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Stepmums can be denied NHS fertility treatment

This morning on The Wright Stuff, presenter Matthew Wright posed the question whether stepmums should be denied IVF treatment because they have (someone else's) children in their life. This isn't the first time I have heard of this. There have been occasions in the past when Primary Care Trusts (PCT) have denied fertility treatment to women whose husbands already had a child, albeit with another woman, or who have had children themselves in previous relationships. It's an example of bureaucratic policy making that doesn't take into account the human experience of the people it is meant to serve.

Susi Henson, a 33-year old woman has been denied IVF because her partner has a 20-year old son from a previous relationship who she has never even met.  This seems like blind adherance to a rule that does not take into account her medical condition, Polycystic Ovary Syndrome, that prevents her from conceiving. The Nottinghamshire County PCT has ignored the true facts surrounding this woman's childless status, in favour of a view that this is not a "childless couple."  However, in no way could Susi Henson ever be considered to have had the opportunity to parent her partner's child, considering that he is only 13 years younger than she is and lives in Wales. 

Some of the points made by Wright and his guests, including Anne Diamond, concerned the limited NHS budget, whether everyone has a right to have children, whether everyone who needs IVF should be able to access it free and how many cycles of IVF should be alotted per patient. There will always be controversy, as long as individual PCTs can use their own criteria for eligibility. For instance, Wright mentioned that about one-third of PCTs will allow patients who are smokers to access IVF, even though smoking is known to inhibit conception, raise the chances of miscarriage and impact upon the health of the foetus during pregnancy and after birth. It is, perhaps, the uneven and confusing allocation of fertility treatment that galls people the most. 

A caller to the programme, Katie, was also denied IVF which she needed due to blocked fallopian tubes because her partner had adult children.  She eventually managed to save the money for private treatment and is now the mother of a 5-month old baby, but considers the financial hardship it caused to be unfair.  Susi Henson phoned in to the show to say that she has received a lot of public support, as well as a phone call from one of the policy-makers who has promised to review her case and the PCT's policies on IVF treatment. However, the policies are only reviewed in April each year. Matthew Wright emphasized the inadequacy of this offer, pointing out that the delay of nearly a year could negatively impact upon Henson's chance of conceiving, as age is an essential aspect of a woman's fertility.

Even if a woman is the stepmother to her partner's young children, and partially responsible for their upbringing, should she be denied the ability to have her own children? By definition, those children have, or had, a mother already. Step-parenting can be difficult and is not always loving or even cooperative, depending upon the degree of amicability between the estranged parents of the children involved, custodial arrangements and other emotional factors. While step-parenting may fulfil some women's needs, others will never see it as an adequate replacement for the experience of giving birth to, raising and loving her own children. Further, it is entirely natural for a couple to want to create a family of their own.

If a woman meets all other criteria for fertility treatment on the NHS, and it is deemed medically necessary in order for her to conceive, it seems cruel and unjust to deny her that chance. Most women have no inkling of their infertility until they have begun trying to conceive, therefore, they will not had the chance to take it into account when agreeing to marry someone who already has children from a previous relationship.  Ironically, they may have had an easier time accessing NHS treatment is they were single, as many PCT's will allow IVF to single women.  This is symbolic of the incoherence and uneven-handedness of the present policies existing across the UK. If we are to ensure a fair allocation of NHS funds for fertility treatment, wouldn't it be better to look at the people concerned and make more individual decisions? Matthew Wright thinks an IVF ombudsman could work. I like the idea of individual, people-centred decision making, but I imagine I can already hear cries of alarm about the cost involved in that: how many IVF procedures could have been paid for with the salary of the ombudsmen?   

Sperm Donor Unknown on TV (UK) tonight

Sperm Donor Unknown is the fascinating story about how a group of children born via sperm donation found their biological father, and each other, through the Donor Sibling Registry Website. It airs tonight on More 4 at 10 p.m.  I've written here previously about Jeffrey Harrison and the 14 children he fathered in the 1980's as a way to supplement his income, in How many siblings do I have? For Donor 150's children, it's 14 and counting. The story of genetic connection isn't cut and dry; it involves real people and feelings, the exploration of identity, discovery and acceptance. This is what I will be watching tonight.

