As a homebirth midwife struggling with infertility, Abby Hall Luca intimately knows the gaps in fertility and maternity care. For 12 years she guided couples through the journey of growing their families while not being able to grow her own.
“It meant things like canceling a prenatal appointment [for her clients] because I was having a miscarriage,” Hall Luca said.
She and her partner were not able to afford assistive technologies until a friend raised money through GoFundMe for them to go through one round of in vitro fertilization. Hall Luca went through all the spiritual and emotional uncertainties of parents struggling to conceive. She watched the odds of the procedure resulting in a live birth shrink with every appointment as the condition of her uterus, the eggs collected, and the embryos created eventually left Hall Luca with a 15% chance of coming out of the grueling medical ordeal with a baby.
But the uncertainty doesn’t end with an implanted embryo. After that come the appointments to monitor hormone levels and fetal development far earlier and with greater risk of things going awry. Every hurdle cleared only led to the next, Hall Luca said.
“The whole thing could come crashing down, and it does for people at any one of those hurdles,” she said.
Fertility treatments are a rollercoaster, and often patients feel they are riding alone. As IVF and other treatments become more common, a need is growing for pastors, chaplains, and other spiritual support to accompany families through the process. Right now, spiritual support specifically dedicated to fertility is rare and finding it can be as emotionally risky as the fertility treatments themselves.
Finding support
Infertility is far from an easy topic to discuss with friends and family, especially those with no experience. Internet forums such as Mumsnet and Reddit are full of parents who have been through the challenges of fertility treatment looking for others to empathize with the intense emotional impact. Many bloggers and forum users describe a near permanent state of anxiety and a deep, chronic loneliness in their pursuit to have a baby.
While some fertility clinic websites recommend seeking spiritual counsel, in practice many leave that to patients’ therapists, who may or may not understand reproductive technology, or their pastors, who may or may not share the couple’s reproductive ethics. Couples describe having to explain amid grief how IVF works. Some choose not to tell their pastors because they aren’t sure if they’ll be subjected to a lecture on what to do about the embryos that are not implanted.
All of this is on top of the shame and stigma that already surrounds infertility and the difficulty many people have talking about “uterus-adjacent” things, Hall Luca said.
“You want witnessing and companioning through that process in a way that is nourishing and therapeutic, and it didn’t seem to exist,” she said.
She decided to become the person she needed and underwent training to become an interfaith chaplain. Hall Luca practices what she calls “modern spiritual companioning” virtually and in person from her home in Maine. She assists through all life transitions but specializes in accompaniment for couples trying to conceive.
Denominationally, Hall Luca said she is closest to Unitarian Universalist. But like many chaplains and spiritual directors, Hall Luca said she prefers to think of herself not as representing a tradition or specific spiritual dogma. Instead, her goal is simply to “sit with them in the mess,” she said, and to “excavate their own best wisdom.”
Rabbi Rachel Van Thyn was already working as a chaplain in a large health care system in New York when she and her husband began IVF treatments. It was the height of COVID-19, she said, and she would wake up early to go to the clinic to have blood drawn and then go immediately to the hospital where she and her fellow chaplains were the only in-person spiritual and emotional support available to quarantined patients and exhausted staff. It was isolation upon isolation, Van Thyn said.
Often, people undergoing fertility treatment may be hesitant to share, not knowing how their story will be received or what sort of questions might follow. Even questions with good intentions can feel invasive. Van Thyn said many fertility struggles feel “invisible” to outsiders.
Despite being thankful for the family and friends who loved and supported her, Van Thyn said, like many of those she accompanies now, “I just needed something different.” She began to think through her chaplaincy training, which, like Hall Luca’s, was about helping people find “their own best wisdom.” As others who knew about her journey began asking for support, she started offering her services more formally independent of a hospital.
Van Thyn found that creating truly equitable access to spiritual support for families trying to become pregnant would require intentionality. She worked to make her family-building focus explicit as she named and marketed her practice, RVT Fertility. Unlike the hospital, where chaplains know how to find the people who need them, people undergoing fertility treatments aren’t staying on-site. It would be ideal if fertility clinics, like hospitals, could have spiritual support on staff, Van Thyn said, so that the burden of seeking help wasn’t entirely on the people in treatment.
Part of that intentionality requires the chaplains to know that even within a couple, the partners might be having different experiences.
Different needs for each partner
For many couples, Hall Luca said, the partners will need to prioritize their bond to each other but seek separate support. Fertility treatments bring rigor and regimen to the space of a couple’s intimate life, along with all the anxiety, fear, and disappointment. It’s normal to feel isolated even from a partner. At the same time, fertility treatment is not a one-time decision, it’s more of a long, slow parade of if-then calculations. It’s common for partners to begin to feel differently about taking the next step — paying for another round or undergoing more invasive procedures.
The most common themes Hall Luca hears as she listens to couples are hopelessness, anger, a lost sense of purpose, isolation, and, perhaps most painfully, shame at feeling all of those things. Big feelings don’t direct themselves rationally, she said, so it can be startling to people who find themselves angry with God or their partner. Chaplaincy training helps her witness that anger without needing to correct or fix it, she said.
Each phase of the fertility journey opens up new questions and uncertainties, even as it requires new kinds of physical stamina. Couples may find surprising resentment toward other people who get pregnant easily or feel alienated from family members with kids.
Even when the journey ends with a baby, as it did for both Hall Luca and Van Thyn, the suffering along the way doesn’t evaporate with a happy ending. It will always be part of her story of becoming a mother, Van Thyn said, and that requires exploration and support as well.
Having dedicated spiritual support can create a safe place to name the messier or more unexpected emotions that come up, especially in the waiting periods that make up so much of fertility treatments.
“Sometimes people just need to say something aloud that they cannot say in other contexts,” Van Thyn said.
Bekah McNeel is a freelance journalist living in San Antonio. She reports on the intersection of faith and early childhood for Sojourners.
Got something to say about what you're reading? We value your feedback!
