I Have to Pay Off My First Child Before I Can Have Another

The cost of conception.

Photo credit: tiffany terry, CC BY 2.0.

My daughter is eighteen months old, which means for the last six months I have answered the question “When are you going to have another one?” at least once a week.

The short answer is hopefully soon but not yet. Sometimes I say that we have our hands so full with our rambunctious, mischievous toddler that we just don’t have the energy for a second child yet, which is not untrue. Sometimes I say that as a same-sex couple, we haven’t decided whose turn it is to carry the next pregnancy, and there’s also some truth to that. Sometimes I say I need to get my anxiety under control before we add another child to the mix. Also hella not a lie.

But the biggest impediment to the second child my partner and I desperately want is the one we’re least comfortable mentioning in public: the debt that we incurred going through IVF to conceive our firstborn.

I’ve written a ton about having mental illness, but very little about having debt. I’m all about facing down mental health stigma, but the shame of being in loads of debt still feels nearly unspeakable. Maybe it’s because my mental health is something I never had a choice in, but many of my debts were totally avoidable — seriously, an MFA in poetry? Why the hell, Past Lindsay?

My partner and I have been incredibly fortunate when it comes to education, careers, and income. In the generation with the lowest rate of home ownership in history, we were able to buy a house last year. Yet we’re still living functionally paycheck to paycheck, sometimes building up a tiny buffer of savings only to have it completely wiped out at the first unforeseen challenge, like this month when we had to replace the crumbling tile in our bathroom. In addition to our mortgage, car payment, and the student loans that reignite my self-loathing on a monthly basis, a big chunk of every paycheck disappears into the high-interest loan we took out to conceive our child.

Not being able to get pregnant is ludicrously expensive. Even if you have health insurance, fertility treatments often aren’t covered. Some tests and medications were covered for us, but the cost of processing and storing donor sperm was not, and six months of intra-uterine insemination (IUI) devoured the meager savings we’d managed to set aside by that point. “We can afford to have a kid or a college fund for our kid, but not both,” we joked. After months of pricey procedures and still no baby, we stopped making that joke because we really couldn’t afford either.

If we’d had fewer resources, that might have been the end of the story. Who knows how many people are childless not because they want to be, but because they couldn’t afford to pay out of pocket for fertility treatments? But we were lucky enough to have a family member with better credit than ours who was willing and able to apply for a loan on our behalf, so instead the story ends with our brilliant adorable daughter, conceived with the help of a lot of medications, a doctor in Arizona, and a sperm donor in California. One of the odd vagaries of the still-nascent science of assisted reproduction is that the price varies so widely from one location to another; even taking travel costs into account, it was cheaper by far to undergo IVF in Arizona than to do it right down the street.

Every month when I write that check, I remind myself all over again that I have no room to complain. After all, at least we were able to get a loan; at least traveling for medical care wasn’t entirely out of reach; at least our insurance covered a few of the tests and medications required. The barriers to becoming parents as a reproductively incompatible couple were high, but we had resources available that not everyone does.

And of course, we were not one of the unlucky families who went into debt for a procedure that didn’t work. As much as I resent sending that check to the bank, at least I have my daughter’s grin to console me. I can only imagine how infuriating it would be to watch that money disappear having nothing to show for it. Some reproductive endocrinology clinics offer the option of receiving a partial refund for an unsuccessful cycle, but they tend to be the ones that are more expensive up front. We decided to go with a lower-cost option and gamble that it would work on the first try, a gamble that happened to work out in our favor.

It worked so well, in fact, that we still have two blastocysts frozen at five days’ development at that Arizona clinic. It’s possible that we could achieve a second pregnancy without incurring further debt, other than a plane ticket to Tucson, but it’s a step we’re hesitant to take. For one thing, we’re currently living with scarcely any financial cushion, and every new person added to our family exponentially increases the probability of unforeseen expenses. Then there are the foreseen expenses — food, clothes, health insurance. Our insurance doesn’t cover midwifery, so that would be another out-of-pocket cost for which we’d need a payment plan. (When my partner was pregnant with our daughter, we paid the midwife with the advance from my first book.)

But I also know that, once we make the decision to have a second child, we’ll follow that path as far as it takes us. If neither of our stored embryos transfers successfully, there’s no doubt we’ll borrow money for another round of IVF — and, in all probability, keep going until either our second baby shows up or we can’t find anyone to lend us any more money. IVF is a gamble, but the first time we played, we won. If we try again with less success, I don’t think we’ll be able to stop ourselves from chasing that high again.

I hate having to put a price tag on an intensely personal and emotional decision like having a child, but the fact is that for us, having a baby costs $375 a month. Until that changes, our daughter will keep being an only.

Lindsay King-Miller is the author of Ask a Queer Chick: A Guide to Sex, Love, and Life for Girls who Dig Girls (Plume, 2016). Follow her on Twitter @askaqueerchick.

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