What's on TV?

It's possible that you are feeling as bereft on weeknights these days as I am over the end of Masterchef and, dare I say it, Embarrassing Bodies. While I enjoy having it on while I'm preparing dinner, Great British Menu doesn't have the same sense of drama as Masterchef, the kitchen isn't as swish and the chefs/restaurant critics/judges lack the personality to make you want to watch every episode. For the first time, my daughter and I couldn't call a winner this year on Masterchef, finding merit in all 3 candidates (Tim, Tom and Sara).

On the opposite end of the spectrum, nothing comes close to the wierd, unattractive and, frankly, yucky aspects of our health and bodily welfare on Embarrassing Bodies, presented by the very likeable Dr Christian, Dr Pixie and Dr Dawn. While I sometimes have to watch with my hands over my eyes, I'm fascinated by the untreated conditions that people keep secret for years, only to show millions of TV viewers, including growths, excessive body hair, "moobs," fungi, bowel disorders and skin conditions. I would go for the privacy of an appointment with my GP any day over sharing en masse. Is it that people don't have confidence in their own doctor, but are comforted and emboldened by the approachable bedside manner of EB's 3 medical presenters?

I've learned quite a bit of quasi-medical information which will hopefully stand me in good stead over the years, including preventive care (not the UK's strong suit) but what fascinates me is the link between bodily function, appearance and self-esteem. What causes people to keep their conditions hidden, to their own detriment? Some have lived 10 - 20 years with discomfort, pain, bad odours, inconvenience and embarrassment that could have been cleared up if they had sought help. Others, unfortunately, didn't receive the best help when they did inquire and didn't seek a second opinion until now. Fear of what the offending body part might mean to their health is a factor, for sure. Shame also plays a big part. Some of the visitors to the Embarrassing Bodies Clinic visibly blossom after treatment; a huge weight lifted off their shoulders. My husband leaves the living room in despair when he realizes that I won't change channels for love or money. If you live in the UK and haven't seen an episode of Embarrassing Bodies (is that possible?) or if you want information about an aspect of your own health or body, go to http://www.channel4embarrassingillnesses.com.

Good news then, that this week there is some worthwhile TV viewing this week. Ha! I laugh, because it all comes at once. On Thursday, May 5th, you can pin your hopes on one of the remaining 5 contestants on American Idol (ITV2, 7:30 - 9 pm), marvel at how pretty judge Jennifer Lopez is, how gentle and sweet judge and former Aerosmith band member Steven Tyler is and wonder what Simon Cowel thinks of Season 11, the first without his input. If you prefer something more educational and fertility health-related, the alternative is 'Is Breast Best?' on BBC3 at 8 pm, exploring the debate over breast-feeding. I may have to do some channel-hopping!

Another dilemma at 9 pm that evening. 'Inside the Human Body,' on BBC1, promises us a view of the moment of conception and the sequence of events leading to birth. I'm hoping that they handle this subject well, because the more information people have about their fertility health, the better prepared they will be when they approach conception and pregnancy themselves. At the same time, on ITV1, is 'Long Lost Family.' This is the emotional tearjerker of the reality show season, reuniting long-lost siblings, adopted children with their birth parents, etc... It's lovely. I like a happy ending and they do it well. Hopefully, you know how to record a program (unlike me) and won't miss either. Happy viewing.

Smiling on the outside; healing on the inside

I saw some wonderful photos of Amanda Holden on one of the morning TV chat shows today.  She's glammed up to promote the Euromillions lottery and looks absolutely gorgeous. If you only saw the photos, you would think that this woman doesn't have a care in the world. You wouldn't suspect that she has recently been through the emotionally devastating loss of her baby.  My first thought was complete admiration for her resilience; my second thought was that I hope people don't misinterpret Amanda's appearance as signalling that she is completely "over it."

