Identity, infertility, and volunteerism within the National Infertility Association RESOLVE

Material Information

Identity, infertility, and volunteerism within the National Infertility Association RESOLVE
Lemos, Diane Marie
Publication Date:
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ix, 122 leaves : ; 28 cm

Thesis/Dissertation Information

Master's ( Master of Social Sciences)
Degree Grantor:
University of Colorado Denver
Degree Divisions:
Department of Humanities and Social Sciences, CU Denver
Degree Disciplines:
Social sciences


Subjects / Keywords:
Voluntarism -- United States ( lcsh )
Infertility, Female ( lcsh )
Infertility, Female ( fast )
Voluntarism ( fast )
United States ( fast )
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )


Includes bibliographical references (leaves 117-122).
General Note:
Department of Humanities and Social Sciences
Statement of Responsibility:
by Diane Marie Lemos.

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Source Institution:
|University of Colorado Denver
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|Auraria Library
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
181588286 ( OCLC )
LD1193.L65 2007m L46 ( lcc )

Full Text
Diane Marie Lemos
A. A., Front Range Community College, 2002
B. A., University of Colorado, Boulder, 2004
A thesis submitted to the
University of Colorado at Denver and Health Sciences Center
in partial fulfillment
of the requirements for the degree of
Master of Social Science

2007 by Diane Marie Lemos
All rights reserved.

This thesis for the Master of Social Science
degree by
Diane Marie Lemos
has been approved
Barbara Walkosz
Leslie Irvine

Lemos, Diane Marie (M.S.S. Social Science)
Identity, Infertility, and Volunteerism within the National Infertility
Association: RESOLVE
Thesis directed by Associate Professor Barbara Walkosz
The coping mechanisms that infertile women utilize to understand their health
status has been examined through the paradigms of biological and
psychological disciplines. From a sociological framework, this paper will
examine the National Infertility Association: RESOLVE to understand social
effects of infertility and its volunteers relationships within the organization
and this connection translates to agency and empowerment. An overview of
literature pertaining to identity, femininity, health statuses, and psychological
perspective on volunteerism combined with RESOLVE volunteers narratives
of infertility and volunteerism present conclusions to their continual
dedication after their reported fertility successes. The research offers a new
construction of the infertile identity and how it intersects with volunteerism.
This abstract accurately represents the content of the candidates thesis. I
recommend its publication.
Barbara Walkosz

I dedicate this thesis to my wonderful husband, Paul Lemos, for his
unwavering understanding and wisdom and for supplying me the emotional
and financial support that was needed to complete this thesis. I also dedicate
this thesis to the memory of beloved mother, Nancy Marie Travis, knowing in
my heart that she is proud of her daughter. An additional dedication of this
thesis to Lydia Brokaw-Nelson with her mother-like presence helped to guide
my footsteps on this academic journey.

My most humble gratitude and thanks to my thesis director, Barbara Walkosz,
for her guidance, patience, and support during my research, writing, editing
portions of my thesis, in which I will be eternally appreciative. I also wish to
thanks the remaining committee members, Leslie Irvine, for her
encouragement throughout this journey, valuable insights, and for her support
during my graduate as well as my undergraduate program. A special
acknowledgement and thanks to Sonja Foss, for stepping in and becoming one
of my committee members at the last minute, for her time, suggestions, and
countless acts of patience during the writing process of this thesis. I would
like to acknowledge, Mellie, for her help in formatting. I also would like to
acknowledge the RESOLVE Colorado Chapter volunteers and Connie for
their time and honesty that without them this thesis would not have been

1. INTRODUCTION....................................................1
The national Infertility Association: RESOLVE..............5
2. REVIEW OF THE LITERATURE.......................................12
The Construction of Identity................................12
Womens Identity and Biology..............................15
Womens Health and Infertility............................17
Stigmatized Identity......................................21
Reconnection to Community: Volunteerism.....................24
Volunteer Characteristics: Opinions, Personality, and Attitudes..24
Opinions and Personality..................................25
The Study of Attitudes....................................28
A Functional Approach to Volunteerism.....................32

From Researcher to Insider.....................................41
Identifying Bias.............................................44
The Infertile Identity.......................................58
Infertility Realizations.....................................59
The Organization...............................................68
First Impressions of Support Group Experiences...............68
Public Education and Awareness of Infertility................71
Becoming Resolved..............................................76
Life Lessons.................................................77
The Function of Support Groups...............................80
Barriers to Support..........................................86
Participants Mission Statements.............................89

Discussion of Infertility and Volunteerism.......95
Suggestions for Future Research.................106
A. CONTENT FORM.......................................109
B. LETTER OF INTENT TO RESOLVE........................112
C. INTERVIEW PROTOCOL.................................114
D. SUPPORT REFERRAL...................................116

I believe that the things we experience in life are what help make us who we
are, but they dont have to control who we are or who we become ...
A life coach, 2006
In 2005, the Bureau of Labor Statistics reported that over 65.5
million persons volunteered (News, 2005, United States Department of Labor
Web site) in some capacity in the United States, with volunteerism up 12%
from 2002 to 2005 (Preston, 2006, p. 16). People cite different opportunities
and needs as motivations to volunteer (Houle, Sagarin & Kaplan, 2005;
Wilson, 2000). Motivations include preparing for careers, learning new skills,
and conforming to particular norms and values of the community (Thoits &
Hewitt, 2001, p. 117). Individuals also work on behalf of organizations
because the organization is designed to meet needs the volunteers themselves
desire to have met.
Another motivation for volunteerism is the active concern for the
welfare of others or at least recognizing a connection to the other. Wuthnow

(1994) offers the idea of empathic support, which means suddenly you
realize are not the only person in the world with problems (p. 174).
Individuals also engage in volunteerism for its reciprocal effects (Thoits &
Hewitt, 2001, p. 118). Reciprocal effects are outcomes of volunteerism such
as greater life satisfaction, self-esteem, sense of purpose, physical health, and
mental health (Thoits & Hewitt, 2000, p. 118). Thus, volunteerism may
provide not only external satisfaction but internal rewards as well.
Another reason volunteers offer their time is to maintain social
balance. This type of engagement is characterized as social equilibrium
(Wilson, 2000; Wuthnow, 1991), which allows the volunteer to pay back a
social debt. Wilson offers that a volunteer might feel good about doing the
right thing (volunteering), but she does not do it because it makes her feel
good; rather it makes her feel good because she thinks she ought to have done
it (2000, p. 222). This action is described by Wilson as reciprocity talk, in
which the articulation of the satisfaction of volunteering is one of the
components of volunteer service, thus part of restoring social balance (Wilson,
2000; Wuthnow, 1991). In other words, how a volunteer describes his or her
volunteer service, such as a personal commitment, enjoyment, or the like, is
also part of the actual action of volunteer service.

Although the reasons to volunteer are strong motivations for
volunteers to remain committed to any one given organization, some
individuals do stop volunteering. One major reason is volunteer burnout
because of emotional exhaustion, a sense of lack of personal achievement,
and being cynical and callous towards ones work (Chau-wai Yan & So-kum
Tang, 2003, p. 795). Another reason for volunteer attrition is that the
volunteer work may be too risky or costly for the participant to continue
(Wilson, 2000, p. 230). Other volunteers stop because they are not
recognized for their efforts (Wilson, 2000, p. 231). The fact that volunteer
work does not offer explicit extrinsic rewards like salary or fringe benefits
means volunteers must rely on intrinsic rewards or motives to continue to
volunteer (Black & Ditto, 1994; Omoto & Synder, 1995). Volunteer attrition
also may simply be credited to volunteers needs being satisfied through
career or skill development.
Besides the needs of the volunteer being fulfilled, another primary
reason for the discontinuation of volunteerism is a disconnection between the
volunteer and objectives of the organization (Wilson, 2000). However, one
organization that violates this convention is the National Infertility
Association: RESOLVE (to be referred hereafter as RESOLVE). RESOLVE

stretches across the United States in the form of chapters and regions
providing support for women and men struggling with infertility. This nearly
all-volunteer-based organization has existed for 30 years, offering support
groups, educational symposia, and on-line support through an official Web
Most of RESOLVE volunteers offer their time to the organization
while they are in the middle of their infertility treatments. Yet, unlike many
volunteer organizations, RESOLVES volunteer attrition rate is low even after
the fertility needs of its volunteers have been met. Nationally, a large
percentage of volunteers continue to remain with the RESOLVE organization
even after fertility resolutions through infertility treatments, adoption, or
adapting to a child-free life style. Thus, I am interested in understanding why
this organization has success in retaining volunteers after the exigence for
their volunteerism has disappeared. To understand why RESOLVE is able to
retain volunteers, I seek to explore one central research question:
What narratives do the RESOLVE volunteers offer for
continuing their service even after fertility successes?

The following definitions are relevant to this study:
The National Infertility Association: RESOLVE
The National Infertility Association: RESOLVE, established in 1974, is a
non-profit organization with the only established, nationwide network of
chapters mandated to promote reproductive health and to ensure equal access
to all family-building options for men and women experiencing infertility or
other reproductive disorders and to provide support services and physician
referral and education. The mission of Resolve is to provide timely,
compassionate support and information to people who are experiencing
infertility and to increase awareness of infertility issues through public
education and advocacy (http://www.resolve.ore;).
In explaining infertility and fertility treatments, definitions of
infertility and the variety of fertility treatments available need to be clarified.
The terms infertility or infertile are defined as the inability of a couple to
achieve a pregnancy or to carry a pregnancy to term after one year of
unprotected intercourse (Merriam-Webster, 1991).

Unexplained Infertility. Unexplained infertility is a catch-all diagnosis
used by physicians when the reason of infertility for the patient is unclear or
all tests to medical protocol lead to no clear conclusion for the lack of
Reproductive Endocrinology and Reproductive Endocrinologists (HE).
Reproductive Endocrinology is a medical subspecialty that addresses
hormonal functioning as it pertains to reproduction. While a major focus of
RE is infertility, reproductive endocrinologists also evaluate and treat
hormonal dysfunctions in female and males outside of infertility
The definitions of fertility medications and treatments are provided to
demystify and clarify the literature review and the excerpts of the participants
narratives in the discussion chapter to provide an understanding of the
complexity and stress of infertility.
Many medications that are prescribed by infertility specialists or
reproductive endocrinologists who are specialists in obstetrics and gynecology
that are used to manage the complex problems relating to reproductive
endocrinology and infertility. However, I have listed only the commonly used

medications for reference to understand the infertility literature and
participants interviews.
Progesterone. Progesterone is a natural hormone that is given after
ovulation to improve the quality of the uterine lining. It can be taken by
mouth, vaginal suppository, gel or intramuscular injection
( V
Clomiphene. Clomiphene or clomid (for women only) is an oral
medication used to induce ovulation, to correct irregular ovulation to help
increase egg production, and to correct luteal phase deficiency
( Usually, this protocol is used when infertility is
first treated and is referred to as the clomid challenge. This procedure
allows the physician to observe the drugs ability to promote egg production
and may also promote conception with its use.
Follicle Stimulating Hormone (FSH). Follicle Stimulating Hormone
(FSH) Follicle Stimulating Hormone (FSH) is a combination of drugs used for
the treatment of ovulation disorders and to stimulate follicle and egg
production for intrauterine insemination (IUI), in vitro fertilization (IVF), or
other assisted reproductive technology (ART) procedures. All FSH
preparations require injections. Gonal F, Bravelle, and Follistim are all

injected just beneath the skin (subcutaneous injections)
( ).
IUI or Intrauterine insemination. Intrauterine insemination is most
commonly referred to as artificial insemination. This is a procedure where the
woman is injected with carefully prepared sperm from the husband or a donor.
IUI is often performed in conjunction with ovulation-stimulating medications.
IUI is used to treat unexplained infertility, minimal male factor infertility, and
women with cervical mucus problems (
ART or Assisted Reproductive Technology. Assisted Reproductive
Technology is defined by the Centers for Disease Control and Prevention as a
procedure in which a woman's ovaries are stimulated, her eggs are surgically
removed and combined with sperm, and they returned then to a woman's
body. IVF is the most widely used of the ART procedures
InVitro fertilization or IVF. InVitro Fertilization is defined as a
fertilization of an egg in a laboratory dish or test tube; specifically, mixture
usually in a laboratory dish of sperm with eggs which have been surgically
removed from an ovary that is followed by implantation of one or more of the

resulting fertilized eggs into a female's uterus (
Gamete intrafallopian transfer or GIFT. Gamete intrafallopian
transfer involves the placement of ripe eggs directly into the fallopian tube,
along with a washed, processed sample of the husband's sperm. The eggs are
retrieved by the vaginal ultrasound route, as in regular IVF.
Egg Donor. This option is available for women with premature
ovarian failure or diminished ovarian reserve or genetically transmittable
diseases. Eggs or ova are obtained from donors from either an official egg
donation clinic or the infertility clinic. The donor should generally be
younger than 35 years old, with laboratory evidence of normal ovarian reserve
and no indication of impaired fertility. She must undergo testing for
communicable infectious diseases (e.g., hepatitis, HIV, syphilis) and genetic
screening both via a detailed family history and specific blood tests, which are
determined by her ethnic/racial background (e.g., for cystic fibrosis, Tay
Sachs disease, sickle cell disease, thalassemia) (
Donor Insemination or DI. Donor Insemination is used when the
husband or male partner has no sperm or a very poor semen analysis

