Infertility Stress vs. Infertility Trauma

Navigating infertility is a stressful process. Initially, you may think that only your infertility will be impacted when diagnosed with infertility. However, you may quickly discover that other areas of your life are also affected, such as mental health, self-esteem, finances, relationships with others, and including your relationship with your partner.

Managing the emotional experience related to infertility is a complicated journey, one in which individuals endure profound anxiety, depression, grief, and loss. 

Research also shows that emotional stress related to infertility can increase the longer one experiences infertility. Prolonged stress can profoundly impact one’s emotional health to the point where your experience can be characterized as traumatic. 

However, while infertility is stressful, not all stress is traumatic. Understanding the difference between the two may be confusing at first. Still, it may help understand how infertility stress and infertility trauma are defined to understand the difference better.

What is Infertility Stress?

Infertility stress can be described as the psychological and stress associated with infertility.

Common signs of infertility stress are:

  • Irritability
  • Difficulty sleeping
  • Overeating/drinking too much
  • Feelings of sadness/anger/guilt/shame
  • Thinking about fertility-related issues constantly
  • Difficulty concentrating/spacing out
  • Decreased energy
  • Feeling distant from partner
  • Financial troubles

Infertility stress usually resolves on its own. However, it is typically helpful to seek support individually or as a couple for stress management techniques.

What is Infertility Trauma

Infertility trauma may be best defined as a type of trauma. 

Trauma can be described as a powerful event that you witness, learn of, or discover (Flemons, 2018). Witnessing and experiencing trauma can leave you feeling anxious, fearful, and in states of shock or distress that can affect someone mentally, physically, and emotionally.

Some infertility experiences are complicated and traumatic, exhibiting various emotional and physical responses.

Common emotional stressors are: 

  • Sadness
  • Depression
  • Anger
  • Fear
  • Denial
  • Shame

Common physical stressors are: 

  • Nausea
  • Dizziness
  • Disrupted sleep patterns
  • Changes in appetite
  • Startle response
  • Changes in breathing when triggered
  • Headaches
  • gastrointestinal issues
  • Avoidance of people and places that remind you of infertility

The experience of stress can shift into a traumatic experience over time. The circumstances surrounding the shift are personal to each individual/couple and therefore need to be considered when diagnosing.

Infertility trauma does not typically resolve on its own. Mental health interventions by a trained clinician are often needed to provide support to support each unique individual.

If You’re Experiencing Infertility Stress or Trauma

Know that self-care is a critical element of addressing infertility stress and trauma. Beyond the basic and ever-important staples of your self-care routine – such as eating properly, getting enough sleep, and exercising – you may find these suggestions helpful.

  • Set boundaries for yourself, which may include:
    • What information you consume online through Google or social media 
    • Who you talk about your fertility journey with and when
    • How much information you share
  • Notice your triggers, and be gentle with yourself as you find ways to address them
  • Do meditation/breathwork (helps soothe parasympathetic nervous system), which helps manage anxiety
  • Find a support group
  • Get professional help.

The emotional and physical symptoms of infertility stress may be similar to that of trauma; however, infertility stress and trauma are not the same. The similarities between the two may make it difficult to know when your experience of “stress” transitions into “trauma.” 

Infertility trauma symptoms encompass infertility stress symptoms and may be felt with greater intensity over a longer duration. Still, an accurate diagnosis can only be made after consulting with a trained mental health professional.

What to Look for in a Provider

  • Look for a trauma-informed practitioner who specializes in infertility or reproductive health. 
  • Is the therapist licensed? Each state has licensing requirements that each clinician needs to meet in order to demonstrate clinical competency.
  • Does your health insurance cover mental health services? If so, what is the cost for in-network or outwork providers? It may be helpful to verify coverage ahead of time.
  • Schedule a consultation and listen to how your practitioner would approach working with your symptoms. Pay attention to how you felt during the consultation. Were your questions answered? Were there any red flags?

In Conclusion

It’s easy to be consumed by the fertility journey, but try not to get lost in the struggle. You are more than your fertility journey. Give yourself and your body, more importantly, space and tools it needs to heal.

Reference

Flemons, Joanna. Infertility and PTSD: The Unchartered Storm. (Self-published, 2018).

