Rabbi Joseph Kanofsky, Phd
Here are some things not to say, if you want to be helpful. “Why don’t you just try to relax?” “Just be glad you have the freedom to travel and you aren’t tied down.” “You already have one kid, isn’t that enough?” “You could always adopt.” “If it’s meant to be, It will happen.” “It could be worse!” We have a well-placed inclination to try to be supportive when it comes to talking with couples who struggle with infertility challenges. Truth of the matter is, though, sometimes our good intentions lead us to say things that are less than helpful, to put it mildly.
Fertility challenges are not something that we talk about too much, partly because it’s private, partly because it’s difficult, and partly because we don’t always know what to say or whom we can trust. It’s estimated that around one in five couples have challenges with fertility at some point, so it’s probably more common than we think.
Particularly in the Jewish community, where having children is such a central value, and rightly so; difficulty conceiving and bearing children is a tremendous stress and emotional burden. Sharona and I had very close friends who were married almost ten years before being blessed with a child; they were some of the warmest, funniest, friendliest people, some of the best friends you could have. I didn’t know until years later, after they had even more children, how painful and stressful and difficult those early years were for them, until she wrote about their experiences for a Jewish family magazine. I went back and reread the article from several years ago: She wrote about the anguish, the silent despair of watching one year after another float by—the emptiness at the bottom of her soul.
Those are pretty serious expressions of pain, and I can’t imagine how those of us who have not experienced it firsthand could appreciate the depth of those feelings. Many of us blessed with children and grand children, and ashreinu mah tov chelkeinu, great grandchildren—we kvell, and we share pictures and facebook and email photos and all this—imagine how it feels for those who are struggling. I heard from another rabbi that a woman once told him—and I will tell you now this never occurred to me…I never even thought of it…that Simchas Torah morning is one of the toughest days for her of the whole year. Because at the end of Torah reading on simchas torah, we call up kol hane’arim—all the kids for an aliyah. And for this woman, who doesn’t have a child of hers up there under the chuppah, up there for an aliyah with all the other kids on Simchas Torah morning—it’s no simchah.
The wisdom of the ages has given us an appropriate message to comfort mourners in their loss; hamakom yinachem eschem; and those who even experience the anniversary of a loss—long life, or we wish an aliyah to the neshama. For some reason that I don’t know, we don’t have words to comfort would-be parents in the face of a miscarriage, another challenging loss that we don’t speak about; or infertility. I’m guessing it’s because we never want to be false, and we never want to give up hope; so maybe the best thing is silence. We don’t want to say, “Oh, I’m sure next time will be better,” or “Maybe that’s just the way it is;” so we don’t say anything. One of the worst is when childless couples are asked, “So when are you going to start a family?” Or “Are you ready for more?”
But just because we don’t have a formula, a line already scripted for us to comfort someone going through these challenges, doesn’t mean we have to stay silent.
One thing is to say, “I care about you and what you are going through.” Another thing is “Let me know if I can listen.” And then just share the burden a little bit through nonjudgmental listening. Another is to offer to remember them in your prayers. We do believe that Gd hears our prayers, and sometimes the answer is even “yes.” So to say, “I’m davening for you” means something serious and practical.
Perhaps not surprisingly, the State of Israel is the global leader in IVF technology and support, and its national health service offers unlimited assisted reproduction treatment to all women in Israel, regardless of their marital status, up to age 45, from the report I saw.
In our community, we have a number of resources to help couples get through their infertility challenges. I believe OHIP will cover one IVF treatment in a person’s life, not including medications; and if you have any experience with IVF, you know that the odds are less than 1 in 2 on the first try. Toronto Jewish Free Loan offers some financial support for infertility treatments, which is a fairly new program. We do have another great community resource called Small Wonders. Small Wonders offers medical education and seminars for couples dealing with infertility. They offer financial support to offset the cost of treatments. They have a friend-to-friend network, a phone support network, and other supports to couples. This is most definitely a community resource we should support, and I’m happy to put you in touch with them, or you can find them at smallwonders.ca; or with a fund in the US that supports couples grappling with infertility, called Priya.
