Coming to Terms with Infertility Grief Before You Adopt

Many people decide to adopt after they have been unsuccessful with infertility treatment. Infertility involves many losses and grief is a natural and common feeling, but it is important to come to terms with this grief before you adopt. We talk with Carole Lieber Wilkins, a Licensed Marriage and Family Therapist specializing in adoption, infertility, and third party reproduction. She is also a mom through adoption and egg donation.

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today we're going to be talking about coming to terms with infertility. Grief. Before you adopt, we'll be talking with Carole Lieber Wilkins. Carole is a licensed marriage and family therapist and private practice in West LA as well as Boise, Idaho and she specializes in reproductive medicine, adoption and alternative methods of family building and she's been doing this since 1986 she's a frequent speaker at conferences. She is a member of the American society of reproductive medicine, mental health professional group, and in addition, and I think this is important, in addition to her experience as a counselor, she also created her own family through adoption and donor egg. And this deepens her understanding of the challenges others face when they're exploring alternative methods of family building and as well as talking about infertility. Grief, welcome Carol to creating a family. Thank you very much. It's a thrill to be here again. You know, this is talking about infertility, grief before adopting, and the thing is about 80% of people come to adoption through in fertility and quite not just in fertility , but failed in fertility and fertility treatment failed in fertility treatment. You know, and that and that complicated in many ways the approach to parenting and the truth is adoptive parenting is the same in many ways as parenting regardless of whether you're parenting or your child is biologically yours or not. But it is also different than not. Then genetic parenting. What are some ways that raising an adopted child is different than raising a child that is genetically related to you?

Speaker 3 1:47

Well, there are so many, but we can start with the fact that from the time that that child enters your life and you enter, there's , there is the need to have ongoing conversations about how your family was created. So the conversations that you're having as a family and with your children about how you became a family is different than your next door neighbors might be if they are not a family of adoption. And that's a significant difference because helping your children to understand adoption, what it means, where to place it, how to process it, how to give them information at different times is a significant role and responsibility that we have to our children.

Speaker 2 2:34

Yeah. And so we were coming from infertility . And so what are, let's flip it around and say, what are some of the, well, you can tell me whether you appreciate the word scars, but what are some of the scars that infertility leaves that we need to reckon with before we adopt?

Speaker 3 2:52

Right? So that was the second part of what makes adoption , um, different than giving birth a child that is genetically related to you. And that is that infertility and having a children that are not genetically related to us represents the loss of the fantasize child that most people initially tried to have. So during fertility treatment, people usually have a very specific child in their mind that is really a fantasy of the perfect embodiment of their DNA and the DNA of whatever other chosen partner or donor that they may have. And people don't always realize it, but there's usually a very specific person that has your ancestry or your grandfather's sense of humor and your partners sparkling eyes or his or her math ability. Um, and it's that child that we have to say goodbye to when we move into non-genetic parenting. Sometimes this can be a very conscious process and deliver it process , deliberate process and sometimes it's quite unconscious, but there are some exercises that people can engage in to bring it more conscious from the unconscious. So what happens is that when there's a child that comes into our lives that is not, that fantasize child, doesn't carry our DNA, doesn't have the ancestry of our grandparents, that was important to us to pass on, we have to work with and tried to remain conscious about the feelings of loss that may come up. And sometimes that may only come up during times of adversity. Perhaps our children are going through a tough time and we might even have some fantasy that if we had had our original wish for children, this might not be occurring or it might be if our kids have some kind of learning disability or psychological issues that they are struggling with. So when we have a little healthy infant, we're just projecting onto them all that perfection. But as they grow and develop into real life , human beings, some of our loss issues can easily get triggered and need to be actively dealt with so that we don't pass them on to our kids.

