"I am more than my procreative capacity": The public and private grief of infertility

Author N. Moss West on miscarriage, infertility and "un-tabooing" women's health

By Mary Elizabeth Williams

Senior Writer

Published November 15, 2021 5:30PM (EST)

Baby Shoes (Getty Images/wragg)
Baby Shoes (Getty Images/wragg)

It's a common feeling that many of us have when we get older. You think you know the life you're going to have — and then your body tells a different story.

In her memoir "Flesh & Blood: Reflections on Infertility, Family, and Creating a Bountiful Life," author N. West Moss does indeed share the tale of her experiences with pregnancy loss, hysterectomy and reinvention. But she also does so in way that's self-reflective, intimate and often droll, as she grieves for the cervix "who never did anything to anyone" and grapples with facing a medical odyssey in a world in which "we don't feel like we can admit that we're ever sick, ever tired, ever injured."

Salon spoke the author recently about the why she thinks of why unsolicited advice is "an act of aggression" and how the real story of her book is "about love."

This conversation has been edited and condensed for clarity.

As you describe in the book, with your first pregnancy, you were very open about it. Then you have these miscarriages, and you go quiet. You become very private, and you say you don't want to share about it, I think for very clear and completely understandable reasons. And then you write this book. What made you go full circle with sharing your story?

I don't know. Writing memoir is a very public thing to do. But even when you're writing memoir, you're still protecting parts of your life and your heart. I don't think we ever reveal ourselves completely. I have had friends of my husband's think that they know me just from social media posts. It's a funny thing. It's like this public persona versus the private persona. I did share early on. I wrote a piece for The New York Times after a couple of the early miscarriages, and got a huge outpouring and felt great about it. And then I was exhausted physically. I was coming to terms with the ultimate decision I was going to be making, which is, let's stop trying.

While I was wrestling with that, while the whole thing was coming into focus and I was going from hopeful and "Let's keep going" to incrementally thinking, "No," that's when I went quiet. I start writing when I know what it is I have to say. There was a long period in there when I didn't know what I had to say. I didn't know what I thought. I didn't know what my plan was. The noise of other people's ideas and thoughts were problematic. So I went into my little cave, which wasn't alone, but it just wasn't public. It was my family and my husband.

Then at a certain point, years later, when I had this surgery and I got a little bit of narrative distance from all of it — the infertility, and then the hysterectomy and subsequent recovery, I had a lot to say. I had a lot to say to myself, and writing, I find to be quite cathartic. It's how I've always processed everything, happiness, grief, confusion, through my writing.

Once I know what I have to say, I'm not a shy person. I have boundaries, so I know what I will share and what I won't share. It was actually quite a lovely thing to write. I write a lot of drafts. My writing process is intense. By the time I had sold the book and was working with my editor at Algonquin, a lot of the emotional weight of it had kind of evaporated.

Every once in a while, as I write in the book, I still am hit by surprise grief or something like that. But for the most part, writing and writing and writing and revising and revising and revising makes you feel like, ugh, I'm sick of my own story to some extent. Which is very healthy. It's healthy for me. It's not like that story has to be my identity. I've moved through it to some extent. Now I'm already hearing from people who've read it, and that's pretty powerful and very different too. 

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You used the word "identity," and that's important. There's a part in the book where you say, "I am more than my procreative capacity." Because that's how women are seen. Tell me why you wrote that line and what that means, to be more than your procreative identity.

There's another part in the book about women over 50 being invisible. I've been told that a lot. I don't feel it, and I refuse to accept it. I know what they're saying. But I think that being seen as a projection of someone else's vision of who you're supposed to be is a kind of invisibility. Being younger and having people whistle or catcall or want to sleep with you is also a kind of invisibility. Being seen only as a sexual object or, an extension of that, a childbearing vessel, those all seem so limiting. I was raised by parents who were very cool about that kind of stuff. My mom and dad never were like, "I hope you're going to have kids."

Once I started getting pregnant, I started really being overjoyed at the prospect. I could see myself and my husband having a life with another creature that we had brought into it. That was was exciting and compelling. So it was coming to terms with my own disappointment more, in a way, than outside expectations.

A lot of people, as I was writing the book, were giving me feedback. I had two different agents who wanted me to be sadder about the hysterectomy, or wanted me to go into that more. I considered it. I just decided that wasn't really my story. I understand that's the story for a lot of people. It certainly came up, so it does get mentioned in the book. But I decided not to delve into it, because it didn't feel that organic. It felt also like talking about that also felt like reinforcing this cultural imperative that's put on women.

The working title of the book, for me, was "Fruitless." I still love that title. There were a lot of people who felt that was too negative. That, I also bridle against. Can't we feel like hell a little bit about these things and have our own version of it, that's not a stereotyped version of what our grief is? It's my own. It's different from our everyone else's. I want to be crabby about it a little bit, and also nonchalant when I feel like it. "Five steps of grieving" is a great concept, but in reality, it's a lot messier and more circular. These attempts to label what we're going through are just reductive.

When I finally had the book written, I realized I had a lot of gender stuff in there that I hadn't even noticed. Like the praying mantis who's male through the whole thing, and then has this egg sac, but Mom and I still call it "he." And then there's a list of questions that I wrote for McSweeney's of what to ask my doctor. I do not want to be just one thing. I rail against that.

I think that the topic of women's experiences, particularly of health and medicine, is so narrow. It's often tied to our sexuality and our sexual viability, and anything that disrupts that is confusing to people.

We only have our stories to tell. One of the problems is that we have so few real stories like this that are told. So each person who's telling the story carries so much weight, because they are almost inventing language to talk about these things in a void. Each person who contributes to the overall work on these subjects I think is adding their own language for other people to use. When I was going through this four and a half years ago, there was nothing I could find to read that either wasn't written by a man, or was about out a catastrophic hysterectomy, or was wildly emotional. There was nothing that resonated for me.

