by Kellie Stryker MSW LCSW
According to reproductivefacts.org, “Infertility often creates one of the most distressing life crises that a couple has ever experienced together. The long term inability to conceive a child can evoke significant feelings of loss. Coping with the multitude of medical decisions and the uncertainties that infertility brings can create great emotional upheaval for most couples.”
Kristin L. Rooney, BA and Alice D. Domar, PhD with Boston IVF wrote: “Infertility is often a silent struggle. Patients who are struggling to conceive report feelings of depression, anxiety, isolation, and loss of control. Depression levels in patients with infertility have been compared with patients who have been diagnosed with cancer.1 It is estimated that 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. Despite the prevalence of infertility, the majority of infertile women do not share their story with family or friends, thus increasing their psychological vulnerability. The inability to reproduce naturally can cause feelings of shame, guilt, and low self-esteem. These negative feelings may lead to varying degrees of depression, anxiety, distress, and a poor quality of life.”
It’s normal to experience times of stress throughout the infertility process. However, it becomes a cause of concern when the feelings become persistent or prolonged.
According to reproductivefacts.org, if you experience the following symptoms for a prolonged of time, you may benefit from meeting with a mental health professional.
- Loss of interest in usual activities
- Depression that doesn’t lift
- Strained relationships
- Social isolation
- Thoughts that are consumed by infertility
- High levels of anxiety
- Diminished ability to concentrate or accomplish tasks
- Change in your sleep patterns, appetite or weight
- Increased use of drugs or alcohol
- Persistent feelings of pessimism, guilt, bitterness, anger or worthlessness
- Thoughts about death or suicide
Help Is Out There
The following resources are dedicated to helping you improve your Reproductive Mental Health:
- RESOLVE: The National Infertility Association – RESOLVE provides free support groups in more than 200 communities; is the leading patient advocacy voice; and serves as the go-to organization for anyone challenged in their family building.
- ASRM : American Society for Reproductive Medicine – ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers. The Society is committed to facilitating and sponsoring educational activities for the lay public and continuing medical education activities for professionals who are engaged in the practice of and research in reproductive medicine.
- Pulling Down The Moon – Holistic care for family health and fertility should be highly personal, compassionate, and customized to meet the unique needs and complex challenges of each patient. Founded in 2002, Pulling Down the Moon recognizes the stress and emotional turmoil and fatigue that can come with infertility as well as your day to day health.
- Shine Fertility – Shine supports women through mentorship, community and education. We empower women by encouraging a proactive approach to fertility health and fertility preservation.
Taking Care of You
It’s ok to be sad, frustrated, angry, resentful, bitter and whatever emotions you may be feeling at this very moment. You are allowed to feel all of the above and more. Sit with it. Don’t force yourself to put on a brave face when you are going through unimaginable pain. However, when you are ready, allow yourself to work through the emotions you are experiencing.
Georgia Witkin, Ph.D with Progyny wrote: “You may not have control over the physical effects of fertility treatment, but you can take control over many of the psychological effects. What you think and what you do shapes what you feel, so choose thoughts and behaviors that reinforce your sense of control.”
Kellie Stryker is a Licensed Clinical Social Worker and owner of Rain to Rainbow Counseling. Kellie has over 10 years of experience in the mental health field. Kellie currently lives in Crystal Lake, IL with her husband and 1 yr old daughter who was conceived through infertility treatments. Kellie’s mission as a Reproductive Mental Health Counselor is to provide support to others as they navigate through their infertility journey.
Rain to Rainbow Counseling offers supportive services which are focused on all aspects of Reproductive Mental Health which include infertility, grief, loss, miscarriage, stress management, adoption and pregnancy counseling. Rain to Rainbow Counseling is currently in network with Blue Cross Blue Shield of IL and Optum United Health Care. In Person and Online Telehealth Sessions are available.
Benefits of Online Telehealth:
- Confidential: Rain to Rainbow Counseling uses Simple Practice, a secure and HIPAA compliant program.
- Online Client Portal: No software to download. Private login and password for each client.
- Same benefits and techniques: Only difference is we see each other on screen instead of in person.
- Convenience: Can literally be done from when and wherever you are comfortable.
By Cathy McCauley, LMT
You’ve received the results – you are pregnant! Take a deep breath. It may have been a long road to get to where you are now.
Pregnancy is an exciting time, and you’re probably feeling a mixed bag of emotions. Maybe you have concerns or stress. These feelings are normal as changes occur in your life and in your body. However normal, it is important to find healthy ways to deal with feelings, emotions and stress during pregnancy.
