This article is a preview from the Summer 2020 edition of New Humanist
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"What do we do now?”
Jason and Nikki are sitting on a park bench after a doctor’s appointment. They’ve been told that with their collective fertility complications, it’s very unlikely that they will be able to conceive a child. Understandably, Jason now wants to talk about next steps. Nikki shoots the answer back quickly. “A small piece of us dies and we just carry on with whatever’s left,” she says.
This is an early scene from Trying, a new sitcom now streaming on Apple TV+. It’s the first British original series commissioned for Apple’s TV-on-demand platform and stars Rafe Spall and Esther Smith as the central couple. They are struggling with fertility issues alongside all the usual stresses of life – jobs, friends, family and so on. It’s fairly standard sitcom fare, other than the fact that the devastation and depression that accompany their attempts to have a family are portrayed with great sensitivity. There’s no quick or easy answer to their problem. Trying to conceive, failing, and then exploring alternative options is a slow, exhausting process.
This series is part of a wider trend in pop culture towards more accurate portrayals of fertility issues. Figures published by the National Institute for Clinical Excellence estimate that infertility affects one in seven heterosexual couples in the UK. In 40 per cent of these cases, there are medical issues for both partners that lead to trouble conceiving. Given this, it’s encouraging to see that the media we consume is starting to reflect the diversity and nuances of how families are started or not started.
This is a recent development, however, within the last ten years or so. Until the 2010s, there were two main ways that fertility was explored on screen. It was either part of a dystopia, as in Alfonso Cuarón’s 2006 film Children of Men, or a goofy romcom, usually as an impediment to the course of true love. The latter is especially evident in the film Knocked Up from 2007, which starred Seth Rogan as an irresponsible, porn-obsessed stoner named Ben who gets a beautiful career woman called Alison pregnant after a drunken one-night stand. A lot of her pregnancy appears in music-backed montages, a secondary consideration to Ben’s personal journey towards responsible fatherhood.
It’s such a standard way for mainstream films and TV to portray conception and impending parenthood – the film was a critical and commercial success on release – that I didn’t even notice it was nothing like reality until my own contemporaries started to have children. A pregnant friend recently commented ruefully that she was currently living very slowly through the part of the film that would normally zip by in a 45-second montage. Getting up to go to the toilet six times a night and taking long naps because of exhaustion don’t tend to feature.
Even in real life, pregnancy is a closely controlled narrative with superstitious rules restricting when certain revelations should be made. Don’t announce anything until 12 weeks, we are told, so that you won’t have to explain it to anyone if you miscarry before then. Don’t say what name you’ve chosen before the birth, as it’s bad luck. There is now a whole industry around so-called “gender reveals”, with couples holding parties and bursting balloons of appropriately coloured confetti for photographs.
Infertility disrupts this linear narrative. It’s harder to talk about the lack of something, about trying for years and having nothing to show for it. The next step for many couples in this position is IVF, which requires expensive hormone treatments to retrieve an egg that is then fertilised in a lab, before being returned to the uterus as an embryo. There are risks involved – either cycles don’t work at all or an embryo is miscarried early in pregnancy – but the success rate in the UK is around 30 per cent, with thousands of babies every year born this way.
A new wave of writers and directors are beginning to reflect this on screen. The 2018 film Making Babies is, like Knocked Up, a romcom, but it focuses on Katie and John’s five-year struggle to have children. We watch as their relationship starts to crack under the strain of the clinical interventions in their fertility: the endless doctors’ appointments, the specimen jars and all the mood-altering hormone injections. The film finds plenty of comedy still – the “donation” room that John has to use at the clinic is like something out of a horror film – but it doesn’t shy away from the difficult stuff either.
The 2018 Netflix film Private Life goes even further to show the trauma of IVF, casting Paul Giamatti and Kathryn Hahn as a middle-aged couple desperate to have a child before biology makes it impossible. They try IVF to no success and then end up being persuaded to use a donor egg. This introduces a whole new layer of stress to the process, since it involves more people, all with motivations different to their own. On top of that, writer and director Tamara Jenkins makes a rare attempt to show the financial side of fertility problems.
In the UK, the NHS will cover IVF in some instances, although many couples have to pay out of pocket. In the US, where this film is set, it’s common for health insurance not to cover IVF at all. Giamatti’s character ends up $10,000 in debt to his brother because of just one surgery. There’s no neat resolution to their story either, which feels closer to what might happen to a couple like this in real life.
The same stigma that surrounds revealing a pregnancy “too early” also stops a lot of people who are going through fertility treatment from talking about it, even to close friends. In an attempt to combat this, more and more people are using tools like social media and podcasting to share their stories – a non-fiction counterpart to the storylines in shows like Trying. Acronyms like “TTC” (trying to conceive) and “2WW” (the two-week wait between completing treatment and being able to test for pregnancy) are now common as hashtags on Instagram and Twitter, allowing those on the same path to find each other. At the same time, greater sensitivity about posting so-called “bump shots” and baby pictures is emerging, as the lucky ones try not to bombard those still trying with images of what they’re missing.
Two writers based in Los Angeles have built up a large community around their own IVF journey via a podcast called Matt and Doree’s Eggcellent Adventure, which has seen them record weekly episodes since they started fertility treatment in October 2016. They are completely frank about the money troubles IVF has given them, as well as the pressure it has put on their relationship and careers. They frequently say that having a regular date to sit down and talk to each other about the process on the podcast has probably kept them together, since it’s much harder to avoid being honest when there is an expectant audience awaiting updates. There are plenty of other podcasts like this too, covering the full gamut of infertility experiences – far beyond the heterosexual couples who are still usually the protagonists on TV.
Pop culture reflects us back to ourselves, or at least the version of us that entertainment’s powerbrokers want to project. The statistics about infertility and IVF are clear: this is, if not a universal experience, then one that a significant segment of those wanting to have children will be going through. The arrival of stories like that of Jason and Nikki on Trying shows that the way we think about having children is broadening and deepening. Just because someone isn’t filling up Facebook with their baby pictures doesn’t mean that they aren’t on the path to parenthood.
