What fertility clinics could learn from teachers

If you have attended fertility appointments with a notebook and a pen the chances are the consultant will have assumed you’re either a teacher or a lawyer.

Teachers know the importance of preparing the right questions for their students, and of probing for deeper understanding. They’re passionate about life learning and this extends beyond the classroom. Teachers enforce positive language in an inclusive environment so that productive learning and growth can take place.

Recently Lena Dunham, a US filmmaker and writer from New York, published a memoir for Harpers titled ‘False Labour: Giving up on Motherhood’ that depicted Dunham’s devastating journey through IVF which including her boyfriend cheating on her midway through.

 

The essay has caused controversy amongst some bloggers and women who have gone through IVF and infertility themselves because they felt like they were being judged.

 

The reason for this is that Dunham described the women who tend to use the hashtag #IVF Warriors as fitting the stereotype of ‘white’ and ‘wealthy’; however Dunham also acknowledges that these women can often have more than one job, are forced to remortgage their house, and take out loans necessary to pay for treatment.

 

This implies that Dunham doesn’t believe that all who use #IVF Warriors as privileged as she sees their struggle.

 

This essay highlighted how language can at the same time both hurt and empower depending on who is reading/ receiving it.

 

#IVF Warriors made Dunham feel ostracised from a group where she believes the consensus is ‘never quit, because nothing is impossible’ and ‘no expense is too great to bring another child into the world’. 

Fertility Clinic Staff played a part in this negative experience for Lena Dunham.

 

Dunham explains how the receptionist mistook her Father to be her partner and how this made her feel sick.

 

Why a receptionist would jump right in assume is anybody’s guess. This assumption on the receptionists part meant an embarrassing moment for Dunham, one that could have been avoided, and a big red cross for the fertility clinic.

 

Dunham continues to describe how she was categorised by doctors as a ‘good candidate’ due to the one working ovary that she had.

1. Teachers ‘address the behaviour not the student’.

If a student, let’s say Laura, was giggling in lesson and talking over the teacher then we wouldn’t say ‘Laura, you’re being rude’, but ‘Laura, your behaviour is not acceptable today’. Separating the student and the behaviour.

 

The first could come across as confrontational to a student and the second would allow the student to process as they would not feel targeted.

 

With Lena, the doctors here were not separating the cause of infertility from the person, and not only this but they used judgmental language in the use of ‘good’.

2. Teachers are adept at using none judgmental language.

We know when writing annual reports that when we need to tell Leo’s parents that he’s a s##t in class and disrupts the learning of others that we will be describing Leo as an ‘excitable character who can distract his peers from time to time’.

 

We do this because we don’t want to sabotage a young character with comments that no matter how true at the time could have a lasting impact. It also wouldn’t be very professional.

 

Had the doctor not have labelled Lena as ‘good’ perhaps Lena would have felt like this was less of a judgment of her character. Similarly, if the doctor could have called Lena a ‘woman’ instead of a ‘candidate’, she might have felt more comfortable and less like she was taking an exam or about to have a job interview, or run for office. 

3. Teachers don't call students 'kids'

Kids is too casual and blasé when used in an educational setting. It can sound quite arrogant and nonchalant to hear a teacher say ‘kids’ in a meeting instead of ‘student’.

 

When teachers call to speak to parents we’re encouraged to use the preferred titles when addressing parents, so that a phone conversation would start with ‘Hello Ms Smith’ and not ‘Hello Mum’, which demonstrates the lack of decency to learn someone’s name.

 

Dunham reflects on the time her eggs failed to fertilise and when the doctor called to tell her of the bad news in his efforts to sympathise with her said “you’re a nice lady…we all would have loved to give you a different result”. Dunham writes how she felt ‘revolted’ by the word “lady”.

 

Patronising, unfamiliar and unhelpful.

Nice is boring and insulting too when describing character. Nobody wants to be remembered as nice.

Do we as a fertility community need to consider whether there is a future for #Fertility Warrior?

Lena describes being shunned by a community that she once felt part of after she made the decision to walk away from fertility treatment.

 

Is it an inclusive hashtag for all women experiencing fertility struggles or is it laced with undercurrents of dismissal?

 

Can women still be #Fertility Warriors if they stop treatment?

 

Jessica Hepburn’s fertility treatment ended after 11 rounds of IVF, multiple miscarriages and an ectopic pregnancy. Whether she would have swam the channel or not she is heroic for that very first round of fertility treatment and every one she entered after that, and for the losses she experienced along the way.

 

Hepburn has written 2 books about infertility and her last one 21 Miles took the reader through the training and mental blocks she had to overcome to be able to swim the channel. Would all the other women in the world like Lena and Jessica who were unable to have their own biological babies still be Warriors? I believe so.

Words can be patronising, insensitive and cruel.

We know this from the cliché comments we hear from family and friends after they learn of our fertility struggles. Phrases such as “just adopt” and “relax and it [a pregnancy] will happen” roll off the tongue without much thought.

 

And so came about the ‘Think what not to say’ (#TWNTS) campaign to raise awareness and encourage others to consider how hurtful their comments can be to those who are struggling with fertility.

 

Showing friends and family what not to say to those who are struggling to conceive is one part of the battle for better treatment but the other half is this lack of empathy found within the healthcare sector. 

Doctor Kate Granger

We know how hard medical staff work and we also know that because of this they can forget to include compassion in their care. 

 

2013 saw the launch of #Hello my name is, after Doctor Kate Granger who was diagnosed with terminal cancer noticed first-hand the lack of compassion from medical staff and health professionals who were treating her: from the nurses who would take her blood whilst chatting to their colleague, to the porter who would transport her from one location to another within the hospital without saying a word, and the doctor who would read her notes without looking up at her to say what he was doing and who he was.

 

In her legacy, Doctor Kate Granger has left a very positive message for health staff globally. That when patients are in hospital effective communication, the little things, and being seen as a human and not a statistic are important, and that patients should be at the ‘heart of all decisions’.

When patient feelings are at the forefront of care language can become empowering, inspiring and kind.

 

There’s no question here that some choice words that were spoken by the professionals to Lena still bring back powerful painful memories for her. There are words that still make her feel negatively about herself and bring about feelings of isolation and loneliness.

4. Teachers get to know their pupils

Teachers get to know their pupils to better understand how they learn. Lesson plans are differentiated to allow pupils to thrive and progress within the classroom.

 

When women are pregnant they create a birth plan with their midwife so that they can make choices about how their baby will be born and so that they know hospital staff are aware of past and present concerns and what is important to them.

 

When it comes to IVF the consultant decides the plan.

 

It would be revolutionary  if within the treatment plan there was an opportunity for the patient to add what help make the experience as positive as it could be for them such as: what they wish to be called, ambiance in the theatre on transfer day, phrases to avoid saying.

 

An IVF plan prepared by both hopeful parents and medical staff  could make way for better communication and understanding between everyone involved. It could also ensure that important personal expectations for the patient- aside from wanting treatment to result in a healthy pregnancy and live birth, are met by staff at the fertility clinic or hospital. 

Lena Dunham has been incredibly brave to write this essay knowing full well that she would receive backlash for taking on #IVFwarrior that brings comfort to so many women. I hope that fertility clinics read her post and thought about the changes they could make to empower patients to feel valued and heard.

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