What is uniquely difficult about motherhood after infertility?
In the words of IVF and rainbow mama Calynn of @brynnnora, “mommin’ after infertility is hard.” The caption of her recent Instagram post begins, “After struggling through years of infertility, years of IVF treatments, miscarriages, and finally having my girls I struggled with complaining/venting about everyday mom stuff. After all I went through I never wanted anyone to see me unhappy…”
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Embedded with permission from Calynn
Calynn’s post hit home with a lot of mamas after infertility including myself. Some comments included,
“I don’t feel like I can complain because I went through so much to get here.”
“I am feeling all of this! I struggled getting pregnant too, along with a miscarriage, now I’m getting anxious about trying for #2.”
“It’s so nice to read this! I don’t feel so alone anymore! THANK YOU for voicing something that seems to remain silent in the post-infertility world.”
When a fellow mama after infertility and co-founder of the Motherhood After Infertility Facebook group shared this post on her personal Facebook feed, a kind friend seeking to understand asked, “I’m just curious so take no offense… but, why? What about it would make it significantly harder than any other first time mom?”
So what does make motherhood after infertility significantly harder?
1. Infertility survivor’s guilt
That increased awareness of how many women struggle with infertility (often silently) and are potentially triggered by your longed-for baby can feel very heavy. We feel like we can’t complain about the hard days because “this is what I wanted for so long,” so we end up struggling through our pregnancy and motherhood difficulties in silence and alone, trying to “enjoy every minute.” Humans were not designed to go through these major life stages alone!
This pressure does not come from the women still struggling through infertility but from our past selves. Our past selves who would give anything for chapped nipples, eye bags, and tiger stripes and who would roll their eyes at the first hint of a complaint about motherhood.
2. Regular mom guilt
All moms face some level of mom guilt, but that is certainly magnified for a mom who’s had difficulty becoming a mother in the first place. There is a pressure from society and family to, “Enjoy every minute. This is what you wanted.” We promise ourselves that if we ever have a baby, we will not complain once about anything to do with pregnancy or motherhood, and we work very hard to keep that promise. That leaves us going through the very real physical, hormonal, and mental challenges of pregnancy and motherhood alone, toughing it out and refusing to ask for help.
When asked what makes motherhood after infertility particularly challenging, one mother replied, “The guilt when I’m angry and want to run away but know the tears and heartache to get here.” Another replied, “The guilt of being a mother to the kids you already have and feeling guilty that you aren’t being present for them like you should while going through infertility.”
Balancing trying to conceive with trying to care for the children you already have at home is also emotionally taxing and can lead to more guilt.
3. Deciding if/when to try again
The decision of if or when to try again for another child tends to also come up more quickly than for moms who haven’t struggled to conceive, and the fear of going through infertility again WHILE raising children can be quite daunting.
For IVF moms with remaining embryos from previous cycles, there is a question of what to do with remaining embryos: transfer them, donate them to embryo adoption, or discard them, none of which are easy routes.
Some moms may eventually come to the conclusion to not try again at all. Things like miscarriage or financial burden may contribute to this decision. With this decision, a mother might grieve her ideal family size, the hopes of giving an only child a sibling, or her body’s ability to function properly.
One mom after infertility expresses, “Choosing to stop fertility with a tubal ligation was so hard. I struggled so long for kids and then what? I just take that away. I still struggle with the decision.”
After five miscarriages, my husband and I have personally considered permanent birth control in the form of a vasectomy after the birth of our third child. We knew we wanted more children but not more miscarriages. After years of fighting for my husband’s fertility, I couldn’t believe we were even considering taking that away at the age of 28.
4. Increased risk of postpartum mood disorders
Infertility increases the chances of moms dealing with PPD/PPA or even infertility-induced PTSD (yep, that’s a thing). The stress of infertility has been compared to that of cancer. It has been well documented that infertility causes stress.
But what about after the baby is born?
Some studies suggest that conception through ART may be associated with an increased risk of depression symptoms during pregnancy and the postpartum period.
One study in the Journal of Midwifery and Women’s Health says the risk of PPD (mild, moderate, and severe) may be closer to 25 percent in women who receive fertility treatments, compared to 13 percent in the general population.