I don't personally know Amanda Holden, Lily Allen or any other celebrities whose pregnancy losses have been in the news this past year.  However I, like many others, sometimes feel like we know these people who appear on our TV or cinema screens, feature in our glossy magazines and in advertisements. It's important to realize that we can't take them at face value and infer emotions from their big smiles, worry- line free skin, slim bodies and glamourous outfits. That is their job. Not only that, but those photos are carefully choreographed and often re-touched.  They are not cardboard cut-out figures. They are real women with real feelings and they are going through a process of healing, which does not happen overnight.

I hope that the gossip rags will be kind to Amanda this week as she re-enters the public domain with the Euromillions Lottery and Britain's Got Talent and as she moves forward from her loss. I hope that it also reminds us that someone in our own lives who is trying to bounce back from a significant loss or disappointment, may look better on the outside than they actually feel on the inside. Be generous with your sensitivity and give them the time and space for the healing to happen in its own time.

Embryo Freezing as a Lifestyle Choice

This morning on the Lorraine show (ITV), the presenter interviewed a woman, Gillian, by satellite from New York regarding the couple's choice to freeze their embryos at age 30 for a pregnancy later in life. The twist was that this couple is young, healthy and fertile. Gillian spoke about not being ready to become a mother and thinking that she and her husband would perhaps be ready to use the frozen embryos at around age 40.  She wants to be more settled, with a higher level of income/assets. Is there ever a perfect time to become a parent?

Some of the questions brought up by Lorraine Kelly and Dr Hilary Jones were:

• Is a child born to wealthier, "more settled" parents likely to be aware of, or any happier because of their parents' financial status?
• Is there ever a perfect time to become a parent?
• How Gillian would feel if, upon readiness, she finds herself unable to conceive, even with the frozen embryos used?
• How Gillian and her husband would feel if their frozen embryo resulted in a handicapped or special-needs child, because the safety/stability of long-term frozen embryos is unknown?
• What Gillian and her husband would do if they never felt ready to become parents and had frozen embryos in storage?

This was an unsatisfying interview for me, with questions hanging in the air and few definitive answers. I'm sure that Gillian and her husband thought about what they are doing very seriously, but the choice itself seemed an extravagant and frivilous one to me. They are healthy, fertile people of childbearing age, spending a lot of money and using a facility meant to help infertile people have a chance at becoming parents, for the sake of lifestyle convenience. Yes, the medical science is there to achieve the delayed pregnancy. No, they aren't taking anything away from anyone else. But, it doesn't sit well with me, in the same way as using a surrogate so you don't gain weight or get stretch marks wouldn't sit well. Perhaps it's because there are so many couples who would bear that child at any age if they could, regardless of convenience, and can't. Perhaps it's because it's down to money, which this couple clearly has to spare and so many who need it, don't.

Where do you sit on this issue? Please leave a comment below.

 

Fertility advice from the Jeremy Kyle Show?

Did anyone (in the U.K.) see the Jeremy Kyle show this morning? He called it his Morning Surgery. Now, I NEVER watch that show because I HATE the format, the type of issues he covers, the type of people who are his guests, the shouting, accusing, and what I see as emotional manipulation. How do I know what it's like if I never watch it? Simply, I dislike the entire genre of talk shows that primarily exist to surprise, shock, allow their guests to attack each other's character and encourage the audience to loudly express their opinions. More specifically, I watch Daybreak and Lorraine in the morning while getting the children ready for school and see the promos for the Jeremy Kyle Show. On certain occasions when thechildren are in the kitchen with me, I have even had to turn off the TV if something really offensive is being promoted for the JK Show. It's the attitudes and behaviour...

That being said, I am always interested in how infertility is portrayed in the media, so I watched the entire show today for the first time. Jeremy had two doctors on with him this morning, *Dr Arun Ghosh  and *Dr Stacey Palastrand. 

