Assume that you are a qualitative researcher who is interested in exploring and understanding infertile womens experiences and viewpoints with regard to their needs. Your job is to code the interview transcript and identify themes. As you go through this, remember that there is no right or wrong with qualitative data analysis. You bring with you your experience and your perspective and that has an impact on the themes you pull out. Moreover, it would be a more practical experience for you if you use peer-reviewed resources to guide your theme selection and provide support of your arguments. You might have many codes, and your job is to determine how they are related and ultimately how they can be collapsed into a few themes.

please answer the following questions: 1. Upload your fully coded Excel file. 2. What are patterns that you see?

Interviewer: My first question is just a really broad question that is...how did the experience of infertility affect you? Jane Doe: Say that again. Interviewer: How did the experience of infertility affect you? Jane Doe: So l'd say, in general, it was shocking. It's not something that you actually think that is going to happen. At times, it felt lonely because it wasn't something that other people were experiencing. There was a strong sense of loss in terms of biology being passed from yourself to a child. There wasn't really a lot of information out there about it. People were scared because there were a lot of unknowns and every situation is different, so when you were trying to find something specifically about your situation, you would find someone who maybe they had a piece of what you were going through but not everything that you were going through. Interviewer: Right. Jane Doe: So I had to compare like "Oh well, the doctor could this for me or this is what I did. In the beginning I was really vocal about it which I don't know if I should have been. I think for me that was the way we thought that did. So we thought a lot of unsolicited advice and so, once you start inviting people into that, you can't uninvite them. Interviewer: Right. Jane Doe: I found that I was angry a lot of times and I took it out on a lot of people. Looking back in high site, there a lot of I had no business attending, friends that I really did not treat well because I couldn't deal with it. My view at that time was, "Woe is me, look at what I'm going through, " and so, you know, "excuse me for snapping off on you, but I can't have a baby." Interviewer: Uh huh. Tell me a little bit about how you came to learn that you had been diagnosed with some fertility issues? Jane Doe; I decided in 2007 that I was going to stop taking birth control and that we were going to start trying. After having a lot of conversations with my doctor, we determined that my cycles were not normal and so we did the ultrasound and I learned about the fibroid's so one of the fibroids was remove the fibroid's and you'll be able to become pregnant and it was that simple. So, we scheduled that as a result of the surgery. For 6 months, and I was told after that you should be fine to go ahead and try. After trying for probably - at that point it had been about a year - I went back to the doctor and we started running a lot of tests. Interviewer: Okay. Jane Doe: At that point, one of the things that I learned was that because of the surgeries I had significant scar tissue and that the scar tissue connected my tubes to my uterus, and that one tube was knotted up so that was the start of it, but I'd say after that, there were a lot of extra things that I learned along the way. Interviewer: Uh huh. Jane Doe: Tell me how far do you want me to go? Interviewer: Why don't you talk about that because I'm also interested if you had to have any additional surgeries or if you have to take any medication or anything like that. Jane Doe: 1 then was referred to an infertility specialist. We discussed whether I would go back to in vitro or an IUI. I was told that the chances were a lot higher with IVF then because of my advanced age, that I might want to think about that. For me, I decided to go straight through that because, I'm like, "You know what, I'm really not wasting time on an IUI. So we started the process. Before they would do anything or be tested and things like that. So, John Doe then got tested and we find out that he has zero sperm count. At that point, we needed to be more detailed but they can't put him on medication for a year and he had different medication for his sperm count to come back. After the surgery, we were able to retrieve sperm from his testes and so at that point, we were able to start the IVF. With the IVF, what they don't tell you is that they don't really know a lot about stuff until they go in, and so after we started the IVF, one of the things that I was told was that I had low ovarian reserve. Also, I didn't ovulate. I was physically ovulating and so, each of the times that I did the IVF, it was really...you know, people were like "Oh, I got 16 eggs! I got 20 eggs!" And I was like I have 2 . And of those 2 they were really poor quality. Interviewer: Okay. What kind of bodily changes or states were you aware of during this time? Jane Doe: During that time [or during that time of the actual IVF? Interviewer: During the time of the IVF. I mean, from the point where you were diagnosed with fibroid's and then even having to go through taking...did you do like injectable's or did you just do like Clomid or something like that? Jane Doe: Oh, my God, I wish I did Clomid. I did 6 shots a day. Interviewer: Oh, wow! Jane Doe: I tell you, in terms of bodily changes... prior to starting any medication, I didn't have a lot of...these bodily changes had more to do with the surgery and not feeling like my...there was any muscle in my stomach and then I started to get back pain because of that or pain in my hips because I was so off center with my abdomen not having enough muscles to support my back. Interviewer: Uh huh. Jane Doe: Then there were the 6 months of the blood clot medicine where I had to watch what I was eating because if you had too much of something, the levels were totally out of whack and you bleed to death or if you didn't have enough or you couldn't clot and things like that, so those were the things that were more the result of the blood clots that really affected what I did, how I did it, if I mean, just simple things like, oh you can't have Chinese food because you can't have soy sauce. Interviewer: Uh huh. Jane Doe: Once the medications started, I'd say that some of the bodily changes were weight gain, soreness around the area, a whole lot of moodiness and crying, happy one minute and sad the next minute, sore boobs and a lot of pregnancy stuff which were really annoying. Interviewer: Uh huh. Jane Doe: So, you think, oh my God, it's working! Because I got sore boobs and I'm sleepy all the time so this has to mean something. Interviewer: And then to find out that it didn't mean anything, it was just the effects of the medication, yes. Jane Doe: I'd say, you know, the other thing about medication [inaudible] about this and that. After I finished my medication, I had treatment so we wasted the first IVF one where they retrieve the egg, they put you to sleep. Interviewer: Uh huh. Jane Doe: They put you to sleep. They had problems waking me up and my blood pressure skyrocketed, so they kept me a little bit longer for that. During one of the IVFs, after I stopped taking whatever the last medication was, I woke up the next day absolutely freezing so fast that I was shaking and I couldn't stop myself from shaking. Interviewer: Uh huh. Jane Doe: I have to think what happened in the third one. I can't remember what happened in the third one. Interviewer: Some of the other women I talked to just talked about how having those different experiences - they had similar experiences such as yours - for some of them, it impacted their sense of self and how they felt about themselves as a women. Did you feel like that had any impact on your self-image or how you viewed yourself as a woman, or your femaleness? Jane Doe: Definitely. I would say there are a lot of feelings around, what kind of woman does this make me because I'm unable to bear children. Then, as you see other people get pregnant very easily, there was a lot of anger around, you know, how is it that this person who is pregnant and is having kids, and I can't have kids. Interviewer: Uh huh. Jane Doe: I'd say there was a lot for me around other people being able to get pregnant and even other infertile women getting pregnant because I was like, what's so wrong with my body? Everybody else was even with a lot of the people that I referred to you, they have biological children. Interviewer: Uh huh. Jane Doe: So, they were able to become pregnant. A lot of them had miscarriages until they were able to birth the child, but they were able to birth the child, so for me the thing was, what is wrong with me that I can't? Interviewer: Uh huh. Jane Doe: I've never understood it. Interviewer: Exactly. Because of that, do you think that it made you close yourself off? Do you feel like you became a closed system where you felt like you couldn't communicate with people or you felt closed off from other people? Jane Doe: I did feel closed off from people. I remember one day my pastor pulling me into the office and telling me, "Jane Doe, you need to get out of the cave." I was like, "What are you talking about?" He was like, "It's like you're in a dungeon by yourself and you won't come out nor will you allow anybody in." The upside of that piece is that I say at that point, John Doe and I became extremely close because he was the only person that I could talk to about the specifics, then that was the place where I could become vulnerable. I remember at one point in 2008, I think it was 2008, me complaining about it at that point. Interviewer: Uh huh. Jane Doe: And this process really turned a lot of that around because that was the person, um, that was the person who was hearing the same things that I was hearing. That was the person who was as consumed with it as I was. Other people have other things going on in their lives, so this stuff doesn't stop or their world doesn't become unhappy just because your world is unhappy. Interviewer: Uh huh. Jane Doe: l'd say definitely there was a lot of feeling alone searching out a support group, trying to find somebody who was like me and that process changed each step of the way, because we did look into donor sperm, we looked into donor