Let's Stop Being Awkward about Infertility and Miscarriage

Infertility Miscarriage | Agnes Wainman | London Psychological Services

Dear society,

We have some work to do. There are so many things we need to work on, but today I want to work on how we deal with infertility and pregnancy loss. 

Because for the most part, we suck.  We suck in how we treat ourselves and others when it comes to these really sucky, heart breaking, monumental situations.

When it comes to infertility and pregnancy loss, we become inept, socially awkward, hot messes. Or we just keep it all to ourselves, and shame and guilt ourselves for something that is completely out of our control. Or we just avoid the topic all together.

This needs to change.

So let’s start with the basics.

Infertility and Miscarriage is Common

For many women, infertility and pregnancy loss is a part of our reality. Statistics indicate that 1 in 6 couples experience difficulties conceiving and approximately 20% of pregnancies end in miscarriage. These are not infrequent events. Add in the additional traumas of later term pregnancy losses, terminating due to medical conditions and stillbirths, there are a lot of women who have had fertility related complications.

This is a lot of women.

You likely know a woman who has experienced a fertility related complication or you are a woman who has experienced one.

This is not some super rare, 1 in a bajillion chance, condition. This is happening to a lot of us.

Despite the regularity of these situations, we are super uncomfortable talking about them. We are super uncomfortable talking about them if they are happening to us and we are super uncomfortable talking to people who are going through them.

What gives?

It's Uncomfortable to Talk about Fertility

For many of us, fertility is considered a pretty private thing. I get that. You’re probably not going around announcing that you’ll be bedding your honey on Tuesday, because that’s when you’re ovulating. Good boundaries! I appreciate being spared the visual.

However, when our fertility journey hits a bump, a lot of that privacy feels stripped away.  All of a sudden we may find ourselves talking to a team of medical professionals about our sex life. People are checking out our uteruses, fallopian tubes, and all other previously private parts. A highly emotionally charged part of your life is being boiled down to scary statistics and complicated sounding medical terms.

We feel exposed and vulnerable.

It’s so hard. It’s even harder to talk about how exposed and vulnerable we feel, especially when we feel that we are totally alone in this (which as we clarified above, not accurate, since it’s happening to a lot of us.)

It’s also so hard to keep talking about it when we get less than ideal responses, like;

“Just relax, it will happen!”

“You can always try again.”

*crickets*

One of the hardest parts of going through my own fertility treatments was sitting in the waiting room with so many other women who were going through similar experiences. There was so much potential for support and empathy, yet we were all too busy trying not to make eye contact.

Maybe we need a better system in those waiting rooms; wear a green pin for “yes, please talk to me, I need to desperately!” and red for “not today, will just be staring at my shoes.” (side note: if you go with the staring at your shoes option, make sure to wear your most awesome amazing shoes. You gotta find joy where you can.)

If you are a woman currently in the midst of this fertility crap, please know that you’re not alone in this. You likely have some unrealistic expectations of yourself and how you “should” be coping. These experiences can trigger all sorts of responses and you need to allow yourself to feel them. You need to talk about your experience. Not sure who to talk to? You can definitely talk to me. Many women report feeling a bit better after just a few sessions (the first session will likely involve some, er, many tears and that’s okay. I’ve got tissues and I’m cool with crying).

If you know someone that is experiencing fertility complications and you don’t know what to say, that’s okay, you don’t have to have the perfect thing to say. Ask her how she is feeling. Give her space to talk about what she needs to talk about. Bring her ice cream. Don’t try to make it better (seriously, retire any well-meaning platitudes today!). Acknowledge what she is going through. Do not ignore or avoid the topic. I know you don’t want to upset her, but she’s already upset, and ignoring just makes it worse.

So society, can we pledge to do better? Can we pledge that we will stop being so weird and awkward. Can we just say “I’m sorry this is happening, it sucks.”

A Grief Like No Other: Surviving Pregnancy and Infant Loss

Grief Loss Miscarriage | Agnes Wainman | London Psychological Services

Your period is late.  You feel a little off, maybe a bit nauseous or you’re running to the bathroom all the time.  Something is up.  You go to the drugstore, pick up a pregnancy test and chug a litre of water.  You pee on the stick and then you wait.  Whether you were trying to get pregnant or this is a bit of a surprise, you feel an overwhelming wave of emotion that comes over you as the positive symbol appears on the test.  It’s official, you are pregnant.  If things go according to plan, in the next nine months (plus or minus a few weeks), there will be a new addition to your family.  You may start envisioning what your baby will look like.  You may start making plans around the due date.  You may buy a pregnancy book, or sign up for pregnancy update e-mails, or buy a cute onesie as a way of telling your partner.  The baby has already become a part of your life.

Unfortunately, for many women, things do not always go according to plan.

All too often, women will experience the horrifying knowledge that they are no longer pregnant and their baby is lost to them.  The pain of the loss is often compounded by the general silence around the experience of pregnancy and infant loss.  Society does not want to talk about it.  There is an unspoken code of silence that exists.   Women are left to suffer in silence, for fear of making others uncomfortable.  However, these losses are very real and deserve to be grieved.

If you were only a few weeks pregnant, you deserve to grieve.

If you had to make the devastating decision to terminate a pregnancy due to a medical condition, you deserve to grieve.

If you had a stillbirth and only held your infant for a few brief moments, you deserve to grieve.

If you have lost your baby, at any stage, in any manner, you deserve to grieve.

