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5 Ways Cancer Complicates Motherhood

When I was very young my mother would sometimes get phone calls in the middle of the night. The water broke. The contractions were coming. It was time for her to go. She was a midwife who performed primarily at-home births. I am told that I sometimes tagged along for these deliveries but I was too young to remember much. I do remember the women afterwards when they would come to visit my mother, new precious packages in tow. Amidst the exhaustion and the worries I could always sense this deep feeling of wonderment and love for this new life they had brought into the world. There was a knowingness that all these mothers possessed. They had been through something that only other mothers could understand and they readily exchanged empathetic glances and comforting words.

From a young age I knew I someday wanted entry into this special club. I wanted to have this powerful life experience. I wanted to give my life over to something outside myself, to go through the pain for the ultimate gift, to be able to share in those knowing glances. In my late twenties my biological clock started ticking and my husband and I made plans to start “trying” once we were both thirty. Life, unfortunately, had other plans. Just a few months after my thirtieth birthday I was diagnosed with an aggressive form of breast cancer. I spent a year in treatment. I lost both of my breasts in the process and the twenty rounds of chemotherapy shut down my ovaries and threw me into medically induced menopause.

My dreams of being a mother suddenly became muddled. On the day I was diagnosed I told my doctors that I didn’t care about my breasts, I only cared about my fertility. They allowed me to push back my chemo a few weeks to go through fertility treatment and harvest my eggs knowing that the toxic drugs might destroy my ovaries. I call my little embryos my “space babies” because the technology that created them seems so futuristic. They currently sit frozen on ice in a storage facility somewhere in Maryland; my microscopic beacons of hope for motherhood.

Despite my determined optimism about someday becoming a mother I have found that my feelings on the topic have grown increasingly complicated. Scrolling through Facebook as a 30-something means my news feed is filled with giggling babies and pregnant bellies. I counted at least a dozen pregnancy announcements in the last 6 months. And while I am always thrilled for my friends and overjoyed to be surrounded by all of these incredible little ones I am also plagued by pangs of sadness. These pangs have been accumulating into a heavy weight that fills me with grief and guilt. I imagine that this is a plight shared by thousands of women: the jealous grief over the denial of this fundamental human experience combined with guilt for feeling that way at all, for weighing down joyful occasions with sadness.

I have thought long and hard about this topic and tried to sort through my many feelings on it. I have wanted to talk about it many times but it often feels too taboo to discuss. So many women silently battle through the pains of wanting motherhood and not being able to have it for a myriad of reasons. I am not sure who we are protecting by remaining silent though. My feelings about this are not meant to take away from the joy that my friends have found. They aren’t meant to make anyone feel bad. And I’m also not sure that not sharing them protects me from anything either. I don’t think my issues with motherhood make me less of a woman or inadequate in anyway. Nor do they change the way I interact with my friends and family who are pregnant or have children. I am capable of feeling multiple emotions at once. I can hold both joy and sadness in my heart and one does not diminish the other. So since I have never been one to remain silent I wanted to share my feelings today in hopes that they might help other cancer survivors and fighters or other women fighting for motherhood also process and maybe even share their own feelings. So here are just some of the ways that I have found that cancer has complicated the prospect of motherhood:

1. First and most fundamentally I am almost certain I won’t be able to conceive naturally. This is a minor loss in the big picture but a loss nonetheless. I am extremely lucky in the scheme of things that I was able to freeze my embryos. Many young adult cancer patients are not even given the option. I am also sort of lucky in that my cancer does not have hormone receptors, which means I do not have to be on hormone suppressing treatment for the next 5 to 10 years, which would make it impossible for me to get pregnant during that time. The trade off is that my cancer is much more aggressive and without a prolonged treatment option my rate of recurrence is much higher in the first few years.

If I came out of menopause I might be able to conceive naturally but the chances of that have been shrinking. My doctors recently discovered a suspicious solid cyst on one of my ovaries that they are concerned about. I’ll likely have to get at least the cyst removed if not my whole ovary in the next few months. This would further reduce my chances of coming out of menopause. As far as I understand I can still get pregnant using my space babies even if I remain in menopause and while I have no conception of how exactly that works I am exceedingly grateful that remains an option for me.

