Limits around Trying to Conceive

How do you know when you are ready to stop trying?

The decision to stop fertility treatments and live childfree involves much self-reflection. Some things to consider:

  • Emotional, physical, and financial limits of fertility treatment.
  • Cost to the relationship with yourself and your partner.
  • Readiness to stop keeping life on hold.
  • Finding meaning in the experience of all of that you’ve gone through with pregnancy losses and fertility treatment.
  • How to cultivate letting go of the idealized family and refocus on being a family of two.
  • Existential concerns on finding purpose and connection and an openness to living life on a different path.
  • Finding new ways of looking at personal meaning around femininity and what it means to be a woman.
  • Recreating relationships – finding a new way to fit in with family and friends.
  • Acceptance of the decision and integrating it into a new identity.

All of this self-inquiry essentially encompasses grief work. There is much grief work to do. As you can imagine, the decision to stop trying is subjective - every woman or couple has to decide when they've had enough and reached their limits around trying to build a family. Through infertility research, we know that over time, the pain of infertility lessens but it doesn't completely go away. It is in integrating infertility into your identity, while no longer letting it completely take over, that the healing begins.

Lonesome Motherhood

How do you find your mom tribe?

The loneliness of parenting an infant takes many new moms by surprise. You may wonder where you fit in now - your main group of friends may have older children, or be childless. It can be hard to connect and feel you are contributing socially with these friends  – you may worry you don’t have much to say since you don’t do much on maternity leave outside of caretaking an infant. There will be days when you don’t talk to any adults all day. This is where many women really feel like they lost their previous identity – the isolation and reduction in social interaction can really impact mood.

Parenting a newborn can feel isolating. As soon as your partner leaves for work, you’re looking at a full day with a blank slate with a baby. Then comes the complex anxiety feelings around staying in or attempting to go out. The challenges of getting out of the house with a baby plus all the baby gear seem insurmountable, so of course, staying home seems most appealing.

It’s essential that new moms find the strength within oneself to do the opposite action and find some source of connection. Joining mommy and me or breastfeeding support groups can help reduce isolation. It’s ok to be late to these meetings. It’s ok to be a mess. It’s ok to cry there. It’s also ok if you don’t particularly like or connect with any of the moms; the social exposure for you and your baby is key. Some moms find wonderful support online through mothers’ groups and parenthood apps. This is a great way to feel understood by others, ask questions, and, most of all, laugh from reading and posting funny things about a mother’s day that others totally get.

Choose whatever path feels right to help you connect to others going through motherhood at your child’s stage. It can be so rewarding. I still remember the anxiety I felt going to the first mommy and me group. I teared up, and almost went home. Then I looked at my baby and thought, we got this. Some of those women still support me today, two years into motherhood. Find your tribe.  

Here are a couple of related articles:

The Loneliness of Motherhood

The Facebook Moms

Coming into Motherhood after Infertility

How to let go of one's infertility identity? 

Many women report not knowing how to accept a pregnancy, or to transition from years of living in the uncertainty of infertility and longing for a child, to becoming a mom. During pregnancy, there are often two paths:  feeling ambivalent or detached from the pregnancy, or feeling overwhelmed by anxiety of something going wrong.

Post-birth, many women are thrilled to become a mom, but complex feelings may arise. How wonderful to finally be part of the motherhood club, yet familiarity with the previous infertility identity and associated thoughts, feelings and behaviors makes it difficult to leave that way of being behind. Some experience loss of support from moving onto a different path from friends whom they bonded with during infertility treatment. Others may have a difficult postpartum experience, which can heighten feelings of guilt and maternal ambivalence.

It can be challenging when partners and family quickly accept this identity change, and forget about the complex emotions of the previous fertility journey. Yet, for someone who has gone through this journey, infertility may always be a part of them. It’s hard let go of something painful that has defined you for so long. Thoughts of the long TTC journey may resurface during the first few years of parenting. That's part of the healing. It is only with time that you can integrate the previous parts of your identity into new ways of being, and become more confident in the new mother role. 

Resolve has some great resources to help with this transition.

