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For known donor insemination, thorough discussion, legal advice and a contract are key to protect all parties, especially the children

There was a news item recently about a sperm donor who is involved in litigation over access to the two children conceived through artificial insemination using his sperm.  He had placed an advertisement in the Gay Times newspaper, stating that he was a gay male in a happy relationship, looking for a similar female couple who want to have kids. The children are now 7 and 9 years old. 

In this situation, there was apparently an agreement for some degree of co-parenting. Unfortunately, relations subsequently broke down and the women tried to rescind the agreement, forcing the father to get a court order in June this year. He won the right to see his children for almost half a year. The women are appealing the shared residency order.

We all know that any relationship can break down and that the fallout can be extremely difficult for father, mother and children. The complications usually arise from the emotional rift between the parents who, in all likelihood, once loved each other and intended to live together as a family. While lacking the personal hurt and emotional desertion, there are a whole host of other complications that can potentially arise from the breakdown of a donor/recipient relationship.

In some ways, it may seem that the very nature of donor/recipient relationships are  clear-cut in a way that a love relationship cannot be. You would think that all parties would have had ample time to discuss their desires and expectations and agree important aspects of the relationship before the children are born. However, no contract can really take into account the potential changes that people  will go through as they age, as their relationships evolve and as the children grow up.  While at least the donor/recipient don't have to deal with the particular ill will of a love relationship that has soured, they still have to work through unrealized expectations of each other as parents to their shared children.

If you are contemplating being a sperm donor to a known recipient, i.e. giving your sperm to a female acquaintance so she can conceive, or receiving donated sperm from a known male donor, through a private agreement, it's advisable to have your own legal advisor. 

• If the donation is completely altruistic and free of any intention to share parenting rights and responsibilities, there should be a written agreement that reflects this.  Regardless, under current legislation, upon turning 18 years old, the child will have the right to seek the identity of their biological father.
• If the donor wants to be involved in his biological child's upbringing, this intention should be stated from the very beginning and an agreement as to the extent of his involvement put in writing, signed by both parties and witnessed.
• Discuss access to the child, which could include co-parenting, visitation rights, holidays together or merely the agreement that one day, after a specified age, the child could reach out to meet his/her biological father. Contingencies should be discussed, such as whether the mother can move residence to a location out of the donor father's reach for visitation.
• Try to anticipate the fundamental issues involved in bringing up any child, such as what religion they will be raised in, who will have a say in medical decisions for their health and welfare, who is entitled to make decisions regarding their education, who can apply for a passport on their behalf and who will be named as their guardian if the custodial parent is incapacitated or deceased.
• Discuss financial responsibility for the child, including maintenance and education, including whether there are any contingencies, and until what age the responsibility is in force.
• Talk about emotive issues like gift-giving, especially if there is a disparity in the financial means of the donor father and the recipient mother/parents. Are gifts welcome at all? Do they have to be approved by the custodial parent? Should financial gifts be made directly or through a Trust?
• Agree who will be regarded as siblings, half-siblings and grandparents.
• A woman who is in need of donor sperm to conceive may make concessions during an agreement with a known donor out of desperation. For example, she may regret those concessions once she is a mother and raising a child without the benefit of child support from the donor father, or she may regret agreeing to visitation because of a different views regarding the best interests of the child. Either way, a change of mind is bound to upset someone and may be best mediated by a third party.

There are so many more areas to cover that this only scratches the surface. Even if everything above is covered by a written agreement before the child is born, one cannot anticipate what the child himself will think of the way in which he was conceived.  It's unlikely that he will wish it had never happened, as that would mean his own non-existence, however, he could wish it away, preferring to love and honour his biological mother and her partner, if any, to the exclusion of the biological donor father. What if the child identifies strongly with the donor parent and wants more access to him than any of the parties originally anticipated? The worst imaginable situation, would be for the child to become a pawn, moved back and forth by parents whose amicable relationship has ceased.

There are several sources of support, information and guidance for donor-conceived children and their families:

• The Human Fertilisation and Embryology Authority is a UK government reglatory body.  http://www.hfea.gov.uk/23.html 
• Donor Conception Network is a self-help network of over 1,300 families created with the help of donated eggs, sperm or embryos; couples and individuals seeking to found a family this way; and adults conceived using a donor.  http://www.donor-conception-network.org/ 
• Altrui provides a professional service to find altruistic egg donors for people who need donated eggs or sperm to help them start a family, and may provide an alternative for you to using a known donor. http://www.altrui.co.uk
• There is a service that helps people find their "perfect parenting partners" which has a good section on their website listing frequently asked questions and answers for people to consider. http://co-parentmatch.com

 

 

 

"My cousin's infertile... can you help her?"

Today, after a meeting, I was approached by a woman who wanted to tell me about relatives of hers who have had extreme problems with infertility and are childless. She was concerned about the couple, both for their individual happiness and for the future of their marriage. I listened to her story and then asked how I could help. The answer: "I don't know."

This wasn't the first time I have been in this situation and I know it won't be the last.  For people like my acquaintance, it's a relief to be able to unburden their worries about loved ones to someone who understands.  They feel helpless, unable to offer help directly to people who choose not to share the details of their infertility and the depth of their pain.  In my early coaching days, I thought a referral would follow, so I kept mental notes of the confidante and her story. I no longer have this expectation, because I know that the inquiry was as much about the enquirer's need for release, information and reassurance, as it was about the subject of our conversation. It makes them feel that they are doing something positive by checking with me and being reassured that there is help available if their family or friends were to seek it. Being there for them in those few moments is simply part of what I do.

