Roni Akarah: Reflecting on my Fourteen-Year Fertility Journey

My first (anonymously) published essay was about my years-long fertility struggle. When I showed it to a friend, she said, “Don’t take this the wrong way Amy, it’s great, but I feel like it would be more powerful with a happy ending.” True, I thought, but that is beyond my control and its absence is precisely what drives me to write!

Six months ago, bechasdei Shamaym — four years after writing that piece and fourteen years after my wedding — I finally got my Happy Ending. As I finally got the baby I prayed for all these years, I thought it would be appropriate to share my neis.

So how does one sum up a fourteen-year journey of painful disappointments and cautious hope?

Hava Li Banim

I grew up in a vibrant American Modern Orthodox community and, together with many of my peers, attended a post-high school seminary program in Israel. I chose an off-the-beaten-track Israeli program where I befriended my future sister-in-law, who subsequently introduced me to my husband. Together, we became more frum and decided to marry when I was just nineteen and he was twenty. To my delight, the friend who introduced us married my husband’s brother one week before our wedding. Five months later, they shared good news while we were still waiting. By the time my nephew was born, I had been waiting about a year and found it hard to be around him. As dramatic as that sounds to me now, at the time I was frustrated and jealous. After a year and a half of marriage, I scheduled a doctor’s appointment.

I’ll spare the details of medications and monitoring, multiple IVF treatments, five operations, four hospitalizations and an early miscarriage. I won’t describe how I felt when I was notified that my third IVF had failed at the exact moment my husband — who was standing next to me — heard that my sister-in-law had just given birth to her fourth child, or when I was told that my long-awaited first pregnancy was not viable. I’ll also skip the insensitive and downright silly comments and advice offered by well-meaning people over the years.

On the spiritual front, we tried countless segulot, were blessed by many rabbanim, and visited kivrei tzadikim on three continents. Some things I struggled to connect to while others felt auspicious and meaningful. One hishtadlut that stands out is saying Tehillim HaChidah at the adjacent graves of the Chidah and Rav Mordechai Eliyahu on Har HaMenuchot in Yerushalayim. Suggested by Rebbetzin Eliyahu — whom I was privileged to meet, it took six hours (!) to complete but left me with the incredible feeling that no mountain was too high to climb in pursuit of the baby we so desired.

Yet while there were obviously tears, doubts and fears, this time was not all pain and suffering. Without the constraints of a growing family, my husband was able to immerse himself in Torah study and eventually received smichah from Israel’s Rabbanut HaRashit. I completed my degree and worked at a job I enjoyed, and since both sets of parents lived abroad, we had opportunities to travel. Thank G-d, our families — particularly my grandmother — stepped in to shoulder some of the bigger fertility expenses. As the years passed and we were referred to private doctors and fancy clinics which sometimes required that we sleep nearby, my husband and I joked that Hashem was spoiling us as the only hotels in the area were four- and five-stars!

With time, I also became more secure about our place in our families and beyond. Watching my sister-in-law have babies while I had none was difficult, but these babies grew into adorable children who adored me, and it was hard not to return their affection. Likewise, not being able to give our parents grandchildren made me sad but I realized that my husband and I gave them nachas though our other accomplishments. Finally, while I was initially sure that everyone saw us as nebachs, I slowly grew in my confidence that family and friends enjoyed spending time with us regardless of whether or not we had children, and that we could use the insight gained through our struggles to help others.

Betoch Ami Anochi Yoshevet

One of the toughest moments of this journey was in 2021, when I suffered a serious and excruciatingly painful complication after yet another failed IVF treatment.  This could have resulted in the loss of an organ, but thank G-d, I was rushed into surgery and it was saved. Still, I returned from the hospital feeling physically and emotionally broken. To make matters worse, the weeks leading up to this crisis had been spiritually uplifting in a way I had never managed before, and I felt I was making real progress towards my tikkun. I had sensed that my yeshuah was near but now felt utterly confused and rejected by Hashem. This event marked a turning point after which I increasingly sought fulfillment in other areas; my tefillot for children became less frequent and intense. I took a long break before returning to further treatment and when a routine medical test detected a steep decline in one of our fertility parameters a year later, it barely registered with me emotionally.

When people subsequently spoke to me about brachot and segulot, I felt like the Ishah HaShunamis who told Elisha HaNavi, “Al tashleh oti” — do not mislead me. Of course, I still wanted children, but I no longer had the emotional energy for hishtadluyot that might not lead anywhere. A conversation with our rav around this time further clarified things: I needed to take ownership of this journey and only invest in areas that would move me forward as an ovedet Hashem.