Speaker 2 5:36

Yeah. And so one of the losses of infertility is the loss of that. Perfect. I like that. The fantasize child, the uh , that perfect child that was in your mind, even if you, even if you weren't conscious of it, you were imagining a child. So that's one of the losses of infertility and there are other losses of infertility just to kind of w we won't spend a huge time on this, but the loss of being able to be pregnant and the loss that you pointed out of, of the genetic connection of, it's not just your genes and your DNA, but it's also the DNA of your grandfather and your, and your mother and whatever. So that genetic connection that goes back through the years, there's, there is that loss as well. And you know, and there's also the loss of just the being able to get pregnant like everybody else. And you know, the, the loss of the easy conception, the loss of being able to share all that neon , imagining, telling your parents that you're pregnant and all those, they may seem small but they all add up. There's a lot loss of time. Oh yeah , yeah.

Speaker 3 6:47

Well certainly the loss of time, you know, that it takes to become a parent but also the loss of time with that child if it doesn't start at birth.

Speaker 2 6:59

Yeah, that's a good, very good point. And even if it does start at birth or is the loss of control over the prenatal environment, you know, the ability to make sure you're eating avocado, you know, three avocados a day and, and uh , salmon twice a week but no more. And you know, just all the , the stuff that you would have imagined that you would do if you had been pregnant and infertility. I mean, and adoption only solves one of the losses of infertility and that is the ability, the loss of the ability to parent. Well now adoption gives you the option to parent, but it is still, there's still grief there. There's still sadness there. There's still lost there. Uh, all those other losses that we talked about, and there's probably some that we haven't even mentioned, things that you've imagined. So how do you know that? We used to say you had to be, had to resolve your infertility loss before you moved to our infertility degrees before you move to adoption. That seems like a, you know, a golden unicorn. A person who has, you know, puts it away and they never feel it again. So how do you know if you have resolved or whatever are come to terms with all the losses of infertility in order to move healthily into being an adoptive parent?

Speaker 3 8:18

Well, Dom , if I had a Pat answer to that one, I, you know, we'd both be wealthy and famous. It's like question to answer, you know, in a thumbnail sketch very often that something that can't really occur without the help of a mental health professional walking you through it and helping you to know whether enough of those loss issues have been addressed. Not necessarily resolved, but addressed to really have room in your home and your heart and your relationship for a who's going to be a different one than the one you've been trying to bring into your life. So you know the, the phrase I think if I could send people home with one catchphrase for them to be remembering is that adoption and I will throw in there also alternative forms of becoming a parent where DNA is not shared. Like Gammy donation does not cure infertility. It doesn't cure infertility and cures childlessness so long after you have become a parent through adoption or egg donation or sperm donation, you're still in fertile . Yes, people do conceive over time, sometimes spontaneously if they actually were subfertile during those times, yes it happens, but one should not go into parenting. Alternatively thinking that it is going to cure their infertility and resolve all the issues that got them there. It doesn't, it cures childlessness. It makes you a parent, it brings children into your life and makes you a part of that child, parent community, but it doesn't cure your infertility. Yeah. And so, and then we're going to talk at the end a little more about some techniques that a parents can have for letting go of the fantasize child and for coming to a resolution with the many losses of infertility. You know, I, I wonder now if the infertility treatment is, I speak of it as an escalator, not a stairs, but an escalator because once you finish one treatment, another one is presented immediately and it's there and you have to take the step up, you know, to take that next. And I think in some ways it's harder now than it used to be to know when to get off the escalator. So, and then there's the concern that we hear from many people. If I stop now, my giving up too soon, if I apply to adopt, is that admitting defeat? What do you tell you talk to people about knowing when it's time or end , you're giving yourself permission to stop treatment and look at alternatives? Well , I handy phrase that it is not really a catchall , but that most people will find very, very helpful that I've used for a long time is when your, your desire to be a parent is greater than your desire to be a genetic parent. Then it's really time to start looking at the alternatives. [inaudible] and not everybody gets there. Some people, I work with, some people who may be in fertility treatment for years, trying to have children with their own gametes, not wanting to be parents through adoption and they keep trying and trying and trying and they finally get to a point where they know they can't keep trying that and they may decide actually to be child-free because now it's a different decision. Now it's not do you still want to be a parent? The question is do you want to be a parent this way? And sometimes that answer is very different. I wanted to be a parent when I could have see a little me or I could see a little, you know my husband in that child, but it's going to be somebody else's DNA if it's going to be accepting the unknown, even though it's always unknown, but people don't accept that. If it's going to be, you know the devil, I don't know for the devil I do know then I'm not sure I still want it.