It got me thinking, though, about those people who are worried about an aspect of someone else's infertility, and don't have the ability to tap me on the shoulder or motion me aside for a quick chat. Whether they are the want-to-be grandparent, the sister-in-law, cousin or friend, it can be a difficult position to be in. So, I've amswered some of the most frequently asked questions I get from them, below:

FAQ:  My relative has been married for several years and not had any children yet. I know they would want children, so I think one of them must be infertile. I feel really bad about inviting them to family get-togethers, knowing that it must be hard for them. What should I do?

Answer: Never assume the reason why someone is childless.  They may have decided to wait a while, or they could be having problems conceiving. If they haven't shared their reasons with you, it's because they want privacy.  Absolutely do not stop inviting them to be a part of family gatherings for a reason you have only guessed at. Even if they find these events difficult, it should be their decision to attend or not.

FAQ:  The rest of the family is speculating about my relative's supposed infertility. I'm afraid to ask questions, but I also don't want them to think that I am part of the gossip.  Is it better to be up front and tell them I'm concerned?

Answer:  Only you can know how thin-skinned your relatives are. However, the other side of the equation is how congruent you want to be. Is it important that you let them know that you are worried about them and that you want to be supportive? If you are just curious, can you justify possibly embarrassing the couple by asking about their fertility?  Balance your desires against their right to privacy, keeping in mind the strength of your relationship and whether it will withstand this conversation.

FAQ:  I can see that this couple is suffering, but I don't know how to handle it. What can I say?

Answer: If you feel strongly about reaching out, then I would suggest that you try to be as empathetic as possible; stand as if in their shoes and think about how you would feel if the highly sensitive topic of your infertility was raised.  What would make it okay for you...sincerity, warmth, a promise of confidentiality, an offer of support?

FAQ:  Can you help them get pregnant?

Answer: I can help them focus on what they want, align their process of trying to conceive with their value system, commit to doing everything they need to do to enhance their fertility health, reduce their stress and restore their confidence and hope.  In other words, everything we do together would be directed at helping them create their family. I believe most people in this situation would have a better chance of conceiving with specialized fertility support than without it.

FAQ:  I think my daughter-in-law needs some professional help coping with the stress of trying to conceive, but I don't dare suggest it. How do I let her know that help is available to her?

Answer:  Tread very carefully here. The difficulty is that a highly stressed, sensitive person could take great offence at the suggestion that they needed professional help, even if it's true. I suggest that you wait for an opening, i.e. a conversation about anything she and your son want to achieve.  You could mention having read an article about coaching and thinking how everyone could use that kind of support at one point or another in their lives. That plants the seed without you having to do any digging. Then just sit back and let the idea take hold.

FAQ:  I would like to refer my relative to you for fertility coaching, but I would be more comfortable if you contacted them directly. Is it okay for me to give you their details?

Answer:  I don't work that way.  It's important that the client have the opportunity to take the forward action themselves. They have to own the decision to go into coaching in order to commit to the process and believe that the desired result can be theirs. So, I ask that prospective clients contact me at first. I will offer them a consultation and then leave it to them to decide whether to be coached.

FAQ:  Can I give coaching as a gift to my children?

Answer: It's a generous gift and one which could be welcomed by your children if they want coaching but think they can't afford it.  You can arrange payment details directly with them and let me know how it is to be set up. However, you must know that the client is the person I see in sessions and our work is confidential.  I will not be able to discuss the progress of their coaching with you, regardless of who pays the session fees.

How many siblings do I have? For Donor 150's children, it's 14 and counting

I've become very interested in the issue of regulations surrounding the use of donor sperm and eggs, so it was with great interest that I read an article in the Sunday Times this weekend, written by Kate Spicer.  It recounts the story of Donor 150 from the California Cryobank and the children born with the use of his donated sperm. A film about six of Donor 150's biological children, Donor Unknown, is premiering this week at the Sheffield documentary festival.  The true story is told of how six half-siblings met each other and their biological father; Jeffrey Harrison.

The children of Donor 150 became aware of each other through the Donor Sibling Registry; a website that helps donor-conceived children find any half-siblings they might have, and potentially, their father.  Wendy Kramer, founder of the Donor Sibling Registry, has been able to match 7,800 of them since 2000.  She predicts that she will be even busier as time goes on, as more donor-conceived children become young adults and want more information about their origins.

The lovely story here is that, so far, six of the 14 children known to have been fathered by Harrison now have the information they sought. They have met and developed relationships with their half-siblings; noticing similarities in their physical appearance, mannerisms and personalities. They now know where at least some of their characteristics come from. I am guessing that the association has added another level of identity to their emotional toolkit; better understanding of who they are because of where they came from.

According to Spicer, Jeffrey Harrison is a likeable beach bum and animal lover, cheerful, happy-go-lucky and spiritual. He does, however, come from intellectual stock, with some accomplished close relatives, so perhaps "his children" can trace their own intellectual and creative talents to them. While this is not their father in any sense of the word other than the use of his cells to create them, their tolerance of his offbeat ways and recognition that he is a kind and gentle person give them something on which to form a relationship of sorts.  For his part, Harrison sounds quite bemused to have a half-dozen young people who are biologically connected to him, look like him and want to know him. He says "I love the kids."

We have to wonder about the other children potentially born from Harrison's sperm, the number of which is as yet unknown.  Harrison donated sperm up to four times a week on and off for a period of eight years.  Because his profile was particularly attractive, mentioning good looks, a mellow personality and his illustious relatives, but leaving out the mention of his camper van home, Harrison was a popular choice of women requiring donor sperm. 