Later Motherhood

A recent CDC study reports that the 2016 birth rate for women ages 40–44 was 11.4 births per 1,000 women, the highest rate in more than four decades. Since 2007, the birth rate has risen 19% for women in their early 40s and 11% for women in their late 30s. For women 41+, attempts at utilizing assisted reproduction through IVF have risen by 50%. Since this path is no longer considered a ‘trend,' it is essential to consider some of the positives of later parenting. (We are all familiar with the negative aspects reported often in the media.) 

Many women report feeling a stronger sense of self and increased financial stability as an older parent. Some were initially ambivalent about motherhood and chose to wait until they were in a more emotionally secure place to provide for a child, even with declining fertility. Other women wanted to be in a strong, supportive relationship. Most report carefully considering their current life circumstances in order to ensure a healthy environment in which to raise a child.

Some surprises do occur: experiencing the perimenopause or menopause transition so close to giving birth, reduced time for self after having a longer phase of independence prior to becoming a parent, and an increase in ‘sandwich generation’ responsibilities from caring for an older parent while also caring for a young child. 

Having a child at any age is a very personal decision. There are many paths to parenthood: natural pregnancy, assisted reproduction, third-party family building, adoption, and foster parenting. The decision is based on one’s subjective experience. One thing is certain: the age range for becoming a first time mother continues to expand.


Pregnancy Reading List

I’m often asked about pregnancy books for expectant parents. Here are some helpful resources to check out. 

For Moms-to-Be:

Becoming a Calm Mom: How to Manage Stress & Enjoy the First Year of Motherhood
Deborah Roth Ledley PhD

Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood - and Trusting Yourself and Your Body
Erica Chidi Cohen

The Birth of a Mother
Daniel Stern and Nadia Bruschweiler-Stern

The Mindful Mom-To-Be: A Modern Doula’s Guide to Building a Healthy Foundation from Pregnancy Through Birth
Lori Bregman

Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child's First Year
Cassandra Vieten PhD

The Journey to Parenthood: Myths, Reality and What Really Matters
Diana Lynn Barnes

For Dads- and Partners-to-Be:

The Expectant Father: The Ultimate Guide for Dads-to-Be
Armin A. Brott and Jennifer Ash

Dad’s Expecting Too: Expectant fathers, expectant mothers, new dads and new moms share advice, tips and stories about all the surprises, questions and joys ahead
Harlan Cohen  

Mommies, Daddies, Donors, Surrogates: Answering Tough Questions and Building Strong Families
Diane Ehrensaft 

Confessions of the Other Mother: Non-Biological Lesbian Moms Tell All
Harlyn Aizley

Postpartum Wellness

Let’s focus on maternal mental health. There is much post-birth emphasis on newborn health, but a new mom’s own health is also a priority. Postpartum mood changes affect both biological and adoptive moms. You have to be able to take care of yourself in order to take care of a newborn.

It can be helpful to talk about what you are experiencing as a new mom.

How are you feeling emotionally? Physically?
Is your body healing from the birth?
Are you sleeping? How is your appetite? Are you getting outside?
Who helps at night when the baby wakes?
Are you having any breastfeeding, supply or latch difficulties?
How is your mood? Are you sad or tearful? Are you irritable or angry? Detached and numb?
Are you anxious? What are your worries? Are any of your thoughts scaring you?
How do you feel about your connection to your baby?
Your connection to your partner?
What worries you the most about the way you feel? Does your partner know how you’re feeling? Is there anything you’re holding back from telling others?
How are you taking care of yourself?
Who can you turn to for support?

Many women experience difficulties adjusting to new motherhood. It makes sense; you've never been a new mom caring for a newborn or infant before. New motherhood is filled with transitions, some expected, but also many, many surprises. And cumulative sleep deprivation can wreck havoc. Often moms report that something feels off, but they may not know how to express what they are feeling or worry they may be judged so stay silent.

How can you take care of yourself? Learn about postpartum mood changes and check in with yourself. Ideally during postpartum and pediatric checkups, you will spend some time focusing on your health as a new mom. If not, find friends, family members or a mental health professional who will check in with you. If you’re not feeling like yourself, tell someone. Remember, it’s essential to put on your own oxygen mask first. 

