Wednesday, January 9, 2013

The fertility issue.

When I first started out my career as a nurse, I worked 3 years in a community hospital, mainly rehabilitating old folks with stroke / injuries and/ or special needs in their activities of daily living.
It was an amicable experience to work with old people, especially when most of them are adorable and I derived great pleasure disturbing those Grandmas and Grandpas and making them laugh/ grumble at my nonsense (no elderly were abused in my care don't worry).
However, I decided to have a change in work environment and switched to working in a gynae field, which was a dramatic change and not to mention, totally unrelated to my prior experience!

Some of my friends may know, I have been working with couples seeking fertility treatment, for slightly close to two years now.
Personally, out of the married couples I know (either relatives or friends), I can easily identify at least three out of ten who have problems conceiving.
Contrary to media reports that Singaporeans are not ready for children, thankfully for me at least, my married relatives / friends want to, or are at least trying to start families on their own, but a minority of them cannot conceive.

Lately, our gahmen has been trying means and ways to entice Singaporeans to procreate, but I think the problem may lie in infertility struggles.
Other than the costs of seeking fertility related treatments, which is actually heavily subsidised* by our gahmen, there is also the associated stigma and tremendous stress involved with infertility.
It's not easy coming out of the closet and admitting that you and your partner have problems conceiving, it's not a likely topic to be discussed openly over coffee with friends in our cultural context.
It may be easier to cite excuses such as, say, you are too busy with work / too young and not ready for committment / wanna enjoy coupledom before being tied down by children.
One couple I know gave the convenient reason that they both love to travel and kids would halt that, which they later on, after many years of marriage, confessed that they are seeking fertility treatment.
Afterall, two people meet, fall in love, get married, have sex and have babies (though sequence may not always be in that order).
It's the only natural human thing to do, right?

Apart from the social stigma, there is also the stress couples have to overcome.
They need to do a battery of blood tests and investigations before they are assessed to be suitable candidates for IUI/ IVF, and when they embark on the IUI/IVF journey, the woman has to do daily self-injections in preparation of the eggs stimulation. Apart from daily injections, she has to come back to the clinic every 2-3 days for ultrasounds and doctor reviews to track the progress of her eggs development. She will often be issued MC and / or Hospitalisation leave during the span of her treatment.
Is she prepared to deal with discomfort in her body and also to be away from work for approximately a month?
Even if she is mentally prepared for these sacrifices to her work and body, will her bosses be prepared for their staff to be absent from work so frequently?
Therefore, there are several deterring factors that couples may face in the journey of fertility treatment.

I do enjoy my job tremendously, and get great satisfaction when my patients come back to the clinic looking for "Veron" and showing gratitude when they test positive on their beta HCG!
When I was pregnant with Ashton, many of them congratulated me abd requested to rub my bump for some "baby luck". When I came back from my maternity leave some couples recognise me and tell me they've been asking for me and found out from my colleagues that I went to deliver already.
One patient called up to make sure I was on duty when she came back for her scans so she could buy me breakfast. So touched!!
They share with me their fears (a thousand things can go wrong between a pregnancy and a normal healthy live birth) as well as their guarded happiness, and I feel proud to be able to share the experience with them. I mean, they must value my duty-of-care enough to want to share such personal information with me!
Along the way, many of my patients became my friends and I realise they are just very normal couples who may be your neighbours, friends of friends, or even someone from online forums you visit. One couple became my friends and while chatting we realised the husband is from Fishing Kaki forum and had gone fishing with Andy before!
It is highly rewarding for me as I am a parent and I know exactly how it feels to be able to bear life.
Although I occassionally grouse about my naughty / demanding children; and their crying and whining make me 99.9% suicidal, but we all know at the end of the day nothing else matters more to me than for my children to be safe in my arms.

It is indeed an out-of-the-world experience to be a Mummy. I've dealt with blood and gore, vomitus and faeces, life and death, but still none of those lessons I learnt in nursing school prepared me enough for what my children have in store for me.

P.S. If you have any personal questions about fertility related issues, I'll be glad to answer you in anyway I can based on my limited knowledge.
*Conditions apply for gahmen grants and utilisation of Medisave for fertility related treatments.

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