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

Disenfranchised Grief: A Q&A with Alex Zappala

The experience of grief transcends different types of losses. While we may all be familiar with its stages of grief, one element of grief that often goes unnoticed is called Disenfranchised Grief.

Recently, I had the opportunity to speak with Alex Zappala, a writer and therapist from the loss community called Grief Uncovered™, about how disenfranchised grief impacts those struggling with pregnancy loss and infertility.

To read more from our Q&A, please see below:

Can you explain the concept of disenfranchised grief, for those who are unfamiliar with it or who may have experienced it but never gave it a name?

Disenfranchised grief – a term first coined by Dr. Kenneth Doka – occurs when a person’s mourning process is not fully supported or recognized by their larger community or society and becomes devalued. 

Doka (2002) has identified five ways we may see disenfranchised grief:

1. The loss isn’t seen as worthy of grief (ex. non-death losses)

2. The relationship is stigmatized (ex. partner in an extramarital affair)

3. The mechanism of death is stigmatized (ex. suicide or overdose death, pregnancy loss, pregnancy termination for medical reasons or otherwise)

4. The person grieving is not recognized as a griever (ex. co-workers or ex-partners, parents whose children are no longer here)

5. The way someone is grieving is stigmatized. (ex. the absence of an outward grief response or extreme grief responses).

How have you seen disenfranchised grief show up in the lives of the women you work with?

Disenfranchised grief shows up in my community when women, men, and couples feel less entitled to honor their losses because of how it occurred or from a particular circumstance like pregnancy loss (miscarriage), pregnancy termination for a medical reason (TFMR), and infertility. 

  • While pregnancy loss (miscarriage) is often misunderstood, it is still the loss of a pregnancy and triggers feelings associated with grieving like anger, sadness, and loneliness.
  • Even though research tells us that early losses (at five and six weeks) has a profound effect on a person and register as a loss, some may feel less “entitled” to grieve because they never “knew their baby” or “could not have bonded so quickly.” For women and couples who have experienced losses, there appears to be an unspoken rule about an “entitlement” to grief that depends on how far along they were in their pregnancies.
  • Regardless, pregnancy loss at any stage is painful, and feelings of grief are normal. Minimizing the impact of the loss due to the length of pregnancy or the perceived ability to bond with one’s baby exacerbates the pain that already exists.  
  • Ending a pregnancy is a delicate topic in general. Because of this sensitivity, women and couples within the pregnancy loss community may experience disenfranchised grief when faced with ending a pregnancy for medical reasons. These reasons include a fetal diagnosis with chromosomal or genetic conditions that result in a poor prognosis or an incompatibility with life or a risk to the mother’s health. While the parents of these babies have made heartbreaking choices out of concern for the baby’s (or their) health, they may not feel open to discussing their losses, especially if they fear judgment from loved ones who have strong opinions about their medical decision.  
  • Struggling with infertility is akin to a perpetual grieving process. Constant grieving over the loss of achieving a family the way you imagined, exacerbated by the grief associated with failed fertility treatments month after month, takes its toll. 

What impact does it appear to have on these women, their grieving processes, and their lives as a whole?

The impact of disenfranchised grief on women is multi-layered. 

Women, men, and couples struggle with pregnancy/child loss/infertility experience grief for the reasons described above. They may also question themselves, their sense of womanhood as a result of these losses. Or, they may even mention feeling like their bodies are “broken” or “damaged” because they are unable to carry a child. 

With so much of the world oriented toward parenthood, redefining a sense of identity outside of grief as it relates to parenthood takes time, extreme care, and patience.

What sorts of recommendations for coping strategies do you tend to share with your clients when they are encountering this?

  1. Acknowledge your pain. It matters.
  2. Accept that grief can trigger many different and unexpected emotions. Also, accept that grief can be triggered by many different and unexpected emotions. Don’t judge what comes up.
  3. Understand that your grieving process will be unique to you. I always say, “Your grief, your process!”
  4. Seek help where you feel supported and valued.
  5. Support yourself emotionally by taking care of yourself physically by eating properly, getting enough sleep, and exercising.

What do you think is needed in order for us to de-stigmatize and validate pregnancy loss? Whether in the field or not, how can we all do our part?

One in four women experiences a pregnancy loss (miscarriage), and 1 in 8 couples struggle with fertility issues. 

Social media is a powerful medium that is being used to promote awareness of many important issues, of which disenfranchised grief is one. The more we discuss the not-so-obvious ways that grief shows up for people, the more we increase awareness and de-stigmatize loss and grief.

Alex Zappala is a Counseling Psychology EdM candidate and writer with a personal commitment to demystifying and normalizing grief. You can follow her on Instagram: @griefuncovered.

Our Q&A was originally published on April 26, 2020. You can find it here.

Related articles: Regrouping During Uncertain Times