The Uncertainty of Infertility

Nothing tests our ability to deal with the uncertainty of events beyond our control as experiencing infertility. This is living in the grey area. Nothing is concrete.

Treatment cycles can be unpredictable and women experience many ups and downs through cycle cancellations, negative beta cycles, or positive cycles that later result in miscarriage. This grey area requires women to learn to sit with not knowing and ultimately, come to terms with the fact that sometimes answers simply don’t exist. Even if you do everything ‘right,’ things may not always go as planned.

Through this process, women experience feelings of hopelessness, disappointment, anger, loss of control and frustration. It can be exhausting carrying this burden for years and feeling as if your life is on hold.

How can we learn to let go?

  • Understand what’s in your control and what is not. Loosen your hold on wanting things to be a certain way. Know that so much of infertility is not in your control.
  • Acknowledge that this moment is challenging. Identify and express your feelings.
  • Promote feelings of acceptance. Things are as they are. Surrender.
  • This means not blaming yourself or your partner for something beyond your control.
  • Notice and release any judgments, expectations, or comparisons to others.
  • Increase self-compassion. How would you support a friend going through this? Show the same care and concern for yourself.
  • Learn coping skills to help face uncertainty without feeling overwhelmed. Try mindfulness exercises, relaxation techniques, spend time in nature, express your feelings through journaling or speak with someone who can hold what you are going through, find humor in this process.
  • Find a mantra that works for you: I let go. Some things are out of my control. The only thing I can control in this situation is my response to what’s happening. Delays can be beneficial. My life is unfolding as it’s meant to be.
  • Remind yourself that you are not always going to feel this way.

Through all of this, make sure to continue to live your life. Remember, infertility is just a part of you; it does not have to define you. The fertility journey is challenging, but what you learn about yourself through the uncertainty of this process can be a beautiful thing.

Secondary Infertility

Secondary infertility is a common experience for many women, but it is not often discussed.  The struggle with secondary infertility affects approximately 12% of women in the US. It is a unique circumstance because you’re not fertile or infertile, and many women feel stuck between two worlds. This unanticipated stressor can be a frustrating and painful experience filled with grief and disappointment as plans to increase family size do not go as planned. 

Having difficulties conceiving a second child can be a major shock to the ego, leading to feelings of anger, shame, guilt and depression. Women often report secrecy and isolation and no longer belonging to a peer group. Many feel misunderstood and express being viewed as ungrateful since they already have one child, causing them to withdraw from others as their feelings are quickly dismissed.

Maternal identity concerns arise as women question who they are as a mother since having one child may not mean their family is complete. Special considerations may arise regarding current child(ren). Being present with your child can feel conflicting at times; you love your child and are thrilled to be a mom, but they can remind you of possibilities of siblings and adding to your family size. It can be helpful to consciously separate the two parts, and to schedule specific time to focus on fertility considerations when your child is not around.

Many complex issues come up during fertility treatment. Besides the physical and emotional toll of treatment on women, the child may notice if there are suddenly more doctor visits or medicines for mom. Special considerations arise when the decision is made to use assistance from third-party donors after having one biological child. Decisions around what to share with others, including the current child (depending on the child’s age), can increase stress. The emotional toll of secondary infertility also affects couple relationships and intimacy. This can be heightened when partners have different limits around when to stop trying or different ideas about family building.

Resolution takes time and involves grieving losses (physical and of the idealized family), and acceptance of the current family size or growing your family in a non-traditional way. It is essential to be able to move forward feeling grounded in your family identity, however that may evolve.

I was interviewed for a Huffington Post article on coping with secondary infertility. This beautiful piece brings awareness to this issue and discusses the emotional journey of secondary infertility. If you are experiencing secondary infertility, reach out for support. Find someone who can hold what you are going through and take care of your emotional health.

Plan of Attack for Anxiety

Feeling anxious? You are not alone. According to the National Institute of Mental Health, roughly 18% of American adults are affected by anxiety disorders. To help manage anxiety, learn a few self-care tools to have handy to take care of yourself and cope with anxiety symptoms. If your anxiety causes severe impairment, please seek specialized help. 

1 Begin to notice thought patterns
Create a thought record to track thoughts and learn to understand the connection between triggers, thoughts and feelings.