One of the hotly debated issues at the recent PET debate was how donor-conceived children will feel when they find out the truth of their origin.  There were a few on the panel and in the audience who thought that emotional upset, if not psychological damage, could result from a child finding out that their mother was paid money in exchange for her eggs. Others challenged this assertion, including me, believing that if the child is given the information in a sensitive and age-appropriate way, honouring the use of this form of assisted reproduction with gratitude for helping to create that child and that family, it would not be damaging. The children of Donor 150 bear this second theory out. Spicer interviewed them:

• 20 year old JoEllen Marsh (no relation to me) who is the child of a two-mother, lesbian couple, who said "If you grow up and it's part of your identity, it's cool. I'm proud. It's my story." 
• Roxanne Shaffer, 21, thinks Jeffrey is nice, with "the kindest heart."
• 23 year old Ryann McQuilton considers herself lucky that her parents were always honest with her about being donor-conceived. She believes that "keeping the truth from [children] can be damaging both to the relationship and the child's self-imag."
• Danielle Pagano, 21, was not told that she was donor-conceived by her parents until she was in her teens and has "some issues." It was Danielle who originally contacted JoEllen Marsh, when they were 16 and 15 years old, through the Donor Sibling Registry.

These young people seem to consider themselves fortunate, for the most part, to have met each other and to have met and liked the man who fathered them.

The industry in America is unregulated, so many dozens of children of Donor 150 could unknowingly be half-siblings. One of these, Rachelle, felt paranoid about the possibility of dating one of her half-siblings so chose only those of different ethnic origins. This was one of the issues brought up at the recent PET debate in London, as a reason to limit the number of children who could be born of a particular donor's gametes (sperm or eggs).  The HFEA is currently examining its UK regulations which govern donor gametes, including the issue of payment v. compensation. Currently, the law in the UK only allows for up to £250 compensation for expenses while there is a free market in the US, encouraging men like Jeffrey Harrison to sell his sperm frequently and over many years.

If UK law continues to limit compensation for donor gametes, the quantity will undoubtedly remain sparse. More people desperately wishing to create families will  feel it necessary to travel to a less regulated marketplace, such as the US, where they can choose from a menu of personal characteristics to find the donor of their choice. However, they will also run the risk of their child being half-sibling to dozens, if not hundreds, of other donor-conceived people.

If the law changes to allow a higher rate of compensation (see my blog post on the PET debate) or payment beyond compensation, more donor gametes will undoubtedly become available here in the UK. The higher cost of the gametes themselves would be offset by the money saved on international travel.  The other, equally if not more important, factor would be that the UK law limiting the number of times any donor may donate gametes is unlikely to change.  This effectively reduces the risk of half-siblings unknowingly engaging in incestuous relationships with each other. Since UK law now entitles children conceived with donated sperm in the UK after April 1, 2005, to know the donor's identity once they reach 18, the children would not be disadvantaged by being conceived here.

If this interests you, you may want to attend The Progress Educational Trust (PET) conference 'PASSPORT TO PARENTHOOD: THE EVIDENCE AND ETHICS BEHIND CROSS-BORDER REPRODUCTIVE CARE', taking place later this month, on Wednesday 24 November 2010 at London's Institute of Child Health, and there are still places available - see http://www.progress.org.uk/conference2010

I'd really like some comments on this topic. Have you seen Donor Unknown? If you have a perspective on any aspect of donor gametes, please let me know what you think.

More UK celebs talk about IVF; Jacqueline Gold's bittersweet story of life and loss

The other day, it was Emma Thompson talking about her IVF in the weekend papers and yesterday it was Jacqueline Gold, known as the dynamo who turned UK lingerie chain Ann Summers into a mult-million pound business. But, whereas Emma's IVF in her early forties was unsuccessful, Jacqueline gave birth to twins at 49. Sadly, one of Jacqueline and her husband Dan's babies, Alfie, died at eight months old in March of this year. Jacqueline spoke to a Sunday Times reporter, Laurel Ives, about their experiences.

By all accounts, Jacqueline Gold has always been a driven businesswoman. However, beyond the public eye, she and her boyfriend Dan started trying to conceive almost immediately after they met ten years ago. Quickly realizing that they would need the help of assisted reproductive techniques, they decided to undergo IVF. The stress of three failed cycles over a period of five years led to their split. Jacqueline's career at Ann Summers took over until she and Dan re-united two years later and decided to give IVF another chance; this time in the States. This time, the IVF worked and they conceived twins, born in July 2009. Unfortunately, though, theirs is a bittersweet victory over infertility.

While Jacqueline was pregnant, doctors discovered that one of the twins had a rare condition, alobar holoprosencephaly, which causes severe brain damage. Jacqueline and Dan opted not to terminate the affected fetus as they were worried about its risk to the healthy baby. No one expected the fetus to survive outside the womb. When Jacqueline gave birth to both twins, she was devastated to find out that Alfie, the ill baby, couldn't see, think or feed and was in constant pain. The next eight months were a mixture of joy with daughter Scarlett and pain on seeing Alfie suffer.

Jacqueline Gold is obviously a very strong woman. She has had to move on from a the life-altering experience of the death of her child, and according to the Sunday Times article, is doing very well. Here are some of the things to which Jacqueline attributes her healing:

• the love and support of her husband Dan, who she married two months after Alfie's death
• knowing that in his eight months of life, Alfie was well cared-for at the Children's Trust Tadworth, that his pain was managed and it gave her the time to know him
• creating a pirate-themed treasure chest for Alfie's mementoes
• her work, which gave her some normality
• that she was able to hold Alfie and say goodbye as his feeding tube was removed
• being a mother to Scarlett, now 16 months old

Jacqueline also spoke in the article about their experience of IVF, which I pass along here so that those who are going through it now, know that they are not alone in finding it difficult:

• She may have pursued her career vigorously during her fertile years, but the delay in trying to conceive was also about her personal life, "when you're older you're more confident, relaxed, resourceful and having the right partner is very important." She met husband Dan when she was 40.
• "IVF is such a rollercoaster. There is a big build-up and then such disappointment - it can be overwhelming."
• "[Y]ou don't have enough time on your side to take a year off." In one IVF cycle, Jacqueline had embryos implanted the day before her mother's funeral.
• After 3 IVF cycles, she and Dan split up for 2 years. "We had stopped communicating...everything had just broken down."
• They went to America for their final round of IVF "They are so much more supportive and positive about the process there, and the success of the treatment has a lot to do with how you are feeling."