Chronic stress during pregnancy can impact you and your baby as more blood is sent to the extremities rather than to the internal organs as a result of the “fight or flight” response. With blood being sent to other areas over the internal organs, stress can compromise blood flow to the baby, perhaps by as much as 65%. This may result in lower fetal heart rate and blood oxygenation (Gorsuch and Key 1974 as cited in Osborne 2012).
Massage for Health
One way you can improve your health and well-being during pregnancy is to receive regular prenatal massage. While multiple sessions can have a greater effect on improving pain and lowering anxiety and depression, even one massage session can offer benefits (Moyer et al 2004 as cited in Osborne 2012). The Unwind the Mind Massage is safe and supportive from transfer through the first trimester at 14 weeks, the Prenatal Massage can be enjoyed throughout pregnancy, and the Postpartum Massage after delivery whenever you feel comfortable or are cleared by your doctor.
Safe, therapeutic touch provides you with deep levels of relaxation that signal your parasympathetic nervous system creating physiological balance, steadier blood pressure, pulse and respiratory rates; regular blood flow to the uterus, placenta and fetus; and healthier immune system functioning, emotional states, and responses to stressful stimuli (Nichols and Humenick 2000 as cited in Osborne 2012). This is good news for you and your baby.
In addition to the therapeutic touch, evidence shows that having a strong support system may reduce pregnancy complications. A study of several hundred pregnant women who had difficult life changes in the two years immediately preceding and/or during their pregnancy found that those who also had strong support systems had one-third the complications of those who experienced similar stresses without a support system (Nuckols et al. 1972; Hobel and Colhane 2003 as cited in Osborne 2012).
Pulling Down the Moon wants to help support you through your pregnancy. Whether choosing prenatal massage, nutrition, acupuncture, or one of our community events; we offer nurturing care for you during this exciting and stressful time of transitions. Our partner, CocoonCare can support your prenatal/postnatal fitness, health coaching, and informative workshop needs!
Take time to relax and celebrate with a massage today! Cathy is available in Highland Park on Sundays, Mondays, and Thursdays, as well as, Buffalo Grove on Tuesdays! Enjoy savings with our package options throughout your journey!
Osborne C. Pre- and Perinatal Massage Therapy, A Comprehensive Guide to Prenatal, Labor and Postpartum Practice. 2nd edition. Baltimore: Lippincott Williams & Wilkins, 2012.
The anticipation, anxiety, the loss of control and not knowing what to expect can be especially difficult during the “two-week wait.” The two-week wait – between ovulation and when your next cycle is due to start – can feel as if you are in limbo as there is no way to tell if you’re pregnant.
You may find yourself watching for signs and symptoms of pregnancy. Each twinge in your belly, tenderness in your breasts and feeling of fatigue, asking yourself, “Does this mean I’m pregnant? Or am I getting my period?”
The questions, the “what if’s,” the TIME all feels endless and one seems to build upon the other until what you’re left with is a gigantic ball of anxiety and feeling a loss of control.
What if instead of “getting through” the two-week wait, we were intentional and mindful of nurturing ourselves by creating a plan? This holistic guide to self-care will provide you with a plan for nurturing yourself in four areas: physical, social, emotional and spiritual.
Sleep is not only necessary and restorative for our bodies, it also allows us to cope with our feelings of anxiety and overwhelm in a more manageable way. If you find yourself having difficulty falling asleep, here are a few helpful tips:
- Keep a journal or notepad next to your bed and write down the thoughts, worries or items on your ‘to-do’ list. Say to yourself, “This will be here for me if/when I need it.” Sometimes the act of writing something down allows for a cathartic release of whatever we’re feeling preoccupied with.
- Listen to a guided meditation app before bed to relax into sleep and take your mind off of the two-week wait. Bonus: the more you practice, the more this cues your body and mind that it’s time to sleep.
Gentle exercise such as planning a walk to a scenic place, a lake or forest preserve. Getting outside can have a calming, centering effect while you are present in nature. Try Yoga for Fertility poses on your own or building community through practice with others. Schedule an Unwind the Mind Massage, “This session was created to be a safe oasis from post-ovulation stress, boosting immune and endocrine function, while supporting a potential pregnancy.” (Pulling Down the Moon, Fertility Enhancing Massage (FEM)
- Plan a social outing with your partner or friends. Socializing provides an outlet for connection as well as a distraction from the thoughts and feelings you maybe preoccupied with. And, it’s fun! What activities do you enjoy doing? Want to try something new? Try being intentional about planning enjoyable activities, especially during the two-week wait.
