PAIL guest post: “the infertility tourist and getting my pregnancy citizenship” by keiko

Earlier this week, we featured a recent post by Keiko of The Infertility Voice examining the experience of transitioning from “infertile” to “pregnant, but now what?”  If you missed it, you can catch our recap of her post “Seeing Pink, Blue– and Green” and click through to Keiko’s post on her blog. Today, Keiko joins us to continue with the theme of transition from infertility towards parenting, passing through a series of milestones on the way.


I’ve been carrying around a secret, hidden passport with me. With each passing week, I earn another stamp in my passport. For the last 8 weeks, I feel like I’ve been going through an endless series of pregnancy customs checkpoints.

First, there was the fertilization report. Then transfer day. Then my Big Fat Positive two-lines plus-sign “I’m Pregnant” stamp on beta day. The “You’re Doubling” stamp 48 hours later. And the big one, two weeks ago: “There’s a heartbeat.” My passport is filling up with this multicolored emotional collection of milestones. Today, I get to add another: “Second Ultrasound.”

As someone who has a bit of a sticker and stamp fetish, it’s been marvelous collecting these imaginary badges of positive reinforcement. And yet, if you were to pass me in say, the baby aisle of Target or that adorable local baby gift shop, you’d be none the wiser of my obsessive private collection.

Photo courtesy of The Infertility Voice

It’s early yet: 8 weeks exactly today. Thanks to my curvy (okay, fat – let’s just call it what it is) figure, I’m not really rocking much of a bump. My gigantic boobs and stylish Sea-Bands might be your only clue if you were to see me on the street. But I know its there – this little knish baking’ in my oven. I sometimes find myself instinctively rubbing the panty line fat crease between upper foopah and lower foopah, pressing gently and smiling to myself as I feel resistance over my uterus now.

. . .

I have always had a bit of wanderlust. I blame the Gemini in me and the Sagittarius at my side. Larry and I are wanderers, travelers, explorers. We don’t really do relaxing vacations: we hoof it, we hike it, we bike it – we want to see and do everything.

We’re also the folks who have their shoes in hand and liquids out in a bag ready to go at airport security. No fanny packs for us. Most of our maps are discreet, either on our phones or iPads or tucked into our single travel guidebook.

We’re travelers, not tourists.

And yet, I can’t shake this touristy feeling every time I engage in activities and feelings that “normal” pregnant women have.

Like I’m some kind of a phony.

Like I don’t belong here.

Like I’m the woman the locals keep casting sideways, disapproving glances at.

Part of me wishes my two foopahs would meet in the middle already so I could sport a visual cue, like, “See! Yes, I belong here! I’ve got a bump too!”

…As the locals snicker.

. . .

“You belong there.”

This was a message of encouragement I got from a friend in a series of frantic texts a few weeks back. I had the privilege of assisting with a car seat event at a local Babies ‘R Us. In it for me was a free car seat – how could I say no?

I don’t think, at the time I signed up for the event, I realized just how emotional the experience would be. After spending three years of avoiding Babies ‘R Us like the plague save for the handful of necessary baby showers I’ve had to attend, it was the first time I was walking in there for myself. For our baby.

I was in there maybe, 10 minutes tops, before I dashed back out to my car, nearly hyperventilating.

“You’re not a tourist,” my friend texted me. “You belong there.”

Eventually, I did get over my immediate issues. I smiled as the lady at the register asked me if I wanted to join their Rewards Club when I bought out first baby item. In the weeks since that panicked moment, I’ve been parsing out these strange, conflicted feelings of belonging and membership. Of citizenship, really.

This week I joined a Twitter party for new and expectant mothers. Who knows how many or if any of them were parents via ART or adoption. Being so newly pregnant, it was hard to join in the discussion of baby sleeping tips beyond “filing this away for later!” and I felt awkward. I felt like the new girl at school who didn’t really know anyone, who didn’t understand the social cues and norms that had been established long before she arrived.

The new girl who just wants to make friends without being judged.

It has been a strange few weeks.

. . .

In finding membership, citizenship and a new community, I have to remember to write letters home. There are still plenty of people who read my blog for the non-pregnancy things about which I write. (Take for example, the Ricki Lake Show fiasco.) I still have very important work and commentary to do over at The Infertility Voice and in truth – I just can’t walk away from that space even if I tried. The unresolved ALI community is still too dear to me, too close to my heart.