There are lessons to be learned in Jacqueline's words, above.

1. A balanced life and a relaxed, empowered attitude are important ingredients in the "readiness" that many women seek;
2. Good paths of communication are essential to a healthy relationship in the face of stressful fertility treatments;
3. Pay attention to what else is going on in your life and how it might affect your chances of conceiving. A time of grief and emotional stress is not going to be the optimum time to focus all of your positive energy on conception; and
4. The support and trust in your medical team can have a positive effect upon your acceptance of treatment and eventual results.

On a final note, I would have added the link to Laurel Ives' article in The Sunday Times Style section, however, I was unable to get it without paying to subscribe online. Since I already pay for my subscription to the paper copy, I wasn't willing.

Two heads are better than one; Avoiding the pitfalls of difficult decision-making

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: 

1. write out what you want to talk about;
2. practice what you want to talk about out loud first;
3. hold off the conversation until your partner has had a chance to unwind; and
4. 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:

1. what one person can't provide their partner; a biological child, the experience of being pregnant, or being parents at all; and
2. 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.

 

Why hire a fertility coach when you can get so much free support online?

Recently, I was telling a friend how wonderful it is that there is so much free support available to infertile men and women online now. Back when my husband and I were confused, ignored, restricted and misinformed, we could have used more extensive glossaries of fertility terms, knowledge of research and medical practice going on in the UK and elsewhere, independent ratings of fertility clinics, price comparisons for fertility treatment and emotional support. It's all changed, thank goodness.  Technology now allows access to infertility websites and their forums whether you are in America or India, independent blogging and the exchange of information on social media networking sites Twitter and Facebook. The IF community and those that serve it, have embraced the internet wholeheartedly and it works because it brings it all to you, whenever and wherever you are, as long as you have access to a computer or a Smart phone.

I must have been preaching like one of the converted, naming my favourite sites, describing my networks, relating some of the comments I have received on this blog and proudly tallying up my Twitter followers for my Your Great Life page (877 today!). When I stopped to draw in air, my friend asked if I wasn't kicking myself in the pants by making so much of my support and resources available online for free. Not only that but, she wanted to know, why should someone hire a fertility coach at all, when you can get so much support online from so many sources? I have to admit that I felt hugely disappointed.  Not that I haven't asked myself similar questions when assessing where my service fits in and its value. I suppose I believed that, by now, most people understand the difference between customized, personal coaching and general support.

I have great confidence that fertility coaching isn't an either/or proposition. In fact, I routinely provide lists of online resources to infertile people as part of my coaching, to get them moving in the right direction. I was able to explain to my friend why fertility coaching is an unparalleled method of information and support, and share with you here why I believe it is so worthwhile.

~

Isolation - Whether you are just starting to think you may have a problem conceiving or have already begun investigations of your fertility, chances are that you are already hiding from people. It starts with not wanting anyone to know you are trying so they won't keep asking "when."  As time goes on, and friends, colleagues, sisters and neighbours announce their pregnancies, what do you do? I remember ducking into supermarket aisles, making excuses for refusing invitations and dodging a ringing telephone at my parents' house. It's worse now; we are all so in-touch that it's hard to keep our movements confidential and privacy lines have blurred.  It's tempting to widthdraw, but what starts as self-protection can easily turn into excessive secrecy, covering up with lies and the loss of valuable friendships and contacts.

It's tempting to withdraw from people entirely, rather than face the discomfort of having to talk to others about your infertility, but isolation will work against you.  Even if they aren't asking intrusive questions, you may imagine that they are thinking about you and why you aren't pregnant.  Instead of building up paranoia, suspicion, embarrassment or shame, a good coaching relationship allows you to air those thoughts and feelings with someone who isn't judging you.  If there are people from whom you must take a break, a coach will help you decide how to manage those relationships so you don't lose them entirely. It puts you back in control; instead of dodging old school pals or friends of your mother, you effectively communicate only what you want to be known.

The compare and contrast exercise - I won't lie. Inevitably, there will be people out there who wonder why you aren't a mother yet. They may be basing their curiosity on your age, the length of time you have been involved with your partner, the level of your career or how often they have heard your mother moan about wanting grandchildren. However, I guarantee you that you are doing more comparing and contrasting of yourself to others than is being done about you. The prevailing response on internet forums, blog replies and Twitter seems to be "I understand. I have experienced that too. Isn't it (or she) a bitch?" Occasionally, the voice of reason will be heard, giving you another perspective on an upsetting situation. They all help, because it feels good to know that you aren't alone. The strength of the online community is in the sisterhood and its value is undeniable. 

However, sometimes your self-esteem needs actual change for the better, rather than just propping up.  Negativity affects your wellbeing, whether it has an internal or external origin. Having to deal with negative, or even cruel, comments from others will certainly upset and stress your system. Self-talk like "I'm not one of them," "They're talking about me," or "I'm not good enough." will do just as much damage, as you are conjuring up your own negativity and will eventually believe it.  Coaching tools can turn this around:  CBT helps you re-program your thoughts with more self-belief and positivity; while NLP visualisations can banish your negative images and replace them with ones that imprint the mindset you want to have: hopeful, focused and committed.

A Support Network - I encourage infertile clients to actively seek a good fit within the online communities. Each has its own personality, its own rules.  Some forums have moderators or resident experts who will respond to your posts, while others are known for its loyal cheerleaders who will do everything they can to lift your spirits if you care to have a moan.  If you are obsessed with the numbers...days, temperatures, test results... there are applications that can help you log them and  blog templates where you can list them all in chronological order in the sidebar. Blogging may give you the opportunity to use writing as a means of stress-relief and healing. If you crave a conversation in real-time, Twitter or Facebook may provide you the immediacy you need. Joining a conversation can help you feel less separate and lacking and more connected, which will aid your sense of wellbeing.

