Advice for health practitioners and health services

Georgia would like health practitioners to listen to people seeking help for infertility, take them seriously, and not make assumptions.

Don’t think that this is just, somebody wants a baby, and it can wait, they’re young. People have these different experiences, and I’ve found that I am young, but I’m at that point where I am ready, and don’t be dismissive of that. Don’t think just because somebody is young and they’re healthy, and they don’t drink or smoke, that they’re going to be completely fertile, and they’re going to be okay. Listen to what they’re saying. If they want to be referred onto somebody, refer them on. Give them good recommendations on where to start. Because some people just want to know, “What’s the first things that I should be doing?” and I think some doctors can be quite dismissive of that, where it shouldn’t be. It should be as if any other consult comes in. Somebody’s got a broken arm, you’re going to refer them to get an X-ray done. Refer us. [laughter] If this is what we want, we’ve come to a health practitioner for advice and for help; we haven’t come just because we want to have a day out. We want some advice.

Belle urges fertility specialists to communicate in plain language and not overload people with information.

The average person isn’t a medical expert or scientific expert. So, how do they dumb it down as easy as they can to make people be able to understand? And then I also think what’s really difficult is that it can feel like it’s information overload, but when you break it down by day-by-day or week-by-week, there’s so much that you probably don’t need to take in upfront. You just need to concentrate on tomorrow and then the next day, and then the next day, or you just need to concentrate on the first week or whatever it might be rather than flashing forward four weeks.

Just try and deliver it to the patients that are going through it in bite size chunks because if it’s given – some people may be different than they want all the information upfront, but realistically, even if you give them all the information upfront, it’s hard to digest it all. So if there’s a way to break it down as best as possible.

Jacinta recommends health practitioners practice empathy and remember what is ‘everyday work’ for them is ‘everything’ for a person undergoing fertility treatment.

I think for health professionals, remembering that for the person that you are treating, this is absolutely everything to them. It might be bread and butter everyday work for you and you’re seeing all of these women going through the same thing, but for the person that you’re in the room with at that time, this is their complete life and all of their hopes and dreams that you’re talking about. Sometimes, I think when you are seeing a health professional, it can seem like you’re just such a part of their routine and you’re just one little speck in their day, but for you this is completely everything and you’re really banking on this one being the one that works.

Melissa began IVF in her late 30s and was unsuccessful. She has a simple message for health practitioners – don’t delay.

Treat people as early as possible. Test them as early as possible and then treat them as quickly as possible too. Don’t let it drag on for too long.

Claire advises health practitioners to think of people undergoing fertility treatment as needing ‘some additional support’ rather than as having ‘something wrong with them’.

Try not to treat people who are going through IVF as patients that have something wrong with them. I think we all need to be a bit more mindful of the language that we use around women who are experiencing infertility. I was lucky with my partner that we never got into any sort of conversations around blame or anything like that. But those things can really be present in relationships.

Don’t make any assumptions of where you think people are at on a particular day. That’s, I know that that’s difficult because people, the doctors are really busy. But each person that goes in there, each woman that’s trying to have a baby has a unique story and a unique kind of situation. So make them feel like they’ve been heard through whatever that experience might be.

Women who are experiencing infertility are often not sick and unwell. They’re just in need of some additional support. Perhaps if it was all flipped on its head and you used much more sort of positive terminology it – the whole situation might look quite different.

Kris suggests that health practitioners remember that for some people, fertility can be as much about identity as it is about having children.

Be kind and talk to women about their fertility and there might be… It’s not just about kids. The conversation about fertility is also about self as well and making sure people are feeling safe and secure in themselves. So it’s got a lot to do with identity. So just being kind and taking time in those conversations, I think for me.

Sue-en reflects on how, compared with Australia, fertility treatment in Korea is more accessible due to greater government support.

Some clinics in Korea are run by government and some are run by private but cost-wise there is no difference because the government subsidises the same. It’s more affordable [than] in Australia, because I think technique wise or the quality of the clinics are the same as Korea but because of the cost I think so many people have less options and that will be beneficial for anyone who has fertility issues if they can have access to all these resources that would be really good.

Because that’s what I said to my husband, we’re in a very secure financial position but still money is a big factor and what if those people can’t afford any or if they can afford but they don’t have a choice to choose this clinic, that’s pretty frustrating isn’t it?

Tallace recommends the medical profession and fertility treatment sector re-examine heteronormative assumptions about gender, parenting and partner relationships.

In a lot of ways, being a queer person navigating a fertility system has been complicated, and sometimes really uncomfortable. It can be things as simple as forms saying “husband”, or assuming that the partner is male somehow. That happens on some forms. I’ve also had a number of friends who are trans men have children, carry children, and so even medical forms that presume that the childbearing person is a woman… They don’t need to make that assumption. It could just say “patient” rather than “woman”. [laughter] Yeah. So I think that the medical profession has got a long way to come in just setting aside some very heteronormative assumptions about who will be the patient, who will be the partner.

After 14 cycles of IVF in three different countries, Hannah shares what she would like to see change about the fertility treatment sector in Australia.

A lot of these nurses in IVF clinics are dealing with a lot of patients coming and going each day, each week, and as a patient, you’re assigned to different nurses, you’re dealing with different nurses. There’s room for error, without a doubt, so yeah, if they could just be more patient, and – yeah, you’re not a number, this is your life, you’re paying a lot of money, and it should be good service.

And then, there’s a whole other scenario about how many days the clinics are open, and if you need an egg collection or a transfer on a Sunday, then is your particular doctor going to be there, and – or on top of that, is the clinic open on a Sunday, or are they just going to randomly do you the day before or the day after? So, there’s all that sort of thing to think about, as well, the availability of the clinic.

I called up a clinic here the other day, and they’re booked out until two months or three months’ time. It’s like, ‘Oh my goodness, I just wanted to ask a piece of advice for the next step.’ So, my point is, there are women going through hell, and there’s no access for them in a lot of scenarios, so – and time is against them.

Then, even if you get that appointment in three months, most of the time it’s like, “Go and get this blood test,” – as we’ve said, it’s back to square one. It’s going through your whole history. That’s why I have that document packed up ready, because I email it all, whatever, I have it ready to give to them and share, because knowledge is power, it’s the background information.

I saw a different clinic over here, when I first arrived, because I had to get medications prescribed for going to America, so that’s why two clinics in two countries always have to work together, and another reason why they have to work together, when it’s across borders, issuing medication, and she was telling me, this doctor here, “Oh, why don’t you want to try another cycle?” I said – I was trying to tell her, that I’d done 14 – and she held up a laminated A4 bit of paper and said, “This is what we do here – bang, bang, bang, for all the patients.” I was just thinking, ‘Oh my goodness.’ “On day this, day that, this medication, that medication, so it’s the same scenario for everyone, the same shoe fits.” I was just like, ‘Oh, goodness.’ At that point, I was 44, and I was like, “No. No, I’m past that, I’m not 30, starting out on this journey. It’s 10 years of infertility, I need another option. I need to look at other options.”

Then, as I mentioned, there’s the legalities of different countries that you’re living in and dealing with, and different Australian laws that you need to work through. And different states in Australia have the different laws, as well, and that’s why it’s sort of hard to navigate the system, and know what is legal and not legal, because there’s different laws in Australia for the different states. So, that’s why people do end up going overseas to pursue other options.