It’s “Subfertility” To You, Please

It’s a fact: the current lexicon we use for Later-in-Life Parenthood stinks.  Leave it to Western Medicine . . . if there’s an opportunity to get a dig in, it does.  Lemme return the favor.

Snapshot: Two years ago.  I’m staring down a cocky med student.  He’s a large guy, imposing.  His manner is upfront, which I can mostly deal with, but his questioning is aloof, which I can not.  In particular, haughty Mr. Med Dude will not stop using the word “abortion” when discussing my multiple miscarriages.  It is driving me and my husband nuts.

Even after our repeated angry protests, he continues.  It’s not that he’s not trying; he simply can’t help it.  “Abortion” is built into his DNA.  “Abortion” is the official medical term.  “Abortion” is how he thinks of my plight and forever will.  I am aghast.  As if living through the miscarriages wasn’t enough . . . now I’m to be forcibly confused — by my own health-care professional — with someone who walks into a clinic to intentionally terminate her unborn child?

Some embarrassing nook of my brain hears a Bones to Captain Kirk exchange: “Dammit, Jim — I’m a doctor!  Not a caregiver!”

Patients do or should — have a right to expect their Bones to be both things: a diagnostician, and a nurturer.  The rampant unchallenged insensitivity so seemingly built-in to older pregnancy pursuits (and even some younger ones, too) isn’t necessary.

And something can actually be done about this, unlike, perhaps, some of the other problems we are facing.

Let’s start by choosing the words we work with with greater care.  It’s a small thing, but huge. Just a little awareness goes a long way.  First and foremost, we should keep in sight what a hurt and grieving almost-parent patient is feeling, has already felt, will have to still feel.

Clearly, the default mode right now is set to obliviousness.

Snapshot #2: Calling in for my much-anticipated HCG results, the nurse looks them up while eating her lunch.  This is a big moment for me; not so much for her.  In early pregnancy, the level of HCG (Human Chorionic Gonadotropin) in your blood needs to double every few days.  Although I am pregnant, I need to stay that way too.

The nurse experiences me merely as a voice on the phone.  For all she knows I may want this number to go down.  Fair enough, I suppose.  Yet entering into any conversation re: HCG numbers, really should be a heads-up; either way this thing goes, it’s gonna be loaded.  Something to be handled with compassion, not in between bites of Taco Bell.

When I hear my HCG number and recognize that it is, indeed, going down yet again, the nurse asks me which way I wished it to go.  “Up,” I say.  “Nope,” she says.  “This one’s gone south.”  (Direct quote.)

From the moment an over-40 woman is blessed with a positive test result — really, from age 34 on up, when the IVF-pushers get involved — her “High-Risk Pregnancy” is skeptically received by the very medical community which is supposed to help her accomplish it.  Due to her “Advanced Maternal Age,” said lady with “Diminished Ovarian Reserve,” who astoundingly managed to connect egg to sperm anyway, despite being a “Poor Responder,” is instantly regarded as suspicious, a normal outcome for her and her child unlikely.

Norman Vincent Peale would shit his pants.  Haven’t these people ever heard of the power of positive thought?

When the process does “inevitably” fail, matters only get worse.  A miscarriage — not the dandiest term to begin with— is charted as an “empty sac,” a “blighted ovum,” sometimes a “missed abortion.”  My personal favorite, exclusive to the lucky recurrent miscarriage crowd only: “habitual abortion.”  The grief-stricken gal who has repeatedly had to endure these losses is openly dubbed a “habitual aborter.”  Like she just makes a habit of tossing her new babies away.  Eh, don’t need that one . . .

Of course there are real and significant issues involved here, issues that need some clear definition.  But whatever benefit the doctors and nurses get from employing their current labels to communicate is surely outweighed by the constant dings and damage to their patients’ spirits and souls.

Western Medicine, you don’t have to believe in me.  But please do keep your pessimism to yourself when I’m dealing with you.  Wink and nod all you want behind the scenes to treat me, but when we’re together, a higher ratio of support to caution is required.  We already know this is possibly impossible; you are not saving us from anything with a reality check.  Give us some space to believe instead.  What’s the harm?

