This was a hard post to write, and I walk a fine line of trying not to offend while needing perhaps to offend in order to make my point. Hopefully you will understand that my point is not to forgo what is already being done, but instead to add. To not be satisfied on this plateau, but to step up to the next one.

While at coffee this weekend with a group of highly intelligent, kick-ass women including the author, M, I brought up the topic she raised in a post called "On Awareness," relating the idea to Pregnancy and Infant Loss Remembrance Day which takes place each year on October 15th.

In 1988, Ronald Reagan declared October "Pregnancy and Infant Loss Awareness Month" and through the work of multiple individuals and organizations, October 15th has been set as a day of remembrance, with each person lighting a candle at 7 p.m. to burn for an hour, creating a wave of light that crosses the globe in memory of children who have died in utero or shortly after birth.

And I think the convergence of this day of remembrance occurring in this month of awareness has led to all sorts of problems. Namely, no one knows whether the day is there to raise awareness or if it is a community building event meant for group support, and while these two things are not mutually exclusive, without a concrete idea behind the act, I think those who have not made the day their own find themselves foundering a bit in the face of numerous posts that pop up in the blogosphere each October 15th.

I saw some gorgeous posts on the topic. The one that stands out in my mind was by Bagmomma, who points out the fact that "I've blogged on this day over the years, and each time I do... I feel emptiness reflecting back on such sorrow." Like others, I lit a candle as I do every year, and spoke to the twins about infertility and loss. It is simply part of our family, a ritual and knowledge as established as eating matzah on Pesach or putting your shoes away when you walk in the house.

In some of the posts, people referred to it as a remembrance day and in others, people referred to it as an awareness day. Again, it goes back to the fact that the meaning behind the day isn't exactly clear. Is it to let others know about our losses? To light the candle in secret? If we post about it on a blog, are we possibly educating another person? Or do we not want outsiders to read about it and ask about it?

Is it remembrance or awareness?

Which brings us to M's post about awareness. M, a cancer survivor and infertile woman, starts out her post with a valid question about breast cancer awareness month: "is there anyone out there un-aware of the dangers?" And she ends with a frank question: "where is the line between "awareness" and simply "being an asshole?" Because how we talk about infertility and pregnancy loss does matter.

You will need to click over to read M's article to understand her point about taking awareness in negative directions, but I wanted to examine an idea she broaches within her post. She links to an old Barbara Ehrenreich article (the author of Nickel and Dimed and more recently, Bright-Sided) called "Welcome to Cancerland" that dissects the help and harm provided by the breast cancer awareness movement.

M quotes one of Ehrenreich's most jarring statements which is that the pink ribbons, three-day walks and collective breast cancer awareness activities makes "it, perversely, as a positive and enviable experience."

I didn't take this statement to mean that breast cancer in and of itself is enviable, but that the support is enviable.

It is enviable when you consider how much the general public is in the dark when it comes to infertility and pregnancy loss. Wouldn't many more of us gladly and openly wear pomegranate strings if it would make other people approach discussions with empathy? If we could be open with employers about fertility treatments or adoption and be given time off to pursue them? If having the visual reminder worn on our wrist would help human resource teams choose insurance plans with infertility benefits or provide adoption benefits as a company? Wouldn't you wear a visual reminder about your disease openly and frankly in exchange for accurate language and ideas conveyed in New York Times articles?

(The best quote of the coffee date came from Two Hot Mamas when I mentioned that the average person can comprehend the term transfer because we're familiar with it via banking, whereas N quipped something along the lines of "you get breast implants and boom, boobies!" Because what does the general public know about the term implant beyond new breasts? They think just as people get new ta-tas once they slip in their implants, they get a baby once they throw back in that embryo with IVF. And it just doesn't work that way.)

Pink made it okay to talk about breast cancer. Which is a good thing. It removes isolation and promotes understanding. Hopefully, awareness makes people think before they say hurtful things, makes employers more flexible, family and friends more supportive. At least, that's what I hope because if that's not the case, then there isn't really a lot of point to awareness. Knowing the underlying causes to breast cancer and doing self-breast exams? I think the general public has that under their belts by now (and frankly, with too many people diagnosed yearly who are not engaging in high-risk behaviour and--beyond self-breast exams--tumours misdiagnosed by doctors, I don't know if that sort of awareness is the best place to devote time and energy anymore).

M and Ehrenreich point out an uncomfortable fact: when pink is slapped on everything in the name of cancer awareness, it smells a bit of businesses using a disease in order to gain brand loyalty (believe me, once I learned about Barilla's adoption benefits that not only provide financial coverage but also time off from work for family building, I have never bought another pasta. They grabbed my loyalty by having a company policy that speaks to what is important to me. And while there was nothing nefarious about this and only good, if Barilla started making a pomegranate pasta, promising to send part of the money to Resolve, well, it would make me feel a little bit yucky even though I like the idea of Resolve receiving the support). We feel good when we see that a make-up company has come out with a pink case. We pick the bag of pink M&Ms over the plain ones. We try to win a pink Dyson.

