Unfulfilled Expectations

Our first son was born in 1995, an "accident" who turned out to be our "miracle baby." You hear about couples who try for years to conceive and finally—after months and months and months—have the child of their dreams, their miracle baby. Our miracle baby came before my husband and I knew we had a problem.

About two and a half years after he was born, we were ready for child number two to make our family "complete"—one son, one daughter, a mom, a dad—the perfect package. However, after a few months, I began to get worried. Why was this taking so long?

My gynecologist immediately put me on fertility drugs, which made me edgy. With a toddler at home and a husband often traveling for work, I found dealing with these side effects increasingly difficult. After some months went by, I decided to see an infertility specialist. He was a wonderfully reassuring grandfather type who helped me to remember that yes, we had one child; conceiving the second had a good chance of happening, too.

One day soon, I thought, I'd finally have that positive pregnancy test. Before much longer, I'd be able to call our family and friends to tell them our son was going to be a big brother. But the pregnancy tests were always negative; our second child was never conceived.

Secondary Infertility Defined

Those unable to conceive a child after 12 months without contraception are considered to have primary infertility, as defined by the Centers for Disease Control. According to a 1995 survey by the CDC, 6.1 million American women ages 15 through 44 experience impaired ability to have children.

Surprisingly, the CDC report on infertility revealed that more than half the women of reproductive age who experience infertility already have at least one child. These couples experience secondary infertility, which refers to the inability to have another child after at least 12 months of trying. Resolve, Inc., the national infertility association, estimates more than three million Americans struggle with secondary infertility.

"Even though secondary infertility is more prevalent than primary infertility, couples are less apt to seek treatment for this condition," reports Resolve, Inc. "When their first child is conceived with ease, many couples are caught completely off guard by the difficulty of having a second child, because they believe past fertility insures future fertility."

Caught off guard is definitely the way I'd describe how my husband and I felt when we realized just how difficult it would be to have our dreamed–for second child. The infertility specialist I saw performed tests that showed extensive endometriosis (probably caused by incomplete healing after my C–section) and found a nodule on my thyroid gland. We coordinated the two surgeries—the thyroid surgery and a laparoscopy to "clean out" the endometriosis—and my mom came to help take care of our son.

Post–surgery, our hopes soared. Surely now we'd have no problem conceiving. But the months wore on, the doctor visits were frequent (and difficult to manage with a toddler), and the medical expenses added up. We found our insurance coverage was less extensive than we were led to believe.

Soon thereafter, my husband and I had "the talk," one step in coming to terms with our infertility. We talked about the emotional toll the treatments caused, the strain on our marriage, and the frustration of not enjoying our son's childhood because we were so wrapped up in having another child. We decided to take a break from treatment.

My physician said, "If you stop treatment, your chances of pregnancy are extremely low." My husband said, "Our family is in God's hands. Let's trust him to know the best size for our family." My heart said, Lord, I can't handle this treatment roller coaster anymore. It's in your hands.

Understanding the Condition

When we first couldn't conceive, I turned to my gynecologist, then to a reproductive endocrinologist to help me understand my infertility and improve our chances for another child. Then I researched and educated myself about all the fancy doctor–speak: polycystic ovarian syndrome, fibroids, Clomid, etc. A simple Google search led to many resources on understanding primary and secondary infertility. Resolve, Inc. provided extremely helpful information. Understanding what to expect from my testing and treatment helped prepare me emotionally to deal with what was to come.

Frequently those who experience secondary infertility feel caught "in the middle." It's hard to talk to friends who have no children and are experiencing infertility because they think, You already have a child. Be grateful for him. It's also difficult to talk to moms who have two or more kids because they think, What I wouldn't give for the free time and quiet of a one–child household! This can make a couple feel more isolated in their struggle; that's why it's so important to find support through organizations such as Resolve, Inc.

Many couples who deal with secondary infertility feel sad as their only child grows older. It's bittersweet to watch our son go through the stages of childhood and know we'll experience these only once. Milestones like his first loose tooth, his first day of kindergarten, or the day he learned to ride his bike came and went so quickly. While I love watching him grow and gain independence, I also feel sad that I'll never experience these special days with another child. In a sense, our empty nest came too quickly.

