In the six years since I started this site, I don’t think I’ve ever done a book review for a novel. I’ve been reluctant to read any books covering the topic of infertility because I feared they might trigger some deep-seated emotions and undo all the work I’ve done. I’ve been especially reluctant to read fiction as I’ve always been afraid of the inevitable happy ending.

But recently I’ve had several requests to review novels on the topic of infertility, so I decided it was time to take the plunge. I know many of you are avid readers, so I hope you’ll enjoy the upcoming reviews.

In her debut novel, The End of Miracles (She Writes Press, 2016), author Monica Starkman, M.D., delves into her extensive professional research to explore the emotional devastation of miscarriage and stillbirth.

After fruitless years battling infertility, Margo Kerber is devastated when her seemingly miraculous pregnancy ends in a late-term miscarriage. Convinced she is pregnant again, Margo finds temporary relief from her grief. But when her fantasy clashes with reality and Margo’s pregnancy is discovered to be false, she slips into a deep depression that clouds both her grasp of reality and her judgment. When she spots a briefly unattended infant, she is compelled to commit an unthinkable crime.

From the opening of the book, I felt as if I were in the hands of someone writing with authority about the psychological aspects of infertility and how numbing grief can be. I found myself recognizing many of the “crazy” thoughts I had on my own journey, which Starkman courageously commits to paper.

I asked Starkman about her work in psychology and about her decision to tell this story:

Life Without Baby:  What prompted you to write this book?

Monica Starkman: I had wanted to write a novel for a long time, in part to give something back to the world of literature as thanks for all the joy I’ve gained from reading. Nothing had piqued my interest enough to make the effort until I was asked to consult on and treat two women with false pregnancies. I realized that here was a topic: the strong desire and need to be pregnant, and the powerful repercussions of the frustration of that desire. That was intriguing and important enough for me to devote the time and determination that writing a novel required.

LWB: In your work as a psychiatrist, have you seen changes in the level of understanding about the emotional impact of infertility and unexpected childlessness?

MS: I can’t say that I have. I think that for even the woman/couple affected, the intensity of the emotions elicited by infertility and miscarriage still come as a complete surprise. And those not so affected are just beginning to realize this as well. For this reason, I recently wrote articles for MariaShriver.com and for PsychologyToday.com about miscarriage, false pregnancy, and infertility. I hope The End of Miracles will also bring such understanding to its readers.

LWB: In the book, Margo’s psychiatrist discusses the mind-body connection as regards to reproductive health. Could you talk a little more about this?

MS: Stress affects the brain, which can then affect the body by changing hormone levels and immune function, which can also impact reproductive function. However, for the survival of the species, Mother Nature protects reproduction as much as possible to withstand these effects.  The mind-body relationship is bidirectional: the body also affects the mind. And as those affected with infertility know all too well, its negative effects on mental well-being are quite powerful.

LWB: As a writer and psychiatrist, you’re involved with both the sharing and receiving of stories. Why do you feel it’s important for us to share our stories?

MS: Being able to express strong feelings, by talking or writing about them, does help process them, relieves some of the internal pressure, and helps to come to terms with and master those feelings. Sharing stories helps others better understand how those affected feel and encourages compassion. In return, social support from empathetic others is a very important contributing factor on the path to healing.

LWB: What else do you hope to achieve with The End of Miracles?

MS: I want to give readers an accurate insider’s portrayal of psychiatry and psychiatrists. I hope to promote the idea that people with severe psychiatric illnesses, such as serious depression, aren’t so very different from the rest of us, and that despite their unraveling, there can be a path for healing.

Monica Starkman, M.D., is associate professor of psychiatry emerita and scientific researcher at the University of Michigan Medical School’s Department of Psychiatry. As a recognized expert on the effects of stress hormones on mood and brain structure, Monica has been published by dozens of academic journals and several news outlets including The New Republic, Vogue and MariaShriver.com.