The Pursuit of Motherhood Read online

  I was born in 1970. I have a career. I don’t have children. I guess on the face of it the statisticians would include me in their hypothesis.

  In the article they describe these women (me!) as ‘child-free’ rather than ‘childless’. It’s a subtle distinction but the implication is that we have actively chosen work over having a family.

  I haven’t.

  My own theory – not statistically proven, of course – is that women of my generation who don’t have children actually fall into one of three categories:

  1. Women who have a career and don’t want children;

  2. Women who have a career and do want children but can’t find the right partner;

  3. Women who have a career, do want children, do have a partner but can’t get pregnant.

  As for the women who do have children, well, they’ve either had to sacrifice their career, or I suppose they must have it all. (And frankly, if there is any woman out there who has achieved that Generation X dream, then I don’t think I want to know as it will only make me feel like a failure.)

  I am Category Three. I have a career and a partner but I can’t get pregnant. I’m pretty sure that if I had got pregnant when we first started trying, my career would have stalled. But that would be another story…

  MADE IN 1970

  Here are some other things it might be useful to know about me:

  I was born and brought up in London – north not south, a distinction that is very important to the indigenous community of the capital.

  I essentially grew up as an only child. I’ve got one half-sister – from my mum’s first marriage – but she’s much older than me, and left home to live with her boyfriend when I was only four.

  When I was six, my teacher announced that the person in the class with the largest family could take home the Halloween pumpkin. I took her aside at the end of the day and told her there were nine of us – my mum, my dad, three sisters, three brothers and me.

  A few weeks later, I overheard my teacher saying to my mum: ‘I do feel for you. It must be a lot of work with all your children.’

  ‘Not really,’ my mum said brightly. ‘I only have the two.’

  I kept my head down. The way I figured it, the basis for awarding the pumpkin was unfair anyway. I always wanted a big family. It wasn’t my fault that my mum and dad didn’t have one.

  I wasn’t the ‘-est’ anything at school. The prettiest, the cleverest, the funniest, the naughtiest (believe me, that pumpkin lie was nothing in an inner-London state school). I’ve never played the lottery because I know I’m not the luckiest. I strongly believe it’s the ‘-ests’ that define us. If you ask any of my friends they’d probably say I work the hardest of most people they know.

  I have been an obsessive list-maker all my life. I have lists of all the books I’ve read; all the countries I’ve been to; all the things I want to do before I die. If our house caught fire, my little library of list-books would be the first thing I’d grab from the burning building.

  My guilty pleasures include eating out at nice restaurants, staying in posh hotels, and buying new season when I’m supposed to be shopping in the sales. I have expensive tastes and modest means. Any month in which my income exceeds my expenditure is an occasion for celebration – which often means that next month I’m back in the red.

  I love food, but please don’t give me carrots and tomatoes in the same dish. In fact, any combination of red and orange on the same plate is a no-no. I’m also very particular about olives. I only eat even numbers, although I can do five at a push. Apart from that I’m a perfect dinner party guest. I eat everything. Oh, except caviar. It’s a texture thing; I don’t like the way it pops in your mouth.

  Like everyone, I have my weaknesses and weirdness. When infertility happens you can’t help wondering whether these have anything to do with it.

  The Infertility Diaries Part II

  One of the things you notice when you start trying hard to have a baby is that the world is full of pregnant women. The strange thing is, I never noticed them before. But now they’re everywhere. They’re walking towards me on every street; they’re all over the television, looking glamorous; and they’re on the Tube with their ‘Baby on Board’ badges, just in case I didn’t notice them in the crush.

  ONLY HUMAN

  Around a year after we begin trying for a baby it becomes clear that not a lot is happening. CORRECTION: nothing is happening.

  I find myself staying late at work, googling things like: ‘Why can’t I get pregnant?’ Incidentally, this is the fifth most commonly asked question on the Internet with the suffix ‘Why can’t I…’ The most popular being ‘Why can’t I own a Canadian?’ Hmmm…

  One evening I decide to broach the subject with Peter.

