By Eliza Pike
There is significant literature available regarding possible causes of infertility and assisted reproductive programs available to address infertility, but what about the mental health implications for women who are unable to fall pregnant naturally?
Suzy is a 39-year-old female who has tried to become pregnant for 6 years. Her infertility has caused difficulties in the relationship with her husband, has caused her to withdraw from social circles and she has become avoidant of any situation that involves a pregnant person and a new mum with a baby. She tries to be happy for her friends who fall pregnant however, when she gets home she cries and finds it hard to get out of bed for a few days. Every IVF cycle she attempts, her depression becomes more severe. Sound familiar?
By definition, infertility can be identified only when it has lasted at least a year. Unlike other adverse life events, which may have a clear resolution, infertility is regarded as uniquely stressful because it can last for many years and for many, will not be resolved. (Beaurepaire et all, 1994).
Infertility and its treatments, collectively known as assisted reproductive technology (ART), are psychologically demanding life experiences. Fertility difficulties often result in feelings of sadness, guilt, emptiness, and social isolation amongst women and men. Treatments with ART are physically demanding, at least for the woman, and accompanied by successive feelings of hope and despair, which is exacerbated when several treatment cycles are undertaken. Psychological distress is compounded by uncertainty about treatment success and particular phases of treatment are associated with especially heightened needs for emotional support.
Infertility can also be about disenfranchised losses: loss of pregnancy, childbirth and the opportunity to be a parent and grandparent. Fertility difficulties can also exert a negative effect on quality of life, compromising planning and commitment to other activities.
So, what can we do to support men and women through fertility issues? Good clinical practice for fertility professionals working in this space involves much more than the essential biomedical and technical competence. It requires a set of acquired skills that promotes patients’ wellbeing and includes empathy, honesty, respect, effective communication, non-judgmental language, patient involvement, and emotional support.
Fortunately, psychological interventions, especially those emphasising stress management and coping-skills training, have been shown to have beneficial effects for infertility patients. Counselling with professionals trained in fertility, grief and loss and adjustment disorders can also be useful when experiencing infertility issues. These professionals may use Cognitive Behavioural Therapy, Acceptance and Commitment Therapy or various other psychological strategies.
The importance though, lies in providing ongoing psychological care for women during and after fertility treatment.
Eliza Pike is a Clinical Social Worker and the Founder of Blackbird Counselling. She specialises in pregnancy and postnatal counselling, including fertility counselling, grief and loss, adjustment to motherhood and maternal mental health.