(You make me feel like a....)

With apologies to Aretha Franklin

I remember sitting in the specialist’s office, one morning in 2018. That time (pre-child, pre-COVID) feels like a bit of a blur now, but it was likely around late-July, so coming out of “Winter” (for those of you familiar with Brisbane weather, you will understand the need for quotation marks). After completing the required intake and documenting all relevant medical history, the specialist ask my partner and I matter-of-factly if we had ever “spontaneously” conceived before. The confusion must have been visible in my face, so she continued “have you ever become pregnant without the assistance of reproductive technologies?”. “Oh, yes, once” I answered. “Years ago, and it ended in miscarriage”. After responding with the appropriate level of empathy, she continued to inform us of the options available for reproductive assistance. Already falling significantly behind the optimal fertility schedule at the grand age of 34, we decided that IVF (in-vitro fertilisation) would be the approach we would take (spoiler alert - it worked).

While so much of those clinic conversations have been pruned from memory, either through either the glorious process of neuroplasticity or suppressed through the experience of birth trauma, the description of spontaneous conception has stuck with me. Prior to this conversation, I had referred to all non-assisted conceptions as "natural” . While I know that in these instances, “natural” for me has meant “happened as a result of penis-in-vagina sexual intercourse at the right time of the menstrual/ovulatory cycle”, I’ve been considering the weight that such a term has. When we consider the opposite, “unnatural”, we think of synthetic, artificial. We could go down a whole sociological and social constructivist rabbit hole here in unpacking the role patriarchy/religion/class etc. has on this, but let’s do something quite radical and focus on the here and now, and how our use of certain language can be loaded to rendering us as deficient, or simply just be words.

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2024 will mark my 20-year anniversary with Zoloft. Like all long-term relationships, we have had our fair share of challenges, and have at times questioned whether we would be better living separate lives. I remember after being prescribed the drug, I had this incredible anxiety and fear over taking this daily tablet. I was consumed with the idea that ingesting this little white pill meant that I was admitting defeat over these demons that as a young, middle-ish-class woman, shouldn’t justifiably be felt. And that reflection in itself would send me down another spiral, which would ultimately lead to a panic attack. I would keep telling myself, maybe you should just try to exercise more? Bach Rescue Remedy? Let’s try natural, before pharmaceuticals as though I hadn’t been obsessively over-exercising. Bach’s Rescue Remedy also did not prove effective in suppressing the constant fear of an asteroid crashing into the earth, killing us all. ¹

In the 19 years since first taking the SSRI, its usage has faced a plethora of questions from well-intentioned loved ones and society at large, largely focused on whether its use is truly warranted, or whether people should try the “natural” (read: non-prescription pharmaceutical) options instead. The counter-response over the years has, anecdotally, seen a shift - from carefully-communicated information about how psychiatric medication actually works, to pastel-hued instagram grid squares with “if your brain doesn’t produce its own serotonin, store-bought is perfectly fine” brush-scripted on it. What’s remained consistent is feeling the need to justify taking said medication, as though an explanation is warranted for an adult making the choice to swallow a tablet. I have not been immune to this urge - I’ve had more internal battles regarding the decision to continue or cease medication, usually falling back on feeling shame that I am reliant on this treatment, that my “natural” way of being is unliveable. In these moments, I feel a massive sense of failure, that I am deficient.

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It was my mental health issues that led me to engage with a perinatal psychiatrist when I did start on the IVF treatment cycle back in 2018. Knowing that I was statistically more at risk of perinatal mood disorders, I attempted to arm myself with as much support as I could to not fail at this whole pregnancy and parenthood thing. My psychiatrist was a pleasant, conversational man, who like me had been a professional oboist before embarking on a completely different career (it’s more common than you would think). He had also recently become a father himself, and shared experiences of feeling awkward at antenatal groups. Among the small talk of the groups, he picked up the fear that many of the parents had that they would not be able to have a “natural” birth. “What do you mean, natural?” He asked the group, who were likely bewildered that this generally silent parent-to-be had asked such a silly question. “You know - natural. No epidural, no drugs, no c-section, no medical intervention”.

How I would see myself, if my son was conceived spontaneously and I birthed him vaginally.

Having now been involved in parenting groups myself, I can see how the human act of comparison comes into full force in these situations. When these seemingly innocuous statements are made, others question and stew on whether their decisions or experiences meet the standard that has been set here. What if we tried to conceive naturally, just a little longer? Maybe I didn’t really need that emergency c-section, maybe if I wasn’t induced…… Combined with the power of post-natal hormones, the fact that a chunk of my pregnancy and parenthood experience so far had been “unnatural” was a source of internal shame. Anecdotes from likely well-meaning acquaintances about their friend who had another two kids “naturally” after conceiving their first through IVF further cemented my status as being completely deficient, because that will never happen to me (…..but what if???).

Whether we are willing to recognise it or not, when we refer to an aspect of someone or their life as “natural”, we are assigning value to it. Let’s look at other areas the term is used - appearance (cosmetics use, hair, skin), bodies (modifications), produce (organic, genetically modified). In pretty much all of these spaces, the preference toward “natural” can be linked to reasons influenced by class or virtue (I promise I won’t dive deeper than this). And while I acknowledge that there is some onus on an individual to strengthen their resolve and be confident in their choices, the fact remains that we are a social being. We rely on connection and interpersonal communication to make meaning.

I’ve been back in that same specialist’s office this week, almost five years since that first appointment. This time, the conversation is centered on potential frozen embryo transfers. In looking at the different cycle preparation options, my eyes flick over the two available.- hormonal, and nat….ahhhhhhhhhhh, for fuck’s sake.

1. This is an example of a genuine fear I had when my mental health issues first surfaced. Don’t worry, I’m fine. :)