If you noticed, all of the imahos, all of the matriarchs of the Jewish people struggled with infertility. Each one. We went into great depth reading about Avraham and Sarah’s inability to conceive, and their joy at having Yitzhak at an advanced age. Last week’s parsha, parshas Toldos opened with Yitzhak davening to Gd because Rivka was not able to get pregnant. Later on she had twins, which proved more than a handful—Yaakov and Eisav. And then in this week’s parsha, as the twelve shvatim and Dina are born, the twelve tribes; we see the struggle and the intense emotions that Rachel experiences when she sees her sister, Leah, having one baby after another. “Give me children, she says, or I am dead.”
Pretty strong language, but what must it feel like for someone who has difficulty conceiving to see someone they are close to; a friend or even a sister, go through pregnancy after pregnancy, birth after birth? And have to keep saying Mazel tov, when all that person wants is one of her own? I can imagine it seems unfair, I can imagine that it seems like Gd is not listening, I can imagine that it feels lonely and isolating.
There’s even a recounting in this week’s parsha of fertility treatments—for those of your friends who think that the Torah doesn’t have everything in it…point them to the fourth aliyah of this week’s parsha, right after the discussion of surrogate parenting, as we had with Sarah and Hagar a few parshas ago. Here we have Rachel and Leah deploying these duda’im, literally a love plant, these mandrake or jasmine or some kind of other plant thought to have conception-enhancing properties. Not surprisingly, Dudai’m turn up toward the end of Shir Hashirim, Song of Songs as well; they are said to have a pleasant fragrance, and to either have some sort of fertility aid or at very least aphrodisiac quality to them. Or perhaps it’s neurorelaxer or even a hallucinogen, which would have put Rachel at ease and dampened her anxiety about infertility; and perhaps even altered her hypothalamic-pituitary system, making it easier to conceive. Ben Ish Hai of Baghdad says that it’s something else—it’s actually a very good natural remedy for eye problems, which makes sense as to why they were useful to Leah, who you remember from the beginning of the parsha has weak eyes.
But the main point I want us to remember is that the same Torah that gives us a mitzvah of pru ur’vu, be fruitful and multiply, also recognizes that sometimes it will be the situation that pregnancy and childbirth does not come so easily, and may not come at all. The Torah notes these various couples, who happen to be the founders of our people, and records the combination of prayers, tears, medical and quasi-medical interventions and surrogacy that came into play in the attempt to have children. In that respect, the Torah reaches forward thousands of years to give us guidance in doing the same.
We have the permission and encouragement of the Torah to use reproductive technology, and a rubric of morality and action to understand how to use it appropriately. We get into practical questions like: can a woman undergoing fertility treatments be considered an ill person, for whom some rabbinic prohibitions of shabbat can be dealt with leniently? Can we, for example, give a woman who needs fertility interventions medications, injections, hormone therapy, and other such treatments that are normally not given on Shabbos? Are we allowed to destroy or donate surplus embryos which have resulted from in-vitro fertilization? What about multi-fetal pregnancy reduction? Is there room to terminate one or more fetuses to allow for one to develop healthily? Are we allowed to select gender in the IVF process? And of course, as we’ve seen in recent news reports, rethinking of surrogacy and motherhood questions with regard to Jewish identity—the long-held assumption that a Jewish mother gives birth to a Jewish child may be in question when none of the genetic makeup of the baby is that mother’s. In a sense, these are very technological questions.
The most important thing for us to remember from all this, I think, is to appreciate how many people wrestle with these challenges, and how often that happens in silence, behind the privacy of closed doors. If we recognize that, I think we can all push ourselves to be a little bit more sensitive and thoughtful in how we speak about and around others who may be having fertility challenges, and of course, we should do all that we can, and even beyond, to take part in and encourage others to support people working through this issue, and our community agencies who support them. In that, we’ll all continue to have a share in Gd’s blessing to Abraham at the end of Parshas Vayeira, that “I will surely bless you and increase you and greatly increase your offspring like the stars of the heavens and like the sand on the seashore.” May we see it in our days with our eyes, too. Gut Shabbos.