I was scrolling Instagram between sessions when a video from Alexandria Ocasio-Cortez appeared on my feed, announcing she was freezing her eggs. Thirty-six, weighing a run for president, and saying plainly she was doing this to feel more in control of her life. She didn’t say whether she wanted children, and said she knew that talking about this at all was a political risk.
What stopped me wasn’t her announcement. It was watching a professional woman put a needle in her own body and then go off to work.
I know this feeling intimately. I know it from my own kitchen, where I close my eyes and cry while my partner handles the needle. It know this means I’m lucky—plenty of women do this part alone, like my girlfriends who send me photos of their own painful experiences—but lucky still feels like a strange word to reach for.
These injections are the most vivid experience in my life, yet it’s the kind we keep most hidden from public view. I’ve been wondering why. My best guess is that it invites judgment about a woman’s body, assumptions about motherhood and fertility, and a heavy load of projections, all handed back for her to carry.
Watching AOC, my thumb hovered over the glowing screen. What I felt wasn’t envy or judgment, which most of the comments underneath the video reflected. It was recognition. A woman with considerably more to lose than me had said the hard part out loud, and hadn’t been struck down for it.
Right now, I’m in the injection phase of my second round of IVF. The first one didn’t work. People keep reassuring me that this happens, which is true, and which I’ve said to other women myself in a gentle voice. What nobody can tell me is why it happened to me, beyond some version of the body being mysterious. It’s easy to sit with mystery in a poem. It’s much harder to be handed mystery by a specialist.
I watched AOC’s video once more, put my phone face down, and walked down the hall toward my office, where I’d spend the next 50 minutes helping my next client tolerate not knowing how her life is going to turn out. I’d love to say I appreciated the symmetry, but I was mostly calculating how many hours stood between me and a pair of sweatpants.
AOC’s version of this disclosure was public, prepared, and immediately turned into content by a team of professionals. Mine happens in a group chat at 11 pm, in the ten minutes before consultation group starts, and over dinners with friends who are also therapists and know how to sit with something without reaching for a fix. Those conversations have been some of the most healing of my adult life—and I’ve never once seen this written down.
We joke that graduate school never trained us for the business side of this work, for the billing and the taxes and the empty Tuesday. It didn’t train us for infertility either, or for a body that stops cooperating in the middle of a caseload. Holding other people’s uncertainty is the job, and I’m good at it. But we constantly tell clients that not knowing is survivable, that ambivalence is information rather than failure, and that you can act without being sure. I’m not certain we believe any of it about ourselves. We work in a profession that treats embodiment and ambiguity as ordinary in the people sitting across from us, and rewards us for appearing untouched by it.
Here’s the part I’m not supposed to say: Somewhere between miscarriage and the failed IVF cycle, I’ve gotten more ambivalent about becoming a mother. Of course, I was never wholehearted about it. I understand parenthood as one way of making meaning—a profound one—and I found mine in other relationships and other work. I’m an aunty to three nephews. I built a practice with my name on it. My partner has been consistent about wanting children and just as consistent in saying that whatever happens, we’re solid.
And here I am anyway, refrigerating vials and setting alarms.
I want to stay in this contradiction instead of explaining it away. I’m not doing IVF because it’s a solution. I’m doing it because I’m not ready to hand the possibility over to biology and time and call it settled. Not doing IVF means acceptance. But doing it means refusing to let the door close while I’m still standing in the hallway.
Meanwhile, I resent what wanting requires of me, even though that resentment doesn’t cancel the wanting. If a client told me this, I’d say it makes complete sense. But I haven’t managed to convince myself. After all, acting isn’t the same as being certain. We know that in the therapist’s chair, and forget it the moment the decision is our own.
What surprises me is how much judgment lands on feeling ambiguous about IVF, as though decisiveness proves you’re well. I’ve stopped asking clients whether they want children. Instead, I ask what they were told they’re supposed to want, who told them that, and what it’s cost to feel differently.
Meanwhile, everyone has advice. Elevate your hips afterward. Stop drinking cold water. Eat the core of a pineapple, but only on certain days. There’s a soup. There’s always a soup. My mother tells me a child is a gift from God, and that my lack of enthusiasm can probably be traced back to not playing with dolls enough. None of it is cruel, which makes it hard to process. These people are doing the only thing they know how to do with their own fear, which is hand me instructions. When uncertainty starts to feel unbearable, reach for a procedure. But before we therapists congratulate ourselves for knowing better, it’s worth noting that we actually do a more sophisticated version of the same thing: We reach for a formulation, a protocol, or a treatment plan. Sometimes it’s care. Sometimes it’s soup.