“Some of these women spend their pregnancies thinking that every twinge they feel in their body is a miscarriage coming,” says [social worker and reproductive counselor] Roth Edney. For couples who have gone through reproductive losses, she says, “Every time they have an ultrasound, they’re waiting to find out their baby has died. By the time the baby is born, they’re still living with anxiety and waiting for the other shoe to drop when friends and family think they should be welcoming their baby.” Today’s Parent
On top of all that, many moms who struggle with infertility have also had miscarriages, which adds a whole new layer of grief, guilt, fear, and anxiety.
If you are or think you may be struggling with a perinatal mood disorder, check out Postpartum Support International. There are resources for moms AND dads like a provider directory, self-screenings, volunteer coordinators, resources for pregnancy or infant loss, and a text option.
5. Increased fear of SIDS
It’s been my observation that moms after infertility also tend to have an increased fear of SIDS after everything they went through to finally have a baby. It’s like finally having a baby is too good to be true, and they’re just waiting for something to come along and take that away. They’re so used to bad news regarding their fertility and pregnancies that they’re just waiting for yet another version of, “Sorry, not this time.”
The fear of losing your baby, having to start alllllll over, and maybe not even getting another baby after that is very real! (Not that one baby replaces another, but it’s just added pressure.)
6. Money troubles
Infertility treatments are rarely covered by insurance, so for women who pursue treatment to achieve pregnancy (or even for those who adopt or spend lots of money on supplements or natural remedies), there can be a financial burden on top of the typical financial strains of having a new baby. Other expenses may include embryo storage fees or counseling to work through the distress, trauma, and/or marital problems caused by infertility.
7. Marriage and relationship strains
Infertility also strains marriages and damages sex lives. Those issues may not be resolved by the time the baby is born, especially when a mom is pregnant/postpartum and hormonal! It can also strain relationships with friends and family who are not understanding or supportive through infertility or miscarriage, so a new mom may have less-than-typical help or emotional support because of damaged or lost relationships.
8. Returning to work (or not)
Then there is the decision for working mamas of whether or not to return to work after giving birth. This decision can be particularly anxiety-inducing for a new mom who finally has the baby she wanted for so long. Feelings of guilt, shame, or loss may accompany either decision. Mamas who have struggled with infertility have already sacrificed so much before ever becoming mothers, and the idea of leaving a job– particularly one we love– may feel like a particulary large sacrifice for a mama who has struggled with infertility.
In my case, I had for years envisioned my children introducing me to their classmates on Career Day as a Radiologic Technologist. Leaving my beloved career meant yet another shattered expectation of my motherhood experience.
Staying home may not be an option for every new mom. Maybe she has to continue working to pay off fertility treatment debt. Maybe her employer is a rare gem that offers insurance coverage for fertility treatments, and she wants to keep that insurance for TTC again in the future.
After a 4.5-month maternity leave with my firstborn, I never got that “I can’t wait to go back to work” feeling. The anxiousness of leaving my longed-for baby increased each day until, finally, we radically changed our lives to make a way for me to stay home. We sold our “forever home” and everything in it and moved across the country to an area of lower cost of living. Though I love being a stay-at-home mom now, it was a lot of sacrifice. Yet another shattered motherhood expectation. Would I have made that decision had I not experienced infertility? I don’t know.
9. Toxic load
For many moms after infertility, there is the pressure to do what we can to prevent our own children from going through infertility themselves because it SUCKS. Many women attempt to naturally boost fertility by eliminating harmful toxins called endocrine disruptors and/or by following special fertility diets. For me, I became super passionate about whole foods and breastfeeding. I also cloth diaper and meticulously read the labels of everything we bring into our home and bodies.
Some moms do these things anyway, but I think moms after infertility are especially prone to taking precautions like these in hopes of preventing our children from experiencing infertility like we did.
10. Delayed bonding with the baby throughout pregnancy or postpartum
This one is tough but so, so common. There are so many reasons a mother may have trouble bonding with her baby after infertility. After years of hearing bad news after bad news, finally seeing that positive pregnancy test feels unbelievable! We may deny or even forget we’re finally pregnant, or we may be just waiting for more bad news: either the pregnancy is nonviable, or it somehow didn’t exist in the first place. It was all a dream or someone switched up the lab results.
