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Book Review: The Pursuit of Motherhood

6 May 2014
Appeared in BioNews 752

The Pursuit of Motherhood

By Dr Kathryn Asbury and Jessica Hepburn

Published by Matador

ISBN-10: 1783061871, ISBN-13: 978-1783061877

Buy this book from from Amazon UK

'The Pursuit of Motherhood' could be best described as a cross between 'Eat, Pray, Love and 'Bridget Jones' Diary'. Perhaps 'Bridget Jones and the Missing Baby'. This memoir by London theatre director Jessica Hepburn has the same breezy chick-lit writing style, self-discovery through self-help courses, and copious middle-class lifestyle porn.

The book tells the tale of Jessica's arduous seven-year quest to conceive, during which she spent more than £50,000 on fertility treatment. Her diagnosis is unexplained infertility. During her ten rounds of treatment, she experiences at least two biochemical pregnancies and a miscarriage. Her only successful pregnancy is, sadly, ectopic.

She charts her journey from first attempts to conceive, aged 34, to resorting to Chinese mushrooms to sustain a pregnancy, aged 41. Near the end of the book, she writes: 'I don't believe that you ever stop trying'.

The writing style is similar to fiction or gossipy confessional journalism with extensive dialogue, short chapters and dramatised anecdotes. It begins on:

Sunday in September. It should be autumn but feels like summer. As I put my make-up on in the car mirror, I start to count the number of babies that our friends and family have had since we began trying to conceive.

'Vicky: Two. Beth: two. Joanne: two. Sarah Jane: two. Jo: two. Antonia: two. Harriet: one. Mel: one. Caroline: three!' My voice crescendos on the number three.

Upon arriving, 'someone thrusts a glass of Prosecco into my hand' and she overhears news of an eighteenth pregnancy. The knowledge is bittersweet.

From there, we backtrack to her lengthy attempts to conceive. She begins with an aborted attempt at intrauterine insemination (IUI), followed by seven full and two frozen cycles of IVF with ICSI. Her last cycle is mild IVF with 'few or no drugs'. Two full cycles are at Dr Mohammed Taranissi's clinic in London.

The Pursuit of Motherhood is an undemanding read, almost a beach or airport novel. I began reading at 9:30pm on a train and finished by 8:00am the next morning with sleep in the middle. The chapters have cheery titles, such as 'The Curious Incident of the Spring-Roll in the Nighttime'.

The clear and lively writing is a boon to anyone seeking information on fertility techniques. Explained in the text are 'mild' IVF, IUI, frozen IVF, and the process of IVF. You can painlessly learn about down-regulation of the reproductive system, stimulation of the ovaries, injections and egg collection, and the transfer process.

By sharing her experience, Jessica apparently aims to 'encourage other woman who are living with infertility to stand a little taller too'. Like all confessional memoirs, it succeeds or dies on the ability to get readers identifying with the author's experiences.

For me, this is where the 'The Pursuit of Motherhood' failed. By placing itself squarely in the tradition of chick-lit, it suffers many of that genre's problems. Chick-lit is a fiction of professional white heterosexual women that uncritically embraces consumerism, self-absorption, mainstream narratives of motherhood and ignores its own privilege. This book is no exception.

The memoir is littered with descriptions of expensive hotels, elaborate three-course meals, trips to the theatre (albeit where the author had a miscarriage), posh Farrow & Ball paint jobs, and girrrrls meeting up for big glasses of chardonnay and a gossip about ovulation predictor tests. The author even naval-gazes à la 'Eat, Pray, Love' on a residential course to discover her inner child.

Never have I felt - as a reader - so out of place, despite having two X chromosomes.

It's a shame that the book, far too often, reads like a scheduled-sex and shopping novel. Amid the flippancy, Jessica makes some important points. She questions why she found so little help with the emotional impact of unexplained infertility:

Fertility clinics – however high their success rates – are crap at psychological stuff. Well that's my experience anyway. When you receive your glossy brochure/photocopied sheets of A4 about the clinic, you'll generally find a (small) section on 'counselling'. It's usually just a few sentences about the emotional impact of fertility treatment, and if you're lucky you might be offered a counselling session. But in all my years of going through this, I haven't yet found a clinic or consultant that has ever proactively encouraged us to take up that session or asked what we're doing to sort out our minds.

There is ample evidence of the damage her infertility causes to her relationship. She temporarily breaks up with her partner after kicking him and pouring a bottle of wine over his head. She takes a sabbatical from work. She becomes obsessed with her caffeine consumption, sleep patterns, and diet - with the belief this may help her conceive.

There are genuine debates to be had about why drugs were used so early in her treatment, instead of natural IVF? How do we still know so little about the causes of infertility? Why she was not dissuaded from seeking fertility treatment beyond eight or so attempts? Why was she apparently not warned about the low probability of success? Why did some clinics offer immune tests and others not? Should she have given up trying for a child and, if so, when? And why - as she points out - was she not offered counselling?

Reading between the lines, her experience is harrowing. She has been unbelievably unlucky. I hope she achieves the postscript of a longed-for child.

I would recommend this memoir to anyone who enjoys novels with pink stilettos and sparkly wine glasses on the cover and is experiencing unexplained infertility. But if you're someone who prefers a good Frederick Forsyth-esque spy thriller, you may find the 'girly' tone jarring.

If so, you may wish to skip the chardonnay-swilling first chapters and skip to the end of the book. Here Jessica makes countless useful recommendations. These include talking to friends and family, and starting with natural IVF if you're diagnosed with unexplained infertility.

Buy The Pursuit of Motherhood from Amazon UK.

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