Once upon a time, in a land far, far away, people had sex to get pregnant. They peed on sticks and waited with giddy excitement for two pink lines to emerge. And when they learned a baby was on the way, they were happy.
Not so much today. One in 8 couples in the United States will battle infertility, and 1 in 100 babies are conceived in a petri dish. Hospital gowns and progesterone suppositories have replaced frilly lingerie and wine-soaked romps. More husbands know how to shoot their wives up with meds that stimulate egg production than how to fix a flat tire.
I know from experience. My husband, Dan, and I spent two years trudging in and out of fertility clinics, plowing through treatments such as the ovulation-inducing drug Clomid, intrauterine insemination (IUI) and injectable medications before bowing down before the granddaddy of them all: in vitro fertilization (IVF).
For us, procreation swiftly morphed from a pleasurable journey to a daily grind. Our baby was ultimately conceived not in our candlelit bedroom but in a darkened lab, where a man I've never met introduced my husband's sperm to my eggs. Five days later, I swallowed a Valium and had two embryos inserted in my uterus through a catheter before eating a Snickers bar and passing out (that's what I was told; the drugs caused amnesia).
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Eleven days after that third IVF attempt, we received the phone call that would change our lives: "Congratulations!" nurse Jamie proclaimed. "You're pregnant!" Our bodies flooded with shock and elation.
Then, the fear set in, and instantaneously, I knew: My pregnancy journey would not be like most women's.
An anxious reaction is common, says Amy Blanchard, Ph.D., a psychologist in Cupertino, Calif., who specializes in infertility. "Women who become pregnant after infertility treatments face more complex challenges than those with a natural pregnancy," explains Blanchard. "They can't relax; there's incredible fear and anxiety over miscarriage or birth defects. They've usually spent years in infertility treatment, and are used to things not working out."
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Walking on Eggshells
I was certain the worrying and pain of infertility would vanish—Poof!—the moment we got our positive result. Instead, my concerns simply shifted from "Will I ever get pregnant?" to "Will this pregnancy last?"
At the risk of sounding like a crazy person, I managed to convince myself in my first trimester that I had doomed our pregnancy by, in no particular order, eating blue cheese, skipping with my toddler niece, inhaling nail polish remover and having a sex dream about Shaquille O'Neal that resulted in an orgasm. (Yes, I actually called the nurse to ask if I might have "squeezed the pregnancy out.")
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Other former infertiles (FIs) report similarly heightened levels of fear and vigilance right from the get-go. It took Jen Matz, 30, of Tega Cay, S.C., 19 months to conceive, during which she had surgery for endometriosis and took fertility drugs.
"Right after I peed on the stick," she recalls, "I called my mother and announced, 'Hi, Mom. I just got a positive pregnancy test. But don't freak out, because I'm going to miscarry.' I wanted to protect myself and was sure the test was wrong." (It wasn't: Her son, Wyatt, was born late last year.)
Blanchard blames the reluctance to share or celebrate the good news on the fact that FIs have often exhausted themselves emotionally, physically and financially, creating "a deep-seated fear of losing the pregnancy or of something going wrong with the baby's development." Indeed, my husband and I waited until we were 10 weeks along to tell our families, and 25 weeks before posting a Facebook bump pic—all because of the "what-ifs?"
An Unexpected Identity Crisis
FIs must also tackle a critical shift in how they view themselves, transitioning from "infertile woman" to "mother-to-be." Notes Blanchard: "Your identity used to be defined by your role in your family,your relationship, career, hobbies and friends. Once you realized that getting pregnant would be difficult, your identity became increasingly defined by your infertility."
There's also anxiety about "leaving behind" infertile friends. "Many women feel they don't fit into the world of their infertile friends, nor do they fit into the world of people who conceive easily," explains Barbara Collura, executive director of RESOLVE: The National Infertility Association.
Consider Christine Otte, 32, a charming, warm, redhead I met in the waiting room during our first IVF attempt. We became fast friends, constantly texting each other messages of worry and support as our doctor synced our cycles. I dubbed her "My IVF BFF." She got pregnant that round; I didn't.
"I felt horribly guilty," Otte remembers. "That's why, when my shower invites went out, I emailed you and told you not to come." (I didn't.) Four months later, when carpal tunnel syndrome rendered her hands nearly inoperative—a particularly wretched pregnancy symptom for a professional photographer—she didn't complain to me. "After all, I was pregnant and you weren't," she says.
Blanchard, who herself delivered twins after four-plus years of infertility, echoes this hesitancy to gripe about morning sickness, weight gain and stretch marks. She experienced an "unbelievably horrible pregnancy" marked by extreme nausea, joint pain and depression. Sadly, she recalls feeling too guilty to grumble to friends and family. "The mentality is, 'You're finally pregnant and now you're going to complain?' You're expected to simply be grateful for whatever kind of pregnancy you have." When she did relay her near-intolerable symptoms to her fertility doctor, he responded, "Enjoy it."
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Seeking Support
Clearly, pregnancy can feel just as isolating for FIs as infertility itself. Identifying a support network is the best gift you can give yourself—better than anything you might have (albeit guardedly) added to your baby shower registry. Blanchard recommends finding a therapist, particularly one who has been through infertility herself (yes, it’s a reasonable question to ask); try resolve.org.
Support groups can help you develop effective coping and partner communication strategies. It needn't be a traditional setting: Heather Martin, now a mom of two young sons in Austin, Texas, went online for a safe space to vent during the three years it took her to conceive, as well as throughout her pregnancy. "I realized I wasn't alone—there are women from all across the country in my situation," the 31-year-old says, admitting that her fear of miscarriage prompted her to purchase a home doppler system so she could hear her son's heartbeat in utero.
"My online friends helped me feel less crazy," she says. Once Benjamin, now 2, was born, she switched over to the mommy message boards. "There I could stress out about everything else, like breastfeeding."
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If anxiety has you struggling to bond with the life growing inside of you, make a conscious effort to connect: Play music for her, talk out loud to her or try a guided imagery CD; I used Circle + Bloom’s Healthy Pregnancy and Delivery audio program. I also signed up for prenatal yoga and loved the sense of community being surrounded by fellow preggos and realizing, “Hey, I’m one of them.”
Still experiencing a disconnect? Blanchard reassures women that it shouldn't affect post-birth baby bonding. "The shift from infertile to fertile will occur in its own time, and the birth usually launches these women right into motherhood," she says.
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As for friends still stuck in the seemingly never-ending cycle of injections and other procedures, know that your relationship might take a hit—for the time being. Blanchard suggests resisting the urge to hide your happy news, but acknowledge the potential for pain and be patient.
"Usually those friendships come back when the other family has moved forward in their journey," she says. It did for my IVF BFF and me: Christine sentme flowers following an early miscarriage (we were pregnant for a few days after IVF No. 2) and was always on-call to answer my nightly freakout texts throughout my first successful trimester.
We'll forever share an extraordinary bond—one nobody wants to experience, but only an FI can understand.
