Background on the Memorial Service for Fertility Losses

BACKGROUND on the Fertility Loss Service
by Meredith Wheeler

A child dies–but nobody arranges a funeral or memorial service, no one sends flowers or offers condolences to the parents. Sounds preposterous, yet something close to this happens frequently in the field of fertility, where patients can easily accumulate ‘invisible losses’.

Couples undergoing high-tech fertility treatment may be shown their living embryos under the microscope before transfer to the womb–only to discover weeks later that implantation has failed. Given the investment of time, energy, money and hope into this process, that is a major setback–but where is the support to face it?

Often fertility problems and infertility treatment are kept private, if not secret–so family and friends have no idea what’s going on–& are unable to offer the necessary understanding and support.

High-tech fertility treatment has created new forms of loss previously unknown in any culture—but societal ways of honouring and acknowledging such losses have not kept pace. Where are the rites and rituals to mourn these losses?

Do fertility professionals collude with patients in failing to acknowledge the pain of failed treatment? Is the determination to be positive at any cost another form of denial?

Some couples prefer to get back on the treadmill of another treatment cycle, rather than face the sadness, anger and grief of treatment failure. The pain of those losses is buried–perhaps to resurface later in life as depression or illness.

There are many people facing these losses too. According to the most recent HFEA figures, only 23.1% of IVF treatment results in a baby ( In 2006, 34,855 women had IVF treatment in the UK—and the vast majority of that treatment failed.

While the fundamental loss is of the biological offspring and membership in that club of parenthood, there are many associated losses too: loss of the possibility of being a grandparent; the end of a genetic line; loss of control over the body as invasive and upsetting medical procedures are performed upon it. There may be a loss of faith. There is possible damage to the relationship with the partner, often including a severe blow to the sexual connection. Some partnerships fail beneath this burden. Relationships with family members & friends who have children or become pregnant may falter. There is often a sense of isolation. Strong emotions of anger, guilt, confusion and grief find no resolution.

Fertility counseling offers valuable help as do support groups.

Up until recently, no ceremonies existed to help acknowledge and grieve these hidden losses of infertility and failed treatment. This lack of external validation makes it easy to join in a conspiracy of denial.

Recognising an unmet need in this area, three women, all counselors and all with some personal experience of fertility losses, put together a special non-denominational service for fertility loss.  I was one of those women.

I noticed that some women who participated in support groups that I facilitated found solace in devising rituals for
themselves to validate their losses.

One who had experienced several miscarriages took lengths of red satin ribbon and marked on each the date of conception, the date of the miscarriage and the due date for her lost pregnancies. She and her husband ritually burnt these in the garden, buried the ashes and planted a rose bush on the spot. This helped bring closure to a difficult chapter of their lives. Although she was over 40, she went on to have a healthy baby without any fertility treatment.

Another women in north London created a more intricate Jewish ceremony in her home, involving a rabbi, family and friends reading prose and poetry. After several years she successfully adopted a baby girl from China.

Those private rituals suggested that there should be some kind of memorial service–a public ceremony–for people who have suffered fertility losses and may be carrying the burden of grief, guilt and anger.

A format was put together with input from two women who had a special interest in the subject. Judith Meredith was a childless psychotherapist who ran miscarriage support workshops; Althea Hayton worked with women who had ungrieved terminations. We took a service developed in Canada and reshaped it to suit our goals: a non-denominational healing ritual with many opportunities for active participation by everyone present.

For example, in our ceremony everyone is invited to light a candle for the child who was is not in life–even children never physically conceived. Everyone is invited to cut off a blossom from a central bouquet, representing their ‘lost’ child and float the flower in the central bowl of water. Time is provided for messages to be written to any ‘missing’ children–and these are ritually burnt outside shortly after the main service ends. Most people avail themselves to every possible means of participating.

The service lasts about an hour and also includes music (everything from Bach to Van Morrison) and readings—from Gibran to e.e. cummings.