Speaker 2 12:46

Exactly. And that's a , that's an equally valid option that should be considered when you're reaching the point where continuing treatment is, is taking a emotional toll, a physical toll and a financial toll and that you're , you're considering other options. That's a valid concern or this is, that's a valid consideration as well. You know, when we talk about continuing in treatment, I not infrequently talk with primarily women who are trying to figure out, you know, they've got to try, they've got to be able to live without regrets. And so the question that in their mind is how far do I need to go so I won't have regrets. Yeah. Do you see that as well?

Speaker 3 13:33

I do. And you know, the phrase that you hear all the time is I just need to feel like I've done everything I can. And I really take exception to that. Well, because there's no such thing, medical treatment is so advanced and so sophisticated now, even though we can't cure so much that there's no such thing as doing everything you can. There's always another IVF you can do. There's always a physician that will take your case that another doctor said you really need to move on. There's always maybe Gammy donation to try or there's another surgery to have. So we live in a time with so many reproductive options through fertility treatment that even though it doesn't work for everyone, that there's no such thing as trying everything I could. Well,

Speaker 2 14:30

yeah. And then it's also not just what you can try, but it's what you can afford to try. Yeah. I mean, surrogacy with donor egg might work, but you may not have the money for that.

Speaker 3 14:43

Yeah. Well exactly. And at what cost ? Not just financially. So what else are you up in terms of your self esteem, your hope for the future, the integrity of your relationship, your optimism, your energy, your bank book . There's so much that we lose in the process of trying and trying and trying to achieve this. The goal of whatever the original goal was and it takes its toll. So you know the question of how do I stop this process and move on to an alternative while I still have resources to give to the family. I may eventually have financial resources, internal resources, psychological resources, relationship resources. Is there going to be enough left for me to then move forward? Now that I'm finally the parents I wanted to be. Those are tough choices, but I just really want people to hear that this notion of trying everything that I could like there's no nobility in that. There are people who do one IUI and they try and they say, you know what, medical treatment is not for me. I'm moving on to adoption. That is just a great choice for me. And you know, there's no nobility in using up the medical resources to say you tried so much,

Speaker 2 16:16

but what about the people who feel that in order to move forward, they need to know they gave it the old college try, you know, they, they, they tried, you know, they, they, they turned over every stone that they were willing to turn over so that they live without regrets. Exactly. Well, that's the , the key phrase is every stone that they needed to turn over , but it's not every stone that can be turned over. That's such a good point. Yes. It's what you need and well, you, and if you're partnered, what your partner needs as well, because that they may not be the same. Exactly. So

Speaker 3 16:54

there's always more out there, but at whatever point you decide you've had enough and it's time to start your life as a family with children. That's a good point.

Speaker 2 17:05

You know, one of the, when people first move from infertility in their mind, move fertility treatment towards adoption, one of the things that often just smack them upside the head is what feels like an overwhelming amount of uncertainty. Uncertainty of not unknowns, I should say. Not uncertainty. Unknown's uh , you don't know , uh, for certainty . You don't know the genetics of this child. Sometimes you don't know have much information at all about family medical history. You won't have as much information as you would like on the prenatal environment. You may know something about a birth mom, but know very little about the birth.

