The miracle of conception is no metaphor for some women

There is an ugly, modern trend towards blaming infertility on the sufferer.

When I was a girl, my mother told me that God had put me in her tummy. This wasn't just Catholic coyness, but reflected the reality of her experience. It took my mother many years to conceive, and when it finally happened it must have seemed a bit of a miracle.

When I suffered a miscarriage last year, my mother's words came back to me. The sheer randomness of my loss left me feeling powerless and out of control. My desire to get pregnant again became all consuming, as did my anxiety that it might never happen.

But I suffered this anxiety in a very different world from the one my mother knew. While she experienced her fear of infertility as a private dilemma, I found that my ''problem'' had a very public cache, and that there was a booming fertility industry ready to service it.

Women today are encouraged to prepare their bodies before they begin trying to conceive. We swallow folate supplements and curb our alcohol consumption, embark on exercise regimes and chart our ovulation cycles. But if this doesn't work, we can also buy pre-conception multivitamin supplements, claimed to enhance our fertility. We can purchase ovulation kits and fertility predictor kits. We can attend fertility clinics, workshops and seminars, or take classes in ''yoga for fertility'' or even ''belly dancing for fertility''.

All these pills, potions, gadgets and classes can be expensive, many without any proven record of success. But they also encourage a false sense of control over a highly unpredictable process. Chance, luck, or whatever you want to call it, is apparently eliminated.

At the pointy end of all this lies IVF. When it is discussed in our media the grief of the many women who do not ''succeed'' is typically obscured by the success stories; each baby a proof that science really can defeat infertility. What is rarely mentioned is the gruelling physical reality of the process, the emotional roller-coaster that follows each IVF cycle and, worst of all, the very low success rates.

And yet the uncertainty and imprecision of IVF treatment are the very things that make it so hard to discontinue. A friend who suffered multiple IVF-related miscarriages told me that getting off the IVF train is incredibly hard. There are no consolation prizes; only the hope that the next attempt might be the one that succeeds, and the fear that if you do drop out you will always be haunted by the thought that you might have given up too soon.

It would be easy to point the finger of blame at those who profit from fertility products; the pharmaceutical companies, alternative medicine practitioners and IVF providers. The more they promote the idea of infertility as ''curable'', the more they put pressure on women to take that ''cure''. But there is a deeper cultural factor at play here.

In 1978, Susan Sontag wrote her groundbreaking work Illness as Metaphor, in which she argued that cancer was often treated as if it was the sufferer's fault. As we promote knowledge about the role that lifestyle plays in some cancers, we run the risk of stigmatising all cancer sufferers, lumbering them with an assumption that they are responsible for their own predicament. If they had just eaten better or exercised more, they might never have fallen ill.

There are parallels between Sontag's point about cancer patients and contemporary attitudes to fertility. If she'd just started trying earlier, exercised more, done that belly-dancing course, or stuck with IVF then perhaps she would have had a baby. And if she doesn't do those things, then who does she have to blame? Only herself.

There was a time when childlessness carried a moral charge, and was often socially stigmatising for women. We are in danger of returning to such a situation, but with a different rationale, based on the neo-liberal mantra of personal choice and responsibility. It's already become commonplace to blame older career women for their childlessness, citing their selfish work choices as the reason they've missed out. There is a trend towards such harsh, judgmental attitudes becoming generalised, with women who want children being blamed for any "choice" that does not allegedly maximise their chances of conceiving.

My mother understood the capriciousness of fertility all too well; the fact that no matter how hard you try or how desperately you want it, whether you get a baby or not is often outside your control. Naturally, we should offer help to women who struggle with infertility, but this must be balanced against the very real cost of promoting false hope, pointless sacrifice and, worst of all, personal blame.