Let me state the obvious: IVF is miserable. Not in the inspiring way, where the difficulty builds something in you. Miserable. The shots hurt, the bruising hurts, and the bloat reaches a point where sitting upright becomes something you do on purpose. My body stopped looking like mine somewhere in the first round. I’ve started avoiding mirrors, which I’ve never done in my life. And underneath it is a thought on a loop: Why is this so hard? What did I do wrong? Am I being punished for something? They’re thoughts I’d readily process if they were my client’s, yet when they show up in my own head in the middle of the night, I can’t touch them.
Nothing in my training prepared me for doing IVF while working. Retrieval dates aren’t built around your caseload; they’re built around your follicles. There’s no paid leave when you are the business. Every cancellation is money lost, and every reschedule is a client whose care got interrupted for reasons she doesn’t know. I’ve sat in my chair through hot flashes and the fatigue that arrives around the fourth hour, and then walked into the next session to hold someone’s grief with my whole attention, because that’s what they deserve.
IVF isn’t the only way therapists learn this. We build practices around chronic illness, caregiving, grief, disability, gender-affirming care, and bodies that don’t care about our schedules. What we all share is the public’s expectation that we not only be embodied people with actual lives, but also uninterrupted instruments, always available and able to carry carrying multiple burdens without making them anyone else’s problem. And that’s a clinical problem. After all, the field has deemed that we serve as models for our clients. And if that model is a seemingly unfaltering woman, we’re teaching that faltering is a disqualification.
This leaves me with a question I can’t seem to answer: Do I tell my clients? There are thoughtful ways to tell a client you’re pregnant, including with clients who struggling to get pregnant themselves. A pregnancy eventually declares itself. There’s a due date, and everyone gets to prepare. But IVF sits in a stranger category. For me, it’s medically consuming, financially burdensome, and physically obvious every hour of the day, but to anyone else, it may never become visible. There’s no announcement coming. There may never be one. What my clients get instead is a series of absences: the Tuesday I’m away, the week I shuffle everyone, and the hour where I’m in the room but my body is somewhere else and I know it.
I’ve been pondering two things right now. If I did disclose this to my clients, whose need would the disclosure serve? And is my silence protecting the work, or is it protecting me? Some weeks I answer these questions differently. Where I’ve landed, for now, is that my clients deserve to know when something’s disrupting our time together, but not what’s causing it. So I tell them plainly: “I’ll be out next Tuesday. I need to move your session this week.” Then I ask what that stirs up for them. Maybe it’s worry, or irritation, or an old, familiar feeling of being left alone. Exploring that reaction isn’t sidestepping their question. It’s exactly what therapy is for.
What makes any of this possible isn’t resilience. It’s a schedule I control—a luxury most people doing this don’t get. It’s a partner who’s never demanded certainty, and a sibling who checks in without asking for an update. It’s a gratitude practice, which I used to find precious and now consider necessary. It’s being outside, or letting a massage therapist touch my changing body. Every so often, it’s sending a long, unedited voice memo to my girlfriends before bed, crying through most of it, and finding three replies in the morning that aren’t trying to “fix” anything.
In the meantime, I’m available to anyone who needs my help. That’s my job, and I’m good at it. But being accessible is a different question, and I don’t think our training distinguishes the two.
I’m not sharing this to be talked out of anything. I don’t need to hear that “it’ll happen for me,” or that my body “knows what to do,” or that my uncertainty means I have more to process. I’ve been processing things for a long time. The ambiguity is still there, and it may be there forever. I like to think we can live in ambiguity, rather than treating it like some sort of symptom that needs to be resolved. We’re constantly offering this possibility to our clients, but I’m not sure we extend it to each other. I’m certain we don’t extend it to ourselves.
I’m at the start of the injections again. The sharps container has been on my counter for months. I have six sessions tomorrow. I’ll show up for all of them. I’ll be good at my job. I still don’t know whether I want to be a mother, or whether any of this will have been worth it.
All of this is true at once.
