When trauma leads to infertility, and infertility leads to trauma

Michelle and her husband had been struggling with pregnancy issues since their wedding three years ago. The longing for a child; the grief of pregnancy loss; the fertility treatments and tests; the pressure from family; the belief she was doing something wrong and more had taken a heavy toll on her mental health. Whilst her husband was supportive and stoic, he too felt hopeless and heartbroken, and their all-consuming desire to become parents had strained their marriage.

Michelle is not alone in her experience of pregnancy issues – a complex trauma shared by many that can have long-lasting psychological effects according to research[i]. Women with infertility and a history of pregnancy or baby loss are more likely to feel less satisfaction, reduced self-esteem, and more depressive symptoms than women who have not experienced fertility challenges.

Research indicates trauma can cause pregnancy issues and pregnancy issues can cause trauma too.

The loss of a loved one, the end of a relationship, a job loss, adverse childhood experiences (ACE) and other traumatic life events can significantly impact a woman’s reproductive system. Stress can shut down the activity of the hypothalamic-pituitary-gonadal axis, which governs the reproductive system. This can disrupt the connection between the brain and ovaries and cause menstrual cycle irregularities and hormonal imbalances.

The effects of trauma on fertility are proven by research. In a study of 774 women of reproductive age, 195 of whom were pregnant, researchers found that women who had experienced negative events at a young age, like abuse, neglect, or family dysfunction were more likely to have experienced abnormal absences of menstruation and fertility challenges[ii].

The effects of deeper trauma

Michelle’s deeper trauma came to light through the process of psychotherapy. When Michelle was in her twenties, her mother had passed away weeks after being diagnosed with cancer. Feeling responsible for her father and younger siblings’ wellbeing, Michelle suppressed her grief and pain. Instead, she threw herself into the role of mum and caregiver, determined to give her family the continuation of traditions and celebrations to lessen the pain of their loss. When things didn’t go to plan, she blamed herself, believing she had failed her mother and family.

Michelle was experiencing Post Traumatic Stress Disorder (PTSD) – from both traumatic life events and infertility. Both traumas were feeding into each other, significantly reducing Michelle’s likelihood of conceiving.

In a safe space, Michelle was able to process the complicated grief and emotions around both the loss of her mum and her infertility challenges. Time was spent unpacking some of the new-age beliefs from well-meaning friends and healers: “manifest and it will happen”; “think happy and positive thoughts”; and more, which inevitably led to self-blame, denial, repression, and internal fragmentation.

Gradually, painful memories and traumatic events that had overwhelmed Michelle’s system at the time were revisited, allowing her to safely access acceptance of her losses, integrate her experiences, and find self-compassion for her struggles.

With courage, hard work and commitment to her own healing, Michelle’s symptoms of PTSD began to ease. Bearing testament to research on the effects of trauma-healing and reproductive health[iii], her menstrual cycle returned and after another year, she conceived and fulfilled her dream of completing her family.

Therapy – a compassionate space for complex feelings

It is entirely normal for women experiencing infertility to feel loss, grief, disappointment, a sense of failure, hopelessness, anger, shame, and blame.

It is normal to feel betrayed by their own body and a sense of powerlessness over their body, life and hopes.

It is normal for intense feelings to come up during monthly cycles of loss, the date a baby was due, or times of year associated with loss.

And it is normal to experience mixed feelings about occasions related to motherhood, like a friend’s baby shower, which can bring up all sorts of difficult emotions – from pain and jealousy if they do attend to guilt and increased social isolation if they don’t.

Infertility is an emotional and, often lonely, rollercoaster ride – one that can lead to extreme exhaustion and burnout.

Navigating and normalizing these and many more complex feelings is not easy or always doable with a partner, family member or close friend. And therapies and treatments that do not validate the multiple losses, ongoing trauma, and strong emotions experienced can do more harm than good.

It is only in a safe, non-judgmental, and compassionate space that a person can bring their complex feelings and have them normalised.

Psychotherapy welcomes and invites you to bring all parts of yourself, with a ground of emotional safety, to express, meet and explore difficult emotions. This is an essential part of the healing process and can foster much-needed self-compassion. There is immense courage in being willing to heal from traumatic experiences – one that is recognised, deeply honoured, and respected.

If you or someone you know would like more information or to work with me, you can book a free, initial 30-minute chat. During this conversation we can better understand your needs and share our approach to decide if it’s right to work together. We can also signpost you to other resources and services – much needed given the loneliness and isolation that can surround those struggling with pregnancy issues.

[i] Schwerdtfeger, Kami L, and Karina M Shreffler. “Trauma of Pregnancy Loss and Infertility for Mothers and Involuntarily Childless Women in the Contemporary United States.” Journal of loss & trauma vol. 14,3 (2009): 211-227. doi:10.1080/15325020802537468

[ii] Marni B. Jacobs, Renee D. Boynton-Jarrett, Emily W. Harville. “Adverse childhood event experiences, fertility difficulties and menstrual cycle characteristics.” Journal of Psychosomatic Obstetrics & Gynecology, 2015; 36 (2): 46 doi: 10.3109/0167482X.2015.1026892

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