I decided to write the book that I wished I'd had, that felt more like, this is nothing spectacular. This is a friend talking to you. This is a thing that happens to a lot of women. Let's just demystify it and un-taboo it, if that's a word.

I started the thing you're not supposed to do, which is reading reviews on Goodreads. A few readers said things like, "it's so graphic. I love her writing, but I wish she'd write about something else." That just makes me want to double down.

It feels like, if we can watch cadavers being dissected on "CSI" and dead bodies in Central Park on "Law & Order SVU," how on earth can we say that a woman talking frankly about bleeding and hysterectomy is too graphic in our culture? It speaks to just how shame-filled it still is. It's still called a hysterectomy, for God's sakes. The statistics from the CDC are that there are 600,000 women a year in America who get hysterectomies. We all know a lot of women who've had a hysterectomy, and no language to discuss it with our friends, I find.

RELATED: She was struggling with infertility. Her best friend was pregnant. Would their friendship survive?

I wanted to ask you about the things that people have said to you about motherhood. We've all had some version of some know-it-all telling us what we should do with our bodies. It really speaks to the way that women's bodies are public property.

I have a good friend and neighbor who has five kids, and she and I joke. People give her a lot of grief for having five kids. "Why would you have so many kids?" "Are you crazy?" And then people give me grief for having no kids. When we both shared those stories a few years ago, it was a great relief because we said, "There's no way to win, so I guess I'm just going to live my life." It was a great moment.

You could have too many kids and not enough kids, and everyone has an opinion. Which I hate anyway. If you ask people's opinions, there are few people who I want opinions from. There's the people I love and people who I know love me. The rest of the world, I don't understand what unsolicited advice is all about. It seems like an act of aggression to me.

I also recognize that even well-meaning people don't know how to talk about stuff. I think a lot of people want to reach out and don't know what to say. That's where, I think, a lot of boneheaded comments come from. Like this woman who said, "Have you been blessed to have children?" I had to go lie down, basically. My reaction, I know, was sort of overreacting. Yet it caught me by surprise. It was a vulnerable moment.

Then she said, "Oh, well, you should adopt." That's a complicated, very personal thing. There are a million reasons we didn't end up adopting, that I don't share with strangers, you know. Then she said, "Well, get a dog." I went and stood in the corner until my husband found me, because I couldn't cope. Sometimes I can cope. And a lot of times I can't.

The impulse is often to fix a problem rather than share the space. Because as long as you're fixing somebody, you're not empathizing with them.

There are a lot of things you can do. My dad died in 2013. And I have often thought, I wish people would ask about that. Not right after he died, but seven years later, 10 years later. Nothing deep, but I reach out to friends and I'll say, "You know, I'm thinking about your mom. Do you still think about her a lot?" I get the most amazing stories and dreams they've had, or "Oh, yes. I've been cooking this dish..."

There are ways to engage with people that aren't judgmental and that don't shut things down. I think when people are shutting the conversation down, it's discomfort, probably. It's because we're in a culture that doesn't know how to talk about aging, that doesn't know how to talk about illness. That doesn't know how to talk about fertility without a lot of judgment.

The thing I hate even more than advice is pity. That's another way that a lot of people enter into conversations. When someone is pitying, that's the end of the conversation for me. Pity and contempt to me are like the same thing. It's basically saying, "Poor you. I have it so much better and I feel really bad that my life is so good."

For me, my reaction is like, Nope, I'm not going there. I did get a couple of phone calls from good friends, who had to tell me about their terrible experiences with hysterectomies right before surgery. One person who I adore, we're on the phone and she just kept saying, "I don't want to frighten you." I did feel compassion even then, because I was okay. I knew I was going to be okay. I thought, "this person has never had an outlet to tell this story." She perceives my surgery tomorrow as, "Thank God, someone I can talk to about this."

This is a book about infertility and miscarriage and hysterectomy. Yet you very consciously frame the book around the mothers in your life, your mother and your grandmother. That feels like a very obviously deliberate choice.

The frame of the book is infertility, but the real story is love. Not to sound so goofy, but it's a love story about my husband. That's what I wanted to try and express what it feels like to have the miracle of a good relationship; the miracle of being cared for and the ways that at people display caring through gesture. It's my husband holding up the corner of the blanket for me, or the way that my grandmother cared for me when I was little and I couldn't sleep, the way my mother cared for me by, , bringing out coffee in my great great grandmother's egg cup, because I couldn't have very much. She found it and she was like, this'll be fun and beautiful. There's that whole aspect of it for me. The infertility is kind of incidental in that.

Part of what I was wrestling with as I was writing it, and maybe continue to wrestle with, is the family stories. I am the repository of the family stories, because I'm a writer, and because stories matter to me. A big part of my grief around my own inability to have children was, who's going to tell their stories? Grandma's story is over with her if I don't tell it. I was always imagining telling it to a kid. That's how I imagined sharing those stories. She was a big force, emotionally, in me writing the book. It was a delight to revisit her and spend time with her.

That feeling was of being part of a line of women who all have struggled with their own fertility and their own survival and overcoming things. What I love so much about all of them is that they never quit. And I don't mean they never quit about having kids. I mean, they just never quit with life. This book took something that sucked and made something beautiful out of it. I feel like they would appreciate that. They would be standing on the sideline saying, "Way to not let life stop you in your tracks. Way to keep living. Way to keep going. And if you can't create in one way, create in another way."


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By Mary Elizabeth Williams

Mary Elizabeth Williams is a senior writer for Salon and author of "A Series of Catastrophes & Miracles."

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Books Health Hysterectomy Infertility Interview Memoir N. West Moss