There were four fertility "stories" told on the JK Show this morning:

• the couple who haven't conceived after 4 years of unprotected sex;
• the couple who have endured multiple miscarriages and the heartbreaking loss of their son only a few hours after his full-term birth, and are now 23 weeks pregnant; and
• the woman who gave birth at 57 to a child conceived through IVF  in a Russian clinic (I believe); and
• a 35 year old single woman, an employee of the JK Show, who decided it was time to be proactive about having what she really wanted in life, a baby.

The Pros and the Cons of this show:

• Pro:  the story of the 60 year old mother to a toddler was not overly sensationalized
• Pro/Con:  Dr Ghosh said that there should be an age limit on IVF because of the danger to the mother, the higher percentage of genetic abnormalities in children born to older mothers and the "limited money in the pot" for their care. While I applaud his intentions of keeping both mother and child safe and healthy, it wasn't clear at what age he would cut off women from having IVF... I must have heard wrong, because I thought he was saying over 35!
• Con:  Dr Ghosh kept talking about how unethical it is to treat women with a small chance of success with fertility treatment.  As long as there is no danger, as in the doctor doing harm, and there is no question of the woman's mental health being in danger, isn't that what freedom of choice is about?  Yes, it's emotionally difficult, however, so is remaining childless if you want a baby more than anything.
• Pro:   Thankfully, Dr Palastrand gave a  more balanced viewpoint on the issue of older women becoming pregnant and giving birth.  My understanding is that there is very little danger to the mother if healthy and given good medical care. Also, everyone is entitled to testing for genetic abnormalities in pregnancy, so surely there wouldn't be a large number of babies born with genetic defects.
• Pro: When asked whether having a toddler isn't exhausting for a woman of her age, the older mother answered with some feistiness, that it wasn't as hard as caring for an elderly person, which she had done for more than 15 years before having her baby at 57 years old. She had also worked with special needs children. (It's worth pointing out that her husband is substantially younger than she is.) It just goes to show that the decision of whether to provide fertility treatment should be done on a case-by-case basis, rather than a uniform ban on women over a certain age.
• Pro:  JK asked the question "Isn't it preferable for a capable, older woman to have a baby she will love and care for, rather than the unwed teenagers who neither want nor can care for the babies they are having?
• Con: Not enough was made of the infertile couple's admission that they both smoke. Surely, if they really want a baby and have been unsuccessful for 4 years, they would be committed enough to make this lifestyle change. They should have been told in no uncertain terms that smoking is not acceptable, not least because it could cause miscarriage or low birth weight if they do become pregnant.  It also made me wonder whether the JK Show couldn't have chosen a couple who have tried absolutely everything to conceive. 
• Pro/Con:  the couple with the previous losses were given a 4D scan of the foetus. This could have been a huge emotional shock to them if there was something wrong. Thank Gd everything seemed well.
• Pro/Con:  the scan and sperm sample given to the infertile couple were good for illustrating what could be an obstacle to conception, however, the Drs seemed to just say you're both fine and should have no problem conceiving. There could have been more discussion of the types of further medical investigations that should be done to discover why they haven't conceived in 4 years and how to access them. "Unlucky" was mentioned...that's not good enough.
• Pro: the single mother was able to see her 15-week old foetus and found out that she is having a boy. That was a feel-good moment for everyone.
• Con: Why did the JK show feel it necessary to pad out the program with a cosmetic procedure? It could have actually gone deeper with fertility issues and explore one more issue or give more substantive advice than it did.
• Pro/Con:  the Drs kept their advice simple and sensible, but perhaps too simple. Dr Ghosh's top 5 tips for conceiving are: 1) have sex 2 -3 times a week, 2) stop smoking, 3) maintain a healthy weight, 4) relax and 5) go see your Dr.

Interestingly, Dr Ghosh's profile on his Twitter page describes him as a "UK media GP" who runs a prescription addiction clinic in Liverpool, specialising in sexual health, obstetrics & gynaecology, weight management & CBT. Dr Palastrand doesn't appear to have a Twitter page, but completed her GP training in 2008, with aspirations to be a "salaried GP in a semi-rural practice." Although I would have liked to see more substantive information and advice from the two doctors, and links to helpful resources for viewers, they both came off pretty well and gave a balanced view of the issues.

