Most paediatricians—myself included—are drawn to the field because they love kids: their energy, their creativity, their resilience. I had worked with children my whole life as a babysitter, older sibling, tutor and camp counsellor. I especially liked the fact that, compared to other medical fields (such as surgery and obstetrics), paediatrics seemed more family-friendly for women who want to raise kids and have a career. Throughout my training, I had countless conversations with female mentors about when was the “right time” to start a family. My husband is also a physician, and we hemmed and hawed and stressed over it, discussing what was best for us. As we came to the end of our intense clinical training and began additional research training, we decided that it finally seemed like a good time to begin “trying.”
A year and a half later—and no baby—all of that deliberation seems a bit ironic now. I am officially a doctor experiencing infertility in her early 30s.
Initially, every month, we excitedly pictured what the next few months might look like if we became pregnant then and how that might influence planning for family get-togethers, vacations and adventures we were hoping to go on. Month after month, I felt like I was getting duped by my PMS symptoms, thinking maybe it’s finally happening, but then the pregnancy tests turned up negative each time.
Both my husband and I have now gone through laboratory testing and imaging studies, and we’re looking forward to discussing the results with our provider next week. I anticipate that our next option will be exploring whether Clomid might be the right fit or deciding to move to intrauterine insemination (IUI) or in vitro fertilization (IVF) sooner. All of this is further complicated by my borderline diagnosis of polycystic ovary syndrome. I have a normal body mass index but ultrasound evidence of many ovarian cysts since my early 20s.
I’ve chosen to be fairly private when it comes to talking about this experience with my colleagues. And even though I’m a doctor, I’m trying not to read about or research it too much. I know that there is not a lot of evidence out there, so it hasn’t felt useful to pore over it. I prefer to hear our obstetrician’s thought process and let her be the one to drive our care.
One of the weirdest things about being a childless paediatrician is that I find myself giving families a lot of parenting advice as part of their clinical care. How will their child’s recent admission to the hospital for bronchiolitis impact the sleep training they were doing at home? How can they convince their child to eat foods other than pizza? What are some of the ways to prevent sun exposure on their winter trip to Hawaii? What should they do if they want to stop breastfeeding but their toddler doesn’t want to? When you are a paediatrician who is not yet a parent, it can feel odd to answer these questions. So my advice is based on the medical evidence that exists, trusted mentors and colleagues and my own experience as an older sibling. I’m learning what works and what doesn’t. I did learn—the hard way—that making the analogy between surviving a 30-hour on-call shift as a medical resident and being a new mom is not the same kind of sleep deprivation. (Note: Never make that analogy again!) And I certainly have a rule about not giving unsolicited advice as well. But when the moment is right—like when friends are relaying the challenges of breastfeeding—I lean heavily on my experience as a paediatrician and feel glad that I can continue to be part of these kinds of conversations, even though I have not yet crossed into the new chapter of life called parenthood. The ability to participate helps protect me from the heartbreak and intense longing of wanting to cross that threshold.
In many ways, the part of clinical practice that has always been hard—caring for children who have been abused or neglected—remains the hardest as I cope with our fertility challenges. Since I’ve hoped to have children for a long time, it is really hard to do the foster-care examination for a child whose parent left him at the local emergency department because “they just couldn’t handle him anymore.” In those moments, I reach back to the place that allowed me to become a paediatrician in the first place, which was my ability to care for children in times of joy and sorrow.
One of the aspects of my job that I love most is greeting happy, nervous new parents for their newborn’s first physical exam before hospital discharge. I explain what’s normal for a child this young: reflexes, rashes, eating patterns, weight. Friends and family who know about my fertility struggles have asked me how I manage to do these exams with brand new babies and their eager, exhausted, beaming young moms. Doesn’t it feel unfair? But I’ve found that seeing these joyful new families—whose fertility backstories I often don’t know well—is much less challenging for me on the job than the thoughtless (but not ill-intentioned) comments I get from acquaintances outside of work.
In my social circles, I’m surrounded by couples who are pregnant or in the throes of the all-consuming, dual-career, juggling-a-baby-and-a-toddler life stage. Conversations frequently focus on pregnancy, birth and little kids. Just last night at dinner, dear friends of mine who are in their third trimester said, “I think everyone we know is pregnant.” I sat there wondering, Is this the time to speak up and say “Well, clearly, that’s not true”? Do I quietly and gently remind them that it’s not that easy for everyone and that making a sweeping generalization like that can be really hard to hear if you’re dealing with infertility or grieving after a miscarriage or a pregnancy loss?
I pride myself on being the type of person who is always willing to talk about things that are hard, but I didn’t speak up last night. Instead, I took a deep breath and a swallow of wine and let the conversation drift away from that place.