Related Articles: Infertility Struggles and Pregnancy Loss, Infertility Stress is Racial Trauma

Infertility Trauma is Racial Trauma

The country is in chaos. People around the world are peacefully protesting the murder of George Floyd at the hands of the Minneapolis Police Department. But the protests represent so much more than a reaction to Mr. Floyd’s senseless murder. 

The world is expressing its rage and despair. We are crying out for accountability for the countless state-sanctioned killings of unarmed Black individuals. 

Many people recognize the racial inequalities that exist in the U.S. and around the world, while others still struggle to understand the meaning behind the protests. 

Living in Different Worlds

These protests represent the individual and collective racial trauma that’s been perpetuated over hundreds of years, as Kareem Abdul-Jabbar penned in a recent article in the Los Angeles Times. 

Navigating racism has been a large part of my experience. As a nine-year-old, I learned code-switching (the not-so-subtle art of changing your speaking style to adapt to different social environments) and other tactics Black Americans have learned to use when living in different worlds.

I write this article as a Black woman, a Black female therapist, and a Black female who is a member of the infertility and grief communities. Being part of these different communities has often left me feeling disjointed. 

I can speak about my experiences of racism with my black community, and I can talk about my pregnancy losses with my infertility community. But I struggle to find ways to marry the two worlds. 

Years ago, in a conversation I had with a friend who was also a professor of social justice issues, I shared how my experience of racism impacted my fertility. But without sound scientific evidence, the discussion ended there. 

I could never fully process this with the members of my infertility community. The overwhelming majority of professionals, therapists, and coaches couldn’t comprehend the depths of my racial experience, which created another barrier. 

The Intersection Where Infertility Trauma and Racial Trauma Meet

Being a part of the infertility community can bring about feelings of isolation in its own way, much like my experience within the racial community. However, I never fully conceptualized or owned the impact that racism and racial injustices have had on my reproductive health until recently.

I know the trauma of infertility. I’ve suffered four pregnancy losses, and I endured five mini-IVF rounds with only a chemical pregnancy to show for it. The hormones and repeated losses threw me into a world of grief and isolation. 

When I began seeing social media posts about infertility trauma without any reference to what’s happening within the Black community, I became even more triggered. 

Infertility and other fertility issues have long been considered something that only impacted white people. Stereotypes around Black female fertility portray us as hyperfertile, thus having no problem procreating. It’s one of the reasons that discussing fertility issues is so challenging within the Black community. Assuming the validity of these stereotypes delays many within our community from seeking help, while some choose not to access services at all.

If you’re working with people of color, particularly Black women and men, you need to understand the intersection between racial trauma and fertility trauma. 

Discussing issues of race is already a challenge. But discussing intersectionality is even harder. Understanding the connections between racial trauma and fertility trauma is essential to understanding this country’s history with slavery and discrimination.

Infertility and Racism: A Complicated History 

Born in 1813 in Lancaster County, South Carolina, Dr. James Marion Sims is considered a pioneer in women’s reproductive health, having developed tools and surgical techniques used today. He is regarded as the “father of modern gynecology.”

Dr. Sims was also a slaveholder, and he conducted research and experimental procedures on enslaved women – without anesthesia. Since they were viewed as property and devoid of human rights, these women could not give consent or take ownership of their bodies. His decision to operate on enslaved women was informed by his assumption that they did not feel pain. This concept still exists in the medical community, as confirmed in a 2016 study conducted at the University of Virginia

His work is part of a long history of medical apartheid, which includes the Tuskegee syphilis experiment and the stolen cells of Henrietta Lacks that have generated millions of dollars for the medical community without any compensation to her or her family.

Racism in the Research

In 2019, the American Society for Reproductive Medicine noted that racial disparities in fertility care continue to exist. Their findings are compelling and validating: 

“The success rate, measured as the ratio of live births per ART (Assisted Reproductive Technology) cycle, was lower for Black women, and the miscarriage rate was higher. Using statistical methods, the researchers found that race was an independent factor related to a live birth, even when controlling for age, BMI (Body Mass Index), previous pregnancy, and etiology of the infertility.” 

