Emotional Support

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In order to survive and finish the IVF race, you need to make sure your racing team is working well together. A long struggle with infertility may take a toll on your marital relationship – as well as your relationship with others – causing distress and isolation.
You will want your marital relationship to feel on solid ground and your support system ready to assist you before starting a cycle. Facilitate communication with your partner by setting aside a limited amount of time to talk about IVF, possibly 20 minutes every day.
Discuss ahead of time whether you want to be together at appointments, on the day of the pregnancy test, or when you are expecting a call from the doctor. Decide which friends you will tell about the procedure by identifying who can give you the support you need (remember that patients often wish that they had not told so many people at the start.)
It can also be helpful to designate a friend as a “spokesperson” who will let others know – when you are ready – what’s going on. Consider joining an IVF support group, if it is available in your medical practice. A great deal of healing can come from others who understand.
Finally, counseling may be helpful if you are feeling depressed, very anxious, or emotionally stuck. Getting the support you need early may avert big problems down the road.
This is the third installment in a series of articles entitled “The IVF Race.” Read the rest of the articles in this series for suggestions in helping you finish the IVF race feeling like a champion, no matter where you place.
Previous articles from this series:
The IVF Race: A Grand Prix
The IVF Race: Maps & Terrains
Additional articles in this series:
The IVF Race: The Plan
The IVF Race: The Schedule
The IVF Race: Coping
The IVF Race: Goal Markers
The IVF Race: Bumps & Detours
The IVF Race: Credit for Completion
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services

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Good decision making involves being well educated and informed about your body and the IVF process. IVF is an anxiety producing experience – and one of the best antidotes for anxiety is information and knowledge.
The more you know, and the more you can anticipate during the process, the less stress you will feel. Look for articles and other reading materials about IVF. If your medical practice runs educational IVF classes, attend as a couple.
Seek out and talk with others who have been through IVF. As you look over the terrain, it is also important to look at the finish line and prepare for the possibility of not winning the race.
This is the second installment in a series of articles entitled “The IVF Race.” Read the rest of the articles in this series for suggestions in helping you finish the IVF race feeling like a champion, no matter where you place.
Previous articles from this series:
The IVF Race: A Grand Prix
Additional articles in this series:
The IVF Race: The Racing Team
The IVF Race: The Plan
The IVF Race: The Schedule
The IVF Race: Coping
The IVF Race: Goal Markers
The IVF Race: Bumps & Detours
The IVF Race: Credit for Completion
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services

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While in vitro fertilization (IVF) has created opportunities for infertility patients to have a biological child, it has also produced some significant challenges. It is stressful, often the last hope, and a gamble. IVF is considered by patients to be the most stressful of all infertility treatments. Patients have rated the stress of undergoing IVF as more stressful than, or almost as stressful as any other major life event – such as the death of a family member, separation or divorce.
Many couples enter an IVF program after several years of unsuccessful testing and treatment, often at tremendous emotional cost. IVF can be a gamble, where the stakes are high and the chance of winning is extremely low. Like gamblers, IVF patients’ expectations may be unrealistic. On the one hand, they may be certain that the IVF will be successful; on the other, they may be convinced the procedure will fail but feel compelled to try one last time. Like compulsive gamblers, they find it difficult to stop, for a great deal has already been invested physically, emotionally, and financially in the quest to have a biological child.
An analogy can be drawn between IVF and the Grand Prix car race, where a long and dangerous drive over the mountainous terrain may result in winning the “big prize.” If you are considering IVF or are currently an IVF patient, it may be useful to prepare for this treatment with the same planning and conditioning as if you were entering the Grand Prix. You need to take the opportunity to refill your “emotional” gas tank and get in the best possible shape before beginning the IVF race.
This is the first installment in a series of articles entitled “The IVF Race.” Read the rest of the articles in this series for suggestions in helping you finish the IVF race feeling like a champion, no matter where you place.
Additional articles in this series:
The IVF Race: Maps & Terrains
The IVF Race: The Racing Team
The IVF Race: The Plan
The IVF Race: The Schedule
The IVF Race: Coping
The IVF Race: Goal Markers
The IVF Race: Bumps & Detours
The IVF Race: Credit for Completion
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services

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Much has been written from the patients’ perspective of the ideal infertility physician. Over the past several years, we have had the opportunity to work together, as gynecologist and social worker, to attempt to meet the complex needs of infertility patients. Through our encounters with these patients, we have formulated our own concept of the perfect infertility patient.