“Unexplained Infertility” is the perfect place to begin shifting the vocab.  To be allowed to cavalierly apply the “U” word to a suffering gal’s not-yet-discovered condition is a ridiculous state of affairs.  Her problem is not unexplained, it is undiagnosed.  Oh, it’s mysterious all right — especially if you don’t take the time to look into finding out what’s actually going on.  What’s really happening is that you are just one of hundreds, thousands, millions seeking a solution . . . and no one especially wants to take on figuring out your individual hot mess.

I propose “Subfertility” as a more appropriate, gentler label to use.  The days of this throw-your-hands-up-in-the-air-and-call-it-solved nonsense should end.  Respect, diligence, understanding are what needs to be granted to all human beings striving and struggling sincerely to create life.

And, once created, that life should have nothing but optimism on its side.

Snapshot #3: From my imagination.  I see a future blissful, fully supported pregnancy experience.  I am not called old.  I am not made to fear my own pregnancy.  I am not rushed into test after test because of my advancing decrepitude and potential to falter at any moment.  Yes, I’m a “Later-in-Life” (™ Ten-Percent Panda) mom-to-be, but this is very cool.  Very, very cool.  How awesome of me to finally achieve this, what strength I have shown, what rare and admirable purpose.

Personally, I refuse to have my psyche pre-bludgeoned by thoughts of the “high-risk” pregnancy I still hope to attain.  High risk, high reward baby.  I may be subfertile, but there could still be life in the ole gal yet.

Even if there isn’t — which, believe me, I fully understand is on the table — let’s think twice about choosing to handicap me before I’ve even begun.

What do you think?  What have your experiences TTC been like as an older-parent-to-be?  Positive?  Negative?  Neutral?  Please leave any comments below, email me at, or use the Contact page on the 10PP website.  All thoughts, reflections, attitudes are always welcome (within reason!). Let’s discuss.

© 2016 Rebecca Bryant/Ten-Percent Panda

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6 thoughts on “It’s “Subfertility” To You, Please

  1. Amen amen! Anyone who talks to you that way should be called out on their behavior – not enough of us do it and I think it’s necessary. I called out my first fertility doctor for being an asshole and while she didn’t like it, tough shit is what my husband and I said. My fertility doctor now is wonderful and kind and he and his wife battled infertility for 8 years before having their kids (which is what got him into RE in the first place) and I think that has made all the difference. I am 42 by the way and had a miscarriage 2 weeks ago with my first pregnancy following 6 infertility treatments (including 4 rounds of DEIVF), and while I’m absolutely pro-choice, I absolutely know the difference between abortion and miscarriage! The worst part was getting the pills to have the medical miscarriage at home and the douchebag at the pharmacy telling me I shouldn’t take the pills if I’m pregnant. Fortunately there is a beautiful community of midwives and doulas who we met who did not once consider me ‘high risk’ or dare use the term ‘advanced age’ or – my personal favorite – ‘geriatric’ when we met with them to discuss partnering with them for the birth (just days before the miscarriage).

    • I’m so sorry for your loss! I know it’s so hard, especially after that many treatments to get there. The miscarriage pills were a really lowpoint for me too. 42 is young! That is the best thing anyone ever told me, and now that I am 46 I especially see the wisdom in it. Best wishes to you!

  2. Aitch says:

    Two weeks ago, I arrived at the hospital for a D&C for a missed miscarriage. The admitting nurse was going through the pre-op checklist and asked me “are you pregnant?” I was gobsmacked. Yes, if I took a test, it would come back positive. Yes, there was a baby in my uterus. But he had died and I was in hospital to have his remains removed from my body. I expected that my care providers would know why I was in their facility and have the sensitivity to not ask that particular question. I know it was just a routine procedure to them but it was the most excrutiatingly sad day of my life and the lack of sensitivity added to my distress. The medical profession needs to do better.

    • That’s so horrible! And yet, sadly, not surprising. What a way to make an excruciating day all the more so. Somehow it all becomes much more impersonal than it should be, but we’re not just names on a chart. I hope you are recovering and have loving support all around you now.

  3. alison s says:

    “Habitual aborter” has GOT to be the worst. Like, “oh, whoops, I MEANT to keep this one going but I’m just so accustomed to having miscarriages!”

    • Yes, it feels like an accusation. So I guess me & my geriatric self should just stop trying to be a mom now since I keep carelessly tossing these fetuses away anyway. . . I had one nurse explain that some of the terms arise from insurance companies’ needs. Great.

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