How do you and your partner make decisions? Some couples, though few and far between, seem to always be on the same wavelength, easily taking each new decision in their stride and coming to a conclusion together. I envy them, don't you? Even though my husband and I have similar values, we often go about decision-making exercises in completely different ways. He says I make everything hard work, while I say he jumps to conclusions. He doesn't read me well and I expect him to know what I'm thinking. It makes for some very spirited discussions between us, which are an integral part of our relationship after 15 years. The good thing is that we now recognize each other's modus operandi and know to stop, take a breath and ask the right questions. The challenge of making vital decisions about your fertility treatment and other parenting options can not only be difficult, they can be imbalanced and/or divisive. This is hard work, but it pays off and will help your relationship in the long run.
Bad timing - 
Often, the scenario is that we go to doctor's appointments, bring home information and present it to our partners, expecting to resolve an issue there and then. Whoa!!! Think before you speak. When you bring up the conversation, what you say and how you deliver it will all have an effect upon how this information is received. An emotional delivery is likely to put the other person's defenses up immediately. Likewise, leaving the discussion until you both fall into bed, tired from a long day, is not a good idea. You may think it's the only place you get undivided attention, but bedtime is for intimacy and sleeping, not grappling with life issues that could have you twisting and turning all night. Trying to conceive is fraught with all sorts of stresses, so don't add to them by making decision-making more difficult than it needs to be.
Top tips:
- write out what you want to talk about;
- practice what you want to talk about out loud first;
- hold off the conversation until your partner has had a chance to unwind; and
- tell your partner what you want to talk about so he or she has a chance to formulate their own thoughts.
The "special-needs" of infertility - While most of the tips here apply to marital conversations about any topic, decision-making in the infertility area is highly charged with emotion because it goes to the core of who you are as an individual, how you see yourselves as a couple, and your vision of how you will be a family. At steps along the way, you can re-visit how important it is to each of you to be parents, how you feel about yourself and your (or his) infertility, external pressures on you to become pregnant, how your love life is coping with the stresses of medical scrutiny and intervention and, most importantly, your values. I never assume that partners have exactly the same values, or priority order of values.
When we initially discuss how a client is handling a particular issue, I often get one answer, but a far different picture once we delve a little deeper. The tidied-up version originally given is usually part of what I call your "marriage-story." We all create these stories and dutifully bring them out when we run into people we don't see very often; a lightly entertaining version of the truth. They only scratch the surface and are meant as harmless conversation. The trouble with them is when we begin to believe the story we have created and fail to look beneath the surface ourselves.
I used to tell people that my husband wouldn't let me start trying to conceive for one year after we married, because he wanted us to have that time to focus just on each other. Then, when we did begin trying, I miscarried repeatedly. Though lightly said, the implication was that it was his fault if I had run out of good quality eggs and couldn't have children. The fact is, neither of us had any reason to predict that I would have fertility problems of any sort. I agreed to wait and then resented him because of the consequences. Out of fairness to him, I have adjusted my marriage-story... the fact is we agreed to wait a year. It also taught me a hard-won lesson; to be true to myself, speak up and stand my ground.
Re-assess your values - When decision-making isn't going well because a couple is going around in circles, I use a coaching tool called a values assessment exercise to focus them. By going back to fundamentals, we tease out your core values and how deeply they run. You may think this is straightforward; after all, we all value love, honesty,family and good health, right? But by ordering and re-ordering your values, you begin to see the fine distinctions that can make all the difference to a difficult decision.
Assuming that you are trying to conceive, having a family is likely to fall in your top ten values. If you are undergoing fertility investigations or treatment, and it's all you think and/or talk about, it will be placed high on the list. However, where it places in the top five may vary relative to the other values that are on the list. Marital relationship or love may come out stronger. Good health could be optimum for a person who has had, or cared for someone in, poor health. Financial security is a value that is very variable, even among couples. There are so many others: spirituality, friendship, romance, lifestyle, etc... A very telling question is whether they value being parents higher than having a biological child, or being pregnant. By going through this process together, a couple may find that one of them has much stronger feelings about the sacrifices they may have to make to create their family.
Fear - If you are using the words "what if" repeatedly, it's worth examining what you fear may happen as a consequence of your decision. What if we go ahead with this procedure and it causes more damage? What if we take a break from treatment and we waste valuable months of possible conception? What if I say yes to egg donation and then, down the road, the baby doesn't feel as much mine as my husband's? What if...? The list can go on and on. It's entirely normal to feel fear and to want reassurance that what we decide will be the best choice. No one can guarantee results, so that reassurance is likely to fall short. The challenge is to find within you the strength and willingness to take the risk and to hope for the best outcome.
It's your life; take full responsibility - It may seem that it would be easier if someone else made these decisions for us, however, that would actually be the worst case scenario. Why? Transferring your crucial decision to someone else strips you of power or control. The lack of control you may already feel because your body isn't doing what you want it to do, would be exacerbated by this, causing extreme stress. While the decision-making process is stressful in itself, there are useful aspects to it when done in a healthy way, such as promoting conversation between you, having the meeting of minds as a common goal, balancing the control in your relationship and taking ownership of the decisions arrived at together.