Not everyone has the confidence to launch themselves and the intimate details of their infertility or the fall-out in their relationship online. For those of us familiar with the daily flow of online conversations between recognized users, it can seem almost cosy.  For the person who is suddenly faced with the worst news they could possibly imagine regarding their health and their dreams of a family, it can seem exclusive, with a language and etiquette all its own. I help clients find the right sites for them, find a comfortable balance between complete anonymity and their true identity, and keep their use of the internet from eclipsing their real life.

It's especially important that you don't replace (and shut out) your partner and long-term friends completely with online friends who seem more understanding. You have to remember that the dynamics of your relationship will have changed as your focus has shifted to your infertility. You may feel you aren't getting everything youneed from the,; remember, that you may not be giving as much now either.  I help clients achieve clarity about their needs and maintain worthwhile relationships in a healthy way that is mutually satisfying.

Filling empty spaces - For those whose family, peer group or cultural community makes living publicly with infertility seem an impossibility, I work with clients to create online networks that will provide them with the support they need.  I believe that the creative outlet provided by blogging can re-establish feelings of self-worth, however, it may not be immediately obvious to those who are not naturally expressive or who have limited their expression to a private journal. I work with blogging as a means of helping clients  communicate their emotions, find positive feedback amidst their own negativity and heal through helping others with their words.

It's easy to forget that you need support in real-time too. Support can come in the form of a kind word, a welcome night out, an alibi when you don't want to attend a function, a listening ear or even a referral to the right doctor, pharmacy or support group. I help clients identify those around them who may otherwise be overlooked, teach them how to ask for help and how to graciously accept it when offered.

Effective Communication - A common theme running throughout the conversations of many infertile people is the inability to make themselves heard. You may not feel you are on the same page as your partner, which can be devastating if you previously shared a vision of the life you wanted. You may feel you are treated as an anonymous number on a medical chart when you go to your fertility clinic. In trying to lay down boundaries with your parents, in-laws and other relatives about what you would like them to refrain from discussing with you, in your presence or about you, you may feel like you are banging your head against a brick wall. In fact, on this last note, infertile people are often made to feel they are in the wrong for wanting to keep details private, for being overly sensitive and for refusing invitations to parties and family dos.

If you want to lay down new rules, while not alienating anyone involved, its essential that you communicate them effectively. You can't expect everyone to understand exactly where to draw the line between pretending that your problem doesn't exist and continously showing an interest in your welfare. You have a right to your privacy, but keep in mind that you will need support and that comes in all shapes and sizes.  Shutting down, pushing people away, having tantrums or snapping people's heads off with sharp words won't bring that good karma toward you. Instead, I help my clients create several statements they can rehearse and have at the ready for every situation they may face.

There is some danger in having a good bitch or moan on the internet, because well-meaning supporters are apt to echo your sentiments: your sister-in-law is a bitch for getting pregnant first, your old school friend has made an unforgivable faux-pas by posting her baby shower photos on Facebook, your Other Half has betrayed you by suggesting that you stop treatment.  It's so easy to build up resentment and easier than ever to purge it.  However, unconditional validation isn't always what you need. You don't want to harbour hateful thoughts and the turmoil that goes with them when you are trying to conceive your baby. Yes, stand up for yourself, but in a way that allows you to retain your dignity, self-respect and inner calm.

Additionally, some IFs have been lulled by the freedom of expression on the internet.  If you have been criticized for something you have written, had an overture of kindness rebuffed or been the target of a backlash for your opinions, I can help you explore individual incidents, allowing you to reveal the players' relative responsibilities for the way they played out, including your own. The idea is not to let upsetting incidents take on a life of their own, disrupting your focus, peace of mind and health.  

Decision-making - At every stage of your infertility, from those first inklings of a problem, through the medical investigations and during fertility treatment, there will be decisions you may not feel properly equipped to make on your own. The beauty of the internet's reach is that you will undoubtedly be able to find other people who have stood in your shoes. It will give you ideas, options, perspectives, successes and failures to consider that may have some bearing on what you eventually decide.

It's essential to remember that what is right for someone else isn't necessarily the answer for you. What infertile people have in common most is the inability to conceive and give birth to a child of their own. Beyond that, although you my have a similar condition to someone else, your circumstances taken as a whole are unique.  The presence of one factor, whether an incurable condition, your access to quality medical treatment, your age, finances, the unconditional support of your parents or a friend, being single, religious values or an unsteady relationship, can make a huge impact on your attempt to conceive and your sense of wellbeing. 

By and large, the biggest factor influencing your decisions is that for m ost people, those decisions are made with a life-partner or spouse. Automatically, the process becomes more complex, necessitating some discussion, negotiation, compromise and agreement.  The process of decision-making has the power to solidify the bond between a couple or break it apart.  What happens when you are unsure of what to do, but your partner has a strong opinion? In times of vulnerability, the pressure can be intense. An imbalance can cause decisions to be yielded to the person with the stronger voice.  Being persuaded to do something that is uncomfortable can cause problems later on, bringing up emotions such as resentment, anger and guilt. It's my job as a coach to ensure that the values of both partners are considered, even if I am only coaching one of them, and that the reasoning is valid. Whatever you are going to do has to work for both of you, or it won't work at all.

Stress-relief - Everyone knows that the stress of infertility can be damaging in itself. If you didn't feel particularly stressed before you tried to conceive, you will surely make its acquaintance once you perceive a problem. This is one area in which the  online community really delivers: post a comment about how you are feeling and you will undoubtedly get a soothing reply. Be specific about the source of your stress and someone will share their own experiences with you and offer practical suggestions. Post an anguished cry for help and you could be answered by an empathetic follower, a seasoned member of the IF community, or a professional. 

