//Jamaica Shirley and her husband Craig Christopherson holding a photo of the implanted fertilized embryo. Photo provided by the family.
Thirty years have passed since Dr. Seuss penned the ever-so-popular book Oh, The Places You’ll Go! The inspirational tale filled with rollicking rhymes and hard truths about life’s ups and downs has found its way into the hearts and homes of millions worldwide, especially during this turbulent year. With nearly a million copies sold in 2020, the book reminds us that journeys are often filled with “Bang-Ups, Hang-Ups, and The Waiting Place.”
Dr. Seuss warned of this “useless space,” The Waiting Place. And that’s where a lot of Americans find themselves as COVID-19 puts an uncomfortable interruption on life—waiting for the pandemic to end, waiting for a vaccine, waiting to return to school or work. So many feel stuck with no escape in sight.
Jamaica Shirley was given the bestseller following her high school graduation. Two decades later, the longtime nanny reaches for the book repeatedly as she spends her days caring for children. When she turns to the page where Dr. Seuss explains The Waiting Place, it gives her pause.
“We are waiting for something very specific to happen,” Shirley said. The 38-year-old has spent years waiting, not for the grass to grow or Friday night, as Dr. Seuss writes. She’s been waiting to become a mother.
“This is my third pregnancy. The other two did not work out,” Shirley said.
Shirley, wrought with heartache over miscarrying, underwent multiple tests, procedures and surgeries in order for her body to safely carry a pregnancy to term. Her journey ultimately led to Dr. Susan Trout and IVF—in vitro fertilization. It’s a treatment the fertility endocrinologist believed was Shirley’s final chance at a family. But then COVID-19 swept across the country, putting an indefinite hold on nonessential medical procedures. Suddenly, in every state except New York, where fertility treatments were deemed “essential services,” women and their families who hoped IVF and other treatments could lead to successful pregnancies had to delay their plans.
“We just had to wait. The world is going down the toilet, and I’m wondering when am I going to be able to go to the doctor again? Extremely frustrating and nerve-wracking,” Shirley said.
Some of Trout’s patients wanted to proceed despite the state’s emergency order to shut down on March 26.
“We had lots of tears and a few arguments about, you know, whether I was willing to break the law and help them. I just kept saying ‘my primary goal is to keep you safe and to do no harm,’ Trout said. “That’s my oath.”
Once Gov. Jared Polis lifted the statewide restrictions, Shirley and her husband Craig Christopherson returned to Dr. Trout to carry out the IVF cycle. She’s now experiencing a healthy pregnancy and is expected to give birth next year. When Trout’s office fully reopened, she noticed a lot of new patients.
“People have decided that COVID is here to stay for a while, and they’re not going to wait a year or two until COVID is gone to start trying to get pregnant,” Trout said.
For Shirley, her husband, and so many others who use fertility treatments, the chance at parenthood carries significant financial challenges. The cost of Shirley’s four intrauterine insemination treatments and fertility medications exceeded $15,000.
“But, we did not have to pay for the IVF cycle; it’s something our insurance company covered. I didn’t know about it until my doctor told me,” Shirley said.
Eight million babies have been born due to IVF since it was first made available more than 40 years ago. But it’s mostly seen as elective, making it an out-of-pocket expense for the majority of couples. According to Trout, one round of IVF in the Colorado area can cost between $15,000 and $35,000.
“I’ve had so many patients take out second mortgages on their house, running up credit card debt, pulling money out of their retirement funds to have a baby,” Trout said.
Today, 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy. According to the National Infertility Association, it’s as common as breast cancer and diabetes. In 2017, the American Medical Association declared infertility a disease with the intent to “promote insurance coverage and payment.” Three years since the designation, the majority of states still do not mandate insurance companies to cover infertility treatments.
Colorado lawmakers set out to change that by passing the Colorado Building Families Act in April, making the Centennial State the eighteenth state in the country with an infertility insurance law. Democratic Senate Majority Leader Steven Fenberg, a prime sponsor of the bill, believes it reverses a longtime injustice.
“This impacts an incredibly wide array of people—by making it so that insurance covers more of these services means more and more people are going to be able to start a family. Frankly, I consider that almost a basic human right,” Fenberg said.
Due to COVID-19 safety concerns, the bill was one of only a few to be considered during this legislative session. The senator was proud it got to the top of the list because of its far and wide impact on families. But it did not come without debate.
“We did see some opposition from fundamentalist religious groups—one was saying it was unnecessary because he felt if folks try for a little bit longer, they’ll eventually get pregnant, and then implying that if they don’t, it’s God’s will,” Fenberg said.
The senator believes the bill is not about religion, but a way to normalize and reduce the stigma surrounding infertility. With that said, the bill offers religious organizations an opportunity to deny coverage if fertility treatments are not in line with their beliefs and practices.
“This should be a basic healthcare coverage, and it’s not, and I wanted to do something to change that,” Fenberg said.
The law focuses on three main areas: Diagnosis and treatment for infertility, IVF including three oocyte retrievals with unlimited embryo transfers, and fertility preservation services for cancer patients. The coverage applies to health benefit plans issued or renewed in Colorado on or after January 1, 2022. In addition, the law does not apply to Medicaid holders or self-insured employers. Earlier this year, Polis said this will help families have children in the wake of COVID-19. He went on to say the law is important for the state’s future economic success.
“It’s a great thing, obviously, this is going to continue to be an issue for women going forward,” Shirley said.