As hard as it may be to believe, studies show that the emotional effects of secondary infertility are identical to those of primary infertility. According to Parents adviser Alice Domar, Ph.D., director of the Center for Women's Health at Harvard Medical School's Mind/Body Medical Institute and coauthor of Six Steps to Increased Fertility (Simon & Schuster), "Women being treated for secondary infertility are just as depressed and anxious as women who don't have a biological child." Moreover, secondary-infertility patients must cope with emotional issues not faced by childless patients. Here are a few of them.
"Secondary-infertility patients are in a kind of no-man's land," Dr. Domar points out. As parents, they're shunned by the infertility world, which is apt to see them as ingrates because they already have a child. Yet they feel alienated from the fertile world because they cannot conceive. And though childless couples can immerse themselves in adult concerns, focusing on travel or career, parents of small children encounter pregnant women and newborn babies everywhere they go. Indeed, some of the best supports they've experienced as parents -- mother-and-child playgroups, for example -- can become, says Dr. Domar, "the greatest source of hurt, because these parents no longer feel like part of the club."
Jealousy and Resentment
Normally rational people often find it difficult to think clearly about infertility; the pain and frustration simply overwhelm logic. "I couldn't quite grasp the fact that other women's pregnancies didn't hurt my chances in any way," admits Sandy Mott. "Somehow I felt that there were a limited number of babies out there, and if I didn't get pregnant soon, there wouldn't be one for me."
"It feels like a knife in my heart whenever someone tells me she got pregnant by accident," agrees Carolyn Hutton, 29, of Campbell River, British Columbia, who is facing infertility for the second time, after having successfully given birth to a son six years ago.
"A lot of patients feel guilty because they're given the message that they should be grateful for the child they have," Dr. Simons says. "They are grateful, but that doesn't take away the longing for another child." "This desire is just as urgent, just as desperate and all-consuming as it was the first time around," says Anne Clements*, an East Rutherford, New Jersey, mother who easily conceived her 3-year-old daughter but has miscarried two subsequent pregnancies. "Sometimes I feel greedy for wanting another miracle so badly."
Some patients feel nothing but fury when others fail so utterly to understand the way they feel. "I am so sick of people telling me to be thankful for Samantha," says Valencia, California, mother Melinda Gruman, 27, of her daughter, now 2. "As if I'm not?"
Melissa Swanson, a Reno, Nevada, mother who prematurely delivered triplets, who did not survive, before successfully giving birth to daughter Amanda, now 5, says, "Of course I'm grateful to have one healthy child: I went through hell and buried three babies to get her. But does that fulfill me? No. I never imagined raising an only child." Being told to feel grateful, Swanson says, is also unfair. "No one says to a woman expecting No. 2, 'Gee, why are you pregnant again? Aren't you grateful for little Bobby?'"
Pressures From the Baby
Sometimes little Bobby himself innocently adds to the heartache. Two weeks after my second miscarriage, my 3-year-old son was with me in a store changing room; when I asked what he was saying to himself in front of the mirror, he answered, "I'm pretending I have brothers." Confused, he patted my shoulder over and over as I held him in that cold little cubicle and cried.
"One of the most poignant experiences for secondary-infertility patients is when their child begins to ask for siblings," Dr. Simons agrees. "They feel they're letting her down." Peggy Birck, of Bethpage, New York, says, "My daughter, Lauren, asks for a sister every day, and it breaks my heart. I know she would be a great big sister."
Existing children can also complicate treatment. Couples who are already parents may find it hard to justify the high costs, which often run into tens of thousands of dollars and are rarely covered by insurance.
There's also the issue of child care. "Infertility treatment is very demanding," Dr. Domar explains. "A lot of treatments require daily blood tests and ultrasounds, injections, and other procedures, and it's hard to do all that when you have a child."
Like primary infertility, the secondary variety can take a steep toll on a relationship. But according to Dr. Simons, couples suffering secondary infertility are more likely to be out of sync than childless couples (though most survive the stress). Tara Jenkins, whose infertility derives from both ovulatory problems on her part and low sperm count on her husband's, says, "It's a good thing he's so tolerant, because the drugs turn me into a real monster."
Many times, too, mothers want to pursue treatment, while fathers argue for settling for the family they've got. "These treatments can be very disruptive, and a lot of men want their happy family back more than they want to add to it," Dr. Simons says.
"My husband is having a harder time dealing with me than with the miscarriages," admits Anne Clements, voicing a common theme. "His biggest complaint is that I am obsessed."
Copyright © 2001 Margaret Renkl. Reprinted with permission from the February 2001 issue of Parents magazine.
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