  ‘Shall we sit at the table for supper tonight?’ I suggest.

  He looks at me, immediately suspicious.

  ‘What’s wrong with the sofa suddenly?’ he asks.

  ‘There’s something I want to talk to you about…’

  ‘That sounds ominous.’

  ‘It’s just that I’ve been doing some thinking…’

  ‘What have I told you about that?’ he says. ‘Thinking is never a good idea – especially where you’re concerned.’

  He laughs at his own joke and starts to lay the cutlery out on the table whilst I dish up. We sit down ceremoniously.

  ‘So how was your day?’ I ask.

  ‘Now I’m really worried. What is it you want to talk about?’

  ‘It’s nothing much. I’ve just been wondering whether we should go and see a fertility doctor. It’s been over a year and nothing’s happened.’

  ‘It’s probably me,’ he says immediately.

  It’s the first time I’ve even thought about one of us being to blame. I suddenly realise that this must be hard for him too.

  ‘Why do you think that?’

  ‘Well, you’re always telling me that I’m not healthy enough…’

  ‘Yes, that’s true, but it can’t be the only reason. Anyway, I’ve been doing some research –’

  ‘You’ve obviously been thinking about this a lot.’

  ‘I have had a few chats with Mr Google.’

  He smiles.

  ‘So what do you and Mr Google think we should do?’

  ‘We could go on the NHS. But it might take a lot of time so maybe we should pay.’

  ‘Won’t it be expensive?’

  ‘An initial appointment is about a hundred quid. It should also be easier to organise appointments around work.’

  ‘If that’s what you want.’

  ‘It’s not exactly what I want… but I do want a baby.’

  ‘I want us to have one too,’ he says gently. And then: ‘Now can we go and sit on the sofa?’

  I am embarrassed to admit that my initial research into the world of fertility clinics is pretty rudimentary. In fact, the main reason behind my choice of clinic is that it’s based at the central London hospital where I was born. I am totally oblivious to league tables. I do a basic Internet search and choose familiarity over live birth rates. I don’t even know what live birth rates are.

  I ring the clinic. They take both NHS and private patients and because I’m prepared to pay they offer us an appointment in a few weeks’ time.

  Whilst it feels good to be doing something proactive about the situation, as the day of our appointment edges closer I feel myself becoming increasingly apprehensive, as a whole new layer of anxiety – my fear of human fallibility – starts to spread over the base-coat of disappointment that I am already dealing with. The day before our appointment I snap at Peter because I can’t find the measuring jug he’s put away in the wrong cupboard. He looks at me.

  ‘What is going on with you at the moment?’ he asks.

  ‘Nothing. Why?’

  ‘You’ve just got cross with me about a measuring jug.’

  ‘So?’

  ‘Misplacing it is hardly a heinous crime.’


  ‘Sorry,’ I concede. ‘I think I’m a bit nervous about tomorrow.’

  ‘Why? I thought you’d be excited.’

  ‘I am. But I can’t stop thinking that we shouldn’t have to do this to make a baby. It seems unnatural.’

  ‘Lots of couples have problems conceiving.’

  ‘I know, but it feels like cheating.’

  ‘Sometimes that’s the only way to win.’

  ‘I also keep worrying that they’re going to make a mistake. That I’ll end up having someone else’s baby and we won’t even know.’

  ‘Aren’t you rushing ahead a bit? We haven’t even had our first appointment yet.’

  I take a bottle of milk out of the fridge and start to pour it into the missing – now found – measuring jug. I know he’s right. As usual I’m hurtling headlong to all the worst conclusions. It’s the pessimist in me.

  I’m not sure what I expected a fertility clinic to feel like before I went to one. It wasn’t something I had given a lot of thought. But if I had thought about it, I don’t think I would have expected it to feel like this. We walk through the main doors of the hospital – which look just like your average hospital doors. We follow a long corridor – which looks just like your average hospital corridor. Then up two flights of stairs and through another nondescript door before emerging into a room with panelled wooden walls, heavy oak furniture and wingback chairs. It looks more like the setting of a Dickens’ novel than a twenty-first-century NHS hospital. It’s surreal. It definitely doesn’t feel like the sort of place you go to create a baby.