Related to this concern for many is the issue of child spacing. As the child in the family grows older, the couple must decide how many years to prolong fertility treatments, resulting in a wider gap between children. The age of the couple affects childbearing, but another factor involved with secondary infertility is how far apart to space children.

For the couple experiencing secondary infertility, they must deal with disappointment and loss; however, their child must cope with the issues as well. Couples may struggle with "letting down" each other, but have the additional burden of feeling as though they've denied their child the blessing of having a sibling.

"It's quite possible that children pick up on the societal norm for families and realize that their family is somehow different. It's painful to feel that your child is being set apart or deprived," says Harriet Fishman Simons, author of Wanting Another Child: Coping with Secondary Infertility "Mom—why can't I have a baby brother or sister?" becomes the refrain for many only children. Explaining to a child that families come in all sizes and pointing out the positives of their only–child status can alleviate some of the frustrations and fears of the couple as well as of their child.

I'd always assumed that if I had any children, I'd have more than one. I grew up with two brothers, and while my husband and I never imagined having a large family, we hoped for at least two kids. Struggling with this "definition" of family is something with which many people experiencing secondary infertility must grapple. As Simons writes, "While on some level couples know they and a single child are a family, it may not always feel like what a 'real family' should be. As the adoptive mother of a second child put it, yes, one child does make a family, but 'two is more of a family.'"

In one sense, my emotional struggle with secondary infertility was more about recreating my expectations of an ideal family; that four–person ideal was going to have to go. As Simons notes, "You may need to grieve for the fantasized family you may be unable to have before you're able to refocus on choosing alternative outcomes."

Finding Resolution

Couples who experience secondary infertility come through their experience in at least three ways. Some couples, after seeking treatment, ultimately have the second child they hoped for. Others may build their family through adoption. Still others come to the conclusion that having an only child (or fewer children) is enough.

It takes time to sort through the muddle of emotions associated with secondary infertility. It's been almost six years since we first sought treatment. While my husband and I would still love a second child, we have found contentment in our family of three and no longer want to go through the stress and difficulties of treatment. The twinges of sorrow are still with me, but mostly, they're only twinges. After holding a friend's new baby or after hearing a stray comment ("Is he your only child?"), I still can be shaken from my normal composure.

But good things have come from our only–child status. Life is simpler with only one sports and music lesson schedule to juggle. Our son may never wear the "I'm the big brother" T–shirt, but we also don't have to deal with sibling rivalry and bickering. Taking care of cooking and laundry are easier. While it made me sad to send my son off to school because I had no little one at home, I relish the free time I have during the day now. That extra time has given me the opportunity to do volunteer work with the PTA and at church, and to pursue my lifelong love of writing.

Remember Hannah, the Old Testament mother of the prophet Samuel? She prayed: "O Lord Almighty, if you will only look upon your servant's misery and remember me, and not forget your servant but give her a son, then I will give him to the Lord for all the days of his life" (1 Samuel 1:11). Hannah, Abraham's wife, Sarah, and other women in the Bible also struggled with infertility. I've prayed the same prayers they did. I've had the same longing as theirs. Knowing I'm not alone in my struggle—that other women felt the same grief and sorrow over infertility—helps me cope.

Most important, though, I'm forced to cling to my Savior. At times I've felt anger and frustration toward God for not answering our prayers the way I think they should be answered. But now, years later, I honestly can say struggling through secondary infertility has been a blessing.

Instead of resenting what we haven't been given, I've learned to become more grateful to God for the blessings we do have, including our marriage, our precious son, and, most important, salvation in Christ. I know now that God can bring good out of difficulties. I've learned, in a small way, that contentment is not something I can create within myself. Contentment is a gift of God, and I cling to him for all good gifts. Mostly, I'm reassured that God truly has sustained our family and continues to do so. He cares for me through all the changes and situations in my life. Psalm 55:22 has proven true for me: "Cast your cares on the Lord and he will sustain you." What more can I hope for?

Julie Stiegemeyer, a pastor's wife, mother, and the author of several children's books, including Saint Nicholas and Baby in the Manger (both Concordia), lives with her family in Pennsylvania.

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