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The journal's commission to review these two books holds a personal as well as a professional interest for me. In adolescence I was informed that for medical reasons I could not conceive, and I accepted that as a given. Ten years later I was told that the diagnosis was wrong and I could procreate, at which point I realised that I didn't have a ‘vocation’ to do so. In many ways I had a relatively simple emotional journey: from never having known I could be a mother to realising that even if I could, I didn't want to be.
The two books that this review covers, however, movingly make the point that for most childless women, the journey is anything but simple. Living the Life Unexpected is written for those women who are ‘without children by circumstance’; that is, they may want to be parents but for various external reasons, often medical, cannot be. Other Than Mother is written for those who are ‘without children by choice’: that is, they are able to procreate but have decided not to. The authors of both books write from their own experience; and their stories form a large part of, and inform the approach of, their respective books.
Living the Life Unexpected is the more practical work and also the more emotional. Its aim is to support women readers in coming to terms with rethinking their lives in the light of feeling denied the fulfilment of childbearing they had expected to be theirs. Throughout the book, the sense of suffering is heart-wrenchingly explored, as are the claims that suffering makes – or rather, tries to make, often unsuccessfully – on others, on society as a whole and on medical professionals. “If it takes a village to raise a child … it takes a whole tribe to heal a childless woman”, writes the author. If you seek to understand the desperation shown by those women and couples who come to you for help for infertility problems – or for any emotional or mental problems created by infertility – this is the book to read.
It is also the book to recommend to such patients when they face coming to terms with unavoidable childlessness. The author speaks not only from her personal experience but also from her hands-on work over the years with what she calls ‘Gateway Women’ at this crossroads in life. The 12 chapters each shed light on a different aspect of what the book's subtitle describes as ‘creating Plan B for a meaningful and fulfilling future’: grieving the loss, regaining energy, and reinventing oneself positively and with purpose. Along the way, each chapter offers information and insights to aid understanding, stories from childless women themselves, and action exercises clearly developed from Day's aforementioned hands-on work.
Other Than Mother is the more philosophical book. The author has a Buddhist background and her childfree choice has been heavily influenced by her beliefs, in particular her wish not to harm others by adding to the world's already unhelpfully over-large population. The book's aim is to help both the reader who wants to decide whether to procreate, and the reader who wants to understand and be at peace with their existing decision not to do so. The 42 chapters – some just a few pages long – cover a broad range of factors to consider, along with regular invitations to the reader to reflect on their own attitudes, beliefs and motivations, and the impact of these on the reader's future and the future of society as a whole.
The book does not proselytise about childfree living, but it does defend it. And as such, though it is not so obviously useful to health professionals as Living the Life Unexpected may appear to be, I do believe it should be required background reading for anyone working in reproductive medicine. Surely we need to understand the personal attitudes and motivations that underlie the current seismic shifts in society following the development of effective contraception. Now that women can reliably choose whether or not to procreate, how do our patients – but also we ourselves – make that choice? Even more importantly, how should we make the choice? Other Than Mother sheds essential light on both questions.
To conclude, when I was facing first the prospect of being childless by circumstance, and then later the dilemma of whether to be childless by choice, I had neither of these books to guide me. But I wish I had. Very different in market, focus, aim, structure and style, both books not only individually add to the canon of useful literature, but as a pair also form a diptych of insight into the challenges of reproductive choice in the 21st century.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.