There is a joke about the angels in heaven who were all lined up in the cafeteria waiting for dinner to be served. Suddenly a conspicuous angel appeared wearing a white coat and stethoscope, who started pushing his way to the front of the line. A new angel turned to the veteran angel and said, “Why in heaven would an angel act like that?” The senior angel shrugged her shoulders and responded, “Oh, that’s just God. Sometimes He likes to play doctor!”
What this joke underscores is the image that the public has of the physician as God. But, an image can also be made of the patient as an angel, who allows herself to be pushed aside and quietly suffers. Interestingly, the word “patient” comes from the Latin word “pati”, meaning to suffer. In fact, the adjective patient is defined as “bearing pains and trials calmly or without complaint.” Thus, we can see the implication that a patient must suffer silently, like an angel.
Through the years, we have learned a great deal from our infertility patients about their suffering in trying to have a child. However, we believe that there are things patients can do to increase medical efficiency and minimize emotional suffering from the treatment process. Here are our suggestions for “The Perfect Patient”:
1. The perfect patient approaches infertility as a couple problem. The fact that one spouse may be identified as having “the problem” does not negate the effect it has on both husband and wife. The infertility workup, evaluation, and treatment is much better dealt with when the spouse participates in at least some office visits and has an understanding of the tests they must go through. The more involved a couple is together in the medical treatment process, the better able they are to support each other and make a decision on options.
2. The perfect patient communicates honestly, openly, and directly with the physician. This begins by abandoning the concept of doctor but rather as a person with special skills. Communications can then flow more naturally and are less intimidating.
3. The perfect patient asks question about the treatment regime. Direct questions about the shortcomings, possibilities of failure, and alternative tests and therapies might include:
  • What are the advantages of this test?
  • Why does this test need to be timed in this manner?
  • Does this test cause any pain, discomfort or complications?
  • What is the percentage of complications from this particular test of treatment?
  • What are the benefits of this treatment over others?
  • Answers to these kinds of questions, or anything else the patient does not fully understand, should be very clear before undergoing tests or treatments. Then, having this understanding and knowledge, the perfect patient can more confidently follow directions.
4. The perfect patient tells the doctor when he or she is failing them. It seems that one of the hardest things for patients to communicate to a physician is when they are unhappy with the way they are being treated. For example, perhaps one of the office staff responded curtly or the doctor sounded demeaning. The hurt from such incidences can go deep and ultimately effect the doctor/patient relationship. However, the doctor cannot be held accountable without first being made aware of the patient’s feelings and then being given the opportunity to respond. As in any relationship, both the positive and negative issues that occur between doctor and patient need to be discussed and not avoided.
5. The perfect patient seeks education on both the medical and emotional aspects of fertility problems. Traditionally, infertility patients are often the most medically well-versed of all patients. However, they may overlook information about the feelings brought on by their infertility.
6. The perfect patient finds ways to reduce the stress caused by infertility. Patients need to understand that infertility is stressful, which is normal, expected, and not permanent. However, to deal with the stress, support mechanisms are needed. Guidance and understanding can be found through support groups (like the ones offered by your local chapter of RESOLVE), or by seeing a therapist whose specialty is infertility counseling. Hobbies, vacations, social interaction, and exercise can help make the problems less overwhelming. Infertility can be an isolating experience unless patients find other people with whom to share these feelings.
7. The perfect patient realizes when infertility treatment “burn-out” is being experienced. This may come out in unresolved marital conflict, sexual problems, or always feeling apprehensive, anxious, or depressed. The couple might consider finding ways in their sexual relationship to separate work (trying to get pregnant on schedule) from play (love making). Or they may want to think about taking a vacation from temperature charts, tests, and medications to alleviate some of the stress.
We feel that the perfect patient is an active participant in the treatment process rather than a passive recipient of medical intervention. These patients see the physician as a person, not as a deity, and thus don’t need to act like angels, silently in the wings. For ultimately, infertility patients are responsible for their own reproductive health.
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services
Paul R. Feldman, M.D.