- Create a list of friends, family members or supports you can reach out to check in with during the two-week wait. Is there a fellow member of your support group, a friend or family member who has an understanding of what you’re going through? Who acts as a sounding board, offers encouragement or provides a fun distraction? Write these supports down so that when you’re feeling especially alone or overwhelmed during your journey you have a few go-to people you feel safe reaching out to.
- Mantras can have a powerful and empowering impact. Choose a word or short phrase you would like to be the focus during your two-week wait. How would you like to feel and respond to yourself and others? Write the mantra on a post-it note or schedule it as a daily event on your phone to be reminded of your intention.
Nurture ~ Empower ~ Peace ~ Joy ~ Warrior
- Practicing meditation & mindfulness “Mindfulness is the energy of being aware and awake to the present moment… Being present is the most powerful place to be.” Thich Nhat Hanh. Bringing your attention back to the present moment can help decrease feelings of anxiety and increase self-awareness. New to meditation? Try a guided meditation app. There are guided meditations specific to fertility, sleep, anxiety and grief that you may find especially helpful in starting or ending your day.
In summary, while creating a plan doesn’t take away the uncertainty, it may allow you to feel a sense of control with how you choose to meet this part of your fertility journey. Creating a plan for the two-week can be a nurturing way to care for yourself during a time when your thoughts and feelings may be overwhelming. Take this time to connect with yourself, your partner and those you enjoy spending time with who play a supportive role in your journey.
- Yoga for Fertility – https://www.pullingdownthemoon.com/services/yoga-classes/
- Fertility Enhancing Massage (FEM) – https://www.pullingdownthemoon.com/services/therapeutic-massage/
- Meditation Apps:
- Calm – https://apps.apple.com/us/app/calm-com/id571800810?ls=1
- Insight Timer – https://apps.apple.com/us/app/zen-timer-meditation-timer/id337472899
- Meditation Studio: Fertility Collection – https://www.meditationstudioapp.com/fertility
- Fertility Mantras & Positive Affirmations – https://fertility-news.rmact.com/path-to-fertility-blog/infertility-mantras-fertility-mantras-your-choice
Emily Heilman is the founder of Flourish Counseling & Wellness. As a Licensed Clinical Social Worker (LCSW) and Certified Perinatal Mental Health specialist (PMH-C), she specializes in perinatal mental health and wellness, supporting women and their families navigate their fertility journey, the pregnancy and postpartum period, and throughout motherhood. Her experience in the field of women’s and perinatal mental health spans the past 13 years where she has worked in community mental health, hospital settings and private practice. Emily offices are located in the Chicago Loop & Oak Park. To learn more, visit: https://flourishcounselingltd.com/
by Cassie Harrison, Yoga Team Leader RYT
June is pride month and festivities are already underway in Chicago and its suburbs. We were lucky enough to have our own Pride parade near us in Buffalo Grove, IL. Regardless of how you identify, you will need support through your journey. Finding community early in the process will help make it more manageable and maybe even enjoyable. What’s often forgotten, at least in the beginning and not until after one faces setbacks, is to take care of oneself. Often I get students in my Yoga for Fertility class who are yoga novices and come to me with an attitude of “well it can’t hurt to try yoga.” Darn right, you should’ve been here from the start! If you’re going to carry a baby, are you (or your partner) preparing your body to support a pregnancy? Whoever is involved in the process to create a family will need community/emotional support, nutrition, exercise, and self-care.
Community is priceless. I felt very alone during my fertility struggle and it wasn’t until I found a community that I realized how much I needed it. One’s path to parenthood is a personal journey, with or without problems. With problems, it just makes it harder to keep it personal and/or private. Schedules getting disrupted by always needing to go appointments, taking medications (that may or may not make one crazy), and add in the emotional roller coaster … well you get the idea. Go. Now. Find your community.
Here are a few resources to get you started:
- Yoga Events: Joins us for Yoga for Fertility in Chicago starting June 25th and in Highland Park starting July 1st! The FREE Weekend Wine Down in Chicago will be July 25th, save your spot and bring a friend!
- Shine Fertility: Join us at the Shine Bright event on July 10th and/or the next Shine Together Meet-up at PDtM Chicago on July 23rd!
