Michelle Obama shares her strug­gle with in­fer­til­ity

The State (Sunday) - - Stay Connected - BY COLBY ITKOWITZ

In a week that saw tremen­dous gains for women in pub­lic of­fice, Michelle Obama just broke an­other ma­jor bar­rier.

The former first lady, in an in­ter­view pro­mot­ing her forth­com­ing mem­oir, shared a painful and per­sonal se­cret: She and Barack Obama strug­gled with in­fer­til­ity, had a mis­car­riage and used in vitro fer­til­iza­tion (IVF) to have their two daugh­ters, Malia and Sasha.

What makes her story so re­mark­able is not that she and her hus­band had is­sues with fer­til­ity, but that she’s now talk­ing about it and open­ing the door for the mil­lions of women who had or cur­rently have trou­ble con­ceiv­ing to share their own sto­ries.

“I think it’s the worst thing that we do to each other as women, not share the truth about our bod­ies and how they work, and how they don’t work,” Obama said in an in­ter­view Fri­day on Good Morn­ing Amer­ica.

That this par­tic­u­lar woman broached this sub­ject could move the fo­cus im­me­di­ately to how pub­lic pol­icy treats it. Obama’s new will­ing­ness to dis­cuss her pre­vi­ously se­cret strug­gles can shine a new light on the preva­lence of in­fer­til­ity and the in­cred­i­ble emo­tional and fi­nan­cial cost of go­ing through med­i­cal treat­ments to have a baby.

While the Af­ford­able Care Act, her hus­band’s sig­na­ture leg­isla­tive achieve­ment, man­dated cov­er­age of ma­ter­nal health care, it did not re­quire cov­er­age of fer­til­ity treat­ments. Nei­ther does Med­ic­aid. And while 15 states have passed laws that in­sur­ers cover or of­fer cov­er­age for in­fer­til­ity treat­ments, women in the re­main­ing 35 states of­ten must pay out of pocket if they hope to con­ceive. And even when it is cov­ered, it’s some­times only par­tially, and still re­quires a mas­sive out­lay of cash that is out of reach for most peo­ple.

IVF can cost as much as $20,000 a cy­cle, so the abil­ity to have chil­dren be­comes a ques­tion of means. In other words, only in­fer­tile cou­ples with that kind of dis­pos­able in­come have full op­tions when it comes to get­ting preg­nant. It’s per­haps the stark­est ex­am­ple of health ac­cess dis­par­i­ties.

In May, Sen. Cory Booker, D-N.J., and Rep. Rosa Delauro, D-conn., in­tro­duced leg­is­la­tion re­quir­ing in­sur­ers cover in­fer­til­ity treat­ments with­out rais­ing pre­mi­ums or co-pays. The bill never went any­where, but could find new life in a Demo­cratic-led House with a record num­ber of fe­male mem­bers.

Much like men­tal health is an in­vis­i­ble ill­ness that peo­ple of­ten fear speak­ing about, so is in­fer­til­ity. Last year, the Amer­i­can Med­i­cal As­so­ci­a­tion voted to fol­low the lead of the World Health Or­ga­ni­za­tion and des­ig­nated in­fer­til­ity a dis­ease, hop­ing it would pro­mote more in­sur­ance cov­er­age of treat­ments and less stigma.

In­fer­til­ity rates con­tinue to rise as more and more women wait un­til later in life to start fam­i­lies. The Oba­mas were in their mid-30s when they went un­der­went IVF.

The worst-kept se­cret about in­fer­til­ity is just how com­mon it is – as many as 1 in 8 cou­ples have trou­ble get­ting preg­nant or car­ry­ing a baby to term – but women still re­sist talk­ing about it, of­ten blam­ing them­selves and silently car­ry­ing shame and an­guish.

Ad­di­tion­ally, one in four preg­nan­cies end in mis­car­riage – of the ap­prox­i­mately 4 mil­lion preg­nan­cies in the United States in a given year, that’s as many as 1 mil­lion women. And yet, be­cause most mis­car­riages oc­cur in the first trimester when women of­ten don’t re­veal their preg­nancy, they go through the loss of that preg­nancy in iso­la­tion.

It’s a sad re­al­ity that Obama spoke to di­rectly.

“I felt lost and alone and I felt like I failed, be­cause I didn’t know how com­mon mis­car­riages were, be­cause we don’t talk about them,” she said. “We sit in our own pain, think­ing that some­how we’re bro­ken.”

Obama isn’t the first po­lit­i­cal fig­ure to dis­cuss openly her in­fer­til­ity. Ear­lier this year, Sen. Tammy Duck­worth, D-ill., an­nounced she was preg­nant with her se­cond child, mak­ing her the first sit­ting se­na­tor to have a baby.

Dis­cussing her preg­nancy, Duck­worth shared, “I’ve had mul­ti­ple IVF cy­cles and a mis­car­riage try­ing to con­ceive again, so we’re very grate­ful.”

DOUG MILLS NYT

Former first lady Michelle Obama, left, Pres­i­dent Barack Obama, right, and their chil­dren Malia and Sasha walk with their dog Bo at the White House in April 2009.

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