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Tips on changing from the difficult patient to the perfect patient

I am angry at my clinic. I feel dismissed, and when I have questions I don’t ask them because I don’t want to be considered a “difficult patient”. Do you have any tips for working with my medical team?

Infertility is an experience that may bring out our most primal emotions (anger being but one) and it is often difficult to differentiate the source—infertility itself or the process. Determining the source of your anger is the first step in finding ways to deal with your feelings in a productive and appropriate manner. It is important to start by examining why you are angry at your clinic. Anger about infertility (and anything and everything that goes with it) is very common and frustration, irritation, and dissatisfaction can surface for any number of reasons–whether valid or invalid. Infertility is a frustrating and unhappy experience, as is infertility treatment when feelings of helplessness, vulnerability, dependency, and uncertainty are exacerbated by the treatment process. As a patient, it is your right to have your questions and concerns about treatment answered by your caregivers. If there is a conflict or problematic situation at your clinic, it is important that you bring it to your caregivers in a calm and open fashion. In addressing a problem, it is often not what you say but how you say it that influences the response you get. Your identification of a problem will be helpful to you and other patients, particularly if your caregiver(s) is unaware of the problem. By contrast, if your anger is due to your feelings of overall frustration with infertility, it may be an indication of your need for additional support, understanding, and comfort which your medical staff cannot provide. Consider getting some counseling with a mental health professional experienced in infertility and ask your caregivers for a referral. Since anger and frustration are sometimes a symptom of depression, counseling is an important step to feeling better.
No one wants to be identified as a ‘difficult’ patient, so it might be helpful to outline what makes a ‘perfect’ patient. There are things you can do to increase medical efficiency and minimize emotional suffering from the treatment process. You need to see yourself as an active participant in the treatment process, informed and educated, rather than a passive recipient of medical intervention. Here are some suggestions on how to be the ‘perfect patient’:
The ‘perfect patient’ communicates honestly, openly, directly, and calmly with the physician and other caregivers. This begins by abandoning the concept of the doctor as a person with special (god-like) powers. Communications should flow naturally and without reservation or intimidation. People often have difficulty bringing about problems or doing so in a calm manner. It is alright to bring aids—such as a written list of issues you wish to address. If it would be easier to communicate in a letter, do so but schedule an appointment to discuss the issue(s) in person as well. Avoid accusatory, blaming, or critical statements. Instead focus on a clear statement of the problem or complaint, your position, and what you would consider a satisfactory resolution of the problem (e.g., apology, different way of handling problem in future).
The ‘perfect patient’ asks questions about the treatment regime, follows instructions carefully, and is an active participant in the decision-making process. Direct questions about the shortcomings, possibilities of failure, and alternative tests and therapies might include: What are the advantages of this test? Why does this test need to be timed in this manner? Does this test cause any pain, discomfort, or complications? What are the benefits of this treatment over others? If this treatment is not successful, what is the long-range plan? Answers to these kinds of questions, or anything else you do not fully understand, should be very clear before undergoing tests or treatments. Having this understanding and knowledge, will make it easier to follow directions and instructions accurately, a crucial aspect of treatment. It is also very helpful to come prepared to appointment with a list of questions and concerns. Take notes or ask for written literature on any tests or treatments you are considering. Some patients even bring tape recorders to record important conversations with their caregivers, particularly if their partner is unable to accompany them to the appointment. Ask about the clinic’s policy on calls about lab results, returning phone calls, and after hour emergencies. Your physician can give you information about treatments available to you, but don’t expect that he/she can or will make decisions on treatment for you: these are ultimately up to you.
The ‘perfect patient’ tells the doctor when he/she is failing them.Sometimes one of the hardest things for patients to communicate to physicians is their unhappiness and/or dissatisfaction with the way they are being treated. For example, perhaps one of the office staff responded curtly or the doctor sounded demeaning. The hurt from such incidences can go deep and ultimately effect the doctor/patient relationship. However, your doctor cannot be held accountable without first being made aware of your feelings in a non-combative manner, and then being given the opportunity to respond. As in any relationship, both the positive and negative issues that occur between doctor and patient need to be discussed and not avoided. Finally, if you have discussed an issue with your physician and it cannot be resolved, thus undermining trust, it may mean you should seek treatment (or at least a second opinion) from another clinic.