  The next shock is the other people. The waiting room is full of them. Men and women, all of whom look completely normal and fertile but clearly aren’t. I can tell from the thickness of their patient files that some are at the beginning of their infertility journey and some have been travelling for years. But none of them look or speak to one another. We all sit in silence, side-by-side, wishing we didn’t have to be there and secretly wondering why everyone else is.

  Eventually Peter and I are called through to see the doctor, who, sitting on the other side of a large desk, leans over to shake our hands and introduce himself. He asks the obvious questions. How old are we? How long have we been trying to conceive? Is there anything in our medical history that we think could have affected our fertility? Sadly none of the answers to these questions can solve anything immediately. The first stage of the infertility process is tests. These end up taking about a month to complete. They involve checking the quantity and quality of Peter’s sperm, and finding out whether I am producing eggs and if they have a clear passage from my ovaries, through my fallopian tubes, and into my uterus.

  At the end of this, our tests prove conclusive in their inconclusiveness and we are diagnosed with what is described as ‘unexplained infertility’. Although the doctor tells us that, technically, this means there is no reason we can’t get pregnant, I quickly realise that it actually means he has no idea why we’re not. This makes it one of the worst forms of infertility, as it’s so much easier to ‘fix’ something when you know what the problem is. IVF, for example, was specifically invented for women who had blocked fallopian tubes. Through the process of IVF their eggs were surgically removed, fertilised outside the body and then put back into the uterus, bypassing their fallopian tubes altogether. Hey presto, they’d found the solution to the problem. But when you don’t know what the problem is, it can be difficult, maybe impossible, to find the solution.

  It turns out that for most couples diagnosed with unexplained infertility the first treatment prescribed is a process call intrauterine insemination (IUI for short). It’s kind of like IVF-lite. The clinic simply monitors you until you ovulate and then at the optimum moment inserts your partner’s sperm – which has been pre-produced and filtered in the laboratory – directly into your uterus using a syringe. The aim of this is simply to make sure that everything is in the right place at the right time to do things naturally.

  I listen carefully whilst our doctor explains the process to us.

  ‘So,’ he says, coming to a close. ‘IUI is a relatively cost-effective and straightforward process that I suggest you try two or three times before you consider progressing to IVF.’

  ‘OK,’ says Peter. ‘That sounds doable. When do we start?’

  ‘On your next cycle, if you like.’ The doctor turns to me. ‘Do you know when your period is due, Jessica?’

  ‘Erm…before we look at dates, there’s just something I need to ask you.’

  I look at him. And then at Peter, who already knows what I’m going to say.

  ‘Yes?’ the doctor says.

  ‘I know this might be irrational,’ I say tentatively, ‘but would it be possible for us to sit with the sperm while it’s being prepared in the laboratory?’

  ‘Why would you want to do that?’ he asks with surprise.

  ‘I know, it sounds stupid…but I have this horrible fear of Peter’s sperm being mixed up with someone else’s. It would really help me if we could be with it at all times.’

  He looks at me askance. ‘I understand your concerns, Ms Hepburn,’ he says. ‘You’ve read about the case in Leeds. You don’t want to risk the possibility of having a black baby.’

  He lingers on the word ‘black’.

  I stare at him aghast. I can hardly believe what he has just said. The special thing about deciding to have a baby with someone you love is that you are creating a new human being together. I want to experience what it feels like for people to look at our child and say that it’s got my eyes and Peter’s nose (actually that wouldn’t be such a good combination, but you know what I mean).

  ‘That’s not it at all…’ I stammer. ‘I don’t want anyone else’s baby. Whatever the colour. I want Peter’s baby.’

  ‘I can assure you, Ms Hepburn, our laboratory procedures are very rigorous,’ he continues. ‘Every action is witnessed by two people, making the possibility of a mix-up extremely unlikely. I’m afraid we can’t allow you into the lab because we have to protect the confidentiality of other patients.’