 

How Surrogacy Relationships Work

I’ve been watching Addicted to Surrogacy on UK’s More 4. It’s not even over but, I can tell you that the film hasn’t lived up to its title. One surrogate, Amanda, is a single mother of three and was filmed during her first surrogacy arrangement. It’s obvious that Amanda isn’t addicted to anything.  She carried a boy, implanted as an embryo belonging to an English man and his multi-talented, Russian wife who was left unable to bear a child by leukaemia, from which she has now been cured. Truthfully, my attention was not on what Amanda was doing or how she felt about being a surrogate; it was on Olga who I thought was very opinionated, controlling and even rude. She announced on camera and in front of her husband Steven, that marriage is only worthwhile if you were going to have children, otherwise “what’s the point.”

 

Perhaps it’s a cultural thing. Olga displayed other strong opinions and a lack of emotional intelligence around Amanda's young children. She altered a drawing that one child had done of a cat. The child objected, to which Olga replied that at least she had improved it. Upon departure, when Edward was three days old, Olga didn’t want Amanda’s young children to kiss him, in case it woke him and he “started screaming.”  This was her third day as a mother; I’m glad I won’t know how this has turned out when the child is having proper tantrums as a three-year old.

 

The other two surrogates in the spotlight were 44 year old Jill and an American woman in Kansas, Tammy Lynn.  Jill was trying to conceive her eighth baby for the same couple who had already used her for Baby Number seven.  I can understand that; Dad and Jill would be the genetic parents to both children therefore; the two children would have the same genetic material as each other.  Not only that, but she is known to them.  It would be horrible to have to find someone new and place their trust in her, with some risk that it will work out. 

 

Jill inseminates herself at home with a syringe filled with the father’s sperm, which he produced in the next room.  By the end of the film, we had been told that after 18 months of trying, and one miscarriage, the couple decided to end the surrogacy arrangement.  Jill stays in touch and brings gifts to all of her biological children, which is apparently a once-a-year visit, but doesn’t want to raise children of her own. This satisfies the urge to be pregnant; she enjoys it.

 

Tammy Lynn was bearing twins for a 50 year old English woman, Janie, who works for the NHS, and her husband Peter.  Janie has tried to have a child for 25 years. Tammy Lynn seemed totally serene and clear about why she was doing surrogacy, saying that even if she has doubts, they were outweighed by the feeling she got each time she handed over the baby to the parents, knowing she gave them the gift of parenthood.  Janie, on the other hand, was portrayed as a highly-strung, very controlling person.

 

We see them, for the first time, visiting Tammy Lynn during her pregnancy. A voice-over tells us that the previous visit didn’t go well, possibly because of expectations that weren’t fulfilled.  The atmosphere felt very tense, all the way into my living room.  The birth was a Caesarean, so Janie and Peter were on hand, however, Tammy Lynn chose her own husband to be with her in the operating theatre.  That didn't seem to go down well with Janie and Peter. They waited for their babies in an adjoining room, where Janie was shown pacing, gaunt and wringing her hands.  I could see it from both sides, but in the end, the fact that Tammy Lynn was having a surgical procedure and had been through these births previously swayed me toward her side.

 

It may all be in the editing, but in this film, the surrogates come off as much more sympathetic and likeable, than the prospective mothers. It just makes me wonder why they used Addicted to Surrogacy as the title; was it merely to entice viewers?  The surrogates each handled themselves differently, but I think that was down to personality, age and experience.  Amanda cried after giving baby Edward to Olga and Steven. Tammy Lynn spent a little while with Janie, Peter and the baby in the hospital, but then relinquished babies number 6 and 7 to their care, tenderly but seemingly without regret. No addiction there either. 