The immediate relief from stress can be realized from the online activities discussed here. A funny comment, a comforting word or a meaningful connection will all help. Coaching reaches below the surface to find the source of your stress, then gives you the tools to eliminate it. This distinction, as much as any other, illustrates the benefits of fertility coaching, if you find you need more personalized understanding and support, as well as more lasting change, than you can get from the internet. If you would like to explore it further, please feel free to contact me by email or phone to arrange coaching.

 

How and when do you begin again after pregnancy loss or failed fertility treatment?

Are we going to try again?

After the disappointment of a failed IVF cycle, or the shock and grief of a miscarriage, the inevitable question hanging in the air is "are we going to try again?" It may be a given that you still want a baby, however the criteria for whether you are going to try to conceive and carry a pregnancy will have been affected by the recent lack of success with IVF, or the terrible end of your pregnancy. Whether you are on your own, or with a partner, the criteria you use to make your decisions may have changed and need to be looked at again. You must consider your current health, age, fitness, need for medical intervention, financial position, other commitments and your doctor’s advice. Assuming that you have decided that you do want to try to conceive again, naturally or with assisted reproduction techniques, the next set of decisions will be about when you begin trying.

Your timing

“When can I try again?” is one of the first questions that will come up in a woman’s mind once she has determined to pursue another pregnancy. Opinion, even among medical professionals, varies. Some doctors will say that, all being well, 3 months is a good amount of time to wait after a miscarriage. Others will suggest that an otherwise healthy patient wait until after she has had one menstrual period before trying to conceive.

Healing needs to be deep and complete

Miscarriage and fertility treatment are both hard on the body and can cause you to feel physically depleted.  This is exacerbated by the emotional toll that they take. It isn’t unusual for a woman to feel that she wants to, or has to, jump right back in and try again and simultaneously think that going through this process again is the last thing in the world she wants to do at that moment. Have you ever felt torn in that way? The reason for this dichotomy can be that you have not recovered fully and need to build up your strength and stamina. It may be worth asking your GP for a once-over health check, paying attention to your appetite, sleep, energy levels and hormone levels.

When I say that healing needs to be deep and complete, I do not mean that you should feel completely "over it." Grief and sadness are healed through the re-discovery of your own purpose, other blessings in your life and the perspective of time. The completeness I refer to is more about having thoroughly examined your feelings, your intentions and your values and decided that a pregnancy is still what you want to pursue. There are other options; alternative paths to parenting. Examine them, if only to rule them out, and then proceed with your next attempt to conceive.

Your emotional wellbeing

It could also be that you are putting on a front, trying to fool yourself and others about how you are really coping. What you say and what you truly feel must be congruent, or the result could be additional stress, sleepless nights and high emotion.  There may be no doubt that you want a baby, but being pregnant may be another matter entirely. Do you feel resilient; as if you have been able to pick yourself up, put your disappointment aside and look forward to the future? Or, do you feel fearful or hopeless? Your thoughts will affect your behaviour and very possibly, your outcome. 

If you are trying to conceive, while simultaneously thinking that it will never happen, or that it will end disastrously, you are draining your positive energy away from your goal. You are literally telling your body, that it will not function the way it is meant to do and reinforcing that message every time you let your mind obsess in this manner. Ovulation does not occur in a vacuum; it is dependent upon signals from your brain to your ovaries. Additionally, the stress caused by negativity has been known to interrupt reproductive function, which may affect your periods, ovulation, fertilisation and/or implantation of the embryo.

Your negative thoughts, sadness, anger and stress are all understandable responses to either a miscarriage or the disappointment of a failed IVF cycle. How quickly you move through various feelings or thought processes to a state of readiness is unique to your circumstances and how you respond. You may feel conflicting emotions and be confused as to whether you are ready to try to conceive again. If so, you are a prime candidate for fertility coaching. A fertility coach can help you isolate your feelings about your miscarriage or IVF experience. This can help you prevent or reverse the spill-over into your abilities, body, medical treatment, relationship and future.

Are you both ready?

It isn’t unusual for two people in a relationship to have different ideas about whether they are ready to try to conceive again. On the one hand, the woman may (erroneously) believe that the previous attempt is her fault and feel the need to make up for it or prove herself. She may be itching to try immediately, in contrast to her partner’s more measured approach. Even if this self-blame is not present, she may feel there isn’t any time to waste. Only she can truly know how strong and physically healthy she feels, so her partner is reliant upon the information she provides.  A partner may be concerned about her health and want to ensure the safety of a subsequent attempt to conceive.  On the other hand, I have had female clients whose partners want to sweep it all under the rug and move forward as if nothing has happened. She may be unready; lacking in self-confidence and feeling unsupported.

Support when you need it

If you think your partner doesn't feel a part of things anymore because of all the attention you have needed, bring him back in.  A joint visit to your GP or gynaecologist could help clear up some confusing medical or health issues, inform you as to the possibilities still available to you or give you the green light after test results have been received. Make sure your partner knows that this is about both of you, and that you won't go ahead until you are both comfortable. If you are ready and he is hesitant, take positive steps to find out why and reassure him.

The best advice I can give any couple in this situation is to talk. Be open about how you feel, what the loss meant and how you want to proceed now. If either of you are unable to communicate effectively without someone teasing the words out of you, get someone to act as a facilitator. A good fertility coach will help the two of you say what you really think and feel; not imposing her own ideas or taking sides.