Subtleties around race and white privilege extend into how a diagnosis is made. The difference in the rates at which African-American women were misdiagnosed with pelvic inflammatory disease (PID) and sexually transmitted infections (instead of fibroids or endometriosis) underscores the assumption that reproductive health issues are related to sexual behavior instead of reproductive ones. 

Quinlan and Johnson (2017) suggested that gynecologists didn’t even believe that Black women could contract endometriosis, which had long been characterized as a “white woman’s disease” until 1960. But evidence suggests that African-American women can suffer from higher rates of endometriosis and fibroids. 

Biases Around Diagnosis and Treatment 

Biases within the medical community exist, and our experiences early on teach us, as people of color, to expect it. 

While in graduate school, I experienced persistent pelvic pain. During my exam, my gynecologist dismissed my concerns and diagnosed me with PID. After conducting research on my own and enduring several more months of pain, I went back to the doctor. Eventually, I received an ultrasound where two large fibroids (the sizes of a grapefruit and lemon) were found protruding from my uterus.

Years later, when I sought help for fertility issues with therapists and coaches, I hardly felt seen or validated in terms of my racial experience and its impact on my fertility. One practitioner even told me that “Africans are having babies later in life” as a misguided way to soothe my anxious spirit.

With the existence of mistrust for the medical community amongst the African American community around basic medical care, can you imagine what it’s like to try to access specialized treatment for infertility?

Representing the Black Experience

The lack of representation and understanding of racial experiences within the fertility world is another barrier to accessing care.

It’s easy for people to dismiss the argument of racism when racial issues have never negatively impacted them. When you’ve seen your story represented everywhere all your life, it can be hard to accept that a person of color experiences it through a different lens.

Being Black in the infertility world means not seeing your story represented in the very communities it’s designed to support.

It means not being guaranteed to see a doctor that looks like you and or who will approach your case with racial sensitivity. It’s one of the reasons my communities fight so hard for representation because it matters.

Racial trauma and infertility trauma are interconnected. But for Black women who experience both, the intersection is rarely discussed or even acknowledged in either community. 

For the Black people who face these challenges every day, what has been your experience with race and infertility? I’d love to hear your story. 

Use the hashtag #infertilitytraumaisracialtrauma and tag me so that we can begin representing our experience for the world to see. 

Resources to Learn More

I’ve compiled a list of resources to help you explore this topic even further: 

Also, the following are social justice activists can provide additional information and support along your journey: 

References:

American Society for Reproductive Medicine. (2019). Philadelphia, PA. Racial disparities in fertility care persist. https://www.asrm.org/news-and-publications/news-and-research/press-releases-and-bulletins/racial-disparities-in-fertility-care-persist/

Hoffman, K.M,  Trawalter, S., Axt, J.R., & Oliver, M.N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences Apr 2016, 113 (16) 4296-4301https://doi.org/10.1073/pnas.1516047113

Holland, B. (2018, Dec 4). The “Father of Modern Gynecology’ performed shocking experiments on slaves: He was a medical trailblazer but at what cost? https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves

Johnson, B. & Quinlan, M (2017, Nov 10). Race, racism, and infertility. Vital. https://the-vital.com/2017/11/10/racism-infertility/

#infertilitytraumaisracialtrauma #racialtrauma #infertilitytrauma #fertilitytrauma #infertility #blackinfertility #endometriosis #fibroids #PCOS #pregnancyloss #recurrentpregnancyloss #IVF #failedIVF #fertilitytreatments #endthedisparity #amplifymelanatedvoices #blackwomen #blackwomenmatter #blackwomeninmedicine #blackwomenhealing #blackdoctors #blackfemaletherapists #blacktherapist #ally #blackally #allyship #representationmatters

— Originally published on June 6, 2020 for Thrive Global

Related articles: Should You Try to Get Pregnant During a Pandemic?, Regrouping During Uncertain Times

How Do You Know When You Need a Fertility Coach

You’re resourceful. You’ve thoroughly researched your doctor. You’ve put together all the information about the fertility process you could possibly find. 

You might have friends or family members who’ve already gone through the process, so you have an idea of what to expect. 

But no matter how much we might think we know about fertility, being thrown into the seemingly endless cycle of appointments, tests, procedures, and potential disappointments can be jarring, even for the savviest of women.

Your medical doctor is responsible for overseeing your treatment process. But the intricacies it involves, along with all the dense medical terminology, can get lost in translation. 