For mamas who have help from a gestational carrier, there is obviously an added physical barrier to bonding. For those who pursue the help of donor eggs, sperm, or embryos, there may be a fear of one or both partners not bonding with a nonbiological child as well as the sense of loss of genetics from one or both partners.
And for those of us who are pregnant after pregnancy or infant loss– especially when coupled with infertility– we are all too aware there is no “safe zone” in pregnancy and believe guarding our hearts by not bonding too closely may spare us the pain of losing another baby.
See also #4: Increased risk of postpartum mood disorders.
11. Challenged faith or worldview
We all enter adulthood and trying to conceive with a certain set of beliefs. Infertility is one of those trials that can really make you question or even those beliefs. This truth looks different for each woman.
For some, infertility may strengthen their faith. Others may have a serious crisis of faith or lose it altogether. Then there are those who have never thought anything about God until the despair of infertility brings questions about him, his goodness, and his purposes to the forefront of their minds.
“If God is good, why does he let bad things happen?” “Why me?” “Does God love me?” “Does he hear me?” “Has he forgotten me?” “Did I do something to deserve this?” These are a few of the many questions someone struggling through infertility might ask. They are hard questions, and sadly, some may not receive an answer they are able to comprehend or accept, causing all sorts of negative emotions such as anger, grief, confusion, resentment, and abandonment.
I personally experienced God pursuing me through my time with infertility and came out the on the other side as a believer when I wasn’t before. While I now have the joy and peace of my faith, my worldview is forever marred. I am now painfully aware of the hurts we all have as humans, even those which no one else sees. If I let myself go there, I become overwhelmed by the endless variety of needs of our world and the people within it.
Wedding photos make me sad for the happy newlyweds and all the trials they couldn’t possibly know they are undoubtedly about to endure. In my mind, every stranger lady with no visible tiny companions is battling, has battled, or is going to battle infertility, and I now know that even those accompanied by children are fighting their own unseen fights.
Infertility has shattered my blissful ignorance. It can be burdensome to realize the world isn’t quite as simple as we might have believed as children. Add motherhood to that, and it can all be quite nervewracking.
“In this world you will have trouble. But take heart! I have overcome the world” John 16:33b.
12. Body image issues
It is incredibly common within the infertility community for women to feel frustrated, disconnected, or even angry with their bodies. They may feel like their bodies are broken and may fear that their bodies will never work properly. Many feel like it’s somehow their fault they can’t conceive, especially if the couple receives a specific female factor infertility diagnosis. Betrayal is another common feeling a woman’s body might cause her while battling infertility.
It is not rare for the negative body image of those suffering through infertility to go as far as, “Why doesn’t my husband just leave me? I’m fat, ugly, and can’t give him a baby. He should be with someone else.” For those undergoing fertility treatment– from medicated cycles to IVF– all the hormones can change not only the way they look and feel physically but also their emotions and how they feel about their bodies.
These feelings don’t necessarily go away once pregnancy is achieved. Many pregnant women already feel negatively about their body changes: the stretch marks, the weight gain, the skin changes. These feelings can be exasperated for a woman who already had body image issues before even becoming pregnant.
Women who struggled to conceive may also continue to feel as if their bodies are broken as their pregnancies may need medical support ranging from low-dose aspirin or progesterone support to cervical cerclages or countless monitoring appointments. A woman pregnant after infertility may feel sad, frustrated, or bitter that she can’t enjoy pregnancy as a “normal” person whose only concern is remembering to take her prenatal every day.
Perinatal complications such as a shortened cervix, preterm labor or birth, placenta previa, congenital abnormalities with the baby, nonelective c-section, or difficulty breastfeeding after birth can all add to the feeling of being broken.
One mom shares, “I wasn’t able to breastfeed my IVF twins and I was DEVASTATED. Felt like my body let me down once again. It was a big contributor to my PPD.”
13. There are, of course, unique joys. But…
even then, it seems friends and family often don’t understand just HOW joyous you are to finally be experiencing these things with your own children, so their reactions can be underwhelming or discouraging. We go from being alone in our anguish to being alone in our overwhelming joy.
These are just a few of the factors that make motherhood after infertility particularly challenging. I’m currently pregnant with my 3rd living child after years of infertility and recurrent miscarriage, and I still struggle with several of these challenges and more. Infertility is just one of those things that changes you and always stays with you!
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