(azoospermia, oligospermia, poor motility) or when there is a genetic problem
that could be inherited from the male. Donor Insemination can be used in IUI
or Intrauterine insemination and IVF or InVitro Fertilization as in egg donor is
only used IVF ( ).
The defining the language of infertility reaches far beyond the medical
terms of diagnoses, treatments, or procedures; this language is a gauge of
understanding between members and volunteers. This measure separates
those who have never experienced infertility and those who are experiencing
and have experienced infertility. An important term that is used by the
members and volunteers is being resolved. Becoming resolved is
considered a verb but also a place. Becoming resolved or being resolved
relates to a mental and physical state of the participant who has transitioned
from infertility to fertility success such as conception, adoption or a child-free
lifestyle. Being resolved also refers to having addressed the psychological
issues surrounding infertility.
This chapter has provided the introduction of the research study,
research question, and relevant definitions to the concept of infertility and the
treatment of infertility. The chapter to follow will examine the literature of

this study focusing on the construction of identity, womens construction of
identity, and the study of attitudes, opinions, and motivations of volunteerism.

If you have knowledge, let others light their candles at it.
Margaret Fuller, 1810-1850
There are two major bodies of literature that are relevant to this study.
They include: (1) identity construction; and (2) volunteerism. This chapter
provides a literature review of these topics as they intersect within the
framework of volunteerism for RESOLVE. In the first section, I address three
categories of the construction of identity: womens identity, womens health
statuses, and stigmatized identity. In the second section, I review how
attitudes, opinions, and personality shape volunteer characteristics. Last, this
chapter will provide a connection between the characteristics of volunteerism
and identity.
The Construction of Identity
The construction of identity is an important phenomenon because it
shapes our concept of identity and thus defines who are and how we conduct

ourselves within society. Identitys structure can be influenced by social
groups, an individuals characteristics, and/or a combination of both. The
classic social scientists defined the construction of identity through paradigms
of economics, culture, and commonality (Durkheim, 1893; Marx, 1844;
Weber, 1904). Early research on the construction of identity from a societal
perspective centered on group interactions; individual characteristics did not
play an important role in these conceptualizations. In the years that followed,
social psychologists writings on the construction of identity began to center
on the individual, suggesting that though an individuals identity is enforced
by role or scripts of societal norms and values, it is also a separate entity and
exists apart from the group identity (Goffman, 1959; Mead, 1934). Today,
social scientists contend that the construction of identity is situated both
within and influenced by societal groups as well by individual characteristics
such as race, gender, and health statuses (Collins, 1990; Gilman, 1977;
Martin, 1987).
With the influence of race, gender, and health status, Miller and
Prentice propose that the content of our thoughts about ourselves reflects not
just our personal characteristics but also our social categories [or our social
groups] (1994, p. 451). Personal characteristics and our referent social

groups could be considered the material that we use to describe ourselves or
construct our narrative. Each unique characteristic contributes to the personal
narrative; in addition, the social construction of gender is also influenced by
our social group (i.e., family and peers).
Master narratives also have the potential to provide major
contributions to our personal identities. Nelson defines master narratives as
the stories found lying about our culture that serve as summaries of social
shared understandings... readily recognizable character types that are used to
make sense of our experience and justify what we do (2001, p. 6). Master
narratives are catalysts for how we view the construction of our identity.
Because gender is a shared social idea, its construction could be seen as a
master narrative.
Narratives about gender can be as simple as how society categorizes
the differences between men and women. With this in mind, the narratives of
gender are scripted and enforced within society and are considered a master
narrative (Thome, 2004). In the master narrative, women and how they are
socialized to present gender is institutionally reinforced and sanctioned.
Institutionally reinforced roles are what Allen terms as a gender embedded in
institutional arrangements (2004, p. 50). These institutional arrangements

have been the basis of womens construction of identity defining women
primarily by their biological functions (Ortner, 1972; Martin, 1992).
Womens Identity and Biology
Womens biological functions, in some sense, are enforced by social
and cultural restrictions. For instance, womens identities have been long
determined by their birthing capabilities, deeming them closer to nature than
to culture and thereby determining a sole connection between women and
reproduction (Martin, 1992). Martin asserts, It is no accident that natural
facts about women, in forms of claims about biology, are often used to justify
social stratification based on gender (1992, p. 17). Similarly, Ortner (1972)
writes that womens capacity to reproduce deems them closer to nature and
further from the development of culture (1972, p. 66). She examines the
significance of the physiological fact that a womans body and its functions
[are] more in the time with species life and [this] seems to place her closer
to nature (p. 66). Ortner also states that the physiology of men free them to
take up the projects of culture thus a womans body and its functions place her
in social roles that in turn consider to be a lower order of cultural [hierarchy
and to] the processes of men (1972, p. 68). Martin (1992) adds:

Women are intrinsically closely involved with the
family where so many natural, bodily (and therefore
lower) functions occur, whereas men are intrinsically closer
involved with the world of work where (at least for some)
cultural, and mental, therefore higher functions occur, (p.
And because women are defined by their birthing and nurturing capabilities,
refusing or being unable to comply with such clearly defined roles would be
considered deviant. Schur asserts (1984):
Norms relating to motherhood further uphold and
strengthen the maternity ideal. They back up early
socialization and its general cultural supports. Perceived
violates of these norms include at least the following major
offenses: intentional nonmotherhood, unwed motherhood,
and the unfit motherhood. (1984, p. 48)
Chodorow also agues, Womens mothering is a central and the defining
feature of the social organization of gender and is implicated in the
construction and reproduction of male dominance (1978, p. 9). Defined by
their biological functions, society has created master narratives that restrict
womens identities within society; to remain childless is a violation of the
master narrative. Consequently, reproduction is seen as a major component of
a womans identity, and thus infertility may be viewed as a stigmatized or
marginalized identity.

Womens Health and Infertility
Historically and socially, the definition of womens identities has
centered on their biological functions, specifically, their birthing capabilities.
This focus has been underscored by the advancement of technology and the
media. Fertility-based magazines such as Working Mother, Parents, Fertility
Today, American Baby, and Cookie, just to name a few, continue to perpetuate
an idealized social construction of womanhood with advertisements that
promote solutions to infertility and specialized fertility clinics within their
pages as means to achieve the ideal solution to childbearing. These
advertisements glorify motherhood and have contributed to the glamorization
of InVitro Fertilization (IVF) by promoting biological parenting as the societal
norm, thus reinforcing social definitions. Condit suggests, Media slants the
success rates of IVF procedures highlighting the up-side of IVF and down
playing painful procedures and low birth rates (1996, p. 344). She also
argues that the term sterility implying a permanent condition was replaced
with the term infertile or infertility, suggesting that this condition is
curable and medical treatment available to all(Condit, 1996, p. 346). IVF has
turned alterative parenting on its ear by promoting biological parenting as
the absolute. Condit continues that in the 1960s and 1970s, adoption was

widely normalized in the mass media and it was endorsed as real
parenthood. In order to overturn this positive view of non-genetically related
families, the media had to change sterile individuals into infertile
couples (p. 344). The media readdressed sterile individuals as broke and in
need of repair holding IVF out as a cure to save them from a life of
biological dysfunction (Daniels, 1999, p. 57). Daniels suggests that the
widespread publicity that has surrounded assisted reproductionmost of
which has focused on the successful outcomesmay lead many couples to the
belief that there is a technological fix that will be available to them (1999, p.
Media representations seem to promote the condition of infertility as
stigmatized and consequently offer technological fixes that keep the status quo
for the norms and values of parenting. While these same media
representations contribute to deeper disconnections of women struggling with
infertility and strengthen the ideal that reproduction is an optimal role for
women, medical technologies continue to entrench the ideal that womens
identities are defined by reproduction. Thus, birthing capabilities have
sanctioned womens roles, and infertility and fertility technologies have
advocated the pathologizing of womens bodies further. Bartholet (1990)

questions if the IVF process is the vehicle for socially conditioning women to
believe that biological parenting is more worthy than adoptive parenting. She
argues that one important piece of the problem is that infertility is treated as
medical problem suited for medical solutions rather than as social problem for
which a range of social solutions should be considered (Bartholet, 1990, p.
255). In other words, we have reinforced the fact that womens identity and
reproduction are synonymous and thus define infertility as a personality flaw.
The miracles of IVF should not be under-emphasized; nevertheless,
the push of reproduction technologies continues to define women in terms of
motherhood. Bartholet illustrates, [IVF] includes the way in which women
are taught that their identities are necessarily wrapped up in fertility,
pregnancy, childbirth, and mothering (1990, p. 255). Benjamin and
HaElyon (2002) state the medical treatment of IVF is dehumanizing [to
women] relating to their bodies as machines ... medical establishments
[have] the tendency to treat womens pain (during IVF treatments) as
irrelevant to the process (p. 674). The processes are not limited to how the
infertile woman sees herself but also to how the medical treatments seem to
theprocess the infertile patient" (Benjamin & HaElyon, 2002, p. 674).
Bartholet (1990) advocates that the current pursuit of IVF is largely the

product of social conditioning that makes women think of themselves in terms
of fertility and think of parenting in terms of biological parenthood (p. 254).
The development of fertility technology has only added more pressure to
achieve biological parenting rather than explore alternatives like adoption.
Sandelowski (1991) suggests that there is a push-pull from todays
mainstream culture to try anything and everything to conceive a child (p.35).
She states:
Women feel compelled by their doctors and their male
partners to undergo medical treatments for infertility because
of the strong cultural pressure for married couples to have
children of their own and for women, in particular, to
demonstrate their normality as women by reproducing. (1991,
By the mere virtue of reproduction, women have been defined solely by the
birthing capabilities of their bodies (Ortner, 1972; Chodorow, 1978).
IVF technology and the statistics that it generates also lull women
into believing that producing a biological child will eliminate their
identification with the infertile identity. Sandelowski emphasizes that the
cultural imperatives of conception technology [are] reinforced and the
political functions [that] it serves, this technology also has a life and style of
its own (1991, p. 34). The cultural imperatives not only suggest but