The ‘perfect patient’ seeks education on both the medical and emotional aspects of fertility problems.Traditionally, infertility patients are often the most medically well-versed of all patients. However, many infertile patients overlook or avoid considering the emotional aspects of infertility in hopes that they will get pregnant and not have to deal with it. Avoidant coping is one way of managing emotional distress, although not the healthiest. And the isolation of infertility can be lessened by finding other people with whom to share unhappy feelings. Infertility patients should become as educated and attentive to the emotional side of infertility as they are to the medical aspects. A good way to become educated is RESOLVE, books that include information about how to handle the feelings of infertility, educational materials available at your clinic, attending a professionally led support on infertility and seeing an infertility counselor. Increasingly patients are turning to the internet for education about infertility, although this can be risky at times. Besides Resolve’s website, www.resolve.org, two excellent sites that provide information on the medical and emotional aspects of infertility are The American Society of Reproductive Medicine www.asrm.org and the European Society of Human Reproduction and Embryology www.eshre.org.
The ‘perfect patient’ finds ways to reduce the stress caused by infertility. Patients need to understand and accept that infertility is stressful—that stress is a normal, expected, and impermanent aspect of infertility. The stress of infertility, its treatment, and the interaction of stress, emotions and optimum body functioning is increasingly referred to as the mind/body connection. Do not mistake this as a form of the old cliché “If you’d just relax, you’d get pregnant.” However, there is something to the mind/body connection and being attentive to one’s stress level, keeping stress at a minimum, and practicing good self care are all good ideas. Additional ways of dealing with the stress of infertility can be found in hobbies, vacations, social interactions, exercise, massage, spirituality, acupuncture, relaxation techniques, and other coping mechanisms that help make the stress imposed by infertility less overwhelming and easier to manage. Stress management improves your overall quality of life.
The ‘perfect patient’ realizes when infertility treatment “burn-out” is being experienced and takes an ‘infertility holiday’ if necessary. ‘Burn-out’ may come out in unresolved marital conflict, sexual problems, or ever-present feelings of apprehension, anxiety, anger, or depression. It may surface in one or both partners and is usually an indication that the stress of infertility and its treatment has ‘overwhelmed’ an individual or the couple. It can also be an indication that a vacation from treatment, stress management, or counseling may be in order. It might be helpful to ask your partner (or friend or caregiver) for feedback on how you are coping, e. g., “Do I seem overwhelmed or overpowered by infertility? Does it seem that I am not myself?” Couples experiencing ‘burn-out’ might consider finding ways in their sexual relationship to separate ‘work’ (trying to get pregnant on schedule) from ‘play’ (love-making), take a vacation together, take an ‘infertility holiday’ in which they suspend treatment for a period of time, or seek couple’s counseling with a therapist experienced in infertility counseling. ‘Infertility holidays’ are not permanent decisions to end treatment but rather breaks from treatment in which one partner or the couple get a welcome breather from the demands of treatment. This holiday also means no ‘trying’—it is a real vacation from infertility on all fronts.
The ‘perfect patient’ approaches infertility as a couple problem.The fact that one’s spouse may be identified as having ‘the problem’ does not negate the effect it has on both husband and wife. The infertility work up, evaluation, and treatment is much better dealt with when both partners participate in at least some office visits, have an understanding of all testing and treatments, and participate in decision-making. The more involved a couple is together in the medical process, the better able they are to support each other and make decisions on options—including those not involving medical treatment. For example, one partner may be resolutely opposed to an alternative to treatment (e. g., adoption or donated gametes) but as an inactive or inattentive participant in treatment, hostility and resentment may arise impeding problem-solving.
The ‘perfect patient’ tries to have realistic expectations of caregivers and of treatment. Caregivers are people too and have bad days, personal stressors, and make mistakes. They are not miracle workers and do not enjoy inflicting pain or delivering bad news (any more than patients enjoy experiencing either). It is important to have realistic expectations of caregivers and treatment—as unrealistic expectations of perfection, success, or extra special care will surely lead to disappointment and frustration. Finally, patients should keep in mind that there may be other explanations for abruptness, delays, or preoccupation and not personalize these events as purposeful actions to irritate or hurt the patient. Considering a variety of perspectives can reduce the stress of infertility and its treatment.