- Path to Parenthood: Every Journey Begins With The First Step
- The Broken Brown Egg: Awareness. Hope. Activism
Additionally, below are a few LGBQT+ resources available to those in the Chicago area:
And what I thought was an nice article from a lesbian couple struggling with infertility:
Enjoy some food and yoga tips today at:
- Food is medicine, eat better. Period. EWG.org has a list of fruits and vegetables high in pesticides to stay away from, called the dirty dozen. They also test consumer products and rate them, most important to stay away from are endocrine disruptors. Start there to help decide when to go Organic and identify products in your home that could hurt your fertility.
- Hello Yoga. It’s both exercise and self care wrapped up in one beautiful package. Yoga connects the mind and body, a moving meditation. It supports the physical body by promoting hormonal balance, improving blood flow, and helping support tissue detoxification. Not to mention self-massage (drink plenty of water after a practice!). A few of my favorite yoga postures (that anyone can do, yes that includes you!). These poses require focus, which settles the mind. Find a quiet space inside or out, and practice Eagle, Reclined Figure Four, Warrior (I, II, III) and Camel.
Have a great summer. Make time for yourself, the kind that fills your bucket! Find your community, eat well, and practice (key word here) yoga.
By Christina Thompson Olson, RYT
Has your fertility journey created a disconnect between you and your partner or loved one? Whether you’re going through this together or on your own, trying to conceive can feel isolating and lonely. Partners, family members and/or friends may have the best intentions of supporting us on our TTC journey, but sometimes it takes a little creativity to find ways to reconnect with our loved one — consider partners yoga!
Keep It Simple
If you hear partners yoga and immediately picture yourself trying to balance in the air on your partner’s legs, not to worry. I’m not talking about acro yoga; just some simple yoga poses you can practice with a partner to enjoy a relaxing time together. These are safe during most times of your cycle or treatments, but always check with your doctor if you’re unsure. Try these poses in your living room or maybe even outdoors now that the weather is getting nicer! Start by sitting cross legged with your back against your partner’s back, noticing your breath and your partners breath, and feeling the support of their back against yours.
Partners yoga can build intimacy and trust by opening the lines of communication. Even just the simple and honest communication required while coordinating movements can help us reconnect with ourselves and our partner, no matter what else is going on that day/week/month. For the next pose, stay seated back and extend your legs out in front of you for a supported forward fold. One partner will fold forward towards their legs while the other partner gently leans back; then come back through center, maintaining contact as you switch. Move slowly with your breath, making sure to communicate your comfort level during this one!
In yoga we link breath and movement which helps to relieve stress and tension in the body and mind. Practicing yoga poses with a loved one allows you both to feel the centering, grounding effects of yoga. One more seated pose where you’ll reap these benefits is the gentle seated twist, practiced back to back. You and your partner will each start by placing your right hand on your left knee and reaching your left hand back to your partner’s leg or hip; lengthen up through the crown of the head on your inhale and twist a little deeper to the left on your exhale, looking over your shoulder if it’s comfortable for your neck. Continue to breathe, coming back through center when you’re ready, then take this twist to the right.
Support during TTC and beyond
Practicing yoga with your partner is a great way to connect and feel supported during your TTC journey, after getting pregnant, and beyond. Make your way to a standing position, allowing your partner to help you up from the floor, and face each other standing within arms reach. Step your feet out wider than hip-width distance, taking the toes out and bending the knees into a goddess squat. Ground down through the feet as your shoulders stack over your hips, then reach your arms towards your partner and clasp forearms. You can decide how intense to make this squat by bending more deeply, or lessen the intensity by gently swaying side to side, straightening one leg and the other as you maintain eye contact.
Don’t forget to have fun with these poses and try others from your yoga practice! Balancing postures are a great reminder to not take ourselves too seriously. Try a tree pose standing next to your partner, balancing on one foot as you draw the sole of the other foot towards your calf or upper thigh, and offering support with an arm behind your partners back, or interlacing the hands closest to each other as you reach overhead. Feel your standing feet rooting into the earth as your arms reach tall overhead, and enjoy this shared experience together!
Try one of our FREE summer events while space is available and our current Yoga for Fertility schedule on our Calendar today! Call us to schedule a private yoga session in Chicago or Highland Park for you and your partner at: 312-321-0004.
By Brooke Laufer, Psy.D.
