Chrissy Metz on Telling 'Really Beautiful, Relatable Stories' of IVF and Miscarriage on This Is Us

The Pearson family drama on This Is Us steamrolled as the Big Three continued to deal with individual conflicts stemming from their upbringing and the grief of losing Jack.

Amid Kevin’s debut in the Ron Howard-directed World War II film and Randall taking charge of the renovations of late father William’s old building, Kate (Chrissy Metz) continues to try conceiving a baby with Toby through IVF. With hot flashes from hormones and daily injections, not to mention Toby experiencing antidepressant withdrawals, the couple has been dealing with a lot. And adding to that stress is the fact that Kate’s been keeping the treatment a secret from her mother Rebecca (Mandy Moore).

But it all came to blows when stepfather Miguel (Jon Huertas) discovered Kate’s IVF medications in their fridge, much to Rebecca’s surprise.

“Kate, have you guys really considered all of the risks? I know that the egg retrieval surgery is a dangerous procedure for someone your size, Kate,” Rebecca told her daughter, knowing full well that Kate has struggled with her weight since childhood, particularly since Jack’s death.

“Kate, I’m just saying why would you take that risk when there are so many other options out there. … I just think it’s irresponsible,” Rebecca later added as Kate retorted: “Because I want to. I want to look at his face and I want to see Toby and I want to see myself.” She even took a jab at brother Kevin (Justin Hartley), “I want to see Dad and I’m the only one in this family who will carry on a piece of Dad.”

In addition, the Pearson matriarch may not have been aware that Kate and Toby were previously warned by their doctor that the egg retrieval process would be too “invasive” despite Kate’s 40-lb. weight loss. “At your weight, the chances of a successful pregnancy is risky … egg retrieval is invasive at your BMI,” the doctor said, before agreeing to take Kate on as a client.

But in the end, Rebecca told her daughter that she never wants her to be in any kind of danger for fear of losing her after Jack’s tragic death. The mother-daughter pair seemingly resolves their fight with Rebecca even giving Kate her IVF shot.

The complexities of Kate’s character, specifically this season, have pushed Metz to act with even more authenticity and raw emotion.

“I’m so grateful that I get to be an instrument to tell these really beautiful relatable stories that we don’t talk about and women are even afraid to bring up,” Metz exclusively told PEOPLE about portraying Kate’s struggles with IVF and polycystic ovary syndrome (PCOS). “It’s exciting, that’s what art is supposed to do.”

Fans were devastated to learn about Kate’s miscarriage in season 2 and Metz revealed “there’s so much going on” with her character.

“It’s tricky because Kate doesn’t want to let anybody down and I think she’s felt all of her life she’s disappointed her family, her parents and, ultimately, herself. She doesn’t want to do that anymore,” she said. “But I think she’s also realizing: What is the impetus and the intention by having a baby? It’s not to fill a void, it’s not to cover up what’s really going on or to make things right or to have Jack live on. It’s multi-faceted. It’s complex.”

Metz added, “As a woman and a human being, you think, ‘I can’t even stay pregnant? I can’t carry a child? What can I do right?’ As a woman that’s what I’m supposed to do right? It’s not necessarily true,” she said. “Not everyone is meant to have a baby and I believe that the child chooses the parent. If it’s meant to be, it will be.”

As for what’s to come in season 3, Metz reminded fans and viewers “there are a lot of complex issues and emotions that she’s handling” and has yet to address. At the end of the episode, Kevin was the one who arguably made the most hurtful jab — without even realizing it — when he told Randall (Sterling K. Brown) about Kate’s “only one who can carry on a piece of Dad” remark.

“I want people to understand that she’s never really felt her feelings deeply and that a lot of them are just bubbling to the surface. As humans we don’t always know how to handle them or express them. Sometimes anger is really just sadness masked,” Metz said.

“She’s a newlywed and still in a lot of pain about her father’s death. There’s a lot that affects a newlywed relationship and how she’s really got to show up for Toby and herself. It’s not like, ‘Oh, I’m done! I’ve evolved to the highest level of enlightenment.’ No, every single thing is a lesson. Every single one of the family members is a teacher and the student,” she shared.

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