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Dr Margarete Sandelowski, Professor at University of
North Carolina at Chapel Hill, has done some very exciting work in
exploring how couples cope with their infertility.
She observed that infertile couples often find that
they are trapped in a maze; and they exhibit 6 patterns of pursuit in
their quest to exit the maze. These are
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sequential tracking,
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backtracking,
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getting stuck,
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paralleling,
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taking a break, and
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drawing the line.
This research describes the behaviour of infertile
couples so well, that it’s a shame mazing has not receive more exposure
in the infertility literature. In this article, I have summarized her
findings, which she has described in greater detail in her very
well-written book, With child in mind: Studies of the personal
encounter with infertility. (1993) Philadelphia, PA: University of
Pennsylvania Press.
The “sequential tracking” pattern occurs when
couples exhaust one option before they start another, such as trying a
variety of treatment options in sequence for a number of cycles. When
pursuing medical treatment , couples move from simpler, less intrusive,
and less high -tech procedures to more technically complex ones. For
example , some will do 4 cycles of IUI, before moving on to the next
step, which is IVF. Importantly, there is no one sequential tracking
scenario. Some couples found out quickly what their fertility problem
was, some couples moved quickly to more complex diagnostic or
therapeutic techniques, and other couples moved slowly as problems were
found that turned out to be “minor”, “insignificant”, “borderline”, or
unresponsive to initial treatment efforts. What distinguishes tracking
is the orderly step-by-step move from one previously untried procedure
to the next.
A second pattern of pursuit is “backtracking”, in
which couples restart a diagnostic or treatment plan when they changed
their doctor; or return to a previously attempted treatment or adoption
option. Couples also backtrack when their physicians felt that a
procedure had been improperly done or when their physicians did
not have the results of a previously conducted test, or when a factor
that can change over time, such as sperm quality and quantity, mandated
that it be evaluated again. In all these variations of
backtracking , couples moved over ground previously traveled.
A third pattern of pursuit is “getting stuck”
.Seeing , believing, or being encouraged by their physicians that
persistence paid off, couples who got struck in a treatment groove
attempted the same regimen over and over and over again – though they
have often crossed the point of diminishing returns. This is sometimes
because they cannot afford more aggressive treatment options, and are
not willing to consider other alternatives. These couples are often
optimistic about succeeding the “next “ time.
A fourth pattern of pursuit is “ paralleling”, or
the attempt to pursue actively and simultaneously multiple tracks to
parenthood, as opposed to simply ”thinking about”, or looking into”
another track should the current track fail to lead in to a child. Often
exhibited by couples who are “in a panic” and “desperate”, paralleling
is a means to “maximize the options” while minimizing the time wasted in
pursuit. Feeling pushed to the wall, paralleling couples decide “
not to close any doors,” “to keep the options open,” “to keep our irons
in the fire,” and most significantly, “to never give up”. These couples
thus attempted to navigate several paths at the same time, pursuing
additional paths as they opened up.
A fifth pattern of pursuit is “ taking a
break” There are many reasons for this, including financial constraints,
the need to recover from failure and loss , and fatigue and
frustration of pursuit itself. Taking a break allows couples to
re-assess their goals, and recapitalize their waning financial, physical
, and psychic reserves for the continued pursuit of a child .
The sixth pattern of pursuit is “ drawing the
line”. Couples drew the line at different points in time, depending on
when they become “ fed up” with , or were no longer willing to
invest in, “doing “ infertility . In contrast , there were women and
couples who had still not drawn the line after five , ten, and even
seventeen years of pursuit.
What about you ? Are you following an intelligent
path in your pursuit of a child or are you stuck in a
dysfunctional pursuit pattern ? Use this research so you can find your
own way out of the infertility maze !
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