Breasts, bras and boys - all to come for you and your preteen

No. 3 in a series: Single fathers raising, caring for and talking to pre-teen daughters about their body

Way before breasts begin to appear, like little soft hills on the flat landscape of a girl's flat chest, she will have an awareness that she is different from her brothers and male classmates. It might seem that awareness has always been present, from when 3-year old girls dressed up as fairy princesses and 3-year old boys showed a preference for any game that made a lot of noise.  That's a completely different thing, due in part to the way they were treated by adults and gifted with dolls or trucks. Physical awareness of gender is inseparable from the child herself. Most girls and boys know innately who they are and identify strongly with members of their own sex, without knowing anything about breasts, vaginas or penises.

The self-consciousness that comes with a girlish growth spurt, dictates that you mustn't run around topless with your boy-friends on a hot day because someday there will be breasts on your torso and not on theirs. Probably at about six or seven, a girl no longer wants to take a bath with her brother unless he is still a baby, but she'll still fall about in a fit of giggles after streaking naked through the house with a hat on. By eight years old, she will close her bedroom door to get dressed and will hide if you open it.  At nine, she is likely to want to wear a pretty half-undershirt that resembles a bikini top, regardless of the fact that there is nothing there to cover. But, by ten, she wants it so that she has another layer between her body and the boys' glances. 

If you are raising your pre-teen daughter without a woman in the house, you are also likely to be buying her clothing.  If you haven't noticed a change in your daughter's figure, you probably think you are safe for a little while longer; before undershirts give way to bras and shoes get heels.  That's a mistake:  At about ten years old, (Year 5 in the UK, th grade in the US) your daughter is observing other girls for clues as to what is expected of her.  She is trying to figure out how she can be similarly equipped without having to ask you outright.

Wake up Dad! This is the most confusing time for a girl and even more confusing for both of you if her mother is absent. Puberty brings moodiness; emotional swings and round-abouts. Girls sneak peeks at each other at school or swim practice, curious to discover their level of physical maturity, their place in the social hierarchy and their style, including:

• whose first hint of breasts shows through her top;
• who turns away from the others to undress for PE;
• who wears an actual bra;
• whose bikini underwear has come from the teen department rather than the Disney store; and
• who is wearing a coveted label (Thank G-d for school uniforms).

If you're open-minded about what you will find for her, and sensitive, there's no reason not to take her shopping yourself, but if you feel out of your element, why don't you ask her to nominate someone else to help her.

Your daughter needs a confident guide for this particular journey. It's not as simple as just buying your daughter the first training bra you find. If you lack confidence in relating to your girl about her body and/or her clothing, find someone who has it to spare. This is where my Single Father's Toolkit comes in handy again. The second tool on the list is "friendship with the Mom of at least one of her friends." Talk to the nicest Mom-friend you know and ask whether her daughter has brought up the subject, and what "grown-up" activities she is doing, i.e. shaving, wearing a bra, using deodorant, experiencing the odd pimple or getting greasy hair.  Ask her to keep you in the loop so that your daughter isn't left behind. She may not be the right person, though, to talk to your daughter or take her shopping.

Ask your daughter to which Mom it's easiest to talk, or whose style she admires. If you feel comfortable with her choice, ask her if she will take the girls shopping and help your daughter pick out what she needs or wants at the same time as her friend. There has to be a trust between them; that she will give it generous attention and help her find "the right things," right not necessarily having a literal definition.

This is still about breasts; visible and undeniable emblems of being female and of femininity. This can be very difficult for a father to accept. There is the sense, that she is yours to protect until you feel she is ready for a relationship with a young man. It's a shock to realize that her body will proceed with its development, with or without your approval. Likewise, you won't want her body to draw male attention, but it will. If you try to keep her in little girls' clothes or display any disapproval of her body, you are in danger of undermining her efforts to accept the changes she is experiencing. She needs to feel proud of herself, inside and out.

It's about acknowledging that she is growing up, while understanding that she will still act childish sometimes. It's about her feeling confident that she will always be loved no matter how she changes. It's about accepting why she has to have whatever the other girls have.  Peer pressure is a big influence to a young girl; she doesn't want to be the only girl with discernible breasts, but doesn't want to be the last girl to get them either. By all means, have those heart-to-hearts about anything she wants to discuss. Positively acknowledge the changes in the rest of her body: her face, waist, hips, legs, etc... so that she can see her breasts as part of the entire, nearly teenage package.  The goal is to help her stay positive, accepting, responsible and confident; actually that is your goal too. Tread carefully, and keep love in your voice.

Something went bump in the night - Pre-teens and Pimples

No.2 in a series: Single fathers raising, caring for and talking to pre-teen daughters about her body

As your daughter approaches puberty, changes are bubbling and brewing under her skin, waiting for a chance to erupt: pimples and breasts. OMG!!! That would be a typical reaction on her part..."I can't go to school. Daddy, please write me a medical absence note."  Hopefully, she isn't the first child in her class to get either of them. You may want to start praying now that she is neither the first, nor the last of the girls in her class for either type of new growth.  At lease, let someone else's child go first, pleeeease. Today I'm talking less about pimples, than about how you, as a single Dad, can help your daughter cope with some of the less welcome aspects of growing up.

If there aren't any women or older sisters in your daughter's life and it's all down to you to help her through this coming-of-age trauma, G-d bless you. Think back to your own pre-teen time and try to remember how you felt when your very first, red, shiny and possibly painful pimple took up residence on your face. I think it's fair to say that most of us approached the mirror with a mixture of curiosity and disgust and then checked every 5 minutes to see if it had gone yet.

She may try to deal with it on her own first. You may find "pimple" in the history of her Google searches. She may be whispering into the phone a lot.  I advise you to pretend ignorance before she brings up the subject herself, no matter how glaring the mini-mountain.  If she pretends that the pimple isn't there, you would be best to ignore it too. The positive message you are giving her is that if she's not bothered, you're not bothered.