Speaker 3 17:49

And so there's so many unknown and that can be so frightening. Some thoughts on that, about coping with the unknowns of this type of parenting. It is. It's very frightening, which is why I used the term earlier except the devil we don't know versus the devil we do know . So what infertility does, one of the many things in fertility does to us fertility challenges does to us is it strips us of the illusion of control that we have. So when we're trying to get pregnant with our own eggs, uterus, and the sperm of our choice, we have an illusion that we're going to have that fantasize for perfect child. And it's going to have a few flaws because it will be human. So it may have a little bit of a quick temper like you do, or it might have impatience like your partner, right? But for the most part, it's the best of all of us. And the hardest job I have is working with people who are moving into non-genetic parenting and they have to accept that they really never had control to begin with over the child that they might have because we all know lots and lots of people who have genetically related children that are very foreign to them. They're really not like them. They don't look like them, they don't have personalities like them, et cetera, et cetera. Of course there are families strains, but we have this allusion that we're going to create the exact child we want. And it doesn't work that way. It just doesn't work that way because people are autonomous and we're not having clones. So fertility slaps us in the face with the reality that we never really got to design that perfect child in the first place. And so it shatters our illusion of control. And then we move on to something like egg donation and or adoption. And we're confronted again with the devil we don't know versus the devil we do. So it requires us to fully embrace children that may and very well likely might be very different from us and from the children that we originally tried to have. Children that are very different in appearance. Children that are different in talents and strengths and personality style that may not fit in the same way that we might imagine are genetic offspring fitting . And you know, we live in a world that values sameness when people, and I deal with this in the infertility community all the time, that have children, particularly through Gammy donation and people are constantly saying, Oh your baby doesn't look like you. Or does it look like its father? Or where did it get its red hair? You know, it's a means of conversation when people have very young children, but it's real trigger for people that don't have children genetically related to them. And contrary to Lee , you might know, and I experienced all the time that people who had children quite easily through their bodies and with their gametes, people will say, Oh my God, they're a chip off the old block. They look just like you and the parents will just beam. It's like a compliment to them, right? Because we have a normal narcissism, we have like a normal narcissism that says, Ooh, I really like that, that my child looks just like me. So then what happens when you know you're not going to get that? Or you know, maybe they have a similar phenotype but you know, they don't really look like you. So is that a bad thing? We have to, I like challenging people's beliefs and saying, why is that a bad thing? Okay, so your kid doesn't look like you. You know, let's confront our own narcissism because what we're teaching our children is that sameness is good and differences bad. And that doesn't bode well for the future in many, many ways as a society, as a family, as individuals, right? So what we really want to do is create families where people are saying, Oh my God, that's so interesting. I've never even thought about that thing you're interested in teach me, or let's learn about it together. Or you go do that thing because I'm not interested at all. But you go for it. It's, you know, that's your thing. And to support those differences and not encourage us all to be similar and fertility does that. Adoptive parenting does that. It says, okay, I'm ready to embrace whatever children end up being the children I parent regardless of any similarity or difference that we have to each other.

Speaker 2 23:01

Yeah, that is so true. And the, of course, the reality is that children by our genetic children will often be either quite different or sometimes it's when they are quite like us, that makes it even more difficult to parent. You know, two very intense temperaments can clash horribly. But I think the point is that of course we never imagined that. And because in fertility robs us of that experience, we go back to fantasizing exactly that of course, that we would feel totally understood and , and that it would, if not be a clone , be really close to one. Yeah, exactly right. Yeah. So, yeah. Now let's talk