 

I was happy to have more insight into what the surrogacy arrangement means to the people involved.  It is such a sensitive situation, fraught with risk, contractual obligations (not shown here at all), personality clashes and a certain amount of desperation on the part of the infertile women.  It's a supplier - consumer relationship in which the future parents are paying for and  which, under other circumstances, they would be entitled to dictate, supervise and have a money-back guarantee. However, in this case, the surrogate is a person with a life, responsibilities and style of her own and there is no money-back guarantee on a child.

 

As is typical of me, I was scribbling notes about how, as a fertility coach/advocate, I could help people in this type of relationship achieve better synergy with each other, through better communication of their desires, hopes and needs.  It’s difficult for people to do that on their own, especially when the couple does not want to endanger the relationship with the woman bearing their child. I thought I might  feel a little kindred spirit with the infertile couples in a "there but, for the grace of God, go I" way. It didn't happen. 

 

I found myself empathizing with both the surrogate and the parents.  Quite complex. It does make me wonder whether spending time together is worthwhile.  These people don't have to be friends and wouldn't be under normal circumstances.  It happens, I believe, because the future mother needs a lot of reassurance that it is finally going their way, after years, perhaps of trying to conceive on their own.  I find it especially strange for the surrogate's own children to be a part of that pre-birth visit.  Will their behaviour at a dinner table give the couple insight into how their child will behave? Hardly.  Maybe just passing on genetic tests and information about interesting talents, mannerisms and medical history is enough. I will look deeper into surrogacy  to find out more.

They've Given it a Name: Gender Disappointment

I had a moment of  identification with the women in the TV documentary 'Eight Boys & Wanting a Girl' who wish they had a daughter and have bittersweet feelings with each birth of a boy.  Despite several years chasing motherhood, and saying I would be elated if I could get and stay pregnant with a healthy baby, in my heart I was after a girl-baby.  But, that's as far as it went for me. I was hardly what you would call obsessed.  My first child was the gorgeous baby girl I had always dreamed of having and I wanted more.  Having had no sisters or female cousins while growing up, I wanted to give Honey a sister to play with, hug, be best friends and all the other idealistic desires I had had myself and projected on her. 

I had amnioscentesis at 15 weeks, not to find out the baby's gender, but because of my fertility history and my age (42).  The lovely doctor called me herself to give me the good news about his health and asked if I wanted to know if it was a boy or girl.  I was genuinely shocked and ever so slightly heartbroken to learn that we were having a boy.  I couldn't hold back my surprise,  responding "You're kidding, right?"  But, I recovered quickly and threw out my lists of girls' names.  For the next 24 weeks I walked around in a sort of astonished daze and reluctantly gave away the very feminine baby clothes I had kept for "her."  Nevertheless, I fell in love with Pip the moment he was handed to me.

Six years later, I laugh to think that I might not have had this clever, noisy, ticklish, artistic and argumentative whirlwind of BOY.  He seems to think that he has to fill every minute of the day talking, singing or making some other noise. He swings from sweet to furious ( I swear I once saw steam coming from his ears) and back again, shrugging off his "no-more-juice?"-rage to tell me that he learned something about earthquakes, aftershocks and tremors on Newsround. My world has expanded to  include dinosaurs, dragons, aliens, superheroes, Lego, gloop and hideous character pyjamas.  I adore him. If I have regrets, it's only that I couldn't have more children: ok, girls. 

In the documentary, one woman had 4 boys, including a set of twins, and persuaded her husband that they needed to try one more time.  You know the outcome already, don't you? After practicing every old wive's tale in the book, including tight underpants and hot showers for her husband before sex, and cranberry juice, herbs and vinegar douches for herself, Michelle had a 5th boy.  I don't care that Michelle wanted a girl and went to silly, unproven lengths to ensure it.  I sort of get it; she wants to share girlie talks, the colour pink and prom dresses with a daughter, as I do.  I feel sorry for her; not for having 5 boys, but for having regrets. 