We tried to create a ceremony that would ‘work’ for those who were atheists and agnostics as well as those following some spiritual path.

The goal is to mourn these losses in the company of other people who had experienced similar setbacks, with a view to healing and moving forward with a lighter heart–it’s not about dwelling on the pain and loss in an unhealthy way. While on one level it is an ceremony where sadness is expressed, by the end there is usually an amazing sense of peace filling the room. Some transformation takes place.

The feedback has been encouraging:

‘It was good to see my partner grieve openly–and to share our sadness with others who understand.’

‘Tears came and for once they were cleansing. The whole ceremony was very beautiful. Everything was simple and accessible and I really valued being able to participate. It made me feel part of something rather than being separated and isolated and alone.’

‘Many thanks for providing such a nurturing and healing day.  I felt the atmosphere was containing, grounding and relaxing…enabling me to get in touch with grief without being overwhelmed by personal or collective material.’

‘This moved me further along the path towards reconciliation, healing and growth. I will certainly attend again next year and would love to take part…’

Inspired by the response, we ran the service in London and Scotland for 5 years. Some people return year after year. One person wrote on a feedback form that she was particularly conscious of ‘how I’ve moved on since I came to the service last year. The intensity of my grief and pain has lessened. Yet I am also able to get in touch with my feelings of loss, which are still there and needed an outlet.’

In London, about a third of those who attend are couples; the rest are women who come on their own or with a friend.

There are tears–but most people find it cathartic. These feedback comments are typical:

‘It has been a unique opportunity to mark our losses and has undoubtedly helped us in our grieving processes.’

‘A very beautiful and healing event. I found it a tremendous comfort and a source of great consolation.’

Past service were usually sponsored by the British Infertility Counselling Association (BICA) and MoreToLife, a patient support group linked to ISSUE.  We encouraged others to run similar events.

A weekend workshop sometimes runs in association with the services for people wishing to do deeper work on the theme of  ‘coming to terms’.

One key exercise involves each person drawing a chart or graph of her/his fertility history or journey–the important moments, turning points, setbacks and dead ends. These are shared in small groups and can be surprisingly illuminating:

‘It really made me focus on what had happened and why. It also made me realise how much I’d buried. Talking through my experience with someone who really understood was immeasurably valuable. Although ‘normal’ people can by sympathetic, they can never know how devastating infertility is and, for the first time, I felt able to express my grief, which has been kept hidden for so long.’

The workshop is often pivotal in people’s healing process. Julia wrote, ‘I had never before experienced such sadness about my own infertility nor such a powerful connection with other women. It was a soulful, humbling and healing encounter that has remained very special and important for me–like a rite of passage. I now feel much more able to enjoy my adopted children, much more of a mother and much more complete as a woman.’

Sue, a single woman in her 40s, attended three London services before taking part in the workshop. She had gone through unsuccessful fertility treatment, two miscarriages and the breakdown of her relationship with her partner. Two years later she wrote: ‘The workshop for me was profoundly about achieving closure. I suddenly knew it was sorted on an emotional and spiritual level–all that hope and longing. I felt resolution in a way that made it easy to know what next–where I was able to move forward.’

As part of the workshop, the group attends the fertility loss service together.

‘The ritual, as a focal point of the weekend, was hugely beneficial. To be able to grieve publicly was a great release. Although the room was filled with people who had been through such pain and suffering, it somehow felt hopeful, perhaps because we all began to realise that we were not as isolated as we had thought.’

Following the one such workshop in London,  three of the 11 participants took steps to adopt. Others were better able to make peace with infertility and childlessness.

The text of the service is available by email for free in the hope others might feel inspired to run a similar service in their communities or devise a ritual for a more intimate circle of family and friends.

The important element is to honour our life experiences–even the sad ones–so that we can learn from them, heal and move on to live creative, fulfilling lives.