One in eight couples experience infertility, making it more common than breast cancer and as common as type 2 diabetes. The waiting rooms of fertility clinics overflow with worried couples who hope that the scientific advances in assisted reproductive technologies will help their dream of becoming parents come true. What many women and men are willing to go through in order to have a child is a reminder of how powerful the desire to welcome your own baby into the world can be.
Infertility is an identity crisis
To struggle with infertility means to have your assumptive world turned upside down. Women will say, “I spent more than X number of years trying not to get pregnant, and now this?!” They ask, “Why me? What have I done wrong?” It is a hallmark of our individualistic culture to assume that when things go wrong, someone must be responsible, and since infertility can make both men and women feel that their own bodies have betrayed them, turning the blame inward can seem reasonable. After all, the largely unquestioned ideas you had about your life and its course — the future, relationships, routines, growing old — come to feel shaky and uncertain. Innocent fantasies are replaced by a trembling question: Will I get to be a parent? If the couple chooses to undergo treatment, they enter the unrelenting rollercoaster of hope, anxiety, fear, joy, and potential disappointment.
Infertility is an identity crisis. It is a (hopefully) temporary, but massive shakedown of all the stories you have told yourself about who you are and where you are going. Even when the couple goes on to experience a healthy pregnancy, the uncomplicated reproductive story with the plot of “we fell in love, had a baby and lived happily ever after” is forever changed. This is not bad or good, it just is. There is grief.
There also is the reality of tremendous human capacity for finding meaning and purpose in the midst of adversity. If there is one thing that witnessing fertility challenges endured by couples has taught me as a therapist specializing in women’s reproductive mental health, it is that people are incredibly resilient. In their struggle, women often discover the potential for growth and increased appreciation for aspects of life they took for granted before. Some report feeling closer to their partners as a result of the shared struggle. They become survivors. This being said, almost everyone I have ever worked with also expressed feeling very misunderstood, isolated and alone when facing infertility.
The silencing of infertility
There is an appalling lack of public discourse about infertility. Infertility is recognized as a medical condition and yet is shrouded in secrecy and stigma. As a culture, we publicly extol and celebrate female fertility while trying to relegate infertility to the medical office and the privacy of the home. This lack of public recognition of how prevalent infertility is precipitates shame and a sense of brokenness often reported by those confronting it. One of my psychotherapy clients found out during the 12-week ultrasound appointment that she was miscarrying. She had been struggling with infertility for some time now, and this was her third miscarriage. Upon receiving the devastating news, she was conflicted about whether she should try to make it to work that day. She ultimately decided against it, but the fact that she even considered it stemmed from feeling at a loss as to how she would explain to colleagues and employers why she was skipping work on the day an important meeting was to take place. Perhaps if reproductive challenges and grief were recognized as legitimate, common, and necessitating adequate support in the form of workplace policies and laws, adequate fertility treatment coverage, equal access to fertility care, she would not have to confront the added pain of such a dilemma.
Validation as the means of accessing resilience in the struggle with infertility
In the words of Sylvia Plath, “It’s so much safer not to feel, not to let the world touch me.” Yet avoidance of feelings is associated with poorer mental health. When it comes to infertility, if you feel that your experience is not understood or accepted, you are almost forced into the avoidance. You power through. Maybe you even judge yourself for being “weak” and for struggling with the powerful feelings of sadness, grief, and anxiety that keep showing up. Who wants to be touched by a cold, uncaring, or judgmental world? In order to not retreat from the world when an individual confronts infertility, that world needs to make it feel safe to stay connected and be vulnerable. Having a community that validates your experience, that sees what you are going through and does not offer platitudes or meet the pain with awkward silence, is what is needed. You might continue to have days when you do not want to talk about infertility, but knowing that you can, and that you will be understood, heard, and supported when you do, is a powerful feeling. It certainly is one of the reasons why people decide to see a therapist during this time.
We all need to do more to support women and men who are experiencing infertility challenges. We need to start undoing the cultural silencing, the lack of supportive laws and policies, the barriers to access. We can begin by recognizing that the current status quo is not okay, confronting shame with validation and acceptance, empowering women and men to seek support, and being an attuned giver of support ourselves.