  He pauses and looks at me. I think he can tell how tense and afraid I am.

  ‘Look,’ he says more gently. ‘I’ll have a word with the senior embryologist. I can’t promise anything but I’ll see what I can do.’

  As soon as I get home, I turn on the computer and google: Fertility Treatment Mix-up, Leeds. It appears the case involved a black baby that was born to two white parents. A further trawl of the Internet throws up dozens of other fertility treatment mix-ups. Although it is ironic that human endeavour and achievement might be the only thing that makes it possible for us to have a baby, it just confirms and deepens my paranoia about the process. People make mistakes. It doesn’t matter how good they are at their job; they’re only human.

  Peter comes into the room and I quickly close my laptop.

  ‘What are you doing?’ he asks.

  ‘Nothing.’

  ‘Google is a very dangerous thing, you know.’ He looks at me for a long second. ‘We don’t have to go through with this if you don’t want to.’

  ‘Of course I want to go through with it. I just need to be sure that they’re going to put your sperm inside me and not someone else’s.’

  ‘You’re going have to trust them.’

  ‘But this is such a horrible thing to have to go through. You’d think they’d want to do everything they can to make patients feel as relaxed as possible.’

  ‘You’ve got to respect that they have a way of doing things. They can’t change it just for you.’

  ‘We’re paying. Surely that counts for something.’

  ‘I’m not sure it does. Judging by the number of the people in the waiting room this is clearly a sellers’ market.’

  ‘But this isn’t a straightforward business transaction. I’m not just buying a can of Coke.’

  ‘The problem is you don’t like it when you’re not in control.’

  ‘The problem is I never knew that havi
ng a baby was something that I wouldn’t have any control over.’

  The next day I get a call from the senior embry-ologist at the clinic. It’s clear that he’s not particularly happy about my request to witness our treatment either. No one likes to feel mistrusted and procedures are power, so I do understand. However, after a long conversation he reluctantly agrees that I can sit outside the lab and watch the sperm preparation through a hatch. With this confirmed, our introduction to IUI begins. I am monitored during the first part of my monthly cycle to ensure everything is progressing as planned. Then, approximately fourteen days in, we are told to report for duty the following morning.

  When we arrive at the clinic, the receptionist suggests I take a seat in the waiting room whilst Peter goes downstairs to produce his ‘sample’. This was something we had also discussed with the doctor. In an attempt to make the process as close to the real thing as possible, we had asked whether I could be there when Peter produces his sperm sample. For me, it’s tantamount to being at our child’s conception. The doctor had looked at me quizzically again, but said that he was sure it could be arranged. It was, apparently, an unusual but not an unheard-of request.

  The receptionist gives us the same quizzical expression. (Note to fertility receptionists everywhere: just a little more empathy wouldn’t go amiss in recognition of the fact that men masturbating in a room on their own is not the way most of us imagined we would make a baby).

  She picks up the phone and calls a colleague: ‘Can you please take a gentleman downstairs to produce a sample. Oh, and…’ she pauses as if for effect, ‘Ms Hepburn wants to come too.’

  Please! Tell everyone, why don’t you?! So much for that all-important patient confidentiality.

  A nurse comes through and takes us to what is known as the ‘producing room’, although really it can hardly pass as a room at all. It is more like a cupboard. There is a table on one side piled high with boxes of surgical gloves. A bucket and mop in the corner. And a green plastic chair with a couple of well-leafed top-shelf magazines lying underneath. Perhaps it’s assumed that men can masturbate anytime anyplace. Perhaps some of them can. Even so, a little bit of extra thought could make the whole experience immeasurably more palatable. A bit of space. A bed, perhaps. Some soft lighting. Maybe an iPod with a selection of music. Especially for couples like us – unusual but not unheard-of (and maybe not that unusual if couples were routinely given the choice) – who want to be together when their sperm sample is produced so we can say to our child in years to come, ‘I was there.’