Speaker 3 23:46

about some of the, so how do you say goodbye to your fantasy child, the perfect combination of you and , and your partners or your donors sperm. So how do we say goodbye to that? Well, there are, you know, of course many ways, but one of the things that I recommend that's also in the book I wrote, let's talk about egg donation. Because the fertility grief is so similar between Gammy donation and adoption is to conceptualize this way. Most people who are saying goodbye metaphorically or literally to the child that they originally tried to have feel like there's been a death in the family. And it's not until someone gives them those words that they say, Oh my God, that's exactly how I've been feeling, but I didn't know it. So we've given them that language and we've said, yes, of course. No wonder you're so sad. No wonder you're depressed is because there's been a death in the family and there has, there's been the death of an imagined, you know, person in that family that they're not going to be able to meet. However, this imagined child does not have a birthdate int he or she does not have a death date. There may be potential children that have been lost along the way to miscarriage or perinatal death , and they may actually have a death date, but for the most part, we're talking about children that were never conceived, and so we don't have a ritual around it. We don't have a funeral. People don't say, I'm sorry for your loss the way they do when your parent passes away or someone close to you passes away, your workplace doesn't say, please take as much time as you need. We're so sorry for your loss. People don't bring you food. They don't knock on your door and hand you casseroles. We don't go to church to grieve the loss of a baby that never even got created in our bodies. We don't sit Shivah . We don't do any of the rituals of mourning . Exactly. We don't. So what can be very helpful is to create them. And one of the ways to do that is through a letter by writing a letter to the child that you'll never know. And that really means, dear child, I'll never know. And you can give this imaginary child a name, you can give it a name that you would not eventually give to a child, you parent, you can give it whatever name you want or you can just refer to it however you want to. Most people imagine a specific gender. Most women imagine a little girl and vice versa, but not always. And the letter would say something like, this is who I imagined you would be. This is what I imagined we would do together. You would have your dad or moms , you know, shining eyes or beautiful smile or a sense of humor and you would have my grandmother's great ability to cook or whatever it is. And to attribute to that last child all these things that you've been imagining. Because what we're doing is making concrete what has not been concrete. It's only been imaginary. And then to tell that child in that letter, but I have to let you go. Now I have to let you go to make space in my home and my heart for the child or children that will eventually be mine. Because ghosts take up a lot of space in our home, in our heart. They're always there. They're always haunting us. And what we want to do is say goodbye to these children so they don't become the ghosts that hang around. And it's very hard to do. Every time I describe this in a session, my clients are crying and when they do it, they're crying because it's sad. It's supposed to be sad because funerals and deaths are sad and hard. But then the idea is that that, you know, we didn't get that funeral, right? So there's no cemetery where we watch our grandfather be lowered into the ground or there's no going out to see and distributing ashes. And so we have to create some kind of a ritual that is like a funeral. Like you said, we don't sit Shivah or go to church and say mass for these kinds of losses. So then the idea is to take this letter and to do something significant with it because we don't put bodies in our attics and hold on to them. So we want to basically give our fantasy of funeral of sorts. And that can be anything that has particular meaning to you and or your partner. Many of the people listening to this may be single. They might not have partners and certainly they may also have same sex partners. So the pronouns certainly are interchangeable, but it's a matter of finding a ritual or an exercise that has particular meaning. Um , many of the exercises or the rituals that clients have done over the years fall into certain categories. I live in Los Angeles, which is very close to the ocean and the ocean is a particularly healing place to be. It's also very ephemeral and eternal. So a lot of people will go to the beach and read the letter to the seagulls and the fish and they'll rip the letter up and throw it in the water or buried in the sand. Um, some people will hike to their favorite mountain top and put the letter in the crook of their favorite shade tree where they stop and always, you know, have refreshments . Some people will burn the letter in their fireplace , uh, which again has that feeling of like a cremation and it's very ritual feeling. It may be in conjunction with lighting candles, it might be in conjunction with going to synagogue or church or a mosque or whatever has meaning in a spiritual way to accompany the ritual. But the idea is basically to get rid of it because this is like technically it's like your child's funeral now. And this exercise is enormously helpful to people in realizing that they'd been carrying around a very specific child in their hearts that they didn't even know that were. And once they do that, it's not a panacea. Obviously infertility is a lifelong disease that goes into remission for long periods of time. So there are going to be periods of time in the life of everybody who was not able to reproduce the way they wanted to when they wanted to, when fertility issues are gonna come up again. But I find almost universally that a space has been created for that individual or coupled to then make decisions about what their next step is going to be about bringing children into their lives. And then usually means a choice between adoption or gummy donation. Sometimes it means they might choose not to become parents at all, but almost always what it does is make them realize that they can't control the outcome and that they're saying goodbye to an illusion they had. And now they're ready to welcome whoever is next.

Speaker 2 32:02

So if the elements are to make concrete the imaginary child, and so first of all, in your mind, make concrete, assign a name, a gender, and imagine how that child would be and then write a letter to that child and then burying in some way , uh, putting to rest in some way that letter as a physical representation of the child that you have imagined. And did I capture it all?