Motherhood, Not What You Thought
Mental health issues are among the most common complications related to childbearing, and yet it is still a topic that is largely misunderstood. A conversation I had with my dentist recently reminded me how little the general public knows about perinatal mental health issues. “Oh,” she said, “I just thought women cried a little bit, but you know, they’re usually just so happy to be mothers, right?!” We want to believe becoming a mother is an absolute joy. Motherhood is expected to be a fulfilling time for a woman, when a woman is in her most natural role–the role she was meant to play as suggested by film and other media–when her true purpose is determined. In reality, having a child is a profound, frightening, and exhilarating experience at the boundary of life, from which one comes back a transformed person. Most women bear this monumental transition to motherhood with some hardship. Experiences range from tearfulness, exasperation, and nervousness to more extreme feelings of obsessiveness, helplessness, and even murderous fantasies. While many women will have what is labeled the Baby Blues, 20% of women will have a Perinatal Mood and Anxiety Disorder, a debilitating psychological experience that interrupts their lives. With a growing amount of research and education, we begin to clearly see what distinguishes a true Perinatal Mood and Anxiety Disorder from the non-clinical experience of the Baby Blues.
10 years ago I was as unaware as my dentist of what could happen to a woman’s state of mind when she was faced with childrearing, so after my daughter was born I learned in a shocking and destabilizing way–the way most women learn–what a Perinatal Anxiety Disorder was. For me, it started with anxiety attacks while in my third trimester. I shook uncontrollably in the evenings and experienced an overwhelming sensation of claustrophobia during the day. I found a good psychiatrist who helped me understand that taking an SSRI (the one I’d gone off when I got pregnant) would relieve my anxiety and would not hurt my baby. Then after a fairly uncomplicated birth, I was supposed to be thrilled, but I had a new baby who didn’t sleep well. I loved her, but I wasn’t completely attached to her; I was also ragged and jumpy. When she was 4 months old, I started having intrusive thoughts that deeply disturbed me. At first they were like small blips on a radar, like thoughts from the periphery of my mind that I could barely hear. But then the blips grew larger and included images. I could clearly hear thoughts telling me that harm would come to the baby. I could see my baby being sexually violated. I had thoughts that my husband and I would be the ones to sexually harm our baby daughter. I could barely tolerate these thoughts as they began popping in with greater frequency. Luckily, my psychiatrist answered his phone the day I called beside myself in tears. He calmly told me that what I was experiencing was Postpartum OCD, he told me about Karen Kleiman’s book This Isn’t What I Expected, and he raised the dosage of my Sertraline. I was a therapist, a clinical psychologist, and I was learning for the first time what a Perinatal Mood and Anxiety Disorder was; this was not the Baby Blues. I recovered from my Postpartum OCD, but my life was changed forever. Since that time I have done what I can to research perinatal mental health, to immerse myself in the literature and new information we have on this condition, and to talk about it. Talk to women, to friends, to family, and especially to my clients, letting them know they are not alone, they are not crazy, and they can still be the mothers they want to be.
The term ‘Baby Blues,’ first used in Nicholson J. Eastman’s 1940 best-selling baby care book Expectant Motherhood, is an umbrella term referring to any emotional experience a woman has in the period after bringing home the baby. It is no surprise this massive life transition, along with sleep disturbance, disruption of routine, and emotions from the childbirth experience itself will contribute to how a mom feels. Her experience is also affected by the hormone changes that occur first during pregnancy, and again after a baby is born. The levels of progesterone and allopregnanolone rise during pregnancy and plummet after childbirth, and this drop is thought to contribute to emotional dysregulation. These short-term postpartum symptoms include weepiness or crying for no apparent reason, impatience, irritability, restlessness, anxiety, fatigue, sadness, mood changes, and poor concentration.The informal diagnosis of Baby Blues requires that these symptoms last no more than 2-4 weeks, occurring for a few minutes up to a few hours each day, and typically going away with rest, support, and time. Baby Blues rarely get in the way of daily life or need intervention from a medical provider.
“A baby opens you up, is the problem. No way around it unless you want to pay someone else to have it for you. There’s before and there’s after. To live in your body before is one thing. To live in your body after is another. Some deal by attempting to micromanage; some go crazy; some zone right the hell on out. Or all of the above. A blessed few resist any of these, and when you meet her, you’ll know her immediately by the look in her eyes: weary, humbled, wobbly but still standing. Present, if faintly.” Elisa Albert, After Birth (2015)
Perinatal Mood and Anxiety Disorders
When a disturbing emotional state lasts beyond 2-4 weeks, clinicians should start to assess for a perinatal mood and anxiety disorder (PMAD). Formerly referred to as Postpartum Depression, or simply “postpartum,” we now use the term “Perinatal” because the symptoms can occur not only one year postpartum, but also during pregnancy, or after a pregnancy loss. We say “Mood and Anxiety Disorders” instead of “depression” because it more accurately covers the range of experiences women have. These include major depression, generalized anxiety, OCD, PTSD, and postpartum psychosis.