And remember: I’m only 8 weeks out from that community, so it’s not like the ALI experience is some distant, fading memory. It courses through my veins.

It’s been a fine line to walk, striking a balance between writing about this pregnancy in all its glory (the round-the-clock morning sickness, the constipation, the so very gross Crinone goop, the boobs-like-whoa, the “Oh, Hello Sex Drive, I’ve missed you” libido dashed by all that Crinone goop, the food aversions and my obsession with grapes, apples and oranges right now) and being sensitive to my readers still in the trenches. The readers who would give an arm and a leg for any of the things I just listed.

I’m still not sure if it’s possible to carry dual-citizenship as a woman pregnant after infertility. I’m not ready to renounce one for the other, either.

. . .

In 1996, my dad finally got his U.S. citizenship. He had had his green card since 1964, when he first came to America from Japan. A few months before he began the citizenship process, we took a drive up to New York City, to the Japanese embassy. At the age of 55, my father renounced his Japanese citizenship.

I was 14 at the time.

I waited in the reception area, as Japanese men in suits bustled about me. When my dad came out, he looked sad and tired. “Do you want to get some lunch?” he asked me. I nodded, hungry and cranky from the long drive to the city.

We ate at this little hole-in-the-wall Japanese place down the street from the embassy. I had chicken teriyaki. My dad ordered lots of things, savoring the many delicious tastes of his culture. He spoke in Japanese with the waitress. I had initially resisted his suggestion to get Japanese food for lunch, but relented after he became ornery himself.

In retrospect, I realize now as an adult just how bittersweet that lunch must have been for him, how much it meant to him to sit down with a bowl of miso soup, to eat pickled plums with his rice, to have a steaming cup of o-cha.

And even though I’ve been an American citizen since birth, I think I can finally understand the unique pain and excitement of leaving one culture for another, to straddle two worlds.

The moment you stop becoming a tourist.

The moment you find belonging…

…if you’ll have me.


Keiko Zoll is an award-winning women’s health writer and infertility advocate writing at The Infertility Voice. With extensive media appearances to spread awareness of and health empowerment for infertility patients, she can be seen later this month on The Katie Show discussing her infertility experience. Keiko is the author of three eBooks and is the Founder of and Social Communication Architect at Words Empowered, providing social media strategy, freelance writing and web/graphic design services to small businesses, non-profits and individual brands.


  1. I am now 20 weeks pregnant after a 7.5 year struggle through infertility. Like you, I struggle with a sense of belonging to the “Mommy-hood” even though I’ve passed through a hundred different customs checks to this point. Truthfully, I guess I won’t get there until I’m holding this baby in my arms. And even then, will I still feel misplaced?

    Unfortunately, I’ve also felt disconnected from the IF community. We suffered a miscarriage two years ago, took endless rounds of clomid, faced the diagnosis of PCOS, dealt with ovarian drilling and dragged ourselves through two failed IUI attempts (not to mention the bad advice from doctors, the ill-advised testosterone shots and moving through three different facilities before finally finding a doctor who would LISTEN). But this pregnancy? Was a surprise. An unexpected, we-assumed-this-would-never-happen-for-us-and-due-to-several-circumstances-chose-not-to-pursue-IVF SHOCK. But getting pregnant on my own doesn’t make me any less infertile. It doesn’t cancel those 7.5 years of difficulty.

    So where do I fit? Is there a middle ground in the infertile but expecting world for women who end up pregnant after stopping all treatment?

    • I think the place is here, actually, although folk range from recently pregnant to small children frolicking to adopting/ed children. There’s been a lot of discussion of this land of limbo, and it at least makes me feel less alone.

    • I agree with Ms. Future PharmD above. PAIL is that place of limbo, of transition – it’s been a welcome refuge as I parse out my own feelings of transition.

    • I never really connected with an IF community here in the blogging world when I was TTC– I stuck to an IF message board on a web forum for 2+ years and when I started my blog, it was more like a personal journal that had no audience. In March of this year, I started actually making “blog friends” and tapping into the awesome network of women experiencing infertility and loss in so many different ways, and some incredibly valuable friendships have come from this experience.