In summary, feeling angry and frustrated does not feel good and should not be ignored, once the source is identified. Being an infertility patient means you are an integral part of the infertility team, with equal responsibility for facilitating healthy communication and cooperative teamwork. And it means acknowledging problems and solving them as they arise.
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services
Reprinted from Resolve Family Building Magazine, Spring 2002 
“Ask the Expert” Column with Linda Hammer Burns, PhD

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For many infertility patients, a longed-for pregnancy is frequently achieved by exhaustive measures involving medical treatments, financial sacrifices and emotional upheaval. There is rarely anything spontaneous or private about the process. For successful patients, a positive pregnancy test marks the unfolding of a new phase. How does pregnancy after infertility differ from other pregnancies and what dilemmas does it present?
Patients anticipating moving on from the distress of infertility and reveling in the joy of pregnancy, may instead find that they have entered challenging new medical and emotional territory. The anxiety of, “Will this work?” shifts to, “Will this pregnancy last?” Many women say that they feel numb, and do not allow themselves to trust their bodies to work properly, sustain a viable pregnancy and produce a healthy child after so many disappointments. While they go through the motions associated with early pregnancy after infertility, checking blood levels, undergoing sonograms and repeated contacts with the fertility clinic, some women protect themselves against the pain of possible loss by being cautiously optimistic, at best. At a time when patients often feel most vulnerable, they successfully “graduate” from a trusted and familiar fertility clinic environment to a new and unfamiliar team of health care professionals.
Women may be surprised that as much as they wished to lose the label of “fertility patient,” they may feel like impostors in the world of pregnancy. Initially, women may feel a sense of isolation and as if they are in limbo belonging to neither the infertile or fertile worlds. Friendships nurtured in infertility support circles may become strained and previous support sources may be off limits.
The dilemma looms of when to announce a pregnancy to family, friends and employers. Early disclosure in the past may have triggered painful situations if a miscarriage occurred. However, when an anxious couple keeps the news to themselves, it can lead to further isolation at a time when the usual social support outlets are unavailable. Couples may also find that their feelings about being pregnant do not conform to the idealized view of pregnancy that they may have carried ever since childhood. There may be disappointment that infertility has robbed them the blissful ignorance of risks that those who did not experience infertility may enjoy.
Pregnancy after infertility involves making the mental shift of changing identity from an infertility patient to a pregnant person and potential parent. During the nine months of pregnancy women move through different stages, including belief in the reality of the pregnancy, altered body image, recognition of individuality and separateness of the baby, and transition to the role of parent. A woman’s normal fears and anxieties may be amplified by her experience as an infertility patient, creating unique emotional challenges. If the pregnancy is proceeding normally, there may be a tendency to mistrust the good news rather than to relax. She may view each new phase or test as a challenge and opportunity for loss rather than confirmation of well-being. Often women describe a sense of vigilance with trying to understand what is going on in their bodies, how best to protect their baby, and how to deal with their feelings. For example, some women will read only one day ahead in pregnancy books, or have rituals and superstitions to protect the pregnancy and manage stressful feelings. Despite these struggles, anxiety will usually lessen when the pregnancy continues to develop without problems. For most women, trust in a healthy outcome increases over time with positive experiences.
Pregnancy after infertility may be further complicated by preexisting conditions related to the infertility diagnosis or related to the process of conception. These include multiple pregnancies, third-party reproduction, older parents and secondary infertility.
Some infertility patients consider multiple pregnancy a desired outcome and a way to avoid future treatment. The inherent risks of the pregnancy, as well as the realities of parenting multiples, may be underestimated during the initial period of joy. On the other hand, complicated situations may arise involving the threat of losing one of the babies or the whole pregnancy, while also potentially confronting painful decisions involving multi-fetal pregnancy reduction. The possibilities of bedrest, prematurity, job adjustments, financial pressures and physical demands grow with the developing pregnancy. Feelings of panic or dismay may arise for a couple who desired one child. The much anticipated pregnancy may instead become too much of a good thing and result in a crisis. Guilt or conflict about decisions made before and after a pregnancy may linger if not addressed supportively with the couple.