2. If I am able to conceive I will never be able to breastfeed. This is a pretty painful loss for me. It was something I had to weigh when deciding to get a double mastectomy. Ultimately research showed that for my kind of cancer a double mastectomy would reduce my risk of recurrence by 5% which was enough for me. But it is devastating to think that the first thing my child needs from me I will be unable to provide. I will fail my baby from the moment they are born and miss out on that bonding experience. To add insult to injury I know that I will be judged by those who don’t know my story. This frustration was quite poignantly written about recently in this Washington Post article in which a breast cancer survivor gets grief for not breastfeeding from just about every angle, sometimes even after she’s explained her situation. I am comforted by the fact that there are many women who are unable to breastfeed for various reasons and they have perfectly healthy babies, but it is still a painful reality.

3. On a more difficult note I often get upset when I think about having children because I just don’t know for sure that I’ll survive long enough to have them. Basically if I can survive three years out from my diagnosis date (which was 09/09/13) the chance of a recurrence goes way down and it is probably safe for me to try and get pregnant. Five years out would be even safer and seven would be the safest. But I am only 3 months out from treatment and have heard plenty of stories of women like me ending up with cancer in their brains, their bones, their lungs, their liver. I take nothing for granted and I spend a lot of time coming to terms with my own mortality. In the end, as morbid as that may sound, it’s actually an incredibly life affirming exercise. I have had an incredible life filled with beauty and love and passion and happiness and I now know that I could find a way to let go peacefully. But the one thing I would be hopelessly depressed about missing out on is becoming a mother. Whether it’s a child I have on my own or one I adopt I want to have the experience of being a mother and I would feel cheated out of that if I were to die young.

Andrew and I used to play the “what are we going to name our children” game in which he would list off the names of old timey actresses and I would explain why I didn’t like them (“Lana makes me think of Lana Del Ray not Lana Turner,” “Ava has gotten too popular already”). This game became too painful to play when I realized that cancer could conceivably take motherhood away from me.

4. On the flip side I am almost afraid to have a child as it would be something that would tether me to this earth like nothing else in my life ever has. I am working really hard to accept the possibility of my death and it seems like having a child would make that acceptance near impossible. The fear I feel when getting test results back now would just be magnified a zillion times over if there was a child in the picture. I know other young adults with cancer who have children and I see the desperate look in their eyes when they talk about not wanting to leave their children motherless. I have practiced a lot of letting go over the past year but I have no idea how one could ever let go of a child.

5. Finally, the thing that is most painful on a daily basis is just that I feel so left out. There is a club that I cannot be in. It is not by choice but by unfair circumstances that I haven’t been granted entry. As more and more friends enter this club I feel increasingly disconnected. While I can certainly relate to feelings of daily nausea, heartburn and bloating I have no idea what it feels like to go into labor, to greet a new life you have created, to try to take care of a crying baby on less than 4 hours of sleep, to watch a child learn and grow and become a curious, competent, communicating person. I can’t empathize with the trials and I can’t fully understand the joys. I cannot relate to more and more friends as they experience this thing that I desperately wish I could also experience. I, of course, have my own club of young adults with cancer and we can relate to things like neuropathy and hair loss and port surgeries. I am deeply grateful to be part of this club but it isn’t one that anyone would ever choose to join and we are largely outsiders to the rest of the world. So in some ways the hardest part is that it just feels a little lonely here on the outside of the Mommy Club.

I hate that this breaks my heart so often. I hate that it makes me feel disconnected from the people I care about the most. I hate that I got cancer, that I’m in menopause, that so much of what makes me a woman is now gone or broken. But I try to remain positive. Even though I cannot guarantee what the future will hold I can be hopeful. And if I am able to have children someday I know that they will have a mother who fought hard to be there, fought hard to have them and will be able to teach by example how incredibly lucky we are to have this life to live.