Women Who Struggle

Women who struggle with infertility and women who have had multiple miscarriages experience a great deal of suffering. Feelings of anxiety, depression, frustration, anger, envy, and often hopelessness are common. In addition, many women feel a sense of isolation from friends and family. It is acutely painful for many women to socialize with their friends who have children and since most women are in their 30s, it is often the case that their friends have children. Baby showers are no longer possible to endure. Marriages, which were once vital, are often strained by the stress of both the infertility. The marriage is often untended while the infertility takes priority. Sexual intimacy suffers as well and sex often becomes just a means to an end – a way to have a baby. As a result, romance and spontaneity disappear and the couple often feel controlled by their drive to have a child. Medical protocols which are required in order to conceive by in vitro fertilization are often very strenuous and put additional burdens on the relationship. Women often feel that they have no control over their lives. Since many of the women I see are women who have achieved personal, professional and financial success in their lives, this feeling of powerlessness is very disturbing to them. Further compounding the situation, the financial burden of treatment is significant. The average IVF costs about $12,000 and is often not covered by insurance. Medications are also very expensive.

Infertility is not validated by the “outside” world. Women and couples often feel that the closest people in their lives do not understand their pain and suffering. Well-meaning friends and family often ask insensitive questions or express sentiments as, “Have you thought of adoption?” or “Just relax… it will happen.” “Go on a cruise.” “Have a glass of wine.” Actually, it has been shown in one study that women with infertility fulfill the DSM criteria for depression and that their feelings of despair often equal individuals with a serious illness.

The field of reproductive endocrinology has grown significantly in the last decade and as a result, many physicians and their office staff see an extraordinarily high volume of patients. Unfortunately, women often feel that they are “just a number” in this system and this further solidifies their feelings of alienation. Fortunately, recognizing the problem, many offices are now offering psychological services to patients.

I have found in my practice that mind/body approaches significantly diminish the disturbing feelings mentioned earlier. In particular, anxiety, depression, feelings of hopelessness, anger and frustration are positively impacted by these practices. It is through mind/body practices that women begin to regain control over their lives and start to live their lives fully again while still trying to have a child. A mind/body approach includes deep, alert relaxation, guided imagery and visualization, meditation, mindfulness practice which is an ancient Eastern practice of learning to focus on life in the present moment, and cognitive-behavioral strategies in which the client learns to recognize and restructure thoughts that contribute to her suffering.

The mind/body approach works very well in a group setting. Groups meet for ten weeks and clients are required to work with a relaxation and imagery tape on a daily basis. The group provides the structure needed to do the work as each week, we discuss how they are doing in their daily practice. The group also functions as a support system. Feelings of isolation are significantly reduced as participants form bonds with the others in the group. It is common that women continue their friendships well after the group has ended. I often lead ongoing groups after the ten weeks to help women stay focused on the practices they have learned. Participants are encouraged to read the recommended books so that the mind/body principles are further reinforced.

The practice of mind/body work is challenging in a culture, which stresses immediate gratification and rewards “multitasking.” This work is about going “inside” oneself and finding peace and acceptance as well as gaining insights. It is not about “doing” but rather about “being.” The practice of mindfulness teaches us to be aware and alive in the present moment- the only moment any of us have. Through mindfulness, we learn to appreciate life as it is happening and to recognize all of the things in our lives that are working rather than focus attention on what is lacking.

This is a particularly important practice for women who are coping with infertility since it is very common for women to agonize on the past or fantasize about what life might be like in the future. Some women regret the decisions they made in the past. Decisions to delay having a child, an earlier abortion, inability to find a partner often cause the woman to criticize herself and cause unnecessary suffering. Conversely, many women live in the future and engage in the thinking of “life will be better when.” Living one’s life in this way robs the individual of her life in the present. Mindfulness allows the fullness of life as it is happening now to emerge.

It is important as health care professionals to recognize the genuine suffering of those who are struggling with infertility. Although infertility is not life threatening as are many of the diseases nurses encounter, it produces enormous emotional and psychological pain. By compassionate listening, understanding and validating, the nurse is in a position to help alleviate the isolation so often felt.

The mind/body approach to infertility emphasizes the power that a woman still possesses. Although she may not have the power to immediately change the outcome, she does have the power to choose her response to the situation as well as the power to enjoy her life in the present. This is no way suggests that having a child is not of paramount importance. Rather, it does not have to obscure all of the many accomplishments, pleasures, and satisfactions of one’s life. My greatest pleasure and gratification is to witness a woman who “returns” to her life and once again experiences joy.