The author with her children.
Over the years I spent struggling to have children, I experienced many
“Sliding Doors” moments ― a term coined from the 1998 Gwenyth Paltrow movie that shows how the small decision to get on a subway car or not drastically changes one woman’s destiny.
So many seemingly small decisions can set our lives on very different paths. We may wish we could, with the benefit of knowledge, go back and steer to a different destination. When it comes to family planning, there are some crucial things that I would have done differently in hindsight.
I hear a lot of people my age talk about how great their 30s were ― when they were building their families and careers. For me, a lot of that decade is a blur. Infertility took a toll on my career, my marriage, my family relationships, my finances, and my friendships.
I was 32 when I started trying to have a baby. I didn’t feel truly ready to let go of life without kids, but I was aware of the biological clock we hear so much about. Still, it never crossed my mind that I would have any trouble conceiving. My family doctor gave me the standard advice for women my age: Try for 12 months, and if nothing happens, come back.
I spent the first few months joking with friends about how much sex I was having. I spent the next few months wondering if my husband was doing something wrong. Eighteen months later, I was standing in a fertility clinic listening to a specialist tell me that my hormone levels were borderline menopausal, and I didn’t have many eggs left.
She explained that the average woman’s fertility peaks in her late 20s, and that by the age I had first started trying, 15% of women were already considered infertile, making it hard or impossible for them to get pregnant.
As I learned the facts about infertility, it baffled me that I had not known any of this seemingly critical, life-altering information before. How was a fertility work-up not a routine part of the medical care of every person in their late 20s who might want a baby someday?
I started fertility treatments immediately, but three years in, I had nothing to show for it but a large medical file. That’s when my husband and I decided to look into surrogacy. Surrogacy was much less common then, but I knew someone who knew someone who had worked with a surrogate, and they kindly agreed to connect me to her. She agreed to be our surrogate, and within months, she became pregnant.
I settled into what felt like a pretty normal pregnancy experience, preparing our house and our life for a newborn and driving to my surrogate’s medical appointments in a city near mine.
The day before the due date, at our final appointment, I listened to the baby’s heartbeat, strong and rhythmic. An induction date was scheduled for three days later if labor didn’t start on its own by then. I felt calm and happy. In the next 72 hours, I was going to become a mother.
That next afternoon, my surrogate called me at work to let me know that labor had started, and she was going to the hospital. My husband and I made our way there to meet her. We were sent to a waiting room down an empty hallway and told that the doctor would come see us. I figured things were too far along for us to be allowed in the delivery room.
After sitting for what felt like eternity, I looked around the room and realized it was eerily empty. It was spotless and sterile, the only room I have ever been in that smelled like nothing. I asked my husband to go see what was going on, but when he stepped out of the room, there was a group of people already walking down the hallway toward us. My heart quickened.
They entered, and a doctor told us that our surrogate had had a traumatic delivery. There was no fetal heartbeat. Once our daughter was out, they tried unsuccessfully to resuscitate her, but she was stillborn.
While they were cleaning the baby so we could see her before she was taken to the morgue, I went to check on our surrogate. I sat on the edge of her bed in the recovery room, and we cried together.
Later, my husband and I drove home in silence. I don’t know what he was thinking, but I was trying to grasp what had changed in that short period. We had arrived at the hospital without a child, and we were going home without a child. So why did it feel like someone had ripped my heart out of my body?
When I posed that question to a friend the next day, she said, “Because you became parents last night.”
I reflected on how much we had lost during the last few years. Month after month, picking myself up after bad news and failed attempts, I often wondered if I had hit rock bottom. That night, I knew I was finally there. My husband and I entered a dark and isolated place as we grieved the loss of our daughter.
But remarkably, two years after that terrible night, not one but two new surrogates became pregnant at the same time. Our first surrogate sadly miscarried. Our second surrogate gave birth to our daughter Georgia. It was much earlier than expected, and Georgia spent the first 10 weeks of her life in an incubator. Around that time, the first surrogate found out that the baby she had miscarried was a twin and she was still pregnant with another baby. Our daughter Sadie arrived just three months after Georgia.
Then, another miracle ― shortly after the girls were born, I discovered I was pregnant with my son Lucas. He was born on Christmas Day with a head the size of a basketball. After seven full years of trying to have children, we found ourselves with three babies in 15 months.
By sharing my experience, I do not mean to scare people or pressure them into having babies before they are ready. Becoming a parent is a deeply personal and sacred choice. Women have already lost access to essential reproductive health care choices across the United States. But if we aren’t educated about our own fertility and the risks of infertility, many will lose control over the decision of if or when they want to have a child.
An ultrasound technician once tried to tell me that the waiting room in my fertility clinic was filled with women like me ― lawyers, doctors, engineers, business women ― because we focused on our careers and waited too long to have babies. I told her the waiting room looked that way because we had money and were privileged to be able to afford help.
Infertility treatment is a $20 billion dollar a year global industry today and projected to grow to almost $38 billion by 2027. But unless you are wealthy or are lucky enough to work for a company that offers generous health benefits for fertility treatment ― and few do ― treatment is often out of reach. The dividing line between those who end up with a child and those who don’t often comes down to money.
But the desire to become a parent transcends socioeconomic status, as well as the other factors that can limit access to treatment for marginalized groups. When people who are struggling with infertility reach out to me for advice, here is what I tell them: Know the facts and make decisions based on those facts. Get your fertility work-up done ― a simple blood test and ultrasound of your ovaries for women. Have the results explained to you by your doctor so that you understand what they mean.
I also tell them this: Whatever path you choose to try to have children, don’t delay becoming informed or getting help. If I had been better informed about my own fertility, I might have been able to avoid spending a painful and futile 18 months trying to conceive.
My children are, without question, the greatest gift that came out of my experience and because of them, I would never change my path. But I want anyone who wants a child one day to be able to make an informed choice about when that day comes.To do that, they need to receive the right information while it’s still early enough to use it.
Alex Johnston is a fertility advocate and author of “Inconceivable: My Life-Altering, Eye-Opening Journey from Infertility to Motherhood” about her experience losing a baby carried through a surrogate and suffering years of infertility. Fueled by her personal journey and extensive policy and reproductive health care research, she works to raise awareness about infertility and its role as an enormous factor impacting the choice to become a parent.