egg, etc. Interviewer: Right. Jane Doe: So that piece of it became even more lonely. I was able to find one support group and that was, so that process was hard too. There were people even in that group that became... it was like an infertility, low sperm, and donor egg group, all three combined. Then, everybody in that group became pregnant whether it was with their own or whether there were some donor pieces of them that was another piece of them that was like goodness gracious okay, what was wrong with us? Interviewer: Right. I think that's really powerful, what you said about the fact that it would be hard in our culture to seek out a donor egg or donor sperm because that's something that's frowned upon in the African American culture. Jane Doe: Yes. Interviewer: And that's something that many in our family or many in our culture...they would struggle to really understand and embrace that. Jane Doe: Right. The only time that I've seen it embraced, even acknowledged is with my cousin who volunteered her services. I feel so bad for her because I told her everything that I was going through with the support system and she started experiencing a lot of infertility herself which terrified her because she was like, "Oh, my goodness, now I'm going to go through exactly the same thing you're going through." But she was able to produce a whole lot of eggs and a lot of embryos and that was the one time where I had family like, "you know you could have my embryos that way, you can be pregnant if you want to, "but that was the only time l've ever even heard it talked about. Interviewer: Uh huh. Did you consider that when they suggested that? Jane Doe: Absolutely not. Interviewer: Uh huh. Jane Doe: I didn't. We had a church member become pregnant and she offered to let us adopt her baby via open adoption so we did a lot of counseling with our counselor from the adoption agency. We did a lot of talking about it. We did a lot of praying, we went and talked to our pastor. We just said, okay, whatever let's just sign the papers and then maybe we're meant to be, and if not, then it wasn't. What actually happened was we were invited through the entire birth process, pictures of ultrasound, spent like 24 hours a day for 3 days at the hospital, and on the third day, she took the baby home - this is someone that I know. We've been talking about, like, okay, now the baby is here and you are changing your mind. She decided to take the baby home and it wasn't as much as a surprise. I was not interested in parenting a child of anybody in that family that I had to have, you know these relationships where there is the holidays then, you know, you don't like the way I am parenting, that kind of stuff. Interviewer: Right. Right. That would create for a pretty uncomfortable situation. It's discord in the church family. Jane Doe: Right. Interviewer: How did you feel about infertility? What were your thoughts about infertility before learning that you had infertility? Jane Doe: Honestly, I don't know that I gave a whole lot of thought to it. Interviewer: Right. Jane Doe: My thought process was more like it doesn't happen to a lot of people, you know. I know a couple of people who have had some issues but because maybe something happened where they had to have a hysterectomy so, you knew at that point that you weren't going to have a child and that's how you found out that all of her children were born via IVF but it was so easy, she got pregnant every time. So I don't think that I even thought that it was something that where you can never have kids. I thought you know you go to the doctor and get the medicine and they're going to figure out how you can have a baby. Interviewer: Right. So now that you're on the other side of this, have your feelings about infertility changed at all. Do you look at it or see it differently? Jane Doe: There are times, you know, l'm going to say that before we adopted I would have people say, "infertility stays with you forever." I thought, "well, you want a baby now even if you adopted it, so I understand that it's something that happened but you are probably only going to feel like 10 percent of what you've known before. Now, I understand what they meant because I don't think, I think it's a lot more and I don't think people own up to how much and how much you are a part of that community and that you still have. For me, one of the things that because I had so many problems with the medication, I tried to tell myself, you know, maybe God didn't mean for you to birth a child because maybe he's trying to save your life. You can't have so many problems and every time, you know, these horrible reactions. Maybe God was just trying to say, "Look here, honey, your body can't do it, or I am not going to allow it" but even with that, it doesn't mean that there still are times where it stinks. A good example is you know, that kind of stuff. But, last week, I was at a swimming class with JUNIOR and I'm talking to these ladies. One of them says, "Oh, where did you give birth?" I was like, I can't get away from them! Interviewer: Yes. Jane Doe: You know, there's time where it doesn't come up or even in doctors' offices. I try to play a game with the nurses now because I've got to make fun of it, so if they always