      PAIL exists for exactly the situation you’ve described– when your experience and identity and journey through IF and loss are still very much a part of who you are, except you’re pregnant now and feel as though you’ve suddenly outgrown spaces that you were comfortable in. It’s like waking up one morning to find that you finally lost the 30lb you wanted to drop, except you have no money in your bank account and no clothes that fit. You lost the weight and that’s what you wanted, right? And yet you can’t walk around in the cute things you’d seen in magazines like other “30lb less” people, you’re stuck in baggy things you’ve hated all along even when they fit because of how they represented the “you” that you didn’t want to be. (Have I totally lost myself in this metaphor here? Everyone still with me?) Either way, this is a place where you can say the things that are now suddenly taboo in other places in the IF world, where you have to be very delicate with the use of IF-related spaces and other IFers’ feelings and experiences. It’s tricky to navigate, so now we have this space set up to talk about it.

      I hope, if you need more support, you’ll stick around. We’d love to have you, even if you’re more comfortable just checking in and not joining the blog roll right away 🙂

  2. Oh Keiko- I love this post. You sum this up so beautifully, and I know exactly how you feel. I’m so glad you are where you are, and I hope to read many more “pregnant after IF” posts!

    • Thanks Maggie! It was good to get this post out there and start to name and own these emotions.

      • I feel I must warn you that they never really go away- my kids are almost 6 and I still find myself confused and bewildered by what I can only describe as the emotional scars left over from our ordeal. Maybe this is my own cross to bear, maybe because of my own personal situation with the ever-elusive magic of pregnancy, but please be easy with yourself if you find the feelings you’re having now wanting to stick with you…. Infertility has changed you. Infertility has changed any woman who has been through it. It’s this very alteration of who we are as mothers and women, after having been through it that most interests me these days… and to know that none of us is alone in this wierdness.

        • Thank you for saying this. My kids are only (almost!) a year old, and it’s good to know ahead of time that it could be years later and the feelings might still be here, and even still feel raw at times, and that other people have that experience too. ❤

  3. Thanks for this post! It’s so exactly how I feel, so good job on finding words for this. I had quite the meltdown after my 22 week appointment with my OB today because I still can’t believe that this is all real, and going just fine after 3 years of trying and 3 miscarriages along the way. It’s such a strange place to be after all of this, so I figure that the only thing to do is travel the weird road together and just feel whatever it is that goes along with it.

    • This morning, after my ultrasound (everything looks great – knish is lookin’ good), I called the OB/midwife practice I’d been considering and made my first appointment. After I got off the phone, I just felt… strange. Jubilant, and still- strange. I don’t think it’s fully hit me yet today that this morning was the last time I’ll be at my RE’s office, either.

      • This transition feels a lot like cresting the first hill of a roller coaster you’ve been waiting in line FOREVER to get on. The line where people passed you, the ride broke down, you had to go back to the beginning, etc. You are now in the car, at the front, and gravity is about to take you on a (sometimes terrifying) thrill ride. The chances are high that you will make to the end safely, laughing at how awesome it was that you just shit your pants. Buy the picture at the end this time – it’s worth it.

      • The feeling both of you just described? It hits me every time I watch TV with my girls. Something in my brain clicks and goes “Oh, wow. You are watching a children’s TV show right now because you live in a house that contains a family that has children in it. It is YOUR family, with YOUR children, because you are a parent. Somehow this happened to you.” It’s just an overwhelming “wow… wow… wow…” on and on, every time. It still doesn’t feel real. Let me tell you, that “disbelief/denial that I really do have children” thought is an incredibly strange feeling to reconcile with the daily reality of having babies climbing on me and touching me and screeching at me and frantically baby-signing for more, more, more!, like how could I ever possibly forget? It’s like living in shock.

        • You guys took the words out of my mouth. I put lil k to bed a bit ago and couldn’t resist the urge to go check in on her an hour later. As I walked out I got all teary and told my husband I still can’t believe she’s with us. She may not be DNA compatible but damn she’s filled up our hearts 🙂

  4. Chickenpig says:

    You have a few stamps left before you can kick these feelings to the curb for good. First trimester, viability, live birth…. But you will still be pinching yourself and thinking “Am I really here?” after your little one’s first birthday (knock on wood). Guaranteed! 🙂

    • I continue to remain cautiously optimistic. Even though this was my first round of IVF, I’ve seen enough in this community that we’ve still got a LONG way to go. And so I try to be celebratory with each milestone. With each week that passes, I remind myself I’m just one week closer.