Although there is no clear indicator of who will experience a PMAD, previous mental health issues, trauma, and lack of resources are some of the risk factors. Important to note: PMADs do not affect just biological mothers. Growing research shows us that men experience postpartum anxiety and depression. In fact a client of mine came in a few weeks after her baby was born and reported that her husband was acting strangely: yelling a lot, throwing pillows at the wall when the baby cried, uncontrollably crying, and openly fantasizing about leaving the baby out in the snow. We were able to get him in for a session with her and help him understand that he needed help. The couple was surprised that he was having postpartum rage, while she was adapting well. He actively resented his child for destroying their former life, while she’d become protective of the child. Eventually, with months of treatment, he was able to love and attach to his daughter.
Similarly, adoptive parents may report symptoms of PMADs: it can be particularly confusing to resent or feel disconnected to an adopted baby whom you wanted and planned for and possibly spent much or most of your savings on. Likewise, LGBTQ families who may have worked for years on fertility treatments or with a surrogate to finally bring home a baby are also vulnerable to PMADs and should not be ignored as a population worth assessing.
Perinatal depression mimics that of a major depressive disorder but with certain symptoms specific to mothering. A woman may be withdrawn from the baby and her family, not want to hold the baby or have difficulty bonding, have a flatness of facial expression and voice, exhibit excessive tearfulness, or severe self loathing. She may have a belief that she can’t handle motherhood or be a good mother, she may be unable to enjoy most of her life, or she may believe her family would be better off without her.
A client of mine described feeling like she couldn’t see herself in the family picture. She vacillated between dissociation and depression. This mom had twin baby girls with whom she was not bonding. She felt like a machine part going through the mechanical motions of caretaking. After her first session of unburdening herself of the sadness and shame she carried, she was able to start to locate herself. Her experience points to the invisibility some women feel as mothers. The erasure of self to motherhood is well noted by the poet Alice Notley:
“For two years, there’s no me here….
Two years later I obliterate myself again
having another child” (1972)
Perinatal Anxiety and PTSD
Perinatal anxiety, or anxiety during and after pregnancy, has received little attention compared to its well-known cousin, postpartum depression, yet anxiety symptoms are more frequently reported. Worrying, of course, is a normal part of new motherhood–checking that the car seat is secure or that the baby is still breathing, for example–but if it interferes with a woman’s life so that she cannot think about other things or take care of herself or her baby, then it verges on mental illness.
For women who are prone to anxiety, the information-saturated era we live in is loaded with potential stressors about conceiving, being pregnant, and parenting, requiring women to be vigilant about what information she is exposed to. An anxiety disorder can be spotted in the repetitive fears and questions moms have, in extreme over-protectiveness such as not letting anyone hold the new baby, or in the too well put-together mask some moms wear, hiding an internal world out of control.
Post-Traumatic Stress Disorder (PTSD) in the perinatal period refers to past trauma resurfacing during the perinatal period, including flashbacks and nervous system responses (freeze, flee, fight) that can interrupt caring for a new baby. What many doctors do not realize is that women who have experienced sexual trauma may have fear of a baby coming out of the vaginal canal, a fear of male providers, and/or a fear of being alone with baby.
Perinatal Obsessive-Compulsive Disorder
Obsessive compulsive disorders are possibly the most insidious of the postpartum conditions because they include the intrusive thoughts that haunt many mothers. Intrusive thoughts are thoughts that happen frequently and randomly, feel uncontrollable, and are often disturbing. These disturbing thoughts, or obsessions, can lead moms to engage in repetitive behaviors, or compulsions, to try to ease their anxiety. Many moms with OCD are plagued by repetitive fears of harm coming to their babies, possibly due to the extreme helplessness of a newborn baby. It is horrifying for mothers to have uncontrollable thoughts and images of their baby tumbling down the stairs or falling out a window, or images of themselves smothering the baby or sexually abusing their own child. Because of the disturbing nature of these thoughts, it can be the most difficult disorder to admit, yet, as was my experience, by breaking the silence women can find tremendous relief in the normalization of Perinatal OCD.
