Managing Mental Health Alongside Fertility

“Someone once said to me, ‘I’m worried about your fallopian tubes, you need to find yourself a husband,’” says Lucy. Nevermind that she’s a qualified professional and business founder, her womb was way more important—and she’s not alone. Society wants to hear stories of quick, easy conception. But fertility is a vastly complex subject that awakens a whole spectrum of emotions and impacts mental health too.

Around 12 percent of women aged 15 to 44 have difficulty getting or staying pregnant—and these stats only cover the US. So, while parenthood may be a major life event, the journey towards it can be life changing too. You’re negotiating the landscape of potential pregnancy loss, infertility and other complications. Add to that the fact that one third of infertility cases simply cannot be explained.

What’s more, only 30 percent of women get pregnant within their first month of trying. Still, if pregnancy doesn’t happen quickly for you, the social pressure to procreate can make those complications seem worse. Despite living in the twenty-first century, women are still fed the message that motherhood is what makes life meaningful. Hence the psychological challenges that infertility presents.

The effects on your mental health while struggling with fertility

A US study of 488 women revealed that those who struggled to conceive felt as anxious or depressed as those diagnosed with cancer or hypertension. Lucy (also known as Dr Buckley) has often witnessed this among her peers. She says, “I’ve seen many women try for a baby and worry when it doesn’t happen in the first month. This is why we need to normalize the fact that it can take much longer to get pregnant.”

“It doesn’t help that sex education tells us we can get pregnant straightaway—all we have to do is have unprotected sex.” If women therefore don’t become pregnant immediately, panic and anxiety can follow. If conception doesn’t happen after many months of trying, and they need to turn to fertility treatments, self-esteem and sense of identity can take a knock too.

This is no doubt exacerbated by cultural associations of womanhood and motherhood. One study in Sweden revealed that social pressure is a main causes of psychological stress linked to infertility. 

Overcoming identity crisis

Dr. Boston is transformative life coach and cognitive hypnotherapist. She works with women who struggle to get pregnant. “Even the women who didn’t think they wanted children are now faced with the possibility that the choice has been taken from them,” Boston explains. “They ask who am I if I can’t have children?”

“I help [my clients] reconnect with who they were before they started trying to get pregnant, and to rediscover their identity beyond motherhood. When you get too focused on having children, it’s possible to forget about all the other things life is offering you.” 

The prospect of infertility can indeed change the way a woman feels about all aspects of her life—from relationships to sense of purpose. “It inspires a primitive response, such as questioning your womanhood, and I encourage women to understand why the prospect of not getting pregnant is so painful for them.”

Navigating external pressure

Cultural, social or familial expectations don’t help. Jessica adds, “The pressure to have a baby can feel intense, especially if you’ve been raised to believe that your worth is dependent on your ability to reproduce. If you can’t, your currency goes down.”

Overcoming this kind of stigma is essential since glorifying children as the be-all and end-all for women is damaging to every woman’s mental health. It is ultimately her choice and each individual will choose differently. For some, having children may be their deepest desire, for others not so much. What’s important is remembering that life can still happen around and beyond pregnancy. You can identify something other than motherhood that gives you a sense of purpose or fulfillment.

But, not everyone sees it that way says Lucy, “Every time you talk to a friend or relative there’s some part of you waiting to be judged. To remove the social stigma—especially the stigma that’s associated with fertility treatments—we must first remove all judgement associated with struggling with infertility.”

The World Health Organization defines infertility as the inability to conceive after multiple attempts. However, a survey carried out by the Bertarelli Foundation Scientific Board revealed that only half of its participants understood this definition. Many actually believed infertility to be some kind of disease. This does little to support those trying to get pregnant, says Jessica. “Pursuing fertility treatments can inspire a sense of betrayal, as if your body has let you down.”

Talking about your experience 

The struggle to get pregnant can also become a grieving process as you deal with the loss of the child you’d imagined having by now. This doesn’t mean you’ve given up on getting pregnant—but you can give up on meeting external expectations. Acknowledging your grief can also help you process negative emotions that get in the way of your overall wellbeing. Studies have indeed shown that women who seek psychological support while they try to conceive can experience significantly higher pregnancy rates as a result.

“Know that it’s important to feel what you need to feel when going through this,” says Jessica. “You have to swim through the muddy waters knowing you will eventually come out the other side. Also know that grief is abstract and it’s personal. This whole pregnancy experience is personal, and everyone is solving their own individual fertility puzzle.”  

Lucy agrees, “Society doesn’t recognize the emotions attached to the fertility journey. Women are told to ‘relax and then it will happen’, which can be painful and offensive. Even if said with the best intentions. What you’re going through is both complex and personal.” Which is why therapy can prove essential.

“Often friends and family don’t know what to say. It would be wonderful if they simply offered understanding, and let you know they are there for you. But that doesn’t happen very often.” So, therapy has the potential to fill gaps in your support network. “It provides a safe space where you can talk about anything and everything, free from judgement.”

Visualizing your outcome to improve your mental health

Seeking therapy isn’t only about grieving the ‘ideal’ outcome you’d expected. It can provide an environment in which you visualize a new one too. “The picture you had in your mind didn’t manifest, which is the very definition of heartbreak,” explains Jessica. “Yet if you keep looking at it, you’ll keep hurting.” So imagine a better picture instead.

As scientific research continues to delve into the mind-body connection, unveiling more and more evidence that points to its importance, nurturing your own could be critical to your fertility.  “We feel the physicality of everything, from a knot in our stomach to a lump in our throat. Think about the way your body becomes aroused in response to your sexual desire. There’s no reason why this mind-body connection isn’t responding at all times to the words you’re telling yourself, so use them to your advantage.”

Perhaps the physical outcomes of your fertility journey may be (to a degree) beyond your control. But, the emotional and mental outcomes are well within your control. So, if every organ—from your womb to your ovaries—really is responding to every thought, what would you imagine to be true?

Joanne Schneider
Joanne Schneider
Co-founder and Head of Product Joanne is a product builder, storyteller, and data junkie on a mission to use data and user-centered design to improve clinician decision-making and patient experience. She runs tight meetings, conducts amateur research on gut bacteria, and her desk is lined with essential oils and tinctures. Ask her about which wellness fads are here to stay, or how we can speed up our understanding of the human body. She earned her stripes at Google, Bridgewater Associates, and Flatiron Health.