Pregnancy After Infertility or Previous Pregnancy Loss
by Our Bodies Ourselves Today
revised August 2022
Infertility is about so much more than the inability to conceive. It can rock your very foundations — your sense of control over your future, your faith in your body, and your feelings about yourself as a woman. It can result in a loss of innocence, as you find yourself on the wrong side of the statistics. Despite all your efforts, you’re unable to achieve the experience that many of us see as a birthright. Pregnancy likely cannot be achieved except with substantial medical help, and may very well never be achieved at all.
If a pregnancy finally does occur, you may not view yourself as a “normal” pregnant person. The long-desired pregnancy may or may not be the joyous experience you have dreamed about. The experience of infertility brings its own set of baggage to a pregnancy: grief for previous losses; anxiety; and fear that your body, which has been unable to conceive on its own, may not be able to carry a pregnancy.
Becoming pregnant after a pregnancy loss and/or infertility can be fraught with strong, and mixed, emotions. Sometimes our feelings are very rational and reasonable, based on the losses we’ve experienced and what we’ve learned about our bodies. Sometimes anxieties are more general and global, such as being afraid of “jinxing” the pregnancy. Sadness can be periodic and manageable, related to the major life changes of expecting a child and standard fare with the hormones of pregnancy. But if you are feeling slammed by depression, or overwhelmed by anxiety, it’s important to talk to someone who can help you get the help you need–your OB or midwife, a trusted friend or relative.
It’s typical to experience one or many of the following:
Feeling different from other friends, neighbors, and family members who are pregnant.
One woman says:
Other than brief spurts, I couldn’t get excited until the very end, and even that was guarded. I’ve had friends who’ve seemed to go through pregnancies with an air of expectation that everything will work out, and I’m envious of the joy they seem to have had. I felt like all the commercials and cards out there about the joys of pregnancy were written for someone other than me. It made me feel defective a bit, that I couldn’t get into fully loving being pregnant, even though my pregnancy was easy.
Feeling like you don’t belong. You may feel like other pregnant people can’t understand your feelings. Yet, you may feel uncomfortable talking about your pregnancy with your infertile friends who are still undergoing treatments or who have stopped trying to conceive. These feelings of loneliness and isolation can be made worse if you’re separated from supportive family and community.
Obsessing over pregnancy symptoms, symptoms of miscarriage, or preterm labor. The internet provides 24/7 opportunities to doomscroll about what that can go wrong.
Finding it difficult to change from a reproductive endocrinologist’s care to that of an obstetrician or midwife. You may miss the provider who helped you conceive. You may feel your pregnancy is vulnerable and fragile, and that a regular provider can offer fewer opportunities for procedures such as ultrasounds that can assure you the baby is okay.
Wanting more appointments and ultrasounds or wanting a home Doppler for reassurance that the baby is still alive.
Distrusting your body’s ability to carry a pregnancy. This may be particularly true if you have a medical condition (such as a blood-clotting disorder, or uterine anomaly) that causes your pregnancy to be high-risk.
Feeling guilty. You may feel like your body, or your actions, are at fault for a previous loss or for putting the current pregnancy at risk. Or you may feel survivors’ guilt toward people in your infertility support group or other friends who are not yet pregnant.
Relationship issues. Your partner will have their own feelings, fears, anger, joy, grief, and their own ways of coping with those feelings, which are unlikely to be identical to yours. These differences can cause strain in the relationship if they’re not acknowledged and faced respectfully.
Being afraid to acknowledge a pregnancy until after the first trimester, or until after the week when you experienced a previous loss, or, for some, until you have grown big enough that you cannot disguise your pregnancy any more.
Being afraid to bond or become attached to your fetus or baby until you feel sure they will remain alive.
Being afraid to prepare for the birth, buy maternity clothes, or purchase baby items so as not to jinx the pregnancy.
Being afraid to complain about pregnancy symptoms or discomforts because you don’t want to seem ungrateful.
What Can Help When We’re Pregnant after Infertility
The emotional effects of infertility needn’t doom a much-wanted pregnancy to a joyless experience. There are ways to ameliorate the despair, anxiety, and sense of doom that years of repeated failures may have led you to expect.
Most importantly, get support throughout your pregnancy.
With roughly 10 percent of US couples experiencing infertility, there are many people having the same feelings as you. You may wish to attend a support group, in person or virtually, such as those held by RESOLVE, a nationwide infertility support organization.
Find a supportive provider.
A doctor or midwife who has both the time and the willingness to help you work through your anxieties and provide reassurance when you are full of fear can make an enormous difference in your pregnancy experience. If you feel your provider brushes off your concerns, try to switch to a more supportive one.
Educate yourself about pregnancy and birth. Knowing the common sensations and symptoms of pregnancy may help keep you from panicking with every twinge — or lack thereof.
Although some causes of infertility may also automatically place a pregnancy at high-risk, infertility itself does not rule out a low-risk pregnancy. Educating yourself about birth practices that lead to better outcomes for mothers and babies can help you make better choices for the precious cargo you are carrying. (One great resource for finding up-to-date evidence-based information and resources on planning for pregnancy, labor and birth is Childbirth Connection.)
Finding a childbirth class that works for you may be challenging. Even toward the end of your pregnancy, being around other pregnant women who “had it easy” may be hard. Some types of childbirth education methods, with their focus on fewer medical interventions, may make you feel like an outsider as well. Hearing that birth is a natural, healthy process — when nothing about getting pregnant has been natural — can be less than comforting.
