Here’s something of which I was blissfully unaware until just last week.
In the UK, you may be refused IVF treatment on the NHS simply because your partner already has a child.
It’s a fight which has been started before, one which is yet to be won, and one which is all the better for having these women on its side.
Jordan and Billie, the beautiful brains behind @thestepmumcollective, and Sarah spoke about the reality of infertility as a stepparent on IG a few weeks ago. Jordan and Billie were horrified (as, indeed, was I) to learn of the additional restrictions that most stepparents face when struggling to conceive.
To hope, and to try, and to know that IVF may end up being your reality – only to be let down at the final hurdle, must be beyond painful.
Sarah has now been officially informed by her consultant that, after years of trying both naturally and with the assistance of hormone treatment, as a stepmother to her fiancé’s daughter she will not be eligible for the usual next step in her fertility journey.
How Can Your Stepchild Prevent You from Accessing IVF on the NHS?
Clinical Commissioning Groups (CCGs) are the bodies responsible for the commissioning and planning of health care services for their local area.
Fertility Fairness recently reported that 91% of CCGs do not offer funded IVF for couples where one partner has a child from a previous relationship.
If you’re a stepparent, therefore, you’re automatically not eligible. To be considered the couple must be completely childless.
What NICE Says
Who is eligible and how many IVF attempts a couple may have is considered by the National Institute for Health and Care Excellence (NICE). This is the organisation responsible for advising the NHS and Government on quality of care improvements needed within the NHS.
Its recommendations are evidence based, and heavily influence policy making and healthcare planning for the country. Fundamentally, they know what they’re talking about.
NICE’s guidance on the diagnosis and treatment of fertility problems aims to “reduce variation in practice and improve the way fertility problems are investigated and managed“.
Its advice centres around the importance of fair access to IVF care across the UK.
It states the following, for all women:
“In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse[…], offer 3 full cycles of IVF[….].“Paragraph 184.108.40.206 – “Fertility problems: assessment and treatment”, NICE Clinical Guideline [CG156]
That’s 3 full cycles, regardless of location or children from previous relationships.
This Failure is an Indication of the Wider Social Issues Surrounding Stepfamilies
I am enormously privileged in not having had to consider IVF and its availability until now, and the disparity in the treatment of stepfamilies in comparison to nuclear families was a shocking, but sadly not altogether surprising, revelation.
It’s why I am so grateful for women like Jordan, Billie and Sarah being visible and vocal – representing the stepmum community and normalising the struggles we all face. Stepfamilies are famously un-catered for, and enormously misunderstood, and it’s a relief to see some voices chiming through that previously deafening silence.
If there is one scenario that demonstrates perfectly the double standards levelled at stepparents, surely it has got to be the conflicting parent and non-parent statuses given to stepparents depending on when it best suits society.
The Double Standards of Society Telling Stepparents that they should be Satisfied with their Stepparent Status in the Face of Infertility can be Demonstrated as Follows.
- You have no automatic rights in relation to the upbringing of, or decision making regarding, your stepchildren.
- You are regularly reminded of your ‘non-parent’ status – by well-meaning strangers, family members with malicious intent, or even something ridiculous like a credit application form (are they a dependant or not?!).
- People in your and your stepchildren’s lives often struggle with how to refer to you, or to explain the role you play.
- Where a relationship sadly ends, your stepchildren have no automatic right of access to you as an influential figure in their lives.
Society absolutely and categorically views parents and stepparents as two different things. Following that logic, it therefore makes no sense for stepparents to be denied treatment on the NHS to become the parents they are so clearly considered not already to be.
“But IVF Shouldn’t be Available on the NHS Full Stop”
This debate drives me absolutely nuts, but I suppose I should pay it some lip service.
- Whether or not you’re able to have a child should not come down to how fat your pay check is. The cost of IVF is thousands and thousands of £s; it’s simply not affordable for the majority of people. Teachers and nurses are paid much, much less than bankers. You can’t be telling me that their fitness for parenthood is also much, much less.
- For those who want to have their own children, the resulting affects of not being able to have them are real and devastating. There are reports of anxiety, depression, divorce… The World Health Organisation recognises infertility as a medical condition because it causes psychological harm.
- But, if we really are just going to boil it down to economics, then all of (2) above cost the healthcare, social and/or legal system a great deal of money, over a long period of time.
- Furthermore, the NICE guidelines actually determined that IVF treatment up to the age of 43 was, indeed, cost effective.
- You could argue precisely the same for other elective treatment that enables a better quality of life. Just because you can live with something doesn’t mean that you should.
- The success of IVF is, of course, not guaranteed but knowing that you have tried everything you possibly could to be the parent you so long to be can go some way to overcoming the excruciating grief of being involuntarily childless.
To argue that becoming a parent is a “privilege” rather than a right in order to support an argument against NHS funding, is to suggest that those with less aren’t somehow worthy. At its best this argument betrays pure ignorance.
At its worst it’s an argument for a form of social cleansing.
How You Can Help
- Sign and share @UKstepmum and @thestepmumcollective’s petition here. In the last two weeks the petition has garnered nearly 8,000 signatures, but it needs your help.
- Write to your MP. Fertility Network UK has a great template you can use here.
- And use the power of your social media to talk, shout, bang some drums. Share, share and share.
Do not be afraid to speak up because “there are wider issues currently at play”. Coronavirus has undoubtedly put a pause on an enormous number of issues which deserve our full attention. Healthcare issues such as this, however, are entirely time sensitive and directly impact quality of life for those affected.
UK Fertility Organisations
If any of this affects you, here are some places which offer support UK-wide.
You can also read more about Sarah’s story on her blog here.
Fertility Network UK – “The UK’s Leading Patient-focused Fertility Charity“
IVF Babble – A leading online resource and community
Fertility Fairness – Currently suspended by hosting company (!) but fingers crossed will be back online by the time you read this.