ask, like, "Oh, when was your last period? "How many kids do you have?" "One." "Okay, how many pregnancies have you had?" "Zero." This one lady had a 15 minutes argument with me because she thought she was educating me. "If you have one child, Mrs. Walker, then you have been pregnant once." I was like, "No. I have never been pregnant." She was, "okay, let's go back. You have one child, correct?" I was like, "Yes, I have one child." "Okay, that means that you've been pregnant at least once." I was like, "Why are you talking to me like I'm slow? You give a little bit more thought. I have a son whom I adopted, that's why I've never been pregnant." She was like, "Oh my God! I'm so sorry!" It's at every doctor's appointment. I go in to the regular doctor or l'm hearing patients say, "How many kids you have? How many pregnancies have you had?" Interviewer: Right. I hear that from a lot of the mothers. You never escape that. The ones who've adopted and weren't able to actually conceive, they talk about that. You never escape that. You're always being asked those questions and how a lot of the questions are comments coming out of the ignorance of others. Jane Doe: Right. Interviewer: And then not totally being emphatic or aware of processing the situation. Jane Doe: True. [inaudible] if you haven't been through it, you don't understand it. So there are some people who don't know, I don't know, I don't think that everybody is being malignant about it. Interviewer: Uh huh. In terms of holidays and things like Mother's Day, do they have a different significance for you now as opposed to before you got JUNIOR? Jane Doe: It's really hard for a couple of reasons. During the infertility process, everybody I know, you bank your holidays for when you're going to get pregnant or when your child is going to come. So, it would be like, oh God maybe l'm going to be pregnant for Valentine's Day, what a lovely gift that would be. Oh, it didn't work? Okay, oh my goodness, my Mother's Day present would be that I'm going to be pregnant [ and if this works, it means that by the Fourth of July, I'm going to have my baby celebration. Every holiday becomes the big significant one. Interviewer: Uh huh. Jane Doe: But now I say that it's definitely has changes some days where I don't have those thoughts. Interviewer: Okay. Do you feel differently now that you have JUNIOR? How has he changed or enhanced your life as a mother? Jane Doe: I definitely feel different. I'd say, he has just been a joy to watch. I think the other thing, because of all of the infertility, I was able to sit back a lot more with some moments and really appreciate and really mindful about how you need to sit back and enjoy this moment. Or you need to sit back and watch so that this is something that you can remember or recognize that each point along the way there's something new and accepting that, there are also times I must say that I question some things like, man, am I the biggest pushover because I couldn't get pregnant and so now, I'm allowing everything. Is it because of the infertility? Is it just because I'm a 40 -year-old mom? Sometimes it does make me question those things. Interviewer: Hmm. Some of the other mothers shared that too, that they sometimes question or wonder if they're overcompensating with their children because of all that they went through to be able to obtain a child. Jane Doe: Yes. Interviewer: Do you think that having JUNIOR has enhanced your relationships with your friends and family? Jane Doe: Hello? Interviewer: Hello? Jane Doe: What now? Can you repeat that? Interviewer: Do you think that having JUNIOR has enhanced your relationship with friends and family? Jane Doe: I would say yes, because I just think by virtue of him just being here has made me a more tolerable person so I think that comes with a lot of it. I think that there are things, just like with anything else, that once you have something in common with someone, that there's a different relationship. In terms of family, I'd say one of the things is that I probably spend more time with my family than I did before because of him and really wanting him to get to know them and so I probably once or twice a month will go to Georgia's house from Thursday to Sunday. I'm there the whole weekend, so that he'll have some time with everybody. Interviewer: Uh huh. Jane Doe: Whereas, I used to see my mom twice a year. I go down there and she comes here four times a year now and I probably go there one, two times a year. Interviewer: Okay. The other thing I wanted to ask you about is, just your involvement with the online support group. I think it's so unique how this group started out as a group for women who were planning their weddings, and then this subgroup developed of women who are sharing their struggles with fertility, and how you all came to bond and form this unique relationship with one another. Jane Doe: What's the question? Interviewer: I mean I was making a statement about the support group. It seems like having been involved in that support group, it was really beneficial. Jane Doe: It was. We laugh at it because we're thinking now nobody was thinking about infertility. Were you able to talk to Angela? Interviewer: Yes. Jane Doe: All of the girls from the group in the Chicago