2 Challenge unhelpful thoughts
Ask yourself:
Is this thought useful? Is it even true?
Am I catastrophizing or jumping to conclusions?
How will I feel if I believe this thought?
Find another way of looking at things.

3 Practice deep breathing and relaxation daily
You don’t need a formal meditation practice, just take a few minutes each day to focus on the breath, without attaching to your thoughts.

4 Do some sort of daily physical exercise
Even a 20 minute walk will do wonders to reduce anxiety symptoms.

5 Practice good nutrition
Reduce (or ideally eliminate) caffeine.
Eat healthy, nutritious meals.
Drink plenty of water.

6 Practice coping skills to stop anxious or racing thoughts
Take deep breaths throughout the day.
Name it to tame it.
Opposite action.
Utilize distraction. 
Get up and move around to get out of a thinking state and into a sensing state.

7 Practice self supportive statements
I am having a hard time in this moment. I can be kind to myself.
This feeling is temporary - I’m not always going to feel this way.
I can handle this.

8) Increase your self-compassion
Treat yourself with loving kindness as you would a friend experiencing anxiety.

Becoming a Mother

What kind of mother will you be? Becoming a mother is an ongoing process. Each stage of  pregnancy and parenting provides an opportunity to examine your life, your childhood, your relationships, and your hopes or fears around this major life transition.

Maternal identity is fluid and evolves over time. Many moms note that their new identity becomes more grounded as they feel more secure as a mother caring for a baby or young toddler. Here are some questions to consider on your journey to motherhood:

  • Who will my baby be?
  • What are my fantasies or fears around the imagined baby?
  • How will I change as I become a mother?
  • What are my hopes around becoming a mother?  
  • How will my day to day life change as I become a mother?
  • What scares me about becoming a mother?
  • How will my relationship with my partner change?
  • What parts of my own mothering do I appreciate from my childhood?
  • What do I want to leave behind from the way I was parented?
  • How will my identity shift as I move from a daughter role to being a mother myself?
  • How will I reconcile my career identity changes?
  • How do I feel about the physical changes to my body?
  • Who can I turn to for support through all of these changes?

It can be helpful to explore your thoughts and feelings around pregnancy, postpartum and becoming a mother. Make space to consider these changes through journaling, talking it out with your partner or a friend, or meeting with a mental health professional who specializes in perinatal and postpartum health.

What Holds Us Back from Change?

One of the primary obstacles for change is getting too comfortable with the way things are. We are creatures of habit, and our defenses can be difficult to break down, especially over time. Change is possible; neuroscience has shown through brain plasticity research that we do have the capacity to form new neural pathways that allow us to make changes in our way of being. Awareness is key – first we need to see that we are stuck in a problematic way of being in order to consider making a change.

How can you begin to shift things and make positive changes in your life?

We can learn ways to mindfully encourage change. It all starts with the understanding that we have the ability to make a conscious shift to do things differently. It’s about slowing down and noticing the patterns of our thoughts, feelings and behaviors. Awareness leads to insight.

What are you getting stuck on? Start by noticing when you’re thinking, feeling or doing the same things over and over. Track patterns and make a list of common triggers that lead to the same responses. Then begin challenging the old way of being and considering ways to change. Continually ask yourself, “Do I want to keep automatically reacting, or can I find a way to be present, pause and consciously respond?”

We can also benefit from giving up the narratives that keep us stuck. Letting go of core beliefs that hold us back (I’m not good enough, things will never be different, I’m always going to feel this way, etc.) can be terrifying, but doing so allows you to shift your way of being (I’m doing the best I can in this moment, things can be different, this feeling is temporary). Encourage openness and curiosity for the unknown, and a willingness to see what happens when you give up familiarity. With consistency, you will begin to notice that you are embracing change. Make sure to maintain this new way of being and continue to move forward in your personal growth. 

Coping Skills for Infertility Support

Infertility can completely take over one's life. Here are some ideas of how to take care of yourself through infertility treatment and beyond. I contributed this article about infertility and trying to conceive to the GoodTherapy blog. I am hopeful it will provide helpful resources for women seeking coping skills during this transition. 

12 Coping Skills to Center Yourself through Infertility