Although estimates vary, approximately 30% of infertility in women is secondary infertility. Secondary infertility can be tremendously isolating and poses challenges that differ from those experienced by individuals and couples with primary infertility.

Even though you can benefit greatly from the support of others with infertility, you may feel guilty or uncomfortable talking with them if you already have a child, while they have not yet been successful in their treatment. At the same time, you may feel like an outsider around parents in your social circle or work environment, particularly if they are continuing to expand their families or haven’t struggled with infertility issues. While you may share close relationships with other parents, you might feel incredibly alone if you believe they can’t relate to your situation. If you have secondary infertility, you may feel pressure to get pregnant while your child is still very young. Prolonged infertility could result in a big age gap that could prevent your children from being playmates. Your child may also want to know when you are going to have a baby, as many of their friends are becoming big brothers or sisters.

Secondary infertility also provides the added stress of juggling the care of your child with issues pertaining to your treatment. Frequent doctors’ visits, uncomfortable side effects, hormonal changes, and emotional challenges may lead you to feel less “present” when you’re with your child(ren). Unfortunately, this can lead to feelings of guilt and shame, even though you are a wonderful and attentive parent.

“We do not get over a death. We learn to carry the grief and integrate the loss in our lives. In our hearts, we carry those who have died. We grieve and we love. We remember.” – Nathalie Himmelrich

Pregnancy loss can happen to anyone, and it is devastating, no matter what the circumstances are or when it occurs. Please be gentle and compassionate towards yourself, and take the time you need to mourn your pregnancy loss and accept what’s happened. This is important whether you experienced a loss recently or a while ago, and whether you experienced the loss physically or you’re the partner of someone who has. There’s no right or wrong way to grieve. There’s also no set timeframe, and some days will be harder than others. Through it all, it’s important to remember that you are not broken, your heart is.

After a pregnancy loss, you might experience a range of emotions, including:

• Denial: At first, it might be impossible to grasp what’s happened. You might find yourself in shock or disbelief.
• Guilt: You might wonder if you could have done anything to avoid the pregnancy loss.
• Anger: No matter what caused your loss, you might be angry at yourself, your spouse or partner, your doctor, or a higher power. You might feel angry at the unfairness of your loss.
• Depression: You might develop symptoms of depression — such as loss of interest or pleasure in normal activities, changes in eating or sleeping habits, and trouble concentrating and making decisions.
• Envy: You might intensely envy expectant parents. It might suddenly seem like babies and pregnant women are everywhere you look.
• Yearning: You might experience feelings of deep or anxious longing and desire to be with your baby. You might also imagine what you would be doing with your baby now.

Mayo Clinic Staff (2020). Pregnancy Loss: How to Cope. Retrieved from: here

I’m here to support you and ease the pain of your loss by helping you:

• Feel validated and cared for as you process your loss
  Be patient with yourself as you learn to understand and sort through your emotions
• Prepare you for situations that may remind you of your baby and cause distress
• Make your own decisions and set boundaries with others regarding how and when you want to approach things related to your loss
• Create memories of your baby that feel appropriate and meaningful to you
• Discover how to communicate with your partner and support each other through this difficult time
• Do things to improve your sense of well-being and help you feel good about yourself again
• Join a support group or otherwise connect with others who can relate to your experience
• Regain confidence to experience another pregnancy or explore other family planning options

The perinatal period refers to the start of pregnancy through 12 months postpartum. In addition to physical and hormonal changes, it can be characterized by mood and/or anxiety disorders. Signs of depression during the perinatal period include sadness, anger, irritability, mood swings, guilt or shame, loss of interest in the baby, difficulty concentrating, changes in eating and sleeping habits, feelings of hopelessness and even thoughts of harming your baby or yourself. Anxiety symptoms can include panic attacks, shortness of breath, chest pain, dizziness, a feeling of losing control, intrusive thoughts or thoughts that you might be going crazy, excessive worries and fears about the baby’s well-being, and upsetting thoughts that something bad will happen.

Please do not let feelings of shame, fear or embarrassment keep you from reaching out. Your symptoms are not your fault and there are effective treatment options to help you recover. You deserve support and compassion, and getting help is important for you and your baby.

…and other female reproductive health disorders

Pelvic pain arising from the female reproductive system might be caused by a number of conditions including, but not limited to, endometriosis, adenomyosis, ovarian cysts, uterine fibroids, and pelvic inflammatory disease. Chronic pelvic pain can also be a condition in its own right. Pelvic pain can vary and fluctuate in frequency and strength, ranging from chronic and severe to intermittent and a dull ache. It can also be accompanied by fatigue, gastrointestinal symptoms, and abdominal bloating. For some, the symptoms are debilitating. Despite strides in medical treatment, symptoms can return, resulting in feelings of anxiety, depression or hopelessness.

Two reproductive health issues I often work with in my practice are endometriosis and polycystic ovarian syndrome (PCOS). Endometriosis is an often painful disorder found in 24-50% of women who experience infertility. Symptoms include excessive menstrual cramps, heavy menstrual flow, pain during/after intercourse, and painful urination and/or bowel movements during menstrual periods. Chronic pain and other distressing symptoms of endometriosis can foster or exacerbate anxiety, depression, low self-esteem and other mental health issues.

PCOS is a common cause of female infertility resulting from an imbalance of reproductive hormones. Symptoms include infrequent, irregular or prolonged menstrual cycles, obesity or weight issues, excessive facial hair, thinning hair or hair loss on one’s head, fatigue and sleep difficulties, abdominal bloating, pain and discomfort, and acne. PCOS symptoms are associated with significant stress, anxiety and depression, struggles with body image, and the development of eating disorders.

Emotional distress experienced by those with pelvic pain, endometriosis, PCOS and other reproductive health disorders can be intensified by the unpredictable nature of their pain and discomfort, lack of a clear diagnosis, continued symptoms due to ineffective treatment or pain management, and concerns regarding infertility. When you aren’t feeling well, it can affect your daily functioning and how you interact with those around you. Relationships are challenged when pain (or the fear of pain), fatigue, diminished self-confidence, depression, or anxiety prevent you from being intimate with your spouse or partner. You may become angry with yourself for not being able to “snap out of it,” especially if your disorder sometimes results in you missing work, family time or social activities. Although deserving of compassion and kindness, you may experience guilt, shame and self-blame.