“If someone had told me, “In five years you will have a baby,” I would have been fine to wait those five years; I would have been grateful to have them, in fact, and would have gotten busy with some of my other goals. But no one could tell me that – the problem with infertility is that it is not a patient, serene kind of waiting, not a simple delay in your plans; it happens for many of us in the context of consuming struggle, staggering expense, devastating loss. It’s five (or eight, or ten) years of trying and failing, which erodes any feelings of confidence or anticipation of a positive outcome.” (Boggs, pg. 19)

The precarious journeys that a hidden population find themselves on to desired parenthood – caught between a swinging dialectic of willed-for fertility and corporeal infertility – is laden with fantasy, longing, loss, and grief. For some, that twilight grief ends with a successful pregnancy or adoption; for others, the challenge is to find growth beyond a black hole. Belle Boggs’ book, while reflecting on her own journey, which included IVF, is a contemplation of social, cultural, and political questions that inevitably come up (in some form or another) during such journeys, but whose answers are only afforded in retrospect.

“We count on literature to prepare us, to console us, but I am shocked by how little consolation there is for the infertile, or even for those who are childless by choice and trying to live in a world that is largely fertile and family driven. Old ideas and prejudices persist – a woman without a child is less feminine, less nurturing. She is defined by what she does not have, and she confronts, again and again, a culture that reinforces the wrongness of her circumstances, which may be biological or social, temporary or permanent, something she treats or something she accepts.” (Boggs, pg. 41)

What is especially commendable about The Art of Waiting is Boggs’ ability to critique and contextualise and to raise difficult ethical questions without passing prejudicial judgement on the circumstances and decision-making of individuals. Exploring the multifaceted terrains of international and domestic adoption, gestational surrogacy, and IVF, Boggs touches upon the moral tensions, inequities, and exploitation of a capitalist political economy that those in search of family-making navigate. Amidst this complexity, a basic point is spelt out: for all of those who fall into the ‘infertility camp’, Plan B family-making is very far from easy. For gay people, for example, facing specific opposition and obstacles to their family-making from socially conservative forces, the experience of domestic and international adoption, or IVF, or gestational surrogacy, cannot be crudely and cruelly reduced to an unnatural and flippant shopping experience. The global and local capitalist networks that lock corporeal fertility and infertility with corporeal inequality and exploitation is laid down at the door of society at large.

“It’s easy to see, even in [US] states that have attempted to provide infertility coverage, who gets left out: people who have complicated diagnoses or need expensive treatment […]; people who are older; LGBT couples, people in unmarried partnerships, or women who have decided to get pregnant on their own. […] More than any other factor – age, sperm count and quality, egg reserve as measured by hormonal tests – the resources we could allocate to treatment appeared to determine our outcomes. It was a numbers game, I began to believe […].” (Boggs, pg. 185-186)

Boggs cites the psychotherapist Dr. Marni Rosner to help explain the emotional impact of infertility: “The losses are hidden. But with reproductive trauma, the losses can happen over and over again”; what’s more, “There are no clear norms for grieving the loss of a dream” (pg.103). Referencing 2012 research into the advertising of fertility clinics conducted by Professor Jim Hawkins, it is noted that IVF clinics emphasize the emotional rather than the practical side of treatment: with, for example, baby photographs alongside the word “dream” and/or “miracle” (pg. 199). What’s downplayed is the price-tag.

“IVF is an elective procedure with a poor success rate and an arguably unnecessary goal. But it is also true that infertility is an emotionally punishing experience as well as a disability […]. It’s hard to imagine that the stress of infertility isn’t compounded by the question of how to pay for treatment, so much that, almost against our wills, it crowds out other thinking. […] Will I max out these credit cards? Liquidate this retirement plan? Take out a second mortgage?” (Boggs, pg. 193-194)

With both a critical eye and an appreciation of the realities individuals steer to be able to afford ‘a chance’ of a positive outcome, Boggs draws a parallel between IVF payment packages and financial derivatives and credit default swaps.

This is The Art of Waiting at its very best: capturing the everyday emotional struggles for fertility amidst infertility which are thoroughly entangled with local and global capitalist networks and relations of power. Boggs asks some hard questions of the society that we live in whilst remaining deeply sensitive and committed to those on their waiting journeys.

“The life an infertile person seeks comes to her not by accident and not by fate but by hard-fought choices. How to put together the portfolio of photographs. How to answer at the home study. What clinic or doctor or procedure. Donor egg or donor sperm or donor embryo. Open or closed adoption. What country, what boxes to check or uncheck. What questions to ask, and ask again. When to start and when to stop. What to say when her child says, ‘Tell me my story.’” (Boggs, pg. 98)