sometimes bully women into believing technology will cure infertility
internally and socially. However, the infertile identity is much deeper than a
biological identity; it penetrates and stigmatizes the core of the female
Stigmatized Identity
Infertility is not always solved with fertility technology; the condition
penetrates beyond the physical condition and imbeds itself into the female
psyche. Spector affirms, Infertility may be a form of stigma or spoiled
identity for infertile women because motherhood is so often the central role
(2004, p. 97). Letherby also suggests:
Infertility is a syndrome of multiple origin, a
consequence or manifestation of disease rather than disease
entirely itself... [It is a] biological impairment, a
psychosomatic disorder [and]... a failure to conform to
cultural prescriptions to reproduce. (2002, p.278)
Infertility becomes a social disorder dividing women into groups by their
biological characteristics. Sandelowski, in Fault Lines: Infertility and
Imperiled Sisterhood, writes that the idea of sisterhood suggests womens
recognition of a shared experience ... [However], for a woman trying
unsuccessfully to have a child of her own, there are two classes of women,

the fertile and infertile (1990, p 34). The shared connections of womens
identities between each other seem to be bridged by empathy or pity of the
infertile woman. Sandelowski notes that a shared experience or the social
capital does not exist for women struggling with infertility (1990, p. 34).
Putman suggests that the analogy of social capital refers to social
organization, such as networks, norms, and social trust that facilitates
coordination and cooperation for mutual benefit (2000, p. 67). Thus, the
infertile woman does not have social capital to exchange and becomes
sanctioned from networks and norms of a fertile world. Sandelowski (1990)
states, Infertile women feel thwarted in their efforts to enter the female world
and to exchange in the currency of women (p.34). The currency of
women, social capital, or solidarity among women is corrupted by infertility.
Infertile women are faced with loss of identity, femininity, and self-
esteem. In the article Infertility and Subjective Well-Being: The Mediating
Roles of Self-Esteem, Internal Control, and Interpersonal Conflict, the
authors state, Most people view the ability to reproduce as a central aspect of
their personal identity; thus the inability to have a child represents a personal
failure that diminishes self-esteem (Abbey & Andrew, 1992, p. 408).
Letherby argues, Biological motherhood is more highly valued than social

motherhood in that biological motherhood enables a woman to fulfill herself
in terms of accepted biological social roles (1999, p. 367). Zucker writes that
the inability to have children makes couples lose a sense of being confident,
competent, and in control of their lives (1999, p.4). With no transition to
motherhood or parenthood, women often experience stress, loss of identity,
and lowered self-esteem. One way to reclaim a sense of self-fulfillment is to
find a connection to ones community. Wuthnow notes that research studies
show that most people do in fact hold the belief that helping others is a good
way of gaining fulfillment for yourself... [also] virtually everyone regards
helping behavior as vital component of self-worth ( 1991, p. 87). The next
section will discuss volunteerism as a pathway to connection and means to
build social capital. Volunteer characteristics from the psychological
perspective of opinions, personality, and attitude in order to lend
understanding to what motivates volunteerism will be addressed.
Reconnection to Community: Volunteerism
Volunteering with an organization may build a sense of community
through a shared experience or having similar connections or interests with
other members of an organization. These connections may be the guiding
reason why individuals choose to volunteer, and if special connections are

involved with volunteer service, then volunteers have a stake in remaining
part of their volunteer organization. Their involvement allows them to
maintain their sense of community. Researchers suggest that volunteerism
may not be random but part of certain personality characteristics that are
guided by an individuals opinions and attitudes. The following section
reviews volunteer characteristics from the psychological perspective of
opinions, personality, and attitude in order to lend understanding to what
motivates volunteers to remain with organizations over the long term, even
after their initial motivations have changed.
Volunteer Characteristics: Opinions, Personality, and Attitudes
Attitudes and opinions serve as mediators between the inner demands
of the person and outer environmentthe material, social, and, most
immediately, the informational environment of the person (Smith, Bruner &
White, 1964, p. 39). According to research on volunteerism, it is the strength
of ones attitudes and opinions that creates the motivation for volunteerism
(Houle, Sagarin & Kaplan, 2005, p. 338). Research on volunteerism also
suggests that earlier studies on opinions, personality, and attitudes define the
characteristics that lead to the motivations to volunteer. Thus, these
characteristics may underline and generate psychological phenomenathe

personal and social needs, plans, goals, and functions being served by peoples
belief and their actions (Houle et al., 2005 pg. 337). The groundwork to
understanding volunteer characteristics and motivations was built on the
psychological research of Smith et al. s. 1956 study of opinions and personality
and Katzs 1960 study of attitudes; both of these significant pieces of research
are the foundations of the functional approach to volunteerism (Houle et al.,
2005). In the sections to follow a discussion of both studies may provide some
insights to volunteer organizations success in retaining their volunteers.
In this next section, the literature review of Smith et al. s 1956 study
will offer an outline of psychological components that may provide an origin to
volunteer characteristics and motivations.
Opinions and Personality
The conceptual framework for explaining volunteerism is based on the
study by Smith et al. (1956) that details the three operational functions for
guiding opinions and personality: object appraisal, social adjustment, and
extemalization. The authors suggest that object appraisal is a ready aid in
sizing up objects and events in the environment from the point of view of
ones major interests and going concerns (Smith et al., 1956, p. 41). This
idea may seem simple and perhaps obvious, but object appraisal introduces

the notion that individuals automatically categorize their environment in order
to make sense of the world. Though volunteering is a choice, it could be
suggested that volunteering for certain organizations offers volunteers a
connection with an institution that represents them. Perhaps, some individuals
volunteer in order to restore lost social norms and values. Thus, the object
appraisal function is engaged by volunteering in that it allows individuals to
make sense of their world and also may provide a connection to societal
norms and values that may have seemed to be lost otherwise. Smith et al.
(1956) state, Object appraisal is the process whereby the person develops
attitudes that are creative solutions to the problems posed by the existence of
disparate internal demands and external or environmental demands (p. 41).
Volunteer associations may offer the solution to internal demands for a social
connection or capital that may have seemed lost by extenuating internal or
external demands of life.
As object appraisal helps to provide creative solutions to internal and
environmental demands, the social adjustment function suggests ones
relationship to another individual or individuals offers a strategy to work
through the internal and external demands of society. This function is defined
through the concept that expression of ones opinion is of a particular

importance in maintaining or cementing ones relationship with membership
groups (Smith et al., 1956, p. 41). Volunteering may provide the cement or
connection to a particular membership group or help to continue good
relations within ones reference group. Thus, social adjustment may occur
even if the adjustment is maintained within an inclusive group.
As the social adjustment function may provide solutions to internal and
external demands, the extemalization function is explained by how individuals
find an analogy between environmental events and unresolved problems
resulting in anxiety reduction. In other words, the person sees a connection
between his or her environment and an outside force that produces unity with
existing internal functions (Smith et al., 1956, p. 43). Researchers of volunteer
characteristics call this type of function the self-development experience such
as learning through volunteering for a particular organization (Houle et al.,
2005, p. 338). Volunteers may develop their sense of self through active
participation in a wide range of organizational events, allowing each volunteer
to become more invested within the volunteer organization. This type of
participation may also instill a realized salient identity and by extension creates
empowerment. Thus, the extemalization function becomes the manifestation of

acquiring social adjustment through participation in social life or perhaps
through volunteerism.
Smith et al.'s research of opinions and personality create a pathway to
understanding the motivations of volunteerism. Katzs (1960) articulates the
specific (or underlying) role that attitudes play in how and why individuals
decide to volunteer.
The Study of Attitudes
Katzs 1960 study of the functional approach of attitudes examines
four components of attitudes: adjustive function, ego-defensive function,
value-expressive function, and knowledge function. Adding to Smith et a/.s
1956 study of opinions and personality, Katz contributes the motivational
piece to the study of attitudes, the action component. (1960, p. 169). He
outlines the nature of attitudes and their dimensions suggesting that the
intensity of an attitude refers to the strength of the affective component (Katz,
1960, p. 168). In other words, intensity refers to the feeling an individual has
for or against some social object and how that feeling addresses his or her
value systems (Katz, 1960). The intensity and affect an attitude produces is
closely related to an individuals self-concept and the action component (p.
169). The action component is driven by the degree of an individuals

attitudes toward a particular person, place, or thing and is understood in terms
of how these attitudes will differ in their structure with respect to relevant
action (Katz, 1960, p. 169). Thus, an individual may decide to take action
(creating a motivation) regardless of the circumstances such as inconvenience,
time, or other deterrents.
In conjunction with Katzs (1960) action component, his four
functions of attitudes (adjustive function, ego-defensive function, value-
expressive function, and knowledge function) build a framework for how
attitudes and motivation spur the action of volunteerism. The adjustive
function suggests that people want to maximize rewards and minimize
penalties or punishment (p. 170). Volunteering may afford participants the
opportunity to find commonality within a community that shares the same life
experiences, norms, or values. Katz (1960) writes that the adjustment
function is either a means for reaching the desired goal or avoiding the
undesirable one ... [thus certain] associations [may be] based upon
experiences in attaining motive satisfactions (p. 171). For example, the
desired goal may not be to find common ground with others experiencing
similar life choices but the avoidance of being alone. Katz (1960) also
suggests that group support for such a personality change or [self-

acceptance] is almost a necessity, as in Alcoholic Anonymous, so that the
individual is aware of the approval of his [or her] new self by people who are
like him [or her] (p.174). Katz (1960) suggests that the same notion of self-
approval occurs through group support. Thus, the adjustive function may be
viewed as a defense mechanism protecting or redefining ones concept of self
against the conflicting view of lifes realities.
As the adjustive function may be seen as a defensive mechanism, the
ego-defensive function continues to support ones attitudes or the attitude
about ones self. The ego-defensive function allows the individual to remove
the sharp edges of conflict thus saving the individual from complete disaster
(Katz, 1960, p. 170). For instance, the mechanism of volunteering may help
to soften the sharp edges of lifes experiences by providing connections with
others experiencing similar circumstances and struggles. Katz (1960) urges,
Many of our attitudes have the function of defending our self-image (p.
172). A proactive action like volunteering may offer some control and sense
of self-worth in addition to defending ones ego.
As the ego-defensive function supplies a safety net for ones self-
worth, the value-expressive function contributes to clarity and direction in
ones life. Katz (1960) suggests that the value-expressive attitudes not only

give clarity to the self-image but also mold that self-image closer to the
hearts desire (p. 173). This function also assists the individual to adjust to a
new version of his or herself accompanying self-approval. Volunteerism may
provide a protective community for persons struggling to find self-approval.
Discovering commonality or community is important for those
struggling to find self-approval or, at the least, a personal connection with
others or an institution. The knowledge function provides a basic framework
to exist within society. Katz (1960) recommends that people need standards
or frames of reference for understanding the world, and attitudes help to
supply such standards (p. 175). Volunteer organizations may provide the
frame of reference by affording its participants a sense of structure through
stability or normalcy through activities or planned events. Katz (1960) writes
that the knowledge function is defined as definiteness, distinction,
consistency, and stability [that provide] meaning into what is otherwise [a]
vague and wavering [world] (p. 175). Katz (1960) also highlights that
definiteness and stability are provided by norms of our culture, which give an
individual the ready-made attitudes for comprehending his [or her] universe
(p. 175).