Pregnancies conceived using donated sperm, eggs or embryos, or pregnancies using a surrogate or gestational carrier can also complicate the emotional response to a pregnancy. When a pregnancy is the result of donated gametes or embryos, potential parents must have grieved the loss of the dream child together. They must learn to attach to an infant not genetically related to one or both parents, and address issues of secrecy and disclosure and adjust to feelings that may include ambivalence and anxiety. Using a gestational carrier or surrogate involves developing an appropriate relationship with the carrier or surrogate, attaching to the potential child and managing fear, anxiety, and loss of control as well as managing societal attitudes.
For the older first-time mother, pregnancy may represent a last chance to have a child and fulfill a dream. Risks to the mother’s health may be minimized or heightened. Parents may wonder if they are too old or question whether they have the energy to keep up with the demands of young children. In addition to medical risks, social complications may result as remarriage, stepchildren or adult children from previous marriages are considered. On the other hand, women may feel secure in their careers and have the time and wisdom to share with a child who is the primary focus.
People experiencing secondary infertility may have had fertility issues in their first pregnancy or it may come as a shock after getting pregnant easily with their first child. While actively parenting one child, parents may feel set apart from the world of families with many children. Frequent queries from others about another pregnancy can cause such distress that parents commonly avoid social groups that had previously been sources of support.
Thus, pregnancy after infertility presents an emotionally and physically complex experience, while offering unique opportunities for healing that sustain and nurture expectant parents. As mentioned, support during the transition from infertility services to obstetrical care is an important process. It can be enhanced and facilitated by finding caregivers who understand the anxieties involved in pregnancy after infertility and are flexible in interacting with patients. Flexible medical appointments that help to manage anxiety, such as opportunities to hear the baby’s heartbeat in between scheduled visits and telephone contact for reassurance, can calm fears and establish trust in the pregnancy (as well as in the new caregivers). In these situations, the expectant parents feel relieved that they are doing everything possible to ensure a healthy outcome.
Pregnancy after infertility support groups offer another transitional service to couples. These groups can be found through local RESOLVE chapters or may be offered by reproductive medical practices as a service to their patients. The support group forum can provide a safe environment to share the fears and feelings often unexpressed or misunderstood in other settings. Once pregnant, it is frequently expected that previous worries of infertility will be eased. However couples may avoid or delay having faith in the pregnancy or buying maternity clothes and baby supplies. Normal social routines such as baby showers may also be postponed until after the baby is born. Decision-making about prenatal care, testing and life after the baby is born are frequent topics of concern. Having defended against the possible threat of loss for so long, expectant parents may only allow themselves to believe that they will be parents late in the pregnancy. As a result, they may find themselves rushing to make plans for job adjustments, daycare or other accommodations for the baby. Being with others who can validate these experiences and normalize feelings is a powerful tool to help these families have a healthy start.
Coping strategies learned during infertility treatment may also be of help. Mind/body techniques such as cognitive-behavioral interventions, stress and relaxation techniques, keeping a journal or developing e-mail networks are particularly useful for managing anxiety and negative thoughts. Reaching out to organizations such as RESOLVE, Parents of Multiples, and Internet pregnancy resources can also be sources of support. It is especially important that couples be encouraged to find ways to normalize the pregnancy such as attending pregnancy exercise programs, childbirth and preparation for parenthood classes. This will help the transition to the non-infertile pregnancy world. Counseling with a mental health professional who has knowledge and understanding about the unique issues of pregnancy after infertility may also help with this process by providing early intervention and support. Pregnancy after infertility leads to parenting, and raises issues about how these infertility experiences affect families later on. There may be increased risk of depression or anxiety in the post-infertility period, especially in families of multiples or when a woman has a history of depression. Concerns about life adjustments and managing as parents may be heightened. Again, reassurance and support at this time may be essential to building confidence and allowing parents after infertility to also experience the long awaited joys and tribulations common to families everywhere.
Despite the dilemmas presented with a pregnancy after infertility, the vast majority of women do well and in fact often feel better emotionally than non-infertile women. The experience provides the opportunity to grow and heal as a woman and as a couple. The pregnancy can renew feelings of self-worth, self-esteem, as well as relationships with others that were hurt by infertility. Birth of the longed for baby begins a new journey.
Contributed by: 
Carole Toll, MSW, LCSW-C
Reprinted from Resolve Family Magazine, Fall 2004

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