Please enjoy today’s guest post from Alice D. Domar, Ph.D. She is the author of seven books, the most recent is Finding Calm for the Expectant Mom (Tarcher, August 2016). She is an associate professor of obstetrics, gynecology and reproductive biology, part-time, at Harvard Medical School, the director of integrative care at Boston IVF and the executive director of the Domar Centers for Mind/Body Health.
As a psychologist who specializes in reproductive medicine, most of the pregnant patients I counsel have conceived “with help”. Some of them got the happy news after a month or two of oral medication, but the vast majority went all the way, to in vitro fertilization. Which means they have endured months, or more likely years, of a roller coaster life- hopes rising with ovulation and nightmares confirmed two weeks later. They have felt isolated from their partner as well as from their fertile family and friends, their sex lives may be profoundly impacted, their career may have suffered because of frequent absences needed for treatment and an inability to travel for work because of it, their finances may take years to recover, and they may feel alienated from their childhood place of worship. All this suffering because of one carrot dangling in front of them- conceiving and carrying to term a healthy baby.
So as soon as one of my patients gets that positive pregnancy test, whoosh, all that pain and frustration and loneliness just vanishes, right? Wrong. This may happen for some women who conceive after infertility; they are able to close that door and hide the pain and they flourish and revel in their growing bump. But for many women who conceive after infertility, it is a far more complex process. They may feel guilty, sort of like survivors guilt. All those friendships built online and in the doctor’s waiting room and with the third cousin of your next door neighbor who brought you together because of your shared misery- they are all still infertile and you are not.
Pregnancy after infertility also may bring with it an overwhelming amount of anxiety, especially in women who have experienced a miscarriage in the past. Getting past “that point” can be excruciating. Even for women who have not had a loss, the anxiety can be profound, and it can take a woman by surprise. There is this assumption during infertility that the golden ticket is the positive pregnancy test. But once you get there, there is the second blood test, and then the crucial ultrasound to check for a fetal heartbeat, and then the first obstetrician appointment, and then the ultrasound scan to check for abnormalities and the blood test to check for genetic defects. Will it ever stop? Many pregnant post-infertile patients feel deprived of being able to enjoy their pregnancy. It doesn’t feel fair.
Finally, there is the issue of complaining. Pregnancy is hard. Your body is busy building a baby and it has no qualms about letting you know what a task this is. Nausea and vomiting, having to pee throughout the night, overwhelming fatigue during the day, leg cramps, heartburn, excess saliva, and insomnia throughout the pregnancy are all definitely complain-worthy issues. But my patients tell me that either they don’t feel comfortable complaining since after all they worked so incredibly hard to get pregnant. Or they do complain to their partner and their mother and their friends and co-workers. Who might not want to hear them. Because for the months or years before the pregnancy, they had to hear her complain about her infertility. So she is in a no-win situation. And why so many of my previously infertile patients come in weekly to see me! They have free reign to bitch and moan and simply feel awful. Because the pregnancy wasn’t the magical experience she had expected it to be. Which just doesn’t seem right.
The good news is that pregnancy is a temporary experience. And most women find that the second semester is far easier than the first. And time brings with it more ease about the pregnancy, more comfort in identifying oneself as a pregnant women, and the nightmare of infertility begins to fade. My observation is that previously infertile women make terrific moms. They delight in their children and take nothing for granted.
But what can you do in the meantime about the nausea, fatigue and anxiety? That is precisely why I wrote Finding Calm for the Expectant Mom. There are any ways to reduce the physical and psychological symptoms which are bothering you and the goal is not so much symptoms treatment but instead symptoms prevention. For nausea, make sure to not only identify the nausea triggers (fish, meat, perfume) to avoid but also the things which are actually appealing (lemony, minty, salty) and aim for those things. For fatigue, try to figure out what is interfering with your sleep. Once you have a handle on what is interrupting your sleep, aim for prevention. Decrease beverage consumption in the evenings, grab every pillow in the house to support your legs, back and belly, and learn some relaxation techniques to practice in the middle of the night when you are too anxious to fall back to sleep.