All of that feels a bit like awareness for awareness sake. Yes, money is usually given towards research and that is a good thing, but really, those companies could make the donation without involving us. In making things pink, they're including us in the awareness side of it and taking credit for their good work.

But really, what is the point of that awareness if it doesn't jog your memory about actual people in your life or your community? I mean, how many times have you seen a pink ribbon and thought of a useful call to action; as in, hey, right now, I could go bring dinner for my friend who has breast cancer? See, a small useful thing you could do tonight that would actively make a difference in another person's life. That pink ribbon should be a reminder--that very real people have this disease and could use your time and capable hands.

It's great to donate to large organizations that are helping fund cancer research, but what about reaching out to people in your community who are experiencing the disease? How many times have you reached out with help, sat down and lent a willing ear to hear a vent, run errands for them, asked how they are and wanted to hear the long answer, kept them company in chemotherapy? Giving money feels like we've done something. It makes us feel good, as if we're fighting back against an entity--breast cancer. But figuratively sticking our hands into the mess by getting involved, looking cancer right in the face in someone we love? That is hard. That is really really damn hard.

Perhaps it comes down to the fact that infertility advocates shouldn't repeat what breast cancer advocates have done in presenting the image of the shining, happy faces doing the Avon walk or the cuddly pink teddy bears. That we should eschew the cheering sisterhood for more of a tone of a friend sitting down next to you on the sofa, holding your hand and saying, "I have something really important I need to tell you."

That the image of women triumphantly crossing the finish line at the end of the Avon Walk for Breast Cancer doesn't convey what breast cancer is actually like--that the majority of the time isn't the glow of victory, but instead the cold fear of mortality. But would that grab the public's attention, make them want to become aware? We are all suckers for the happy ending. We like to see the sick character become well by the end of the film and if they die, we want redemption to come for those still living.

When I complain about the media coverage out there, I often ask why they don't do newspaper stories about the vast majority of us who experience infertility, go through a lot of shit, and build our family, without anything extraordinary happening? We devote pages and pages of newsprint to Nadya Suleman and the Savage's botched embryo transfer and Kate Gosselin's sextuplets. Where are the stories of the average family? The one who cried their way through treatments and exited out the other side with a singleton?

But when considering it through this lens, is that the awareness I really want put out there? The victory at the end of the finish line? Because that wasn't really my infertility experience. It was only a small part. I want people to understand why I came to work looking like I had spent hours the night before lying on my bathroom floor crying. Well, it was because I had spent hours the night before lying on my bathroom floor crying (or, more accurately, I usually curled up in the dry bathtub). I want people to know that I became depressed. That I couldn't escape it even for a few hours because cycles were happening in my body, that babies were everywhere outside my body. That infertility was humiliating and scary and painful and expensive and made me lose myself sometimes. And then there were the good sides too--the friendships and education and empowerment I felt the first time I gave myself an injection.

Awareness is not action. I can be aware that a car accident has just occurred without pulling over my own car to help the injured. Awareness is, for the most part, a very passive position of being educated with the focus being on the intake of ideas, not the output of action.

Therefore, I don't want Infertility Awareness. I want some Infertility Action. I want take-your-insensitive-coworker-to-the-clinic day. I want every American to receive the bills we received to build our family.

I don't want more people to experience infertility or loss because frankly, 7.3 million Americans is an impossibly large number. That's 1 in 8 people of child-bearing age. 12.5 % of the child-bearing age population. I don't want people to experience what I experienced.

I just want them to have the same empathy towards my disease as they bring to other diseases out there. If they value their family, I want them to emotionally support me as I work to build mine. And just as they don't pass judgment on one person's usage of chemotherapy over another person's usage of surgery to treat the same illness, I don't want judgment passed over my decision to use one treatment over another nor do I want the input of outsiders such as "why don't you just adopt" hurled my way. Because just as cancer treatment should be a decision made between a doctor and patient, infertility treatment should be a decision made between a doctor and patient and family building decisions should be made solely by the person or couple.

Unless, of course, we'd all love a little input from others as to how we should build our families?

I'm sure that next October 15th, I will light a candle again. It feels right to remember those who aren't here right now. But I also hope there will be a little more Infertility Action next October. Less looking inward with remembrance. Less passive knowledge with awareness. More kicking infertility's ass while bringing more empathy into this world with action.

The revolution may not be televised, but it hopefully will be blogged. Go out there and use your words for change.

Melissa is the author of the infertility and pregnancy loss blog, Stirrup Queens and Sperm Palace Jesters. She keeps a categorized blogroll of over 2000 infertility blogs and writes the daily Lost and Found and Connections Abound, a news source for the infertility blogosphere. Her infertility book, Navigating the Land of If, is currently on bookshelves (May, 2009).