It was when Michelle compared the flip-flop feeling she gets in her stomach over hearing that someone else is having a girl, to how a woman who is infertile must feel when someone tells her they are pregnant. No Michelle, it isn't.  There is a huge difference between having 5 easy pregnancies and births resulting in 5 healthy, loving little boys and a woman who hasn't been able to have children at all.

Other women in the program went to America for Pre-Implantation Genetic Diagnosis, or PGD, at about £8,000/$12,600 approx a time.  Embryos are screened for gender before implantation, meaning that these couples actually pay for and put themselves through an IVF procedure, even though neither of them are infertile.  This procedure is available in the U.S., presumably to anyone who wants to choose their baby's gender and can pay the fee, but is only allowed in the UK to prevent a gender-based hereditary disease.  UK hospitals will not even tell women their child's gender from a scan, at least partially because the NHS is afraid that the large Indian population will follow a cultural preference, choosing to abort rather than give birth to a girl. 

Gender Disappointment is not a recognized psychiatric condition. That doesn't make it any less real for the women who suffer it, for whom it can form the basis for post-natal depression.  I will admit to sitting on the fence here.  I have at times felt an ethnocentric horror at how the cultural preference for boys manifests itself in some parts of Asia. However, as an American, coming from a society that celebrates freedom of choice in practically everything, a part of me thinks it's cool that PGD exists and that it fits within the "live and let live" philosophy that I would like to believe I possess. It's another reason for the so-called fertility tourism, but this time for purely self-serving preferences, rather than having to travel elsewhere just so they can have the chance of having a child at all.

The women who participated in this documentary are very brave for being completely honest about their feelings, in front of their families, to an audience of thousands of critics.  (There was another woman who already has 8 boys and still wants to try for a girl.  I didn't focus on that here, because frankly, I thought it was on the edge of bizarre.) Now, even though Michelle is lovingly cuddling another baby boy, I wonder if she wishes she had spent that £8,000. 

The One Thing You Would Change

If you could change something about yourself, what would it be?  You may have instantly, without a second's hesitation, thought "my nose" or "being such a perfectionist." If you could change something about your life, what would you trade in?  In the last half of the 20th century, the Western world leapt forward at a dizzying pace from "For God and Country" to "What about me?" 

Since then, we have taken the culture of individuals to new levels.  If we are not already who we want to be, we can become it.  We are assisted by plastic surgery, cosmetic dentistry, casual Friday, flexi-time, personal fulfilment, same-sex marriages, personal sabbaticals, assisted conception and the internet, all of which have been invented or progressed beyond our imagination within our lifetime. This is the world that everyone under the age of 50 has grown up in.  We fully expect to be able to reinvent ourselves; our appearance, careers, relationships and social life.  I have certainly done it.  The girl who wanted to be an artist studied hard to be a lawyer instead, which wasn’t a good fit and became, in the end, a fertility coach, which fits beautifully, thank you. 

We have outgrown a one-size-fits-all culture, but there are a lot of people who still don't know what to do with so much choice.  In some instances, that amount of choice is paralyzing.  We have a consumer culture that allows us to do so many things temporarily and then trade them in for something else when we grow tired. Women can now have breasts that can be pumped up or deflated depending upon the style that year, while men with skinny legs can have calf implants.  One of my very favourite developments is the bright and capable, career secretary restyled as the independent virtual assistant, taking business on her own terms.

If you have tons of money, you can try everything on the current hot list and then trade up. If you can't flash the cash, you sit home in front of your biggest purchase of household electronics and watch reality shows: Extreme Makeover - House Edition, Pop Idol, Could you be Joseph or Maria?, Britain's Got Talent, Top Gun and Masterchef. You name it. There, on the screen, or even more likely on You Tube, is our fantasy life being played out by other people. 

