.

I hadn’t thought about that summer in a long time, but all those memories came back earlier this year, when I saw that Louise Brown, the first-ever IVF baby had just celebrated her 40th birthday. I’m not sure how she feels about hitting this landmark, but it’s a significant milestone for the many thousands of people whose fertility problems have been solved by IVF.

Let’s be honest, no one expects to have problems conceiving. It’s basic biology, after all. How can it be difficult? And yet, it happens, and to more people than you might expect. I was surprised, after my miscarriage, to discover how many people I knew who had been through the same thing. Similarly, if you start thinking about IVF, you realise that even though it is an extraordinary exercise in medical technology, the process has become almost routine. Everyone knows someone who has undergone IVF.

In the Emirates, there has been an upsurge in the number of IVF treatments − around 6,000 couples a year now − and a parallel rise in women seeking to freeze their embryos. The laws relating to embryo freezing have recently been amended, in response to a general fall in fertility rates. It is estimated that fertility issues affect roughly 30 per cent of couples in the country at some point. And yet, here as elsewhere, the rise of IVF treatments offers a paradox: even as more would-be parents are turning to IVF, there is often an unwillingness to talk about that fact, as if the medical intervention must always be seen as an indication of a biological failure, rather than as a commitment to having a child.

My husband and I had thought about IVF at one point, actually, because before the miscarriage, I’d given birth to a premature baby. It had been my first pregnancy, and I’d been the perfect expectant mother: no caffeine, no alcohol, no junk food. I’d done everything just right, but for some reason, the baby stopped growing. When I went for an ultrasound, the doctor told me, in far less tactful terms, that I had an inadequate uterus. I lay there under the blue light and wept. I was a fertility failure.

Ten days after that diagnosis, I had an emergency cesarean section and was delivered of a baby who weighed less than 500g. You’ve probably eaten burritos that weighed more than he did.

As with my miscarriage, the reasons why my baby was born prematurely were never explained. The doctors used the word “idiopathic,” which is medical-speak for “We don’t know”. And yet that baby thrived; continues to thrive. Idiopathic, indeed.

Research suggests that miscarrying happens because of some chromosomal problem in the fertilised embryo: it is the body’s solution. But because miscarriages often happen in the first trimester, before a woman looks pregnant, it can be difficult to talk about the loss. The response is often some version of, “How can you grieve about something that didn’t ever really exist?”

It was after the double whammy of premature birth and miscarriage that my husband and I considered IVF or adoption, but the cost and complication of both options overwhelmed us. Others, of course, make different choices. In my extended family, for example, we have many options: adoption after multiple miscarriages; IVF twins; single parents of adopted children. It’s a glorious array of possibilities.

In many of the stories that my relatives tell about their journeys to parenthood, there is an underlying sense of disappointment at what didn’t happen: an easy conception, a baby carried to term with no intervention. That doesn’t mean that they love the children they have any less, only that it was a long and sometimes arduous journey to arrive there.

This column will run during Baby Loss Awareness Week, which started in the UK as a way to open up the discussion around miscarriages, reminding us all that even if the blob of cells was not viable, the prospective mother may well have had – as I did – a whole mass of hope wrapped around that microscopic speck.

Few of us will have birth stories that are as dramatic or ground-breaking as Louise Brown’s, but as more and more of us confront the unexpectedly rocky road towards parenthood, we need to allow room for all of our stories – the stories of loss, as well as the stories of joy.

Deborah Lindsay Williams is an associate professor of literature at NYU Abu Dhabi