Postpartum Psychosis is the most rare of perinatal conditions, occurring in .1% of moms, but it is the most dangerous. Psychosis is a break from reality that can happen over time but can also become a medical emergency very quickly. As with Postpartum OCD, a mom may experience intrusive and paranoid thoughts, but instead of being disturbed by them, she may begin to identify with them. For example, a new mother may have the thought that someone is going to steal her baby, so she acts on it by hiding the baby or running away with the baby. Unfortunately, it is typically after a postpartum psychotic episode has ended badly that the media gives it attention. Just a few years ago a woman who I know from my hometown was arrested for the death of her 14 month old boy. After months of working full time, bad day care experiences for her baby, an unstable partner, and increasing symptoms of OCD and paranoia, she came to believe she and her son would be better off dead. After she suffocated her baby she attempted to overdose on medications, but she survived. Even though the she had an expert forensic psychiatrist diagnosed her with Altruistic Filicide, deeming her Not Guilty By Mental Defect, she was sentenced to 25 years in prison. Unfortunately, there is still little understanding or mitigation done for mothers convicted of infanticide, resulting in excruciating treatment and excessive sentencing.
Women may find it difficult to reach out for help, as it is taboo to admit you are unhappy or unnatural at motherhood. To the extent that women in our society are still seen as playing their most natural role as mothers, to acknowledge unhappiness or discomfort may have high stakes relating to women’s own identities and how others may see them. A mom may fear being seen as a “bad mother,” which would ostracize her from mainstream society. With more education and awareness around the frequency and epidemiology of perinatal mental health issues, much of this silencing can be alleviated. What is essential to understand is that a woman herself should not be blamed–not by her providers, her family, or herself–for a perinatal condition. We often have little control over the occurrence of a Perinatal Mood and Anxiety Disorder, but we can do much about its treatment.
Psychotherapy and Medication
With a proper diagnosis of a Perinatal Mood and Anxiety Disorder, good treatment can support a full recovery. The best form of treatment is individual psychotherapy that reduces stigma and shame and normalizes the client’s experience. Besides reassuring women that it’s normal to feel ambivalent during pregnancy and motherhood, I also educate each woman about her particular diagnosis. Women often feel desperately alone and deeply ashamed when they experience PMAD symptoms, especially ones that are less talked about like rage or intrusive thoughts. I reassure my clients that these inner experiences don’t indicate their worthiness as mothers but are instead treatable symptoms of common disorders. Women express tremendous relief when they realize that their scariest and most shameful symptom is something others also experience–and something we know how to treat. Helping women accept all the parts of themselves will reduce symptoms of anxiety and depression. One important goal I look to when working with PMADs is helping women regain a sense of self. It may not be the self they knew before the baby but a new self that emerges in the transformation. Questions we consider: How does having a baby disrupt a mother’s sense of who she is, of her body, her understanding of life and death, her relation to the world and to her sense of independence, her experience of fear and hope and time, and the structure of her experience altogether?
Therapy may include the new baby, so that I can support a secure attachment and help the mom experience the infant’s behavior without insecure projection and negative interpretation. I may recommend infant massage or, inversely, setting the baby down for an extended period. Therapy may also include the partner or other family members. Marital disharmony is the most commonly cited non-biological cause and consequence of PMADs, so by bringing in and educating the partner on PMADs, a mom is more able to be understood and get her needs met at home. Group therapy, such as a moms support group, can be an excellent way to reduce shame and isolation, as it can provide universality, catharsis, socialization, and good information.
Additionally, psychopharmacology is an effective form of treatment for Perinatal Mood and Anxiety Disorders. Current research and an updated classification system (no longer the A, B, C labels for medications that were often misleading) suggest many medications are safe during pregnancy and breastfeeding. There is still damaging stigma around medication and pregnancy that needs to be fought with accurate information. Reducing a previously prescribed medication for pregnancy or changing a medication during breastfeeding are potentially misguided recommendations that can put a women at risk of relapse. The American College of Obstetricians and Gynecologists and the American Medical Association agree that treating the mother’s health is the priority; the trace amounts of medication that a fetus or nursing baby will receive should not keep a mother from the medical treatment she needs.
Although public awareness of postpartum depression has increased in recent years thanks to celebrities like Brooke Shields and Serena Williams, many people–including therapists–are still learning that PMADs are serious and pervasive experiences. When I started talking about my Postpartum OCD experience one of my aunts told me the story of my grandmother, who had three children in four years. The day after they brought home the third baby my grandfather got in his car to go to work, as he started to pull out of the driveway my grandmother came running outside and threw herself on the hood of his car. She spent the next 7 months in a sanitarium, a nicer version of an asylum in a neighboring state, and came home to her children who were being cared for by a strict German nanny. It’s possible my grandmother was experiencing depression or anxiety or even psychosis, they sent her away and no one discussed it. Although awareness and treatment have improved since the harsh days of my dear grandmother, perinatal mental health is still overdue for the attention it deserves, considering women are doing some of the most laborious and important work of our world.