Personally, I need look no further than A Place in the Sun and Location, Location. I keep pictures of Caribbean beaches, the English seaside, the coast of France and the Jersey shore to remind me what I’m working toward.  It’s not my dream, it’s my intention.  What else would I choose? The fantasy would be to indulge in my love of cooking and eating without putting on weight.  That’s probably shared with a few million people.  Some time ago, my wish might have been to “fit in.”  Now, I simply want to be me, attracting the kind of people with whom I want to enjoy life to me and me to them.  It comes back to the uniqueness and personal fulfilment again, that we feel entitled to have.

It's your turn.  If you could change one thing in yourself or in your life, what would it be? What would make you unique, happy and fulfilled?  Answer quickly, so you don't talk yourself out of it.

Fine, now what is holding you back?  Your answer must not start with "I can't." 

Can you reframe it from a wish into intent?   

It's all a bit of fun, but also very telling. Somewhat like an old adage; the branch of a tree planted in jest, has its roots in truth. I think I just made that up to cover for my poor memory of the real saying, but I think I made my point. 

If there is something that you are not doing in your life; an image of the person you want to be, or a space inside you that isn't being filled, it's good to ask yourself why. 

What would attaining it mean; what would never doing it or having it mean?

Where are you going to go with this?

Haitian Children in the Aftermath of the Earthquake

I have now seen the footage of the beautiful, little, Haitian girl, Mia Charlotte, rescued by British firefighters from the wreckage of her nursery about a dozen times.  When her mother turns toward the camera with her daughter in her arms, I can just about imagine what it feels like and I get shivery.  I realized, about the 5th or 6th time, that I was unconsciously hugging myself, feeling the weight of the child, her soft baby skin covered in dust from the rubble, and the need of one for the other.

Certainly there were times when my own children were that age and I scooped them up, hurt and tearful, both of us relieved that we had found each other.  The difference is that my babies might have fallen off of a seesaw at the park or knocked their foreheads on the corner of a table. I am fortunately lacking a closer frame of reference, but as a mother I can watch this news story and imagine what this Haitian mother, in the midst of a natural disaster and crisis, felt when she had her daughter back.

Tonight I was cruising the timeline on my Twitter page, idly searching for anything that might have happened since my last visit.  I came across a tweet, which I can't find now, referencing the Haitian disaster: Adopting a Child from Haiti, Post Earthquake.   My immediate thought: "Oh no, please tell me this isn't a bunch of desperate Americans seeing an opportunity for themselves."  I hesitated just a second and clicked on the link; just like how I watch particulary brutal bits in TV shows between my spread fingers. I don't want to know, yet I can't keep from looking. 

Instead, I found a blog, http://CreatingaFamily.org/blog by Dawn Davenport, which was beautifully written, sensitive and sensible.  Dawn spoke directly to the followers of her blog about how she could understand their desire to help a Haitian child, possibly orphaned by the earthquake, and provide a loving home for them.  She explained quite thoroughly why this is not the time to entertain those thoughts: too early, uncertainty about children's family survivors, the inability to fly into Haiti, use resources (shelter, food, clean water, transportation ) best reserved for the Haitians themselves and aid workers, trauma, etc... "Orphans of a natural disaster have been traumatized, and moving to a new home, with new parents, new language, and a new culture may not be in the child’s best interest even if they can not be adopted in their birth country."

Dawn also passed on her knowledge and experience with the Haitian authorities and adoption agencies; tough to work with even in better times.  "Also, with all that the Haitian government has on their plate right now, processing adoptions is not and should not be their top priority."  She has promised to relate more news as it becomes available.  There are about a dozen organizations listed in the blog, who are accepting donations to help provide health care, food, shelter and other necessities to orphanages, hospitals and communities.  I hope they will also provide money to help reunite, support and keep together, Haitian families in Haiti. 

Creating a Family is a non-profit organization providing education and resources for Infertility and Adoption.  The Creating a Family radio show (blogtalkradio) on January 20, 2010 will be on Adopting from Haiti Post Earthquake.

I am really grateful to have found Dawn's blog and, to pass on to you, her very balanced take on the Haitian disaster.  She seems to me to be a woman you want to know, and an organization to both use for your own adoption plans and to support for the work it is doing in the infertility and adoption communities.