area decided to get together. We actually had gone one step further and said, "Hey, you know, since we're all in Chicago, you guys want to get together and have lunch?" So we had already started to have those interactions - that's how things started to come out. Interviewer: Uh huh. Jane Doe: Because people were talking about it in that arena, when something else happened to someone new, they would send you a private message, like "Hey Jane Doe," and that's what happened with Angie. She sent me a message that, "Hey, I know you went through this, and I know that you had gone through that. I have gone through such and such many IVFs, we're looking at each other now like what was your experience?" So it was definitely helpful and not something that we had even anticipated would happen. Interviewer: Right. I think that the majority of you all in this group were African American, but there were some non-African American people who were part of the little subgroup where you talked about your fertility issues. Is that correct? Jane Doe: Right. Interviewer: Just in terms of thinking about culture and ethnicity, do you think that culture or being African American, do you think that that played a part in how you experience infertility? How do you link those two together? Jane Doe: I'm not sure because I actually had thought about that a lot. I think that the one thing about this group and when I say group, I mean this group of persons who are ensured with the means to take care of a child with access to health care and regular primary care issues. I often wonder because of those experiences that there's a percentage of us in a group, a percentage of me that's really able to understand what somebody of another culture might be going through because I might have the same access to things that they have. Interviewer: Uh huh. Jane Doe: I think that in some other things in terms of what some of the differences are it's something that you don't talk about and it's something that we tell people, "Girl, just pray about it and it will happen," or "You're going to have another baby," or "you know what, if you're not pregnant by now, God didn't mean for you to be pregnant, so you need to just. hang that up and let it go, because l've got different work for you to do." I rarely heard anybody of a different race being told things like that. Interviewer: You know what? Gosh, that's so interesting that you say that, because you're right. You don't hear that. It's interesting that that's only indicative of our culture. I wonder if that just has to do with historically how we've always dealt with things. Jane Doe: That's true. Interviewer: That's a very good point. Actually, those were all of the questions that I had for you, unless there was anything additional that you wanted to add. Jane Doe: This went a lot better than I thought. It's so funny because I had been thinking like you need to plan what you want to do after this call because this call might trigger something and how exactly because I wasn't expecting it to bother me as much as it did so I was a little concerned about how I'm going to be after this and what kind of things am I going to do to take care of myself to make sure that I'm okay and that I'm not having all these re-occurring problems. So that peace feels really good. Interviewer: Okay. Good. I'm glad. Jane Doe: I mean, honestly I like talking about the infertility. I like talking about the adoption. I think there's more because that's something that people don't talk about. Because they don't talk about it, people who are going through it are always walking around talking about it. Because his experience is different, which therefore makes my experience different in how he grows up and how we raise him, you know we had open adoption. I see his birth mom all the time, and so, I can't just not talk about it because it's a piece of me and it's a piece of my life. Interviewer: Uh huh. Jane Doe: Yeah I am becoming a living champion. Interviewer: [Laughter] Jane Doe: I was just talking to somebody last night at church and her daughter, 9 years old, she doesn't know she's adopted. So she keeps calling to me about, I don't know if I can tell her, I need to tell her. Last night she said, "You know what, if she finds out [inaudible] who cares if she's mad at me by that point." I was like, "But it's not just about her anger. Think about what may be the result of that anger is. You don't care if she's mad at you." What if that anger results in action and those actions become promiscuity and drugs because I don't know how to deal with finding out now I have issues with identity and now I'm still wondering who am I really and where is my family so then where do I get this? Where do I get this personality trait? It's not just about oh, she's mad at me. Interviewer: Right. Jane Doe: It's a constant topic of conversation for me. I think a lot of this stems from because people will say, "How could you do this open adoption?" I was like, "I don't know my father." So that made it a little bit easier for me, because I was like, "l'd love to know something. So if I can get JUNIOR a piece of something, I'd love to give it to him." Interviewer: Exactly. Jane Doe: I think that's it, I don't want to talk your ear off. Interviewer: [Laughter]