The outline of Smith et al.' s (1956) discussion of opinions and
personality and Katzs (1960) study of attitudes present a clear picture of how
both sets of proposed concepts may contribute to an understanding of the
motivations of volunteerism. In this next section, the characteristics of
volunteerism that are based the foundational research of opinions, personality,
and attitudes will be discussed.
A Functional Approach to Volunteerism
Both Smith et al.s (1956) research on opinions and personality and
Katzs (1960) study of attitudes provide a gateway to identifying the
characteristics of volunteerism. Houle, Sagarin, and Kaplan (2005) offer six
functions that explain the characteristics of volunteerism: values function,
social function, protective function, understanding function, career function,
and esteem or enhancement function that are based in part on from studies of
personality, attitudes, and opinions.
The six functions of volunteerism researched by Houle, Sagarin, and
Kaplan (2005) study may provide an additional means of understanding
peoples motivation for volunteering. One motivation for volunteerism is the
value function (Houle et al., 2005, p. 338). Houle et al. (2005) state that the
value function refers to the concern for the welfare of others and to

contribute to society (p. 338). Clary and Snyder (1991) add to the definition
of the value function approach suggesting that the [value-expressive] model
states that volunteering is not guided by values themselves but helps
individuals remain true to their conception of self and allows for the
expression of deeply held values, convictions, and personality dispositions (
p. 125).
Researchers explain the value function as a mechanism for individuals
to search out others who share similar values. For example, those who share
similar health concerns like patients recovering from cancer treatments may
align themselves within an organization that provides support and/or
encourages volunteering within the organization thus promoting solidarity.
Like the value function, Houle et al. (2005) suggest that the social function is
the normative or social pressure to get along with others within his or her
reference group (p. 338). Wilson (2000) discusses a different perception of
what social means offering that belonging to social networks prior to
volunteering may increase the chances of volunteering.
Wilson (2000) notes that social resources play a crucial role when
volunteering means activism to bring about social change or when the
collective goods, such as safer streets, are the goal (p. 223). For instance,

Neighborhood Watch engages all the members of a community regardless of
commitment level because the goal reflects the common good like safer
streets, protecting personal property and preventing crime. Wilson (2000)
contends that common goals like safer streets and organizations such as
Neighborhood Watch may engage citizens and promote social solidarity
among members of a community, such as frequent interaction, increases the
rate of volunteering (p. 223). To Wilsons credit, social solidarity among
volunteers suggests that certain volunteer organizations may foster a shared
identity among its participants. For example, cancer patients have a shared
goal of surviving their illness. Thus, support group or volunteer organizations
that promote this identity may be extremely helpful for the patient, his/her
family and friends by endorsing a collective consciousness of wellness.
Further, the shared identity of volunteerism offers a Durkheimian
perspective of a collective consciousness. Durkheim (1912) suggests that a
new collective consciousness intimates traits of religious culture providing
rituals, norms, and values (p. 62). In circumstances when social roles do not
conform to the norms and values of society, secular organizations may
encourage volunteering in order to create a bridge to mainstream society. Clary
and Snyder (1991) state that volunteering may help one fit in and get along

with important members of ones reference group (p. 125). A social
connection or perhaps reconnection to similar situations may be high on the list
of motivations for some volunteers.
Volunteering may also help one fit in with societys norms and values or
just a particular reference group. The protection function suggests that fitting in
with ones reference group may provide a safeguard for ones self-image. On the
other hand, the protective function also refers to the group members having a social
responsibility to one another (Houle et al., 2005, p. 338). Volunteerism may
support a self-image that is essential to a particular identity such as being part of
wellness group for former cancer patients or being part of a Neighborhood Watch;
in these cases, both groups advocate an identity that is in the best interest of the
member or volunteer. In other words, the volunteer identity may depend on the
organization. Clary and Snyder (1991) suggest:
Some people may look upon volunteering as a way to
provide self-protectionto protect themselves from accepting
the undesirable or threatening conclusions about the self that
might be warranted in the absence of the good works of their
volunteerism. (pg. 125)
Perhaps in the case of cancer patients or participants of a neighborhood watch,
either identity insulates it members or volunteers from threatening or undesirable

conclusions by using the old proverb that there is safety in numbers. Group
saliency may be a desirable aspect of volunteering. Houle et al. (2005) support that
[an] individual [may] had a greater level of commitment to volunteer when the
salience of personal responsibility for others is high (p. 338).
A high level of commitment to volunteer also may be due to the
understanding function (Houle et al., 2005, p.338). Houle et al. (2005) describe
this function as having an opportunity to learn, understand, practice, and apply
skills and abilities (p. 338). The understanding function may be one motivation
for individuals to volunteer in order to learn new skills that may lead to a career.
However, this function also may service volunteers as mechanism for new
insights into the people they have contact with, thereby satisfying an intellectual
curiosity about the world in general and the social world in particular (Clary &
Snyder, 1991, p. 126). Katz (1960) simply explains this function as a means to
give meaning to what would otherwise be an unorganized chaotic universe (p.
Like the understanding function that may give a participant an opportunity
to learn a new skill or ability for a future vocation, Houle et al.'s (2005) career
function offers the notion that volunteerism may increase ones job prospects and
enhance ones career (p. 338). This type of engagement may also increase the

volunteers feelings of self-efficacy, confidence, and competence (Thoits &
Hewitt, 2001, p. 117) or produce high feeling of self-esteem, which presents
another motivation for volunteering.
Houle et al.'s (2005) self-esteem and enhancement function provide an
explanation for how volunteering increases self-acceptance and self-
improvement (p. 338). In this case, volunteerism is further explained by the
exchange theory suggesting that volunteer service must be reciprocal; thus,
both the volunteer and the organization should receive rewards or emotional
profit. Wilson (2000) notes, The rational choice assumption is that actors
will not contribute goods and services to others unless they profit from the
exchange (p.222). Emerson (1976) adds that exchange theory is more of a
frame of reference thus within this light the reference is limited to actions
that are contingent on the rewarding reactions from others (p. 336).
However, Emersons description is limited in that persons in this frame
reference are seen as unemotional beings. He offers, The exchange approach
in sociology might be described, for simplicity, as economic analysis of
noneconomic social situations (Emerson, 1976, p. 336). Lawler and Thye
(1999) urge that many common exchange relations suggest that emotions
both enter and pervade social exchange processes (p.218).

The exchange between volunteers and their organizations may provide
a mutual benefit offering self-esteem and enhancement for the individual and
a service for the organization. Lawler and Thye write:
Friendship relations are often propelled by strong
affection or feelings of joy; corporate mergers may result from
fear or anger; economic partnerships may thrive because they
produce positive feelings such as confidence or pleasure. (1999,
Volunteers may enter into their relational exchanges for self-enhancement but
also may look to find some emotional exchanges with others who share
similar experiences. Wilson (2000) acknowledges, Volunteering often
provides solidary benefits, the pleasure of socializing with staff, other
volunteers, and clients to whom emotional attachments may be formed
(p.222). Thus, volunteers may experience a moment of reconnection with
other volunteers or clients that may enhance their experience of volunteering;
therefore, this opportunity may increase volunteer motivation and
continuation. Lawler and Thye (1999) illustrate that the processes of
exchange may cause individuals to feel good, satisfied, relieved, excited, and
so forth (p. 218).
These social and emotional exchanges are illustrated throughout each
functional approach to volunteerism; however, it is the values, social and

protective functions that highlight the individuals search of similar
connections with individuals and the group as a whole. On the other hand, the
understanding and career functions may provide opportunities for the
individual to seek out new experiences that may enhance skills and abilities as
well as increase personal and professional prospects in the job market.
However, all the volunteering functions relate back to a basic human need to
support an individuals self-esteem as illustrated in the esteem or enhancement
function suggesting that clarity and stability of the self-image is of primary
significance ( Katz, 1960, p. 174).
In this chapter, the literature review examined the construction of
identity as identity pertains to womens identity, health status, infertility, and
the stigmatized identity. The literature review also examined volunteer
characteristics through the study of opinions and personality, the functional
approach to attitudes, and the functional approach to volunteerism. In the
following chapter, the methods section will focus on the role of the researcher,
bias, the profile of the participants, interview procedures, and coding and
analysis of the data.

Knowing is always a relation between the knower and the known.
Dorothy Smith, 1990
This thesis was designed to address the continual and existing
relationship that the RESOLVE volunteers had to infertility. The research
question guiding this study was: What narratives do the RESOLVE volunteers
offer for continuing their service even after fertility successes? This thesis
extends previous explanations and studies of infertility and volunteerism by
offering the participants the opportunity to address for themselves their
experiences of infertility and volunteerism and howand ifthese two
contexts fit together.
From Researcher to Insider
Entering the world of infertility can be shaky at its best and
overwrought with emotion at its worst. Though I share a common bond of
infertility with the participants of this study, I was tasked to continue to build

rapport and trust with them. This required dedication to their interests and my
assurances that I would tell their experiences accurately. Part of the research
design and methods required me to take an active role within the study. I
contacted the National Infertility Association: RESOLVE and met with the
co-president of the Colorado chapter to introduce my research proposal. To
gain access, I offered my personal time by becoming this chapters librarian.
This particular lens of participant observation was described by Adler and
Alder (1987) as an active membership role:
Researchers who adopt active membership roles do more than
participate in the social activities of group members; they take
in the core activities of the group (to the extent that these core
activities can be defined and agreed upon by the group
members). In so doing, they generally assume functional, not
solely research or social, roles in their settings. Active-
member researchers (AMRs), therefore, relate to members of
the setting in a qualitatively different way than researchers in
peripheral membership roles. Instead of merely sharing status
of insiders, they interact as colleagues: coparticipants in a joint
endeavor, (p. 50)
My active membership was an advantage to the design of the research.
Securing a position within RESOLVES functions and interacting with its
volunteers afforded the avenues of building trust, rapport, and access. Though
I have a personal experience with infertility, an active membership provided

me with an emic perspective or an insider perspective to the study (Patton,
2002, p. 84).
Building from the emic perspective, I volunteered my time to the
Colorado chapter because an insiders perception of reality is instrumental to
understanding and accurately describing situations and behaviors (Shaffir &
Stebbins, 1991, p. 90). I attended volunteer meetings and volunteered for the
2005 symposium. My insider perspective afforded me the privilege of hearing
the volunteers stories of infertility of struggles and diagnoses, and finally,
fertility successes and their reasons for staying active with RESOLVE. The
volunteers defined fertility success as a reproduction succession that leads to
pregnancy, childbirth, and parenting with medical assistance. Through
participant observation, even as an insider, I discovered an emerging
phenomenon between the volunteers and their connection to infertility. The
volunteers had come to a fertility resolution by achieving parenthood. The
research plan was purposeful or information-rich sampling because of the
volunteers connection, or the lack of connection, to infertility (Patton, 2002,
p. 230).