Imagine how you felt after first hearing terms like AFC, FSH, AMH? 

A therapeutic or fertility coach can help you understand how these new medical issues can impact your fertility journey.

Going through the fertility process can be a traumatic experience. But you can work with a professional to mitigate its impact and start prioritizing your mental health. 

What Exactly Do Coaches Do? 

Therapeutic or fertility coaches guide you through the fertility process and help you identify a plan that works for you. A coach can be the “point person” who helps you manage everything outside of the time you spend with your doctor. 

Coaches are space holders and mentors. They help you stay on track while assessing your needs at every step of the way. Coaches help you manage your experience throughout the treatment process. 

Coaches can assess and help you navigate your struggles with helping you make lifestyle changes in your food and exercise. They can encourage you to use additional treatments such as acupuncture, massage, and chiropractic care while keeping your that your budget and spiritual needs in mind. 

A Therapeutic Coach or a Fertility Coach: Who Should You Work With? 

With so many coaches and mentors in the field, it can be hard to figure out who you need to work with. Here’s a breakdown of what you can expect from different coaches: 

Fertility Coach or Mentor

Most fertility coaches and mentors have gone through the process themselves, giving them first-hand experience with the fertility world. 

Having personal experience with fertility treatments can make a fertility coach a good option when you need a sounding board as you work through treatment-related issues that may come up for you. A fertility coach can offer support and guidance around your fertility journey.

Therapeutic Coach

Therapeutic Coaching is the intersection where therapy and fertility coaching meet. 

Most women going through the fertility process tend to focus on the here and now as they try to navigate the complexities of the fertility world. But this can keep them from addressing emotions that can come up when women struggle with fertility issues. 

A Therapeutic Coach can help you create a space where you can work through feelings and emotional difficulties with the guidance of a licensed psychotherapist. 

Therapeutic Coaches can also include anyone who’s been trained in specific research methods that address the emotional pitfalls of the fertility process. 

For many women, fertility issues can be experienced as traumatic events. Research shows that this can lead to challenges with anxiety and depression.

Having the support of a licensed clinician through Therapeutic Coaching can help you manage and overcome traumatic emotional triggers, such as hearing unexpected diagnoses and going to doctors’ appointments. Developing a plan for managing them is part of the foundation taking control of your long-term mental and emotional wellbeing. 

Other Coaching Resources for the Fertility Process

Other professionals you might see in your research include nutritionists, naturopaths, chiropractors, or functional medicine doctors. Each one can provide a unique perspective on how to care for yourself during fertility treatments.

Choosing the wrong coach can lead to frustration and an inability to address the root causes of whatever issues you’re trying to address. So it’s important to understand what your unique needs are so that you can choose the right professional to work with.

How Coaching Can Help You During the Fertility Process

Fertility research is still grossly underfunded. The data we do have continues to show that women who undergo mind/body programs can have higher chances of conceiving, fewer miscarriages, and better egg-retrieval rates (if they pursue IVF). 

Other benefits can include:

  • Having the personal space to manage your nutrition, lifestyle choices, and emotional wellbeing.
  • Getting help to create an action plan that matches your needs.
  • Having support and advocacy for your medical and emotional needs.
  • Saving money: Working with a coach or participating in a structured program can potentially increase pregnancy and IVF success rates. This can reduce the number of additional treatments you might need down the line. 

You may need more support around creating a healthy nutritional plan. Or you may be someone who needs more emotional support. In order to find a good fit, identify the areas where you need support and find a coach who has expertise in those areas.

Having someone on your treatment team who understands what you’re going through and has the practical solutions and strategies to help you along the way is invaluable.

Do Your Research

Most coaches offer a 15-minute consultation so you can learn how their services might address your needs without feeling obligated to sign up for coaching you don’t think is right for you. 

In the meantime, if you still don’t know where to start, my 6-Step Fertility Self-Care Plan provides information about managing the fertility process. You can also get more information about my Therapeutic Coaching services here.

There are plenty of resources for getting the help you need during the fertility process. But this can make it harder for you to figure out who you should work with. 

The more you know about what different coaches can provide, the sooner you can get started creating the self-care plan you need as you start this next chapter in your life.