I finished the new Serial Productions podcast hosted by Susan Burton today, the five-part series The Retrievals (you can find it on New York Times or wherever you get your podcasts).
I was on the fence about listening. It's a podcast about a collective trauma women experienced undergoing IVF at the Yale clinic when a nurse replaced the fentanyl for the egg retrieval procedure with saline, and what happens when women report pain and it's ignored. The premise was fascinating to me, but also... 5 hours of listening to IVF experiences. I'm in a pretty good place now, but would it be stupid to re-enter that world voluntarily? Especially knowing how immersive Serial tends to be?
Well, I got hooked. But I sure made a lot of faces while listening and sometimes had to consciously take a break from it. It's a compelling story. I'm not sure if there's "spoilers" for such a thing, but just in case, you've been warned.
First, it is horrific that these women experienced egg retrievals without pain control. I found that procedure painful afterwards every single time, but to experience the whole thing without any pain relief whatsoever? Horrific. Brutal. Unconscionable.
What is hard to understand is that while the nurse responsible lost her job and was convicted, WHAT ABOUT THE CLINIC ITSELF? The DOCTORS who performed the procedures while patients bucked and screamed and made it clear that they weren't under in any way, one, after another, after another?
There was discussion about what's considered within the realm of "normal" for medical acknowledgement of pain. Particularly women's pain, which is often considered exaggerated by medical professionals.
For instance. When I was in my early 20s, my gynecologist did a laparoscopy to look for endometriosis because I had horrific pelvic pain and highly irregular and heavy periods. He didn't find any, and basically threw his hands up. He actually said to me, "well, some women just have pain." WHAT THE EFF IS THAT? This from a doctor who also explored the idea of PCOS, and when I embarrassedly said "no" when asked if I had excess body hair, GOT MAD AT ME when he observed that I shaved my belly button area. But he also didn't give me the PCOS diagnosis I finally got at 33 from the fertility clinic.
I also had an experimental Integrin-3 receptivity test including an endometrial biopsy towards the end of my treatment journey. I came into the room and lay on the table, and the nurse said "You know what he's about to do to you, right?" NOT OMINOUS AT ALL. What it was was the equivalent of a vegetable peeler inserted through my cervix, that took an easily 5" ribbon of my uterine lining (which Bryce saw dropped and coiled into a clear container). I was not sedated at all. Not even a Valium. It was insanely painful, during and after. But I wanted it, I wanted answers that could lead to a successful pregnancy, and it was worth it to me (although I did say FOR THE LOVE OF ALL THAT'S HOLY, GIVE SOME KIND OF MEDS FIRST next time you do this).
That was another point made by the podcast. That the stakes are so high, the desperation for the desired outcome so intense, that it's hard to not endure the pain. That when given the choice of continuing while unsedated, or losing eggs to ovulation and possibly losing the chance of an entire cycle of possibility, it's an impossible choice. One none of the women should have had to make.
But, in talking about the desired outcome, the focus was largely on the women who were successful; who had pregnancies that ended in live birth. But there were questions about cycles that failed, or that resulted in miscarriage, or preterm birth. Was it in part because of the trauma? Because of the stress of the pain, and not being believed, and then PTSD? But, ultimately, most women interviewed had become mothers.
One woman said something to the effect of, "at least I had a baby. I can't imagine how sad the outcome would have been if I went through that and didn't have a baby. That would have been a tragedy" and other sentiments that fall into the "being childless is the worst possible thing that could happen" camp. Hmmmmph.
Another woman, Laura, who did not get sustainably pregnant, but had moved to a new clinic and was still hopeful, had palpable grief. She said, "I just have so much love to give." And, "I just KNOW I'm going to be a mother. I know it." It felt like being haunted by my previous self. I remember that visceral longing, that gaping hole where a baby was supposed to be, the insistence that it WOULD work out because I couldn't imagine an outcome where there was no baby.
I want to say to Laura: "Yes. It is sad when you want a baby so badly and that baby doesn't come. It is an incredible heartbreak. But you will find places to put that love. You are more than your ability to have a baby. It is awful to be where you are, where there is still hope to cling to, but when and if you have to let go of that hope, you will be okay. You will survive and eventually thrive. There are actually quite a lot of us that were failed by IVF, who left without a baby, and it is not at all the worst case scenario you believe it to be."
Of course the whole point of IVF is to have a baby. That's empirically the successful outcome. But it's not a failed life to be on the other side of those success rates. You can still be a success for surviving the experience and making a new life.
Lastly, there was the issue of the nurse's sentencing. She willfully replaced the fentanyl in the vials with saline, and in some cases she was in the room for the procedure. That is another level. But then, you find out that she was also once an IVF patient, and the level goes deeper. She knew exactly what the women were experiencing, physically and emotionally, and she did it anyway, albeit while in the throes of addiction. And then... Because she was a single mother with an abusive ex-husband, her sentencing ended up very light, barely any prison time, and it was arranged to be during non-custodial timeframes so she missed virtually nothing with her children. She got preferential treatment BECAUSE she was a mother. She may have cost women their chance to be a mother, but her status is motherhood afforded her sympathy and lighter sentencing. That was maddening.
Ultimately, I found the podcast to be fascinating and infuriating and both unbelievable and highly believable all at once. But also, pretty heavily pronatalist. I feel like if I were to listen 13 years ago, I would believe that IVF almost always ended with a baby. That that's the only outcome worth talking about.