Infertility and Mental Health
Q&A with a Registered Social Worker
April 18th-24th is Canadian Infertility Awareness Week
We’re talking to Registered Social Worker Cassandra De Oliveira about Infertility and Mental Health. She will help us understand how to feel supported through this very real event that affects many people with feelings of shame, guilt, embarrassment, failure, expectations and stigma.
Q: What are some common mental health factors for those experiencing infertility?
A: Infertility can cause a variety of emotions and can affect a woman’s mental health in many ways. Some factors can include:
● A sense of hopelessness and helplessness
● Depression and anxiety
● Lack of feeling in control
● The inability to change the situation
Infertility can be seen as a crisis in how it impacts mental health, as it can cause a sense of worthlessness, hopelessness, and helplessness. There are a lot of mixed emotions that come with this for women, as it can lead to questions of self-worth. It is also important to note that there can be an element of grief in loss associated with fertility issues. It could be the loss of having a child, the loss of the experience you could have, or even the loss of security within a relationship.
Some may experience relationship difficulties with intimate partners, family members or other social relationships where individuals are pregnant. When it comes to personal relationships with partners in which women are trying to have children, women sometimes fear that their partner(s) will no longer love them or remain committed to them. This can lead to further relationship concerns, whether it is with a current or future partner. Infertility can also lead to friendships not being maintained if you have friends who are having children; it can be triggering to be reminded of their circumstances. This can lead to further social withdrawal in needing to pull away from friends, colleagues, or family members who may be starting a family or expecting a baby.
There is also a notion that when you struggle with infertility, it is not public and kept as a private matter, leading it to come across as shameful and secretive. Because this is a personal challenge, others may judge when women try to draw emotional boundaries with friends or family. The judgment may be unintentional; however, sharing these struggles with friends and family who are aware you are trying to start a family may inadvertently trigger a woman.
Those who undergo In-vitro fertilization (IVF) may also be scrutinized in a cultural way, as some believe it is an unnatural way to conceive children. The other side of IVF that can have a negative impact on a woman’s mental health is the cost of the treatment - it is a significant financial obligation.
Q: Is this a common concern women seek support for?
A: Yes, this is a very common concern that affects more people than you think. However, there are not a ton of therapists or supports who specialize in this, making it difficult for individuals to reach out for support initially. However, once you find a therapist or organization that works for you, the mental health effects can be managed effectively.
Q: Are there supports other than individual therapy available?
A: I understand that some fertility clinics themselves have supports that they refer to or in-house support for all their clients. Many fertility centres require at least one session with a counsellor before beginning treatments. They help when screening for coercion and undergo an intake process for clients. Concrete research shows that fertility counselling patients have a much better experience during treatment. It allows women to understand expectations and how best to manage their emotions through this very intense process. These supports ultimately exist as the health care providers understand that patients have a lot of reliance on the process of fertility treatments. There are also hesitations and further worries, such as the treatments not working or other physical things going wrong.
A few fertility counsellors and centres in the area are below:
Q: Why is there a stigma around infertility?
A: Many people believe that the inability to conceive a child results from an individual's personal choice or issue. Often, infertility issues are attributed only to the woman and women are often blamed for infertility even if the cause of it does not relate to them.
For example, others may perceive it as an unhealthy lifestyle, that you haven't taken care of yourself, your physical body cannot conceive, or that you may have been exposed to substance abuse. There is also the stigma that fertility is something that you can control. Therefore if there are issues with having children, it is automatically your fault, and something is ‘wrong’ with you.
Additionally, this stigma and many other examples exist because there is a lack of education available to young women about what is required to conceive a child. There is a lack of education about other health factors that could lead to complications related to fertility later in life; as you get older, it is more difficult to conceive. There is also a lack of information about how other health conditions could contribute to difficulties, such as PCOS or endometriosis.
There is also a stigma regarding pregnancy that sometimes contradicts the end goal. There is a significant emphasis on preventing pregnancy when you are young, but what happens when you want to get pregnant and feel like it is the right time for you? There always seems to be a perfect time when the pregnancy will fit for you, but what happens when infertility occurs? There is a notion that if you cannot conceive when the ‘time is right,' the inability to get pregnant can seem like a reflection of a failure within your life’s timeline. This timeline does not exist and looks different for everyone, but there is a strong stigma.
Q: How can someone put boundaries on this topic if asked by family or friends?
A: When trying to draw boundaries, the most important thing is to convey and reaffirm the right to privacy regarding your personal choices, such as pregnancy. Additionally, reiterating that this is a personal issue and doesn’t need to be broadcasted if not necessary is critical to keep in mind. Sometimes, other aspects of your mental health need to be prioritized to create these barriers. On the other hand, sharing these questions' impact on you allows individuals to see your perspective and how it makes you feel. The hope is that it reduces people asking future questions that could trigger individuals.
Another thing to keep in mind is to ensure that the impact of personal questions is ultimately conveyed and understood so that the woman does not internalize them. People typically ask these questions to be supportive, but understanding that is not always easy.
Q: How can someone’s partner or family be there for them?
A: Since the experience of infertility is a personal experience, the answer is going to differ for each woman. An essential piece around this is an open dialogue between partners so that women can discuss all emotions, feelings, and thoughts safely without judgment. Partners or family members can ask direct questions about what individuals need and how or what they can do to ensure she feels supported. It is also critical that individuals take direction from the woman about what she feels comfortable speaking about and what may be triggering topics for her to elaborate on.
Q: When should someone seek support from a therapist?
A: Ultimately, this can rely on a lot of things. However, suppose you feel that your emotions, like grief, are consuming you. In that case, it may be a good time to consider support from a therapist. As we mentioned earlier, women who have access to counselling through the fertility process tend to have a better experience.
Whatever it is, we’re here for you.
Life is uncertain. Jobs are stressful. Parenting is hard. Relationships take work. Families can be dysfunctional. And, sometimes love hurts. When you’re confronted by feelings, events, or issues that are making your life challenging, it’s okay to ask for some help.