Speaker 3 32:34

And the , the, the, I would just add the letter is a hello and a goodbye letter. Is that the reason being that it's so hard to say goodbye to someone or some thing we never said hello to. So the, the idea of the letter is to be able to say hello because you never got to hold that child in your arms. You know, the same way that in the old days they used to whisk children away from birth mothers who were going to make adoption choices and they didn't even know what gender of child they had. They didn't get to hold that baby and they thought that was best. Right? They thought that would help that birth mother and resolution. And then we got to know better and that it's exactly the opposite. And that birth mothers who are able to hold their babies and say hello and maybe named them and then say goodbye and tell them about the choices they're making, it makes all the difference in the world in some level of resolution in this excruciating choice. And there are many examples of exactly that kind of thing that it's just so hard to say goodbye to an idea as opposed to a person. So the letter is concretizing that notion saying hello and then goodbye and also

Speaker 2 33:54

similar in that we've learned with a stillbirth that it is not every parent chooses, but if they choose, there is some good research that would indicate that it is healing for parents to have been able to hold touch and for a short time nurture , um , there's the , the child that was born dead. Yeah. So I think that would be very similar. Pause for a moment and remind people that this show is underwritten by the jockey being family foundation post permanency adoption support programs are vital to helping preserve families. However, the availability of these programs is not always communicated clearly during the adoption process. I would say that is very true. Legal professionals and judges are essential to encourage the use of these services when permissible by law judges and the court clerks and the job should agencies can order backpacks through the jockey being family website. And these backpacks can be shipped to the courthouse for adoption day as a way of celebrating the finalization of an adoption. What's important about the backpacks? Not only are they high quality backpacks and they're have the child's initials embroidery RJ into Intuit , but also there is a post adoption option . Resources included for the parents included in these backpacks. Your agency or if you are a judge are an attorney or even a a court clerk. A , you can sign up@thejockeybeingfamily.com website. Click on backpack and you can sign up. It is free for you. It is free for the , uh, it is the mission of jockey being family. So pop on over there and , and sign up. Uh, we're talking about coping with the losses and grief of infertility before you adopt. And you were talking about the ritualization of , uh, creating a hello and goodbye letter. Does this also help with coming to terms with, you're never going to be pregnant. You're never going to feel the, you know, the, a baby, a move in your stomach , uh , your uterus that , uh , you're never going to be able to sit around when women are complaining about their labor stories and have a story to share. Does the saying goodbye to the imaginary child help with any of these other losses? And if not, are there things other than just realizing that that's just not your path that help with that loss, those other losses?

Speaker 3 36:31

Yes, yes and no. This letter can be adapted to really be a hello and goodbye letter to almost anything or anybody meaning, Hey , you know, it's, it's a very adaptable exercise and oftentimes people have multiple goodbyes to make. You know, anybody who's been through fertility treatment long enough, many of them have had miscarriages, they have had failed embryo transfers. And I've had many clients who might write multiple letters. One might be, you know, to the child they never had after an embryo transfer or multiple embryo transfers because many people feel like that's a miscarriage. They might write a letter to a child that was growing in them and then they miscarried. But it can also be to a pregnancy that never happened. It can also be to the partner I never met. Right. So it's really anything that we imagine that never came to fruition. So I would say yes definitely. This exercise could be used for anyone. A woman for example who may be one letter is for the child but she's not going to have. But another letter might be for the pregnancy that she has to say goodbye to, to the imaginary feelings that she might have experienced during the pregnancy. All in which are imaginary, right. She imagined all imagines, all those great things that one hopes will happen in pregnancy and she doesn't know that maybe she might be so sick she's hospitalized or you know, things can occur during a pregnancy, but this is her fantasy. So yes, definitely it can be to the pregnancy. I'll never have, this is how I imagine that occurring. But now I have to say goodbye to you.