Conversation - In order to hone in on the essential question to be answered, you and your partner will have plenty of conversation about the issue involved. Sometimes it may seem that this is all you talk about. You are sick of talking. You want to go back to talking about music, planning vacations and world peace. I don't blame you. My answer: take enforced breaks from talking about your infertility and trying to conceive, but agree when and where you will talk about it again.
You may each decide to discuss your decision-making with others too. Voicing the options and the imagined consequences will help you sort it out, clearing out some of the mental clutter as you go along. It also gives context to any fears you may be having. Men often have difficulty admitting to fear and feel the need to reassure their partners when they express fear. If you make it clear that you don't expect him to be a tower of strength, it may give him the permission he needs to express this often-repressed emotion. You may be surprised at where his thoughts are going, but don't dismiss them as silly or you may not get him to open up again in the future.
The balance of power - You may be surprised to know that there is usually one dominant partner in a relationship (not just in yours). When someone is absolutely convinced that they have the correct answer, it can be difficult to keep your own conviction strong. If the less convinced one prevaricates, they could be steam-rolled by an argument heavily weighted in their partner's favour. It's important that both parties are heard; that they believe their feelings and opinions have been given equal consideration. If you know that you are the stronger-minded person, try taking a step back to allow your partner to express themselves. If you're frustrated by how your partner takes over, gather your courage and suggest you do a SWOT list together, which will help you lay your argument out on paper.
The dominant decision-maker is not always the obviously confident person. One person can grab power merely by refusing to budge an inch. No discussion means no negotiation and no compromise. Eventually, the other person may just give up, however, it will almost certainly cause resentment in the future. Even if one of you is more convinced about the way forward, the other one must arrive at a state of acceptance that the intended result is one they can live with. Try talking out the worst-case scenario for each option, so everyone knows the risks.
The happiness card - One person may gain the upper edge by playing the happiness card. "It doesn't feel right." "It's not fair." This is what I have always dreamed about and now..." The worst one of all is "if you really loved me, you would..." Infertility is hard, unfair, exhausting, lonely, expensive, scary, confusing, painful and not even-handed. One of you may have to shoulder the greater physical burden, while the other may feel more stressed emotionally or financially. However, ultimately, you are in this together and the best way to do that is to maintain open, clear and honest communication. Never forget that a baby is not a commodity. A baby will not make an unhappy couple happy or a dysfunctional couple functional. Remind yourselves frequently why you want to have a child together and be as generous and loving to each other as possible. That way, your fertility journey doesn't become a lost highway.
Eliminate guilt - In fertility investigations, there is quite a lot of emphasis placed on which person has the reproductive health issue (although, sometimes it's both people). That doesn't mean that one person is to blame. How could it be, when the conditions that make up the infertility weren't purposefully created? Guilt really confuses the fertility issues and speaks more about the person, how she sees herself and her security within her relationship. (This applies equally to men.) Even when sincere, guilt is a misplaced emotion that impairs your thinking and interferes with the process of comparing valid options.
Two types of guilt often present among infertile couples:
- what one person can't provide their partner; a biological child, the experience of being pregnant, or being parents at all; and
- what one regrets the other person has to endure in order to give them a chance of a biological child, the experience of being pregnant, or being parents. This could include pain, stress, exhaustion, loss of self-esteem, loss ofromance and passion in the relationship, financial insecurity and/or change of lifestyle.
Either scenario is likely to leave one person afraid to even bring up certain options, let alone express interest in them. If that's the case, they aren't getting to air all of their questions and feelings, which throws the decision-making process out of balance. I've got 3 useful rules to keep in mind.
- 1st rule: don't leave words unsaid; your partner isn't a mind reader.
- 2nd rule: don't assume what your partner is thinking or feeling.
- 3rd rule: don't confuse guilt with sadness.
Identifying emotions - Sadness is a legitimate emotion when you have suffered pain and/or loss or observed that suffering in others. Guilt is a number you do on your own head, placing yourself at the center of a scenario and assuming that it revolves around you and your behaviour. A healthy expression of sadness might be "I always thought I'd have a baby of my own and I feel sad that we can't conceive our own biological child together." Guilt sounds more like "without my infertility she (or he) would have a child of his/her own. I'm useless."
Mr Duck, above, fails to ask Mrs Duck an important question ...will she consider donor eggs so they can have a baby? That's his real guilt; that he wants to consider the option that could result in her conceiving his baby with another woman's egg. He feels disloyal. But, think about this: Mrs Duck may very well be distraught and tired, but it could actually be freeing to be given an alternative treatment option, not relying upon her own eggs. By not initiating the conversation, he is making a unilateral decision, taking away his wife's power to contribute. He also gives up any chance of conceiving with a donor egg and may always wonder if it could have worked. By letting his guilt rule, he shortchanges both of them.
I can give no better advice than talk, talk and talk more! If you find yourself unable to bridge the gap between you, to talk without arguing, to shed yourself of interfering guilt or to even come up with legitimate options which you can discuss openly, stop struggling and get some coaching. It is the best process I know for clearing a path through all of the obstacles to arrive at the core of your issues, and then systematically resolving them. It could change the way you cope with your infertility, the way you work together as a couple and the way you make the essential decisions about your treatment or other paths to parenting.
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