  5. My IF miracle daugher just turned 5, and I still look at her daily in disbelief! I was cautiously optimistic with each passing day of my pregnacny and never truly believed it was happening unitl she was in my arms! It’s an amazing journey. 🙂

  6. Is “foopah” a medical term? 😉

    It’s a great metaphor, your current state of having dual citizenship. I’ve done a lot of work in adoption about moving from Either/Or to Both/And. Seems like you are doing the same with your pregnancy, bridging both worlds of infertility and parenting.

  7. Keiko, I have my IVF miracles are 4.5 and 15 mos. I think I might always feel like a bit of a tourist. What I’ve chosen to do is revel in that feeling. Sometimes I think our struggles while TTC were a gift. I pinch myself more often. I cherish the little things with my kids. I think I am a little more patient. I take nothing for granted.

    Your journey will make you a very special mom. One whose passport may never be fully broken it. Embrace it. Congrats!

  8. Keiko, this is like the pregnancy version of the “Passport Children” post that I wrote a few years ago: If you’re anything like me, you will NEVER feel like you are not a tourist, at least to some degree. I still think of my kids as walking passports. Though I live in the lush lands of Parenthood, I my home country will always be the Land of IF. No matter how long you’ve been away, you will always feel the pulls from the motherland.

    One interesting thing that I have noted — ever since I’ve retired from surrogacy and I’m no longer trying to get pregnant for myself (or anyone else), the feeling of mild disquiet and unease that I have when I’m around other parents is lessening. I don’t think it will ever be gone completely, but I don’t feel like I’m completely out of place. I think it’s because I’m now experiencing infertility as a memory and NOT as an everyday part of my life. It’s around me without choking me.

  9. justinelevine says:

    I love this post, and like the other commenters, agree that this feeling of duality never really goes away. Sometimes I wonder if I belong in the ALI community. Sometimes I wonder if I will ever fit in as a parent.

    Lori’s comment about moving from either/or to both/and is spot-on. I think for many of us, the journey is to accept, to come to terms with even if we don’t fully embrace, the duality of parenting as someone who experienced infertility and loss (because for me there is no “after”). Here’s wishing you many more passport stamps along the way.

  10. I thought for sure I would feel safe now being 25 weeks. But I don’t. I am back to waiting. Waiting till I surpass 28 weeks (which is when I lost my daughter). Waiting for what I consider another safe zone. Its like I felt safe for a while, for a minuscule second reaching viability and then the moment you get a chance to breathe and swallow it all the lump emerges in your throat again and you realize you’re not done collecting badges and then I wonder will I ever be done. I’ve been making myself busy not wanting to think or feel, just wanting the weeks to go by so that either time proves me wrong or my dark thoughts win. I just don’t know when the ease will come, when I’ll feel like I belong.

  11. For whatever reason my comment did not post the other day but I want to say I love this post and I am so pleased to have you over I this space as well.

  12. Great post Keiko! I echo those who said that of course you belong, but I also get and agree that after dealing with infertility (whether primary or secondary or both) that the touristy feelings never go away completely. Now that my family building days are over and our SIF and loss has been resolved, at least from the stand point of not trying anymore, I still have moments where I feel jealously of those who got the families that they hoped and dreamed of. Not that my family isn’t wonderful and amazing just as we are, but I always imagined having more than *just* two living children. It is was it is though and I do my best to make the best of how things played out and like you also try to be an advocate for those still in the trenches. So happy that you are in the position to be writing a post like this, because you are in fact pregnant! Sooooooo exciting! xoxo

  13. This is a wonderful post. As someone who’s just hit the 9.5 week mark and had my second u/s with twins I relate to so much of it. I can’t believe we’re here, after finding a donor, after treatments, but at the same time ‘here’ is hard – I’m sick sick sick and barely coping. I haven’t joined a single pregnancy related thing yet, partly just to do with low energy but also partly because I don’t know what I’d say to people? Everyone always asks with twins ‘do they run in the family’ and of course I both have no idea and the twins are down to treatments not genetics anyhow! I’ve had one friend say that makes it a bit easier to talk about with people so I’ll run with that for now.


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