Grief can come in many forms.   You may want to wear a piece of jewelry that symbolizes your baby.  You may want to acknowledge your child’s birthday or the date of their loss each year.  You may need to spend some time away with your partner. There is no wrong or right way to grieve; you need to do what works for you.  The most important thing is to acknowledge how you are feelings; do not try to minimize, avoid or shame yourself out of your feelings.  Be prepared for the grief to come in waves.  It may be months or years since your loss, but the intensity of your grief may be triggered by an anniversary, a song, the cry of a new baby.  While the grief may become less intense, more tolerable, there may always be a sense of loss.

One of the most powerful healers can be talking about your loss.  Many women who have experienced a loss, such as miscarriage, find that talking will often open up a floodgate of women who have experienced something similar and are desperate to talk about it.  Considering that 1 in 4 pregnancies end in miscarriage there is a good chance that someone you know has had a loss.  Today, October 15 is Pregnancy and Infancy Loss Awareness Day.  Reach out.  Grieve your loss.  You are not alone in this.

The Emotional Roller Coaster of Infertility

Infertility | Agnes Wainman | London Psychological Services

May 24-31, 2014 is Canadian Infertility Awareness Week.  The goal of this week is to raise awareness and break the silence about infertility, treatment options and the impacts of infertility.  One of these impacts is the emotional experience that comes along with infertility, which can include both exhilarating highs and devastating lows.  Unlike an actual roller coaster though, this ride is not fun.

When we think about “normal” procreation, we think that it will go something like this:

Step 1. Decide to have a baby

Step 2. Have unprotected sex

Step 3. Get pregnant

Step 4.  Have a baby

Imagine our surprise, when it doesn't quite happen that way.  For years we have heard about the importance of birth control and preventing unwanted pregnancies.   We believe that getting pregnant is relatively easy.  How could our high school health teacher be so wrong?  Given that the chance of pregnancy in a “normal” couple in any given month is only about 20%, we clearly are slightly delusional about the level of control that we have in conception.  This is where the emotional roller coaster can begin.  We start realizing that we are *not* actually in control and that can be a very uncomfortable realization.

While many couples will naturally conceive in a few months, some of us aren't quite so lucky.  1 in 6 couples will experience infertility. Infertility is typically defined as the inability to conceive after 1 year of trying for women under the age of 35, or 6 months for those 35 years of age or older.  This means that many couples experiencing infertility may experience at least 6-12 months of this cycle:

Period starts – After the  disappointment of not achieving pregnancy (more on this later),    we start feeling hopeful, believing that this may be the month that pregnancy is achieved.  We may start planning our due date if this month is *the* month.  Things are feeling positive; the roller coaster is moving on up.

Waiting for ovulation – we begin tracking fertility signs, checking in with various fertility apps we have installed on our phone, use ovulation predictor kits.  We try to regain some sense of control over the situation.  The roller coaster is going straight ahead, but we know that there’s twists and turns ahead. Anticipation starts to build.

Ovulation – WE NEED TO HAVE SEX NOW!  As many couples struggling with infertility will tell you, nothing puts a damper on your sex life like having to schedule sex.  Relationship stress, particularly around sexual intimacy, can be deeply affected by the struggles of infertility.  Couples struggling with infertility will often report that the quality of their sexual relationship starts to deteriorate as sex has changed from something enjoyable to merely a means to an end.

The dreaded 2 week wait- this is where things get super fun.  Once ovulation has come and gone, we now wait to see if pregnancy has been achieved.  Every twinge, ache, pain and physical symptom is analyzed.  Emotionally this is where the rollercoaster starts twisting, turning, going upside down, sideways and backwards.  We feel hopeful, then despair, then back to hopeful.  It can be emotionally exhausting.

Period arrives – this is when the emotional roller coaster plummets.  All of that hopefulness has disappeared.  All that is left is the disappointment.  Another month has gone by, and no pregnancy.  We feel sad, angry, disappointed and then.....that little bit of hope starts to rear its head and we prepare for the ride again.

Going through this cycle repeatedly is emotionally exhausting.   As each cycle goes by, the disappointment may feel more intense while the hope starts to decrease.  If a couple decides to pursue fertility treatment, this emotional roller coaster is intensified.  Now you have to endure medical testing (which can feel embarrassing and invasive), figuring out medical terminology (I.U.I. vs I.V.F.), the additional stress of financial pressures (fertility treatments can be very expensive), talking to strangers about your sex life and potentially experiencing side effects of fertility medications.  The stakes get higher as each cycle passes.   Participating in treatments often includes regular bloodwork, ultrasounds, injections, uncomfortable procedures and all with no guarantee that it will work.  You have to attend multiple appointments, miss time from work, possibly travel far distances if there is no fertility clinic near your home.  The stress starts to compound.

The emotional roller coaster may start plummeting lower and lower.  You may start feeling anxious and depressed.  You may start isolating yourself from friends and families.  Well-meaning, but often poorly informed, advice (just go on vacation, have a few drinks and it will happen!) can feel terrible.  You start realizing just how out of control you truly are in this entire process.

How do you cope with these emotional highs and lows?  Social support has been found to be beneficial for couples experiencing infertility.  Having a family member or friend who will let you vent, cry and express your feelings can be helpful.  You may need to be explicit that you are not looking for advice or platitudes, you just need an ear.  Setting healthy boundaries for yourself may be helpful.  It's okay to miss the occasional baby shower if the emotional impact is too intense.  Allow yourself to feel your reactions; they are normal and understandable.  Working with a therapist may be helpful to help cope with these intense emotions.  Whatever you do, please do not ride this roller coaster alone.