Identifying Bias
At this juncture, I acknowledge that my subjectivity could imply
complications of bias and jeopardize legitimacy. My active participation and
volunteerism was crucial for the recruitment of the participants. Personal
experience was also important for understanding my participants within the
setting of infertility and volunteerism. However, bias was an ongoing issue.
To address this concern, I again turned to Alder and Alder (1987), who assert
that in functioning as a member, researchers get swept up into many of the
same experiences as members (p. 64). As a volunteer, I became caught up
with, not only, the participants past infertility struggles but was constantly
reminded of my own past struggle with infertility. Yet, as 1 identified this
swept-away perspective during the coding of the interview data, I came to
realize that the participants struggles with infertility and their tenacity to be
subject to a number of infertility treatments until success did not match my
own personal experiences.
While coding and categorizing interview data, I was reconnected to my
personal struggles with infertility, and this provided the distinct advantage of
adding [my] own [self] as data to the research, both as a cross-check against
the accounts of others and as deepened awareness of how members actually

think and feel (Alder & Alder, 1987, p. 64). However, I minimized bias and
ensured legitimacy by allocating the process of self-checking or cross-
check against the accounts of the other (Alder & Alder, 1987, p. 64). Self-
checking permitted me to question my interaction with the participants. This
interruption urged synthesis of my personal reaction to both the participants
and how I perceived the data.
Cross-checking afforded me the chance to understand not only the
participants narratives but how I felt about their perceptions and perhaps my
own sensitivity to infertility. Another mechanism to lessen bias was analytic
induction (for a detailed explanation, see procedures). This method is similar
to grounded theory.
Regardless of whether bias was perceived within this study, I reported
my findings in the only possible way as dualisms. McCorkel and Myers
(2003) suggested that a dualistic emphasis on both the front and backstage of
the research is a crucial resource of obtaining objectivity and legitimating
knowledge claims (p. 203). The front stage analyzed the participants
narratives of identity, infertility, and volunteerism, offering some conclusions.
The backstage undergirded my personal perceptions of identity, infertility, and
volunteerism and how [those identities are] implicated in the structure and

process of fieldwork (McCorkel & Myers, 2003, p. 203). The backstage also
supported the validity of the participants experiences and perceptions by
correlating my experiences as guidelines.
The sampling plan was convenient and purposeful because of the
presented participants characteristics or certain criterion. Criterion sampling
prescribes that all cases [or participants] meet some predetermined criterion
of importance (Patton, 2002, p. 238). During the recruitment phase of this
research, an opportunity was presented at the RESOLVE symposium where
the volunteers fertility statuses became clear. The volunteers of the Colorado
chapter had achieved fertility success yet remained dedicated to RESOLVE.
During the symposium, at volunteer meetings, and via email, I recruited and
interviewed seven volunteers from the Colorado chapter of the National
Infertility Association: RESOLVE and one professional member of the
association. The Colorado chapter is the smallest of all the national
RESOLVE chapters or regions, having only ten active volunteers. 1 defined
active volunteers as those who still perform tasks for RESOLVE functions
such as fund raisers or hold official chapter positions. Prior to the
symposium, one volunteer, in a gatekeeper capacity, provided an official

introduction to all the volunteers at a meeting and provided a list of
volunteers addresses, phone numbers, and email addresses. Gatekeepers, in a
sense, exercise the institutional authority to permit or deny access
(Denscombe, 2002, p 71). During a volunteer meeting before the symposium,
I presented my prospective research and later, after the event of the
symposium, I emailed the participants to set up interview dates and times.
All participants were female, white, heterosexual, and married. The
seven participants had obtained fertility success through medical-assisted
conception, and one participant had achieved fertility success naturally. The
participants income ranged from $60,000 to $150,000.
The general structure of the face-to-face interview was as follows.
The participants and I arranged a convenient, private meeting place where we
could be undisturbed for the duration of the interview. We met in their homes
and at library study rooms. Upon my arrival, I set up my tape recorded
equipment and made small talk with participants. I explained my research
study had been reviewed and approved by the University of Colorado at
Denver and Health Sciences Centers Human Subjects Committee. Before
turning on the tape recorder and with the interviewees permission, I presented

each participant with the research consent form (Appendix A), I asked for
each participant to read and sign the consent form. The participants signed for
their permission in two places: (1) authorization to be part of this study and
(2) authorization to use their quotes from the interview (removing all personal
identifiers). The participants were allowed time to read the consent form and,
at the same time, I handed-out a support referral form (Appendix D). The
support referral form provided support and counseling resources for
participants who may become stressed from sharing past experiences with
infertility. Each participant received a copy of the consent form. I retained all
the signed copies and stored each copy in a secured location to ensure
I informed all participants that they may discontinue the interview at
any time. During the interview, I enforced breaks or check-ins with the
participants emotional condition. The discussion of infertility brought up
unpleasant and emotional memories; check-ins offered an assessment of
participants status. As a cautionary measure, I also referred the participant to
the support referral form (Appendix D) for professional emotional support for
future use.

As stated above, I began each interview with small talk or an
interviewing strategy of breaking-the-ice. The ice-breaker strategy
primarily functioned as a mechanism to establish rapport with each participant
and allowed for the eventual transition to sensitive questions and discussions
of infertility and the interviewees experiences with RESOLVE. In order to
break the ice with each participant, I began with my personal history of
infertility. This discussion offered proof of my authenticity with the subject
of infertility and [opened] up a range of possibilities within the interview
process (Patton, 2002, p. 342). Authenticity is extremely important to
establish with vulnerable populations. The authenticity that I created with the
participants was that not only did I know where they were coming from, but I,
too, had knowledge of the same experiences. The authenticity is defined as
identification with the other or:
Verstehen ... entailing a kind of empathic
identification with the actor... getting inside the head of actor
... [and] to understand what he or she is up to in terms of
motives, beliefs, desires, [and] thoughts. (Patton, 2002, p. 52)
Along with the ice-breaking technique, I planned a very flexible
interview protocol (Appendix C) with questions that focused on infertility
diagnoses, treatments, emotional impact, and RESOLVES impact on the

individual. I started with open-ended questions such as: Tell me about your
infertility diagnosis? The question allowed the interviewees to share their
story of infertility and, in turn, this discussion presented me the opportunity to
interject my own paralleling circumstances continuing to reinforce trust.
Asking questions about infertility diagnoses and treatments opened the
dialogue of infertility language (see Definitions for fertility treatments and
The question about the participants' infertility diagnosis was necessary
to understand and explore the interviewees self-identity and how the impact
of infertility still lingered after fertility success. Though infertility diagnoses
and treatments were discussed throughout the interviews, the two topics led to
primary questions of RESOLVE involvement: Did going through infertility
treatments lead to you to RESOLVE? Is that how you became involved with
RESOLVE? Tell me about that relationship? The questions helped to tie
in the explanation of the organization RESOLVE and the participants
ongoing connection to infertility.
The remaining questions centered on RESOLVE and volunteerism;
however, the subject of infertility and the participants experiences with
infertility surfaced throughout our discussion. The interview questions guide

was not strictly followed; its main function was to keep me mindful of time
constraints. Each interview was limited to 90 minutes yet participants could
elaborate on each question as long as they needed. 1 did not take notes during
interviewsjust the occasional one word or phrase for future reference. I felt
that the note taking during the interview represented disregard to the
participant; I remained engaged with the respondent throughout the entire
interview. After the interview, I wrote about and mentally processed the
interviewees responses, body language, and emotion over the questions.
Keeping notes and my impressions close and mindful, I transcribed the
interviews, read, and listened to them repeatedly thus submerging myself
back into the moment of the interviews. One method I used to code the
interview data was analytic induction (Morse & Mitcham, 2002), which is
similar to the grounded theory (Glaser & Strauss, 1967). Grounded theory
allows the researcher to be in effect, a generator of theory, and in this
instance the theory is clearly seen as process: an ever-developing entity
(Glaser & Strauss, 1967, p. 242). Within this process, I read each transcript,
naively marking passages with simple codes that captured the context of the
excerpt. To expedite the emergence of themes and patterns, I separated the

marked excerpts, sorted the excerpts, and began to place each excerpt into
categories. This process produced an explanatory schema.
The explanatory schema allowed for themes to surface and to doubling
back with the data when a questionable excerpt emerged, thus allowing me to
reconsider the passages value to answering the research question. Analytic
induction, in much the same way, offered the same procedure of identifying
emerging themes and patterns. Analytic induction is a way of building
explanations in qualitative analysis by constructing and testing a set of causal
links between events, actions etc. in one case and the iterative extension of
this to further cases (Katz, 2001). Aristotle was cited with this analogy of
analytic induction, He (Aristotle) suggests that the formation of concepts is a
little like what goes on as an army retreats under attack, constantly falling
back here and there looking for a place to make a firm stand (Morse &
Mitcham, 2002 p. 2). Falling back here and there extended the option to
disregard themes or patterns that had no basis or direction; this technique
allowed for how concepts are developed through trial and error engagement
with phenomena (Morse & Mitcham, 2002 p. 2).
After several sorts of the interview data, solid themes and patterns emerged to
construct the explanatory schema. I organized participants quotes into theme

topics using the literature review as a loose guide. Another influence on
identifying themes and patterns is the literature on how women construct their
identity. Harding (1991) asserted that a reliable picture of womens worlds
and of social relations between the sexes often requires alternative approaches
to inquiry that challenge traditional research habits (p. 117). Reproduction
resolution defined in this study is not as patriarchical design to produce a
genetic heir but a process or right of passage to womanhood.
Along with womens construction of identity, another influence
pressed upon the data analysis was my personal experience with infertility and
the self-reflexivity perspective.
My personal experience with infertility allowed me to define and
clarify the participants beliefs and norms. This process placed me squarely
as another apparatus for research analysis. Wasserfall (1993) states, Some
argue that the researcher has become the instrument of his/her search and so
reflexivity has become one of the most important tools controlling the
acquisition of knowledge (p. 151). One theme was the participants
definition of identity; the participants were highly sensitive and understanding
of each others experiences of infertility, including the personal experiences of

this researcher. McCorkel and Myers (2003) emphasized that the researcher
put her taken-for-granted assumptions, beliefs, and stereotypes on the table for
dissection (p. 205).
Though I was diligent in maintaining my experiences as separate, it
was obvious, mostly to the participants, that the participants and I shared
similar self-identities with infertility. The stories of infertility brought back
emotional and painful memories of loss, disconnection, and fragmentation
with others outside the world infertility. Wasserfall (1993) confirmed:
[RJeflexivity is continual self-awareness about the
ongoing relationship between the researcher and informants ..
. [thus] the researcher becomes more aware of constructing
knowledge and of the influences of her beliefs, backgrounds,
and feelings in the process of researching, (p. 151)
The ongoing relationships with the participants did not stop at the end of the
interviewing process. As a RESOLVE volunteer as well as the researcher, I
was required to continually build, or at least, maintain productive relationships
with the participants. Productive relationships between the participants and
me entailed disclosure of my ongoing stints with infertility.
As I explained in my interviewing format earlier, I began all
interviews with an ice-breaker strategy offering up my past and current

thoughts about infertility as an area for discussion. This disclosure led to
interactive interviewing (Ellis, Kiesinger &Tillmann-Healy, 1997).
Interactive interviewing did not stop at the formal interviews but continued at
every volunteer meeting or social gathering where I interacted with the
participants. Ellis, Kiesinger, and Tillmann-Healy (1997) contended that
[t]his interaction, of course, occurs in the context of an ongoing relationship
where the social identities of both the interviewers and the interviewees
continually change as each responds to the other (p. 123). The interviews
allowed for the participants to share their stories of infertility and began to
explain how their connection with infertility steered them towards
volunteerism. My reflexivity within the interview process allowed for two
notions to surface: 1) participants self-identification with infertility even after
infertility resolution; and 2) my standing connection to infertility when I
believed that the infertile identity was no longer personally relevant. The
analysis of the research gave way to my socialization and gave form and
substance to not just [my] experiences in the field, but [my] sense of [my]
own identity as well as the identities and differences of others ( McCorkel
& Myers, 2003, p. 205).

Analytic induction and grounded theory are the mechanisms to provide
a voice and balance to the experiences of the participants. However, because
of my personal experience with infertility and my membership, my
perspective is also caught up with the participants but only through such
candid examination of the researchers backstage that the implications of
identity and difference on the research process can begin to be explored
(McCorkel & Myers, 2003, p. 205). I offer that my voice helped to emphasize
the participants explanations of infertility and motives for volunteering.
This chapter has examined the researcher to insider role, bias,
description of participants and interview procedures, and the coding and
analysis of the interview data. In the chapter to follow, the results of the data
analysis will be discussed.