Speaker 2 38:28

[inaudible] one of the things that we will often hear, it's, it's interesting cause I think this is, this happens not infrequently, but I don't think it's talked about too

Speaker 3 38:36

often and that is uh , people staying in fertility treatment while they apply to adopt hedging their bets, you know , and what they will say, w what , uh, the people who are doing this will say is I'll be happy with either outcome. I just even bet. But why should I go down just one path? So what are your thoughts on that and what would be your concerns are and are , do you have any ? Yeah. And so tophi you know, that , uh , in the olden days, social workers and agencies really required people to be finished with. And sometimes they still do. Sometimes that is , sometimes they still do, but it's loosened up, I think a little bit. You know, it's a tough call. There are some people who really should not do it because it represents kind of not being as finished as we hope they might be. You know, the reason for it, just to be explicit is because if one is continuing to try to become pregnant with genetically related child, it's really, I know I have a child already, but I still really need the wishing for a child that fantasize child. And sometimes you know, especially today it might also be I just really, really want to be pregnant, but I'm okay if that child's not genetically related to me. So there are more options today that may get more possible that it could be okay. It's very individual and I don't think there's a black and white rule that we can do, but I think for anyone listening, you just have to ask yourself, why are you continuing treatment? Is it the pregnancy? Is it because your partner really wants a genetic offspring? Is it because you really still want a genetic offspring? And then what does that mean? And honestly, obviously I'm biased, I'm a mental health professional, but I think most of this stuff is too hard to do on one zone and requires some kind of a guide who can help them figure that out. There are also some consequences. I mean certainly there are a lot of bio adoptive families with children of different origins. My own family included, even though neither of my kids are genetically related to me, I did give birth to my son who was conceived through egg donation. So they do have different origin stories and those families can be very successful, but there can be consequences to a family where maybe one was a , was adopted and very little is known about their original story or their birth family. And then along comes a biological child or a genetically related child born to mom and they're , you know, there are issues, sometimes challenges to address and to be dealt with. They're not insurmountable, but they certainly have to be addressed, you know, and that raises

Speaker 2 41:34

an issue that comes up more now and that is going back into treatment, fertility treatment after you have adopted. There is a lot of guilt associated with people who were doing this. And so I don't think they're talking with their adoption professionals. It's almost the, the feeling that, am I being disloyal to this child that I have adopted? If I go back into treatment and , and also are we adding complications to our first child, our adopted child? Because is that going to be reflective for this child that you are just a placeholder until I could get emotionally ready to go back for what I really wanted. And I think parents need to , to wrestle with it. But the reality is fertility treatment continues to advance. Your finances may improve. So there are options. I mean that is a real option. So what are your thoughts on that?

Speaker 3 42:28

It's just a very, very individual choice and you know, nobody, I can't tell you whether or not that's going to be a good idea for your family.

Speaker 2 42:37

It takes a lot of soul searching.

Speaker 3 42:40

But yeah, the circumstances do change and finances change and you know, new treatment for different fertility challenges arise.

Speaker 2 42:50

Well yeah and , and or the, the reality for some people is that adoption is expensive and adoption is stressful. And, and, and you know, when , when you're going through treatment you think, Oh man, this is expensive. This is stressful. But after you've gone through another, another form of family building that is also a differently expensive and differently challenging, but it's not a walk in the park either. So , uh , there's the function of time , um,

Speaker 3 43:20

because depending, I mean there's, there's no guarantee obviously with fertility treatment, but adoption can take a very, very long time and maybe [inaudible]

Speaker 2 43:30

maybe people would prefer to have a second or a third child more quickly than it would take to go through an adoption process. It may be uncertain. Yeah. I think that , uh , what would be some questions that families should ask parents should ask themselves to help them sort through. And then we're going to talk about how to find a professional, because I think this is a , uh , a mental health professional that understands some of these issues because I think that this is a big decision. And so , uh, what are some questions that a big decision that outside help can certainly help , uh, help you sort through? So what are some questions that parents should ask themselves when they're trying to make the decision on going back into treatment after they have adopted? What's my motivation? Is this related to pregnancy? Is it related to the genetics? Is there a function of the parenting experience

Speaker 3 44:32

I've had thus far that feels unsatisfying that I somehow imagine or fantasize that a different parenting experience would be more satisfying? Um, am I buckling to someone else's pressure? Am I doing this for my partner? Am I doing it because my parents have concerns about the family I created through adoption? What do I think the next child will bring our family that adoption would not, I mean those are just right off the top of my head. Those are hard questions to answer.