But, what do you do if your daughter reacts as if Mt Vesuvius is erupting on her nose? Panic. Evacuate. The sky is falling. The way that you respond is crucial to this second test (first was hygiene) of your new relationship. "What new relationship; nothing's changed" you might ask. It surely has. Before, you were the father who picked her up from a fall, kissed the bruise and put a Band-Aid on it, reassuring her that everything would be fine.  That will not placate her now. Instead, you must be careful:

• Don't use more negative or exaggerated words than the ones she uses;
• Don't react emotionally. Do not say "you're growing up. You're not my little girl anymore," because that will confirm her worst fears (that comes in my next post about breasts). She wants you to help, protect and support her; or
• Don't laugh, say she is over-reacting or call her silly. Her face has been smooth, soft and unadorned all of her short life thus far. Now she has a Christmas tree bauble on it.

Equip yourself with both emotional and practical tools for parenting in this area, traditionally the domain of mothers.

In your Single Father's Toolkit, make sure you have:

• familiarity with a good search engine,
• friendship with the Mom of at least one of her friends,
• knowledge of which pharmacy and/or supermarket is open late,
• familiarity with trusted names in skincare,
• calm, patience and wisdom, confidence; and most of all
• time and attention to devote to your daughter. 

Back to that pimple now. If she is hysterical, or extremely low, comfort her. Look your daughter in the eyes and keep calm, speaking to her with a soothing voice. Be patient. Don't drop away. Eventually, she will calm down too. If she seems able to listen, tell her what causes a pimple. If you know what something is or how it works, explain. If you don't, it's not necessary to bluff. You will earn much more credibility by being honest, so look it up together, or ask if you can talk to her a little later.  Patiently, explain to her how to keep her face clean and not to scratch, pick or otherwise attack her pimple.

The most painful part of having pimples is the social aspect of it. She still has to go to school.  She will probably worry that she will be stared at, teased or called a name. Even if there's not a boy-crush to worry about, other kids can be insensitive or even cruel when they see a sign of vulnerability. It's not necessarily going to be bad, but you can't promise her that it won't happen. Remind her that she has friends there, who care about her feelings. Reassure her...if her classmates haven't had one yet, their time will come. She will have an opportunity to be kind toward them, adopting a stance of blemish-blindness; what you pretend you don't see becomes invisible.

Next up is my discussion of how to cope with your daughter's feelings about her breasts

Single fathers raising, caring for and talking to pre-teen daughters about her body

Personal hygiene: No. 1 in a series about girls growing up

If you are a single father, raising an adolescent or teenage daughter on your own, having a talk with her about her body can be really difficult.  It's hard to know when is the right time. Do you arrange a conversation the moment you notice a slight roundness developing where breasts will be soon? You both may be appalled to realize that you noticed. This is your little girl. You want her to be informed, responsible and savvy to the threat that is called "teenage boys." You want her to stay your little girl. How do you reconcile the two?

These days, the school curriculum includes sex education for children who are 9 to 10 years old. It seems so young, but if you have done the school run lately, you will notice that 10 year old boys look like someone has grabbed them by shoulders and feet and stretched them to an awkward height. Girls' legs are becoming shapely and they are noticing some hair on their legs.  Both the boys and the girls are whispering about crushes one minute and furiously playing dodgeball together the next.You may find some hearts with scribbled-out names inside her notebook. Do NOT panic.

Dad, I'll make it easy on you by listing the topics you may need (even if you don't want) to explain.  Do not assume what she knows, what her friends talk about in the playground, or how much of the sex ed class she heard while burying her flaming cheeks behind her fingers. There is no hard and fast rule that says you have to do all of the explaining yourself.  However, if you are chief cook, laundryman, shopper and source of comfort to your daughter, you are responsible for making sure she is informed, in the most positive way possible.

This is where you may need some help from a sister, aunt or close female friend.  Don't completely pass the buck, but

1. talk to one of the women in your daughter's life and ask if she is willing to be the touchstone for your daughter's questions.
2. Each time you introduce a subject, ask your daughter if she would prefer talking to you, or the woman you chose. 
3. Break it down into bits, because (cue the sirens and flashing red lights now) telling too much at once is too much information. If you attempt to give her the top to toe explanation too quickly or too much in depth, it's likely that she will say "T - M - I!" (too much information)  Stop, right there and then. The topic will come up again when she's ready.

That being said, there are practical reasons why you need to discuss personal subjects. First up is hygiene. You may feel shocked the first time you smell body odor while hugging your little angel or bringing her laundry down to the washer. Get over it quickly. Too much attention paid to this and you will have lost her before you start.

Calmly, bring up the subject of deodorant/anti-perspirant, for instance: "have any of your girlfriends started using deodorant?" If she is ready for this conversation, explain why underarms smell (Google it) and how washing is important. Take her to the shop and let her look at the bottles of deodorant for awhile and smell them until she finds one she likes. Remember to tell her that deodorant goes on after a shower, not instead of one.  Whatever you do, do not tease her.  She may seem either disgusted or relieved that she knows what to do, or both, and possibly even a little proud of having hit a milestone in her life.

Dad, listen closely. Do not think about killing 2 or 3 birds with 1 stone; there is no need to discuss pimples, vaginal cleanliness and feminine hygiene products all at the same time. One step at a time, or you will lose ground. Do not buy overly scented items, inappropriate for young girls and a possible source of skin irritation. People who clean themselves regularly should not need to use feminine body spray. Anyway, they usually smell like air freshener meant for the toilet. Just give her moisturizing soap of her own that you do not use for her body. Tip - young girls can be rendered hysterical by one stray, adult, pubic hair on a bar of soap.

Come back this week for my next post on single fathers and pre-teen/early teen daughters. Future topics will include:

• Breasts and bras;
• Shaving, bleaching and clipping;
• Moody blues (door-slamming);
• Periods;
• The talk about sex; and
• Privacy (no one in her knickers but her)

Oh, please leave a Comment below if there is anything else you want me to blog about in this series.