By then, I viewed my childlessness as an entry point into the Jewish People’s long and painful saga of Galut, and I tried to focus on what I could do to help. I changed jobs to work for a chessed organization, shared my story through an organization that supports Jewish women struggling with childlessness, and leaned into the perks of not having children — like more time, independence, and financial flexibility. I felt strong and connected to Hashem, and open to the future He envisioned for me.

When people subsequently spoke to me about brachot and segulot, I felt like the Ishah HaShunamis who told Elisha HaNavi, “Al tashleh oti“ — do not mislead me. Of course, I still wanted children, but I no longer had the emotional energy for hishtadluyot that might not lead anywhere. A conversation with our rav around this time further clarified things: I needed to take ownership of this journey and only invest in areas that would move me forward as an ovedet Hashem.

Zoy Habrachah

I was at work when I received notification that the results of my latest treatment were available online. As I robotically typed in my username and password, I tried to push away the thought that bothering to check was a waste of time. For the HCG hormone test, a result of twenty-five or above is positive while a result of one hundred or above is a strong indicator of a viable pregnancy. My personal information page finished loading and I was suddenly staring at the number three hundred twenty-seven!

Shocked as I was, I knew better than to get too excited — I still had two follow-up HCG tests and an ultrasound ahead of me before the pregnancy could be deemed viable, and even then, the risk of miscarriage loomed large. My newfound acceptance and serenity crumbled as I now wanted this pregnancy to succeed more than anything. For the first few months, I sobbed ahead of every ultrasound, terrified that there would no longer be a heartbeat. As time passed, more tests confirmed that my baby was healthy and growing, and I eventually felt her moving and kicking myself. I calmed down somewhat, but there was always a feeling of dread lurking in the background.

On Hoshana Rabbah — exactly seven years after our tefillah at Har HaMenuchot — we welcomed our daughter, Rivka Mazal Yehudit. When the surgeon asked if I wanted to see her before she was taken to be cleaned and checked, I squeezed my eyes shut in apprehension. When I opened them, I saw a beautiful little girl covered in white calmly staring at me.

The first three days after birth were a happy blur of feedings, visitors and learning to care for a newborn, but that Friday night, Rivka spit up through her nose and mouth simultaneously and stopped breathing. Terrified, I ran to a nurse, who raced Rivka to the nursery. Still recovering from surgery, I tried to run after them; I arrived as the staff was pushing a tube down a screaming Rivka’s throat to pump her stomach. I’m not one to show emotion in public but I fell apart and fled the nursery. My room was shared with an Arab woman hosting her entire extended family, so I locked myself in a bathroom and sobbed. I didn’t understand if Hashem had finally given me a baby only to take her away three days later?!

Baruch Hashem, Rivka was fine, but on Sunday it happened again. After running several tests, the doctors assured us she was healthy and that the problem would resolve on its own as she grew. I reluctantly took my baby home, but the problem only got worse — Rivka would choke on her spit up several times a day as we frantically turned her over, tapped her back, and davened that she start breathing again. After a week, we returned to the hospital. Rivka had a major choking episode in the emergency room and was finally admitted to the Pediatric ICU.

My husband and I were scared and in so much pain. Throughout our years of waiting for children and during my pregnancy, my husband had been an indefatigable source of optimism but on that dark night, I took up the reins. Standing in a deserted hospital corridor after Rivka was safely hooked up to various monitors, I tearfully insisted that her birth ahead of parshas Zot Habrachah was a sign that she was Hashem’s brachah to us and that she would be okay. He sent her to bring us joy and nachas, not to hurt us!

After a long and sleepless month during which we watched Rivka 24/7, we finally found a doctor who diagnosed her with severe reflux and prescribed a thicker formula that would hopefully stay in her stomach and not flow back up into her nose and throat. Thank G-d, it worked immediately and although we are still careful with feeding her and putting her to sleep propped up, we feel we can finally relax.

Al HaNissim

My first article was about the difficulty of celebrating Chanukah — holiday of miracles — for those who feel that their personal miracle continues to elude them. After davening for a miracle opposite the candles for so many years, this Chanukah I will be holding her in my arms. Rivka is the Happy Ending of my fourteen-year journey to motherhood and I am so grateful. But the difficulty we experienced during her first few weeks remind me that the story is not over. We are still in Galut and therefore life will never be without challenge. Yes, I have reached the top of this mountain, but I have more mountains to climb. We are sent to this world to grow, overcome and do our part to move the Jewish People forward towards the ultimate Miracle: Mashiach. My job now is to care for and enjoy Rivka, daven that she fulfills her potential, and learn to climb future mountains with acceptance and love.

This article was originally published in Binah magazine, and the original version was slightly modified.