Speaker 2 45:08

Yeah. And not only you, but , but you and your partner if your partner , um , we'll also need to be, yeah. That , that is very true. So let's talk now about any of these decisions. Uh , whether it is to, am I ready to stop fertility treatment and move to non-genetic parenting adoption, a donor gametes, or do I need to continue in treatment awhile longer or can I love a child who is not genetically related to me? All of these are, or should I go back into treatment after I have adopted a child? All of these circle around the issue of infertility, grief and it is complex and it's, and it's not well understood. So this is a time when getting mental health , uh, seeking out mental health professionals. But I think it helps to talk with a professional who understands infertility and infertility grief. So how would people find such a professional?

Speaker 3 46:13

Well, one place is that there is a , there's an organization called the American society for reproductive medicine and that's sort of the, it's like the American medical association for reproductive professionals. Um, primarily physicians, but there's a subgroup of mental health professionals and that's called the mental health professional group. So , um, and those are people who specialize in fertility issues and many of them are , uh, well they're all very well versed in fertility treatments and reproductive medicine, but many are also very familiar with adoption issues. And you can find one of those professionals by going to the website, a S R m.org. And then you can go to find a professional and it will lead you to where you can look for a mental health professional. The other is the national association of social workers will often have a sub specialty group of social workers that are very familiar with adoption. You know , I will

Speaker 2 47:30

suggest one Oh good if you have been in treatment and even if you haven't calling up a nearby clinic, they either very often will have sometimes. So I have somebody on staff that you can see, I mean you're paying for it, but um , or they will have an affiliation , uh , with a mental health professional , uh, that they refer their patients to. And the other thing , uh, I would , uh, keep in mind is that because we do hear from people saying, you know, I live so far away from it , that's just not a practical solution. You know, the nearest town that might possibly even have a fertility clinic is two hours away or, or whatever. There is a, an increased use of telemedicine and I, and some of these professionals that , uh, mental health professionals that specialize in infertility. And as you point out , uh, non-genetic parenting including adoption is often included within their specialty. We'll also be able to see you even if you are not living nearby and that, so that don't let that be. And I think there's some advantages to being in person but don't let that be. There are also some disadvantages. So don't let that be your, your, your hesitancy for going, well let me pause now and remind people that this show and all the resources that we provide at creating a family would not happen without the support of our partners and our partners, our agencies that believe in our mission and they, they put their money where their mouth is because they support us financial aid to allow us to provide these resources. Uh, both pre and post adoption. One of our wonderful partners is hopscotch adoption. They are hae accredited international adoption agencies , placing children from Armenia full Garia , Croatia, Georgia, Ghana, Kiana , Morocco, Pakistan, Serbia, Ukraine. And they also do kinship adoptions from many countries throughout the world. And we have adoptions from the heart. They have helped to build over 6,000 families since 1985 through domestic infant adoption. They work with people all across the U S and there fully licensed in Pennsylvania, New Jersey, New York, Delaware, Virginia, and Connecticut. Well, thank you so much , uh , Carol LIBOR Wilkins for being with us today to talk about , uh, coming to terms with the infertility grief before you adopt. It's an important topic and we very much appreciate having you here to talk about it. Oh, it's my pleasure, Dawn. Anytime. I'm always happy to come back. The views expressed in this show are those of the guests and do not necessarily reflect the position of creating a family. Our partners are underwriters and keep in mind that the information given in this interview is general advice to help you understand how it applies to your specific situation you need to work your infertility or adoption professional. Thanks for joining us today and I will see you next week.