Fertility Blues…Can’t Motherhood be a choice?

Mrs. ‘V’ was admitted about an year ago at the hospital I work in. When I went through her medical history I was stunned. She was in her mid thirties and was admitted with a tubal pregnancy ( when the embryo get implanted in the fallopian tube which can be a fatal condition if not treated in time). This was her fourth tubal pregnancy ( medically termed ectopic pregnancy) . She had two operations (laparotomies) for previous tubal pregnancy and one was medically managed. All were diagnosed in time though because she was undergoing infertility treatment for past 10 years. She lost one of her fallopian tube and still she was trying to conceive. I have a habit of talking to patients whenever I have time off my rounds. Like an informal sort of tete-a-tete so that I can understand the social and psychological dynamics of a raw medical or surgical condition.

So I sat by her  bedside after the rounds and took all her medical record papers from past and present and started my chat. I learned that she was married to a man who was 10 years older than her. She had a teaching job but had to leave it because she was getting treated to conceive. I further learnt that her husband was posted in another town from where it was not possible to travel frequently to get the treatment so she was living alone at a place near the infertility centre while her husband came on weekends . She sounded a reasonably intelligent and sensible woman. She lacked self-pity though I could sense the deep loneliness she has so seamlessly incorporated in her being. She did not utter a negative word about her situation . She was treated successfully and I do not know whether she is still trying to conceive.I still remember how she described the infertility clinic ultrasound room. They made all the women lie on examination tables and the doctor came in started putting in ultrasound probes one after the other…  it felt as if we were cattle.

On similar lines I met Mrs. ‘K’ who  had conceived after 20 years of marriage but unfortunately she had a tubal pregnancy too. She came to the hospital requiring urgent  life saving surgery and her  fallopian tube had to be removed. The other tube was not communicating with the uterus. After the surgery I wondered how to tell her that she can’t conceive naturally again. Surprisingly she brought up the query and made it easier for me by saying “So doctor that means I don’t have to worry about getting pregnant now… it’s not possible right .”To my surprise she seemed relieved rather then distressed.  I gave her an affirmative. During her stay I learnt that she was a Gram Pradhan’s wife. A very down to earth lady of the rustic roots but I can bet if she got an opportunity she herself had the intelligence and patience to be a leader .

I remember when I was still a post grad student in medical college which had a running infertility clinic. A frail woman in her late 20s had given me a sheepish frustrated smile and said ” Now it feels embarasing to come to the clinic . It has been 6 years of treatment and I never conceive .”

It pains me to see how many brilliant women waste their lives trying for  biological motherhood when they should be out there living their lives. I do not say that they would go and win  a Nobel prize but they could contribute more productively to the society by focussing on their skills and abilities other than producing children.

The other end of the spectrum is where the fertility is in bounty. Which is  actually the case with most women in India who do not get the freedom of contraceptive choices. Women in rural India invariably have multiple children only intercepted by death or disease or the Family welfare program in good faith . Left to themselves they would just go on reproducing. What startles me is the scenario where women who are educated and have access to sterilization ( I am deliberately not bringing up the topic of male sterilisation)  do not opt for it despite medical contraindication for further pregnancy . A bureaucrat and his wife refused tubal sterilisation even when it was the third caesarean section. A muslim well to do educated female did the same counselling her was banging your head on the wall. In both cases both earlier issues were alive and well above 5 years of age. Perhaps these women think sterilisation to be the end of their significance cos I see no sanity in subjecting oneself to life threatening situation like a uterine rupture. They rather seem to be happy with such decision. I feel it is nothing but systematic cultural brain washing that makes a woman risk her life in such a manner.

Instinctually woman are supposed to have a drive to have children and become mothers. It is natural for a woman to desire to be a mother. It is part of the evolutionary biology and psychology . But in a world where the population is going 7 billion and beyond can’t women have a choice? We are a surviving species we are so many that we are endangering other species on the planet. Yet the frenzy and the mania to have more and more children and pressurizing women to be biological mothers is growing stronger.

When a friend of mine expressed lack of maternal instinct and that she did not want to have children. I was a bit taken aback and judged her for a while. But now to think of it is she not entitled to have that choice ? Wouldn’t it be better if she has children when she chooses to? What is so wrong if she never chooses to?

I do not say that it is wrong for a woman to desire for children and in that attempt undergo years of treatment. She has all the right to try for it. However do we ever consider that a lot of these women might be driven by societal pressures and would be yearning to be free of this obligation consciously or subconsciously.

Mrs V could have the choice of  going back to her teaching profession rather than going to the clinic and endangering her life every time  she conceives.

I wonder if we can ever have a society that places more value to a women as a person rather than her womb and her fertility. Where women don’t have to give up everything else and risk  their lives just to produce children.