Find Out How To Cope With The Psychological Impact Of Infertility
“Couples assume they will get pregnant when they choose to bring a child into the world,” says Nancy Wright, marriage and family therapist for over 25 years who specializes in counseling women and couples with infertility. “They visualize life with their child – the first step, first day of school, getting married – and when a pregnancy doesn’t materialize, they experience grief, similar to the grief experienced when someone dies.”
Wright struggled with infertility for eight years, using her struggle as a means for research and a way to help other women and families going through the same grief. She has written articles in parenting magazines and even made an expert appearance on The Oprah Winfrey Show.
“Twenty five years ago, infertility was big in the news – it is still in the media now, especially with the increase in infertility and new treatments – but back then it started getting a lot of attention,” says Wright. “However, the information in the media -- as well as the doctors treating infertility -- ignored the emotional aspect and psychological burden that infertility creates. Because of this, my practice has focused on helping individuals and couples going through what I did.”
Five stages of grief
Couples go through a roller coaster of emotions, starting from when they elatedly decide to have a child to the see-saw of disappointment and hope they experience with negative pregnancy tests, ovulation kits, and medical procedures. “Infertility may not be something you can fix, it just is, and that is why it can be so much like a death and cause grief,” explains Wright.
Wright says it is common for individuals and couples to go through the stages of grief established by Dr Elisabeth Kubler-Ross, groundbreaking psychiatrist and author of On Death and Dying. People often get stuck in one of the first four stages and continue to experience painful emotions until they can move on to the stage of acceptance.
Stage 1: Denial
Wright says, “As a woman, you trust that you will get pregnant. When you don’t, you deny that anything is wrong or that it isn’t that painful.” You continue to keep trying to conceive. And even if you are at the point of trying different medically-based infertility treatments, you may still deny that there is a possibility you won’t get pregnant.
Stage 2: Anger
Anger is most common. You may be angry at yourself, angry at your partner, angry at God, angry at your doctor. “This anger creates havoc for couples. You may be furious with your doctor but choose to say nothing and then come home and take it out on your mate. You may also be angry because the infertility treatments are expensive, which adds a financial strain. Conflict between you and your partner can last a long time,” Wright explains.
Stage 3: Bargaining
As your anger subsides (though keep in mind you can experience anger throughout the process of grief), it is natural for you start to make promises to God. For example, “If I go to church every Sunday and not take my anger out on my husband, will you please let us conceive?” When you don’t get pregnant, you may continue to bargain or, more likely, you will fall into depression and sadness.
Stage 4: Depression
You may feel numb and hopeless, even though your anger and sadness are still very much a part of you. You may find it hard to socialize with others, particularly those who are pregnant or have kids, even if they are your family and friends. Your depression may subside as you process your feelings and start looking at your options or if you get pregnant, or it may hang on and require professional help. Consider seeing a mental health professional, particularly one specializing in women’s reproductive issues. Depression does not have to be part of your life.
Stage 5: Acceptance
This stage occurs when your anger, sadness and mourning have tapered off and you’ve accepted that you may not or will not get pregnant and can start looking at other options. This stage seems impossible when you are going through the painful throes of grief, but it is possible – and paramount to your health and happiness.
Another stage: Guilt
According to Wright, women experience an inordinate amount of guilt when they can’t conceive. “Women especially feel guilt if they’ve had abortions or miscarriages or if they decided when they were in their 20’s that college or their career was more important than having babies and, now in their 30’s, they can’t get pregnant.” However, Wright stresses, “Whether you get pregnant or not, you aren’t being punished for abortions or miscarriages. And if you took the career path when you were younger and are now 42 years old unable to get pregnant, there is a good chance you may have had the same difficulties at 22.”
Steps to deal with the psychological impact of infertility
1. Do not place blame. Regardless of the cause of the infertility, Wright empathetically suggests that you do not blame your partner or vice-versa. “More often than not, doctors can’t find the cause, which is even harder on couples because they don’t have something concrete. Placing blame on each other puts an undue amount of stress on the relationship and the damage of conflict lasts a long time.”
2. Talk about your feelings. You might be thinking every therapist says that, but they say it because it helps. It is important for you and your partner to be able to face and express your feelings, process the roller coaster of emotions you experience, and know that it is okay to be sad, angry and disappointed. Opening the lines of communication between you and your partner is essential in keeping your relationship strong and helping each other through the difficulties infertility can cause.
3. Find a good Ob/Gyn. Wright says, “Find a doctor you feel comfortable with and who will talk with you about what you are going through physically and emotionally in light of the infertility as well as the treatments.” Find a new doctor if you aren’t comfortable with the one you have now. “Women know their bodies better than anyone else, so if you feel like your doctor doesn’t understand you, look for a new one,” adds Wright.
4. Relax. Being stressed out won’t help your quest to get pregnant – it will put your body, mind and relationship under duress. “Don’t panic within the first six months of trying to conceive,” advises Wright. “If after six months you are still not pregnant, go through reproductive testing, but continue to work on reducing your stress.”
5. Take care of yourself. “There is a lot of pressure on individuals and couples to not see infertility as being painful. Even if others don’t, it is essential that you honor your boundaries. If you have friends with kids and it’s hurtful for you to be around them, you need to let your friends know that you are having a difficult time,” Wright recommends. Honor your feelings and don’t feel guilty for needing to nurture yourself.
6. Look to the future. While you are going through reproductive testing and infertility treatments, it is natural to put your life on hold. However, it is important to set a time line so you don’t miss out on living your life. Wright says, “You need to ask yourself how long before you start looking at different options. What are your goals – is it to have a family or is it to get pregnant (there is a difference)? If it is to have a family, set a date to start looking into alternatives, like adoption.
Wright didn’t let infertility stand in her way of having a family. She adopted a son, who is now 25 years old. She says, “Whether you go through infertility treatments and are successful in getting pregnant or, if you don’t and adopt, it’s a difficult emotional journey. But at the end of that journey, when you hold your child in your arms, it’s a done deal, you will have achieved your ultimate goal of having a family.”
Wright encourages you to visit her website TheWrightTherapy.com and to check out her newest book, Tapatoa, The Land of the Missing Sock, which teaches both children and adults about imagination, friendship, kindness and forgiveness.