The beginning of knowledge is the discovery of something we do not
Frank Herbert, 1920-1986
The research question guiding this study is centered on determining
what motivated the participants to remain committed to RESOLVE as
volunteers after their fertility successes. To deconstruct the participants
motivations, the analysis of the interview data has produced three themes:
identity, the organization, and becoming resolved.
The theme of identity examined the participants state of self. Past
research has focused on infertility from a medical or psychological aspect and
though both perspectives have relevance, each standpoint seems to overlook
infertility as a social condition. The participants describe feeling isolated in a
society that seems to focus only on motherhood and family as a remedy for
success. The participants concept of self-identity was explained through their
personal examinations of infertility; their assessments suggested a possible

motivation for the participants to pursue support and to volunteer for the
organization of RESOLVE.
Next section, I identified the theme of the organization illustrated by
the participants first impressions of RESOLVE through their first-time
experiences of support groups. Their descriptions of these groups are relevant
because these groups and the support they offer are the core of RESOLVES
mission statement. The participants illustrated their preconceived beliefs of
support groups describing what they expected, and how these groups provided
more emotional support than first anticipated.
The last theme that emerged from the data is the process of becoming
resolved; this concept is uniquely used by RESOLVES members and
volunteers. Becoming resolved is a fluid and on-going process and is
described through the participants life lessons as they express acts of
surrendering and accepting change. Becoming resolved is manifested through
the experiences of support groups. These experiences include supporting
others, overcoming barriers, and finally, accepting support that facilitate the
functions of becoming resolved. Last, the process of becoming resolved
encouraged the participants to become more involved with RESOLVE, and

the participants experiences were expressed in the form of mission
The following section examined the theme of identity and how
participants describe their infertility and self-perceptions of infertility.
Our identity is the essence of who we believe we are and colors our
perceptions of society and the world around us. The creation of our identity is
in part enforced and manipulated by lifes circumstances, what we struggle
through, what we learn to live with and what we are able to overcome.
Infertility, one of lifes circumstances, can overshadow what we believe about
ourselves, what we think about the world and what we think the world thinks
of us. Though this researchs sole purpose is to understand the connection of
infertility and volunteerism, it is extremely important to highlight the
construction of identity and the identification of the infertile identity as a
significant phenomenon.
The Infertile Identity
The excerpts from the participants interviews detail that infertility still
has a part to play within their lives even after their fertility successes. They
offered that infertility continues to shape their self-perceptions. The

participants revealed that experiencing infertility had shadowed their sense of
self outlining a paradigm of success and failure. For them, success equated to
becoming a mother and failure as being childless. The participants
underscored that the latter of two choices was unthinkable.
As the participants described their challenges with infertility, it
became very clear that the participants experiences with infertility would
underscore their personal associations, volunteering, and their involvement
with RESOLVE. I found that the classification and identification of the
infertile identity is intertwined with the participants motivations for
remaining involved with RESOLVE. I contend that both the infertile identity
and volunteering for RESOLVE are circular in nature. Within this section, the
participants comments reflect how they came to terms with infertility.
Infertility Realizations
The participants expressed that before they were diagnosed with
infertility, they had their lives planned out and felt that they had complete
control over lifes circumstances.
The Loss of a Planned Life
Connie articulates the advice of her first reproductive endocrinologist (see

You are the worse person to have this [infertility]
happen to you because you are somebody who thinks that if
you work hard enough and do a good job that you should reap
the rewards. You feel that you can have control over it
[infertility] because you have controlled everything else in your
life to this point [pause]. This [infertility] is totally not like
that at all.
The expectations that the participants held dramatically changed with
the diagnosis of infertility. For some participants, achieving parenthood did
not meet their expectations. Gina described that achieving motherhood could
only be realized through an egg donor (see Definitions).
There is a point that you go on the [egg] donor list and
you think youre going to get someone that is just like you then
the realization hits. These are not your eggs. This realization
is actually hard to take. There is a point when I had to come to
terms that these arent my eggs. So, I began dealing with a
grieving process.
Because their expectations did not reach their desired outcomes, some
participants expressed that infertility caused feelings of jealousy, envy and
sometimes shock. Connie illustrated that while you are going through
infertility there is this sense of failure. She explains:
I had never been jealous or envious, ever, until
infertility and now those feelings are accompanied with
sadness and feelings of inadequacy. Asking the question, will
this [infertility] ever end? [Pause] Is this going to be like this,

Jenny stated that she was in shock:
It was just unbelievable that here and now I couldnt get
pregnant. It has been so easy the first time. [She ended up
miscarrying]. I had been able to pregnant so quickly the first
time and that it was amazing that things could go downhill so
She also laments the loss of a planned life:
This never even entered my mind that I would miscarry.
I mean my life is so [She pauses]. I am very organized,
planned, I am a control type of person and my life had fallen
into place. Life was great then I miscarried.
The participants offered that infertility changed how they viewed their
lives. They explained that, with the diagnosis of infertility, they were forced
to change their self-perceptions. The participants expressed that their sense of
control helped to define them, and infertility changed their self-definitions,
self-worth, and chipped away at their self-esteem. This next section outlines
the participants decline of positive self-perception providing examples from
their interviews.
The diagnosis of infertility, for participants, introduced feelings of
failure, inadequacy, and even suggested a defeat. When I asked one

participant about how she had heard of RESOLVE, she revealed that it was
hard to accept the word infertile. Dee explained: That was another big leap
for me to even accept the word infertile that was huge for me to take [pause]
because nobody wants to accept defeat.
Tension between Success and Failure
When first seeking support or turning to RESOLVE, the participants
interpreted this action as a defeat. This sense of defeat was followed by
feelings of inadequacies, depression, or just being emotionally spent. Connie
illustrated these feelings as a personal failure:
I never could get pass that [feeling like a failure] even
after all the therapy I have gone through. Finally I look at my
therapist and said, Im just going to accept that I am going to
take this [infertility] as a personal failure.
The loss of control, especially over reproduction, complicated the
participants lives. This realization translated to self-blame. Donna illustrated
how she blamed herself for the diagnosis of infertility:
I guess it was just easier to blame myself for it
[infertility] even though I know that is not why my husband
married me. However, I thought maybe if he had married
someone else, children would have come easier.
Self-blame also was expressed as failing to follow a life plan.

As Connie suggested:
I feel that what you are supposed to do is: when you
grow up, you get married and have babies. I was always
taught. For a simple thing of what you are suppose to be able
to do and then not be able to do it; this brings incredible failure
The diagnosis of infertility was interpreted as a definition of failure:
Jenny explained:
The definition of success to me was to be a stay-at-
home mom and raise kids. Not have a career so I feel like a
failure and depression really set in. It [having children] was all
I wanted in my life and I couldnt achieve it.
Failure to become mothers led to depression and emotional strain, and,
at times, the participant explained that they were unable to function effectively
in their day-to-day lives. Jenny stated that I started dealing with depression
and it got to a point that I didnt want to get out of bed in morning, the day
was huge chore. Other participants, like Kelly, offered that she was
emotionally irrational and on the edge:
I couldnt even look at a kid, I couldnt even look at
anyone pregnant or talk to anyone talking about kids or hearing
about someones kid. Like how happy they are or how cute
they [children] are. They made me want to strangle them
[pause] I mean I was really crazy. It was really sad.

Though their fertility successes changed some negative self-
perceptions, their infertile identity seemed to linger and the participants still
expressed feelings of personal failure, feeling inadequate and self-blame.
They still identified with the emotional stress of infertility, Connie did:
You get accustom to failure, and you get use to dealing
with failed cycles. You get accustom to dealing with
infertility. At some point you just accept it [infertility]; it
[infertility] doesnt go away you just get better at dealing with
it because you get adjusted to it [infertility].
Donna agreed:
Deep down I still feel bad [pause] like why did I wait so
long to have a child, or maybe I didnt take care of myself,
right. I mean, my sister got pregnant right away [pause] in a
month [pause] she didnt have any problems.
The shadow of infertility shaped how the participants viewed their
world. Connie urged that infertility will always be part of her life just not the
active the part.
The Aftermath of Infertility Experienced during Post-Infertility
Even after fertility successes, the participants expressed feelings of
unfairness or being unable to reap the rewards of their hard work. One
participant, Donna, lamented her past infertility struggles: It still bothers me

to see other women not having to try hard to have their children [pause]. Its
just not fair [pause] I dont think that ever goes away. Kelly added:
It really doesnt have to do with I want to be pregnant
again [pause] but the unfairness of it all. Its not the same raw
feeling as before infertility. Its that feeling of being unfair.
Theres no winning on this topic theres just degrees of losing.
Even as the participants describe their feelings of infertility while
experiencing post-infertility, the pain of infertility still cuts deep and still
affects their self-image. Dee depicts her sensitivity to infertility:
I dont think it [infertility] ever goes away. I mean the
sensitivity to infertility. I dont go around saying I am an
infertile woman but I definitely know I struggled with
infertility and I look at my baby everyday knowing that she is a
miracle. I just shared this idea two weeks ago at an event that
she is a miracle of God and science.
The participants still associate themselves with infertility and the emotional
struggles that accompany the process. Connie explained post-infertility as
being in neither space:
After you experienced infertility for a very long time
and then you get pregnant [pause] you are caught between two
worlds because for while you have your friends you met
through infertility and they are still experiencing it.
Other participants still identify with infertility because of the physical
repercussions of reproductive surgeries or infertility protocol. Jenny offers

that it [infertility] is still there but has taken a back burner with my
daughter. However, she is still reminded of her past struggles with infertility
during routine doctor office appointments or special holidays.
Jenny reminisced over her passed Gynecologist appointment: When they [the
nurses] ask me what form birth control are you using and I say 1 dont have to
use any kind and from that perspective infertility still hurts.
Another example of Jennys was celebrating Mothers Day:
Mothers day was kind of strange going to church and
having them give me a rose and say Happy Mothers Day.
[She begins to cry]. There has been so much heartache in the
past, you know, to wait for this day to pass. The church would
have a children chorus sing that day. I mean other people are
still struggling. So, I guess from that perspective I still do
identify myself with infertility.
Another participant, Kelly, states that 1 dont think it [infertility] will ever go
away .. having a child does not make difference because having a baby isnt
the issue, it is the why [pause] why them?
Dee underscores those sentiments by offering:
You just still identify with infertility and as such as I
accept that fact that we are done [with infertility treatments]
[pause] there is a part of me that goes, Why? What make you
so special? Why does your body work so much better then

The participants feelings are complex, and they balance between these
emotions of being angry and blessed. They expressed frustration because
fertility, for them, was a struggle and for other women conceiving, children
seemed to happen so easily. On the other hand, the participants felt blessed
that their infertility treatments and procedures resulted in success. Dee
expressed acceptance and frustration:
Then comes the acceptance piece [pause] OK! You had one
great kid. [Pause] One is good. [Deep sigh] Thats my mantra
right now. But there is a part of me that still doesnt like it [only
being to have one child because of infertility].
As one participant offered, the volunteers are in neither space infertility or
post-infertility. Their accounts are still layered with anger, sadness, and at
times deep pain from the cost of struggling with infertility. However, when
the interviews move from infertility treatments and procedures and into
volunteering with RESOLVE, the conversations shifted to upbeat and charged
statements layered with identity-shifts.
This next section examines RESOLVES support groups and the
participants first impressions and experiences of reaching out for support.
These first impressions showcased the participants motivations for remaining
dedicated to volunteer service.

