When the Choice to Grow Your Family Isn’t Actually Yours

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Maybe it’s because I have a big(ish) birthday on the horizon or because close friends around me are pregnant again, but lately I’ve had a persistent, nagging thought that has taken over my brain: I want to have a baby.

The idea itself is absurd on a number of levels — the main one being that I already have a 4-year-old and a 2-year-old whose irregular sleep schedules make it so that my husband and I constantly exist in some kind of wavy, nebulous plane between waking and dreaming that has left us permanently exhausted. Adding a newborn to the mix seems irrational. On top of that, we parent these two beautiful, sleepless people in a large, punishingly expensive city — we live in Toronto — where the cost of day care for just one child can be paralyzing, let alone for three. But these reasons, however valid, are not really what keeps me from going forward. No, the truth of why this desire, and the inner debate it inspires, feels not just silly but cruel is that it’s not entirely my choice.

I’ve always had an unspoken sense that I might not have a straightforward ability to conceive — between debilitatingly painful, heavy periods and years of sexual activity without a single pregnancy scare despite partners and I using, uh, slightly less than scientific means of prevention. Still, I was gutted when, six years ago, my husband and I could not conceive after 12 months of trying. Friends were announcing their joy with increasing frequency: Like pregnancy dominos, their news seemed to collapse around me, filling me with a mixture of happiness and profound but private pain.

Even though in the U.S., for instance, 15 percent of couples will deal with infertility, when it’s happening to you, it feels like it’s only happening to you. The inability to conceive when you want to is so deeply personal, so painfully specific in its ability to wound, that it seems impossible that anyone has ever or could ever feel what you’re feeling. Although there are a lot of us, with many IRL and online communities, we are still, each of us, a private island of loss, disappointment, guarded optimism, and tenuous hope.

At the time, talking about it felt impossible. People offered well-meaning clichés — eager to move the conversation along or just not knowing what else to say. Some would serve up a deluge of strange but kind advice: pineapple recipes and ways of placing your legs just so after sex to encourage, well, I don’t really know what it was supposed to encourage, but the hope was that it would lead to conception. It didn’t.

I felt isolated and deficient, and because each disappointment was both an overwhelming loss and an utterly ordinary, monthly rite of passage, my grief felt invisible and unimportant. How do you explain what you can’t show? What you can’t name?

Adding to the heartbreak was the silently looming but ever-increasing financial tally. Our collective health-insurance plans covered some of our eye-poppingly expensive medications but not all of them. Every single month, I endured the physical, emotional, and mental trauma of being poked and prodded, of near daily transvaginal ultrasounds on cold beds in sterile rooms. Then, at the end of the month, I’d receive both a negative pregnancy test and a positively alarming medical bill. When it became clear that IVF was likely our best and only option, my body wracked by sobs as I tried to imagine where we’d get the money from as I did the math on what a baby was “worth.” I was adding up the cost of who gets to be a parent in this country, and I was nervous that we were coming up short, that choice was something afforded people with more means than we would ever have.

Witnessing the overturning of Roe, I’ve thought even more about how elusive and illusory this idea of choice really is — in the U.S. in particular. IVF is expensive. The average cost for a basic cycle is between $12,000 and $17,000 — not including medication, which can cost thousands of dollars. Only 16 states offer insurance coverage for the procedure, and of those 16, seven are Republican-controlled. Many of those same states, like Texas and West Virginia, will face much more complicated IVF access post-Roe as issues like embryo rights come into play. Already, many Americans travel across the country in hopes of accessing cheaper treatment — some ordering medications from international pharmacies online. It’s clear that those on the right who have bulldozed the right to not be pregnant, on the one hand, have done nothing to improve the ability of people to actually get pregnant, on the other. Cost, access, time off of work, support for pregnancy loss and failed IVF cycles, and insurance coverage for expensive medications and procedures all make the struggle of infertility that much more onerous, closing the door entirely to some families who can’t afford to continue.

Although infertility affects so many Americans, battling it is still not recognized as essential health care. It’s an issue on the margins — further hindered by our inability to speak about it openly and plainly.

Social-media platforms like Instagram and TikTok have certainly helped make the conversation around infertility louder and much more transparent, but it’s mostly led by wealthy, cis, straight, white women — the same people who have always had the means and access to conceive on their own terms. But for those who are low-income, queer, or people of color, access and affordability are privileges for which we are made fight over — and to be thankful for the scraps we receive. For all their talk about babies, many on the right continue to carefully guard who gets to conceive and how.

After a fourth failed fertility treatment in 2017, I was ready to give up on the possibility that I might conceive. But in a moment of blind luck for which I’ll forever be grateful, we were able to receive a funded round of IVF through a lottery system in Toronto. We still paid thousands of dollars for medication and embryo storage, but something that once seemed impossible was now accessible. Our version of the infertility story has a happy ending, though that sense of foreboding (that any good news is just bad news in disguise) never really leaves you, never quite lets you relax after years of loss. Thinking about adding to our family now, I can see that luck running out as the financial reality of another IVF cycle feels out of reach. It’s an unmistakable reminder of who gets the privilege of parenting, of the gossamer-thin veil of choice afforded to some when it comes to parenthood in North America.

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When the Choice to Grow Your Family Isn’t Actually Yours