Be prepared for questions about how you got pregnant.
Relatives, friends, and even perfect strangers may ask whether you’ve done IVF or if you used donor eggs. This is particularly true if you are carrying multiples or are an older mother. Remember that how much you want to disclose is a matter of personal choice.
Don’t feel guilty complaining about pregnancy discomforts.
You may feel like you have no right to complain. Even your friends and family may respond to your griping with, “Well, you asked for it….” The truth is that pregnancy can be uncomfortable. Your dislike of frequent vomiting, pelvic pain, Braxton-Hicks contractions, hemorrhoids, or heartburn does not mean you cherish the pregnancy any less.
Consider going ahead and preparing for the baby’s arrival.
The vast majority of pregnancies will result in a live baby, and that baby will need at least a few necessities. Basic infant care skills are more easily learned before the sleep-deprived days a newborn can bring.
One woman advises:
Infertile women need to be gently reminded that it is important, for the sake of their babies, to look ahead. They may even need guidelines so as to prioritize and break down the task. For example, they can let themselves off the hook when it comes to baby clothes and crib sets they want, but they should definitely learn how to feed and settle their baby in some detail, as much as they can before time.
Try to have compassion for yourself and your partner.
Even though it is much wanted, pregnancy after infertility isn’t necessarily easy. Giving each other some space and grace can be a lifesaver when your feelings and needs diverge. Being vocal about your needs—not expecting your partner to read your mind—is also important.
If you plan to breastfeed, educate yourself beforehand and identify local sources of support.
The vast majority of women, including women who have struggled with infertility, are able to breastfeed. However, breastfeeding can be challenging, whether or not you’ve experienced infertility and/or pregnancy loss. Many women need support and help from a health care provider, lactation consultant, or support group such as La Leche League. Lining up support people during pregnancy will ensure that you have help if you need it in the early days after birth. Even with help, some women are unable to breastfeed. If this happens, it may feel like your body has once again betrayed you. Finding people who will support YOU, no matter what happens, is vital.
Line up a support team for after the baby is born.
No matter how much you’ve longed for this baby, the early months of mothering can be demanding as your body recovers and you learn to take care of a new baby. Women who become pregnant after infertility treatment may be at increased risk for postpartum depression. Seeking out people who can provide practical help and emotional support can make all the difference.
Try not to worry if you don’t feel bonded to your baby during pregnancy or the minute they arrive.
For many of us — and not just those who have experienced infertility and loss — bonding doesn’t happen the moment we give birth, but occurs over the days and weeks of caring for the baby.
Don’t feel pressured to gloss over or forget about a previous loss, or the feelings about it that the current pregnancy might stir up.
Every pregnancy and every child is unique, and one cannot take the place of another. Acknowledging your loss is part of the grieving process. It can be emotionally important to acknowledge and honor the anniversary of your important losses. One woman, currently pregnant, who lost another pregnancy at 20 weeks, says,
The hardest part for me has been answering the question, ‘Is this your first?’ Most often, the question has come up in casual conversation and it wouldn’t be appropriate to give any answer other than ‘yes.’ But even now, at 35 weeks, I feel a little like I am betraying my son when I don’t tell his story–how at 20 weeks, we found out the devastating news that even though we had waited so long for him, we would still never be able to take him home. How, just when I was beginning to show, I went into the hospital and gave birth to a tiny, stillborn boy. But casual acquaintances would rather focus on the potentially happy future, rather than the unhappy past.
Don’t be surprised if having a child does not resolve the grief of your infertility.
You may have overcome your medical condition this time and achieved a successful pregnancy. However, grief from years of repeated failures, losses, and invasive, expensive medical treatments takes its toll and may be felt for years to come. If you want to have more than one child, you may or may not experience secondary infertility. The roller coaster of hope and grief may be something you ride again in the not too distant future.
Give yourself, and accept, as much self-care as you can manage.
Meditation, massages, time in nature, time with supportive people, enjoyable exercise, plenty of rest, your favorite foods or music: anything that helps unwind your body or mind will make your pregnancy a little easier and more relaxed. While not all pregnant people can take the time, or spend the money, on treats and escapes, any little mental or physical getaway can help.
Seek professional help if you think you might need it.
Anxiety and depression don’t need to be severe to warrant help. In fact, since your experience with infertility puts you at higher-than-average risk, it can be wise to reach out for mental health support even before you experience severe symptoms. If you find that feelings of guilt and worthlessness are overwhelming, are unable to focus on everyday tasks, sleep way too much or are unable to sleep at all, or have thoughts about harming yourself, it’s important to bring this to the attention of your care provider immediately. You worked hard to become a mother and deserve the support you need to give yourself and your new baby the best possible start together.
Infertility and pregnancy loss may have unavoidable effects on your experience of pregnancy, but with support and understanding, you may find more moments of peace than fear during your long hoped for and long-awaited pregnancy. Good things, after all, can come to those who wait. As one woman succinctly states:
I am thankful beyond belief that we have a child. We came very close to living child-free. I will never take her for granted.
For more information, see:
- Pregnancy After Infertility
Information from RESOLVE, the national infertility network, that explores different ways your infertility experience may affect your pregnancy.
- Pregnancy after a Miscarriage
How to manage and accept the difficult emotions you may experience during pregnancy after infertility/loss.
- Depression During Pregnancy
Information from the March of Dimes about managing depression during a pregnancy.
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