The Organization
The National Infertility Association: RESOLVE offers an official
network of support resources through on-line information, help-lines, and
organized support groups. RESOLVES primarily volunteer-base maintains
this non-profits superstructure throughout its state-to-state chapters and
combined states regions. The following section illustrated the participants
first impressions of RESOLVES resources.
First Impressions of Support Group Experiences
The first impressions of support groups for the participants were met
with visions of sadness, pain, and pity. Gina actuated her first assumptions of
support groups: I thought I would see a bunch of people feeling sorry for
themselves [pause] crying all the time. I thought what kind of people are out
there that have this problem. You just dont know.
After Gina and her husbands first encounter with a support group, they had
mixed emotions:
My first impression when I went was a little intense.
[Pause] I noticed that people came in and sat in their spots or
sat alone. I didnt really want to talk to anybody because I felt
strange that I was there. We grabbed our paperwork and sat
down. What I noticed was there were other people that seemed
to know each other, talking to each other, and telling their story
[of infertility]. I remember being a little envious that this

interaction was going on. I also remember personally feeling
uncomfortable. My impression was that all these people are
going through the same thing as I am. Theyre just going
through the same thing.
Some of the participants stated that they expected not to fit in with support
groups or they expected the members of support groups to be emotionally
distraught. Dee was one of these:
I had gone to a womens support group downtown and
left in tears I left so depressed. [Pause] People were ranting
and raving at one another and this one woman just shrieked
that she was in so much emotional pain. She was shrieking in
so much pain and there wasnt a whole lot of solution in that
room. I left in tears and never came back.
Like Dees first negative encounter of support groups, Karen, a long-time
volunteer, also commented that her first encounter of support was negative as
The truth is that my first contact with RESOLVE
wasnt satisfying at all! I called to obtain a recommendation
about which particular specialist I should see out of the many
REs (Reproductive Endocrinologists) in the area. The person
who answered the phone would only give me the names of two
clinics, chosen at random, since I wasnt a RESOLVE member.
She said I would have to join RESOLVE in order to get an
individualized referral. I got off the phone rather put off by
this interaction!
However Jenny, a continuing volunteer, described her first encounter with
support groups as coming home:

I saw a brochure for the RESOLVE symposium and I
thought we would check it out, and it was the greatest thing
that I ever did. It was wonderful being surrounded by others
going through the same thing. [Pause] I had felt so isolated
and alone. All our friends have kids. My family understood
my struggle but none of them had gone through something like
Later, Dee and Karen found a support group that provided the
connection they needed and the association that transitioned them both to
become volunteers. Dee found a couples group that offered hope and a
community for others facing similar challenges thus changing her impressions
of RESOLVE. She also created a support group for women in her area:
When I think of the couples group, I definitely think of joy
[pause] one time, we thought this going to be pity party but in fact
there was lots of laughter. It was like we were all on the same boat,
we all wanted to parents very badly.
Other participants, like Karen, became a board member of the national office
for RESOLVE and continues to remain involved with RESOLVES national
conferences and local functions.
Public Education and Awareness of Infertility
The participants explained that their past struggles with infertility
inspired them to volunteer and provide support for others. One support
mechanism the participants emphasized was public education and awareness.

To increase the importance of education and awareness, they suggested the
need to restructure RESOLVE to be an organization that invites public
A major factor that the participants contribute to their continued
commitment to RESOLVE is their singular belief that there needs to be more
public education about infertility. Infertility education includes the advocacy
for health insurance reform focusing on providing more coverage of
treatments, awareness of infertility treatment options, and dispelling infertility
Public Stigma versus Public Disclosure
The participants discussed that one barrier to increasing public
education and awareness is the stigma that is associated with infertility. In
past interview excerpts, the participants expressed feeling like failures,
depleted self-worth, and feeling isolated. The participants stated that being
unable to have a child, for them, was seen as a personal failure. They
illustrated that you are raised with the dream of getting married, setting up
housekeeping, and having a child. In addition, the participants offered that
infertility is hard to understand unless you personally go through it. Jenny

I think it is important to make it [infertility] a public
issue but, on the other hand, I think until you really go through
it; you kind of have the attitude that, oh, well, thats
something other people deal with, I wont have to deal with
that. I think it is important to get the word out there and, if it
makes a difference for one person, then I think it is worth it.
Donna adds:
Its really tough because you have to get the person
dealing with infertility to speak up but it hard because there is
such a stigma attach to it.
The stigma of infertility impacts womens entire lives because
infertility is so personal. Kelly expressed that awareness is important
offering that the stress of infertility affects all the parts of ones life:
You dont understand all the different ramifications and
how stressful it [infertility] is and how it impacts your life.
[Pause] It impacts your relationship with your husband [pause]
your relationship with your family [pause], your relationship
your friends, and your financial situation. I mean, infertility
can be financially devastating.
Both Donna and Kelly believe that infertility education is important even if it
only dispels infertility myths and focuses on the stress that infertility can
On the other hand, the participants believe that public education and
awareness also can disperse media sensationalism that distorts infertility

treatments and characterizes the treatments like IVF (InVitro Fertilization)
(see Definitions) as freakish or extreme. Donna explained that the problem
with the media is that they focus on outlandish stories of IVF patients who
give birth to seven children or more. She offered one solution:
We need to push so that the media will report real,
balanced stories and offer a backdrop that only certain
percentage of couples that use IVF procedures have
extraordinary results [pause] but finding that person is hard.
Karen agreed:
The media needs to present positive images of the
issues around infertility and adoption, instead of exploiting
negative stories. Infertility needs to be better understood, and I
want to do all I can to raise awareness and promote
Besides dispelling outlandish stories of infertility, education and
awareness are also needed to fight for better healthcare coverage for infertility
treatments and procedures. Donna expressed her anger on the failures of
insurance companies to offer coverage:
I guess I have real problem with the fact that insurance
companies will pay for Viagra and pay for abortions, elected
abortions, not medically necessary, but they wont pay for
someone who desperately wants a child. You know, its
[infertility] medical condition [pause], but they think IVF is
Karen offers that same concern of societys family values:

We as a society often proclaim that we are pro-family
or pro-child, but we sure dont treat infertility as if family
and children are our values. Its an injustice that needs to be
addressed. If we are pro-family then all insurers should cover
infertility treatments and employers and the tax system should
provide better benefits for adoption.
The participants are united in stating that accessibility to infertility
information like treatments and procedures would dismiss the myths of
infertility as experimental. Their hope is for RESOLVE to resemble
organizations like the Susan B. Komen Foundation, which created a positive
image for women who are fighting breast cancer. Gina, one of the
participants, advocated that Susan B. Komen Foundation is not only geared
toward people with cancer but their family, friends, and the general public.
She urged:
The interesting thing is that I think RESOLVE can
really go somewhere and do some things for non-infertility.
We havent stretched out beyond our core. [Pause] I mean that
our core focuses on people with infertility [pause], but why
arent we doing educational meetings on husband support,
grandparent support or friends support?
Connie shares this view:
I think other non-profit organizations naturally compare
themselves to the Susan B. Komen Foundation. I have gone to
a breast cancer run, and I had no one in my family who has
ever have breast cancer, but I went and I supported others.

Once I got there, I was really touched how many people it
[cancer] affects while infertility statistically affects 1 out of 5
and, its extremely fixable or curable.
The participants volunteer efforts are also driven by the need to
educate family and friends about infertility and the myths that surround
infertility. The participants suggest that if family and friends have a better
understanding of infertility, then they would become a better support system
for those struggling with this issue. Gina offered this example:
My bosses told me that they have a cousin who has
infertility and they feel strange going over to their cousins
home because they bring their kids, and they know their cousin
feels uncomfortable. [Pause] So, why arent we educating
those people [family]? Then those struggling with infertility
will have a better support system.
Donna concurred:
Not only the education of infertility patients but
educating the general public. [Pause] Because there are many
misconceptions about it [infertility] and we should try to
change some of those perceptions that people have.
The participants agreed that public education of infertility is a major
motivation to remain involved with RESOLVE. They are passionate about
creating awareness around policies such as insurance companies lack of
coverage for treatments as well as to dispel the myths of infertility treatments.

However, the participants underscore the fact that public awareness is a
difficult proposition because infertility carries a social stigma.
In the next section, the participants discussed how support groups and
public education are part of the process of becoming resolved. They provide
examples of becoming resolved through their life lessons, with examples of
support, supporting others, barriers to support, and finally accepting support.
The participants also offered their statements of dedication to RESOLVE,
highlighting their transition from victim to activist.
Becoming Resolved
Experiencing infertility has been compared to being on a journey. One
destination of this journey is referred to as becoming resolved. The
participants transitioned from their infertility diagnoses by expressing
disbelief, frustration, and sadness to slowly finding support, resources, and
personal social exchange as they move from being members of support groups
to becoming volunteers. Their experiences of infertility taught them
perseverance, and this attribute was described in their life lessons.
Life Lessons
The German philosopher, Friedrich Nietzsche (1899), once asserted, That
which does not kill us makes us stronger. The participants offered that as

painful as infertility was recounting the struggle of infertility instill valuable
life lessons. It is these life lessons that seem to initiate the process of
becoming resolved and are used an inspirational tool for support.
The participants expressed how their personal experiences of infertility
can provide encouragement as they passed their struggles and successes on to
Stories of Surrender, Patience, and Change
The participants accounts of the struggles of infertility noted that their
adversities made them stronger, more patient, and better parents. Dee
explained that I was given the strength to put one foot in front of the other.
She continued: I think the biggest thing I have learned was that I wasnt
alone and for me and my life it is always good to reach out for help and to also
extend my hand to the next person.
Kelly illustrates how infertility contributed to her life lesson:
I learned not to take things for granted, to be more
patient, which is the hardest thing for me because I am not a
patient person. I remember before my infertility diagnosis that
1 wanted things when I wanted them. [Pause] I always tended
to get the jobs that I wanted when I wanted, and I got married
when I wanted. I was pretty young, and I felt in control of
everything until infertility. I had to surrender to it [infertility].
I believe that infertility happens for a reason.

The participants stated that infertility caused them to revaluate how
they lived their lives. Dee offered that you can choose to be a victim or take
what life gives you and go with it. Jenny explained surrendering as letting
go, and everything doesnt have to be perfect.
She continued:
Lifes chores are endless [pause] [Jenny refers to lifes
chores as a box that] is never going to be empty, there is
always going to be something in there. It will be there
tomorrow so enjoy life while you can.
The participants cited their many years of struggling with infertility as
making them better parents when they finally achieved their fertility success.
Their struggle taught them patience, and they concluded that their longing to
have a baby made them more appreciative of their children. Kelly explained
that I just have to believe that Im better parent because of it [infertility]. In
addition, Dee expressed, I am extreme grateful for everyday, I could just cry
thinking about it [the birth of her child] I mean I chose not to be bitter.
The participants life lessons are mixed with life changes, acts of surrender,
and gaining perspective. When first experiencing infertility, Connie offered
that I lived in secrecy with it [infertility]. However, she continued that the

education she received from RESOLVE made it possible for her to view it
[infertility] differently. She continued:
I would say the single largest thing I learned from
infertility was how to weed out situations and people that didn't
add at least a little something positive to my life. Infertility put
my life in perspective in a way I never could have imagined. I
learned what was important and what was not. I learned about
myself and, amazingly, how strong I could be. I discovered
who my true friends are and who I can depend on for support.
I have also learned, even though it is still a struggle, how to ask
for and receive support. I know myself better than most people
my age because of the very bad experience that, in the end, will
leave me a better person. My life is richer and clearer because
what I have gone through. As I grow as a person in the future,
I will reflect on infertility as a touch point when experiencing
difficult times.
Supports groups became another forum to express new perspectives.
Jenny expressed that I know for me it has been more healing talking about it
[infertility]. The participants provide examples of the stories they shared, the
stories they listened to, and the powerful emotions they experienced while
attending support groups that illustrated another motivation to remain
dedicated to RESOLVE.
The Functions of Support Groups
Support groups offered more than emotional support while struggling
with infertility; the participants explained that support groups taught them

more about themselves. They learned to trust again, to rely on other people,
and became part of a community during and after infertility.
Support Groups Created Friendships and Commonalities
Dee, a participant, explained that I had to learn to trust certain people
and to trust myself and to trust the doctors. Thats another big lesson.
Connie added:
I became a little bit more open with people through
RESOLVE. [Pause] People who are going through it
[infertility] [Pause] I never attended support groups because I
didnt want to listen to everybody whine about their infertility,
[she laughs] which was not what happened at all. What I found
was that it [support groups] was a place to gain a lot of
information and get support. People do understand what you are
going through.
Other participants commented on how support groups provided a
communal environment, a place to share their stories of infertility and at the
same time to express joy, hope, and celebrate imminent successes. Dee
describes her experience:
RESOLVE groups helped. We found other people that
we could joke with about the magazines that our husbands have
to jack-off to [pornographic magazines are used to help male
spouses produce sperm samples]. You cant tell your other
friends [non-infertility] about this stuff; we are all in the same
Jenny included:

It was just wonderful meeting others and being able to
share your story and supporting each member going through
fertility cycles [pause] being there for the heartbreak and being
there to celebrate the successes. It was good for my healing, it
was really important to me.
Dee offered that it [her support group] was pretty wonderful, we had a lot of
laughter describing the room as having a lot of hope.
Other participants illustrated their support groups as being very
powerful, elaborating on their opportunity to associate with others struggling
with similar infertility issues. Gina hedged a little that she was not convinced
she needed to attend a support group in the beginning of her infertility
diagnosis but then she expressed: When I got to the real hard part [of
infertility], I had it [RESOLVE support groups], and I dont think I would
have been able to get through it [infertility] without the group.
Kelly offered that she needed her support group explaining that her group
provided essential information on proper medical protocol. She illustrated:
I dont know what I would have done without
RESOLVE. Theyre the one that gave me more information
then the doctors and theyre provided me with the questions to
ask the doctors. What I should ask, which helped me to move
forward to a new doctor. And, if I hadnt moved forward I
would have been stuck with this doctor and it [having a baby]
would have taken forever if it [having a baby] would have

happened at all. I might have never come to a place, mentally,
where I was able to become successful.
The support groups that the participants attended offered emotional
and informational support. But the support group provided another venue for
the participants; the groups supplied the motivations to remain dedicated to
RESOLVE. By attending group sessions and sharing their stories of
infertility, the participants took on the role of friend and support. They
created friendships and a community with the stories they shared.
Sharing Similar Infertility Experiences
Many friendships created through the participants infertility
experiences have evolved into lifelong relationships. Gina explained that it
is amazing the relationships that you build from this [infertility]. Dee offered
the illustration of infertile couples being on the same boat together or ship-
wrecked together. She explained that one couple she met through the
support groups and volunteering are her best friends.
Jenny explained that by becoming involved with RESOLVE, she was
able to build new relationships:
Building friendships with people I had something in
common with, there was this one gal that actually went through

the same infertility protocol at the same time, and her due date
was two days after mine.
These commonalities facilitated the participants to move forward in
their lives after their fertility successes by regaining a lost sense of social
capital. Dee expressed that there was a special kind of bond that was
developed by volunteering for RESOLVE. She commented, There was a lot
of phone calls back forth, plans for baby showers. These events that once
caused pain and stress in the participants lives began to take on new
meanings as they transitioned further into their fertility successes. The
perceived meaning of baby showers and holidays changed for the participants.
These familiar earmarks were now associated with joy and success instead of
pain and loss.
After struggling with infertility, the participants gained a new set of
friendships. Dee illustrated that we do Christmas cards and emails. Jenny
added, You develop a whole new set of friends. She continued that her
other set of friends who had not experienced infertility were unable to relate to
her experiences. Yet, Jennys new friendships share similar experiences of
infertility: she explained that Mia [her daughter] will have friends that have

gone through the same things [conceived by the same infertility procedures]
that she has.
The development of new friendships created a social capital that
changed the participants self-perceptions. These changes offered the
motivation to remain involved with RESOLVE. Along with creating new
friendships, the participants became volunteers and found it necessary to
develop a role of support uniquely their own.
Creating Unique Support Roles
Wuthnow (1991) wrote that we choose which care-giver role to play,
but we do not define it (p. 196). Perhaps for other volunteers, their roles are
set; however, the RESOLVE volunteers roles are more fluid. The
participants explained that supporting others that are careworn with infertility
is a fragile job urging that each support encounter is unique. Gina articulated
that telling her story of infertility can be helpful but also noted that I am also
a little worried because telling my story can be also painful for other people,
The participants actively define their role of support within
RESOLVE. Dee described her role:

I remember that I clearly stated [pause]. Look, I am
not a therapist but lets get together and talk and share ideas
[pause] and thats exactly how the group ran. We talked about
our experiences, shared information about doctors. We are not
really supposed to do that [share experiences about doctors]
according to RESOLVE [pause] but we did. We are human so
we did share experiences with different doctors and nurses.
Dee defined her supportive role as encompassing many avenues to provide
information for her support group even if her construction of support violated
organizational rules.
Another participant, Karen, explained that after her fertility success,
she resigned from her profession and was compelled to dedicate her time
completely to RESOLVE:
After my maternity leave with my second child [that was
conceived through IVF], I decided to resign from my profession
and devote myself to helping others with infertility. I thought an
important way to help would be to make RESOLVE a better,
stronger organization. I became active on the national board and
helped with the interests of infertility patients, and work on
fundraising events on both local and national levels.
Other participants see volunteering as translating into future vocations.
Jenny offered some future aspirations:
I would like to do something along the lines of
acupuncture focusing on the infertility perspective. It
[acupuncture] has done wonders for me, and I would like to
share that with others. I just want to help others that have gone
through what I have. Infertility was so isolating until I found

RESOLVE and found other people who were going through
similar things.
Ninas role of support: Pretty much what Ive learned is that I enjoy listening
to people, trying to help them figure out their problems and just being a
shoulder to cry on if they needed it.
The participants moved from support-group members to actively
giving back to others struggling with infertility. One motivation the
participants suggested for staying involved with RESOLVE is the chance to
provide the support that they themselves received as members. However, the
participants revealed that sometimes support was hard to find, especially from
family and friends who did not understand infertility. Also, they hedged that
sometimes support for them was hard to accept as well.
Barriers to Support
The participants expressed that no one understands infertility until
you go through it. According to the participants, family and friends, though
well-meaning, could not understand the emotional or physical impacts of
The Boundaries of Family and Friends
Gina illustrated her family support:

I would be having these emotional roller coasters, and I
would go to family my sister who would try to be
understanding but as time went on, I notice that they would
start to glaze over. They were trying to be supportive but they
had heard enough, and this is when I needed to go to a support
group. I needed to keep my co-workers and my friends as
friends and my family as family.
Jenny added that a couple of my family members were against my
treatment options so that was extremely hurtful. I just didnt talk to them
about what I was going through. Dee explained her experience with friends
who did not understand infertility:
I had some friends who just didnt get it, could not get
it. I had one friend, in particular, who is the quintessential earth
momma and could not understand what I was going through
with the [infertility] drugs, IVF, and the surgeries. She thought
it [infertility treatments] were crazy and tried to be supportive
but couldnt. All I heard was judgment in her voice [pause] I
stopped calling her [pause] that was painful. Another friend of
mine didnt understand the whole In Vitro thing [pause] her
comment was, what are you two doing?
Boundaries From Within
But not all the barriers to support were hinged on family and friends;
the participants explained that sometime the barriers to support came from

One participant, Connie, struggled with infertility for many years and
deep down she felt that family and friends did not understand her pain. She
explained that after feeling so bad like a failure for so long I think I cried my
whole [baby] shower. Connie could not accept the support that was actually
there all the time. Her self-perceptions affected her self-worth. Connie
offered, If I could have grasped it [the support] and how much people really
did care about it [her struggle with infertility] then I would have been so much
better. Connie suggested that her own outlook was so distorted that she
could not accept the support.
She described her baby shower:
They were so happy for me, and I feel like they went
above and beyond what they would do for somebody else.
Because they were so happy, they knew the struggle [Connie
starts to cry]. They knew how much I wanted it [a baby], and
how much it [wanting a baby] was part of me. They came [to
her baby shower] every single one of them came, and every
single one of them was happy for me.
This type of actualization was not uncommon for the participants;
however, some like Connie had struggled with infertility for so long that she
was unable to believe that support was possible until an event like her baby
shower. However, through an analysis of the participants interview excerpts,
it was clear that the experience with RESOLVE created the transformation

from the infertility patient to activist even in the smallest degree. This sense
of activism was evident in the participants statements of how RESOLVE,
support, and participation instilled empowerment and agency.
In the following section, the participants described a personal mission
statement and what RESOLVE means to them.
Participants Mission Statements
RESOLVES mission statement, in essence, is to provide education,
commerce, and support. The participants echo this mission statement by the
illustrations of their support groups, life lessons, and the relationships they
encountered with other volunteers, members, and with this researcher. The
participants dedication to RESOLVE even in the smallest capacity and their
desire to participate in this study corresponds with their continuing dedication
to RESOLVE and its mission statement.
The following are some of participants personal mission statements
and their reasons for continuing their dedication to RESOLVE.
Jenny assured:
You know RESOLVE and the support groups and being
involved in the RESOLVE support group was just so helpful to
me. I just want the chance to give back to others who have
gone through similar issues that I have gone through. Its just
important to me.

Donna offered:
I guess it is like my husband says, I just cant save
myself. [She laughs] I just feel strongly about the whole
topic. I want to give back because RESOLVE gave so much
support to me. I guess part of it I need to give something back
and the other part of it I just feel strongly that the public
doesnt know much about the issue. There are so many people
that are just unaware. I feel that RESOLVE is a really good
organization. 1 want to be part of that.
Karen continued, stating:
I remain committed to RESOLVE because this cause
matters to me. We as a society often proclaim that we are
pro-family or pro-child, but we sure dont treat infertility
as if family and children are our values. Its an injustice that
needs to be addressed. If we are pro-family, then all insurers
should cover infertility treatments and employers and the tax
system should provide better benefits for adoption. If we are
pro-family, then the media needs to present positive images of
issues around infertility and adoption, instead of exploiting
negative stories. In sum, infertility needs to be understood, and
I want to do all I can to raise awareness and promote
Callie explained:
Maybe we have this predestine plan and I had to
experience infertility so I would know how to help others. But,
I think of infertility more as, if I had to go through it
[infertility] then I needed to do something positive with my
experience. And because I experienced infertility then I should

help others. As personal coach, I believe people need to talk,
need to get out, to tell their story.
Connie seemed to sum up how infertility changed her life:
The main commonality is that people grieve very
similarly. The emotional aspect of infertility has a profound
effect on people, that when shared, allows people to not feel so
isolated and alone. When I volunteer, it gives a part of my
experience meaning. It means it happened for a reason. If what
happened in my life can help to ease the suffering of someone
who follows me in the process, then, I feel it is partly my
responsibility to help them. After all, there were people who
went before me that offered the same comfort for which I was
extremely grateful. I would, at this point in my life, say that I
would like to make helping people feel better during infertility
a part of my life always. It may not be the largest contribution
to the world, but having a family is at the core of who we are
and supporting others who can benefit from my experiences is
something I would like to continue to do because I truly care
about the people behind the experience and treatments.
The participants statements encapsulated that their involvement with
RESOLVE created empowerment and agency extending beyond RESOLVE,
support groups, and volunteering. On the other hand, their mission statements
can be interpreted as giving back the similar support that the participants,
themselves, had received and their actions are described as not just saving
themselves but being part of a greater good. The participants expressed that