Brooke Laufer is a Clinical Psychologist who has been practicing psychotherapy since 2005. Brooke began her clinical work in psychiatric wards and then in schools with adolescents and their families. After having her first child Brooke had a disturbing Postpartum OCD experience, which inspired her to begin researching, understanding, and specializing in the treatment of perinatal mental illness. She has a private practice in Evanston, where she continues to treat adolescents and adults, specializing in perinatal mental health issues.Brooke Laufer, Psy.D.
by Elizabeth DeAvilla RD
While becoming parents as a couple takes two, preparing your bodies is definitely an experience that takes both teamwork as well as some independent actions.
Know that everyone has different needs
We all know that men and women have different needs, that’s a given, and we also know that reasons of infertility can be very different as well, I mean, our bodies are built differently, thankfully! Let’s say that we need to increase or decrease a certain hormone, well, in our partner’s case it may be the same story, but with a whole different food group! Being able to understand where certain problems lie, could lead to very different solutions. While there are definitely foods and supplements that work wonders for both, no matter the gender, just know that what one partner is following for treatment may not be applicable, or even supportive of the others.
I used to hate running with my husband, he was so competitive, and I found myself trying to race him all the time. I bit the bullet and finally let him in on how I was feeling and he had a great response, “Oh, I thought that was your pace!” It was something that we had never talked about, and never set that game plan. Now we’re able to go out, set a good, (tolerable!) pace and have an enjoyable time. We are able to act as a cheerleader, as well as give accountability when that couch looks oh so tempting as well!
Be that Cheerleader
We all could use that high five every once in a while, and who better to give it than the one working towards the same goal? In fertility journeys there are many hurdles, as well as small successes when you look for them. Following treatment plans, taking our supplements/medications, completing medical/therapy appointments, procedures, positive results for one/both partners are all great ways to celebrate when you can!
Want to learn more about how nutrition can help you and/or your partner? Schedule a nutrition consultation today! Save in February with our $99 Wild Card special for an initial nutrition consultation!
Questions? Call us at: 312-321-0004. Elizabeth is available on T/R evenings in Chicago and alternating weekend days including Highland Park. She is available for phone consults as well for your convenience.
by Cassie Harrison RYT RYPT
February. Romance is in the air…or is it? Students in my Yoga for Fertility class audibly groan at the mere mention of sex. Especially if I suggest they have more of it. I get it. When trying to conceive, more often than not, sex becomes a chore. A root canal, really anything, is preferred over seeking passion in the bedroom. Mind you, this suggestion isn’t just about sex, it’s more than that. It’s about regaining an intimate connection with each other. Reminding each other that we are not just pawns in the bedroom, but two people (who are both struggling and who need each other more than ever) to regain trust, love, and compassion. Join me on on a journey to find more quality time in the bedroom.
Let’s go down that rabbit hole to open your minds to the thought of sex. The folks over at SexLoveYoga said “We don’t leave room in our mind for sex. It’s filled with other thoughts, but none devoted to sex, not sexy sex anyway.” This begs the question, what kind of thought comes to mind when you think about sex with your partner? Wait, am I being presumptive? Have you even thought about it, that is, outside the window of time to reproduce? Let’s start there. Now that you thought about it, what came to mind? Still having trouble, maybe this webinar, Sex Kitten from Tami Quinn, Co-Founder of Pulling Down the Moon, and Dr Shameless of Vibrant will help remind you what sexy sex is, and no it’s not what you’ve been doing!
Now that you’re thinking about sexy sex again, let’s tap into desire. It’s there, but it’s buried under all the other stuff that’s entered your life recently. Doctor appointments, medications, shots, ultrasounds, you have literally placed your sex life in a petri dish, not sexy! In order to get back on each other, what I mean is, no I meant that! Desire will not happen on it’s own, you must create it. Kissing. Touching. Snuggling. Spooning (my personal favorite). Effort will need to be made by both of you to receive the other. It’s easy to take each others role for granted during the fertility process. If your sex talk resembles “It’s time, hurry get in here, now perform!” Add pressure to that and then…nothing, mood killed by pressure, followed by disappointment, because it feels like an opportunity missed. This doesn’t have to be your story. Repeat, this doesn’t have to be your story. Hold each other, then write or name out loud a sexy sex bucket list. Should that fail to get your desire flowing, there’s always partner yoga. You can do it anytime, anywhere according to https://www.badyogi.com/.
Conceiving, sex and love making, what do these three have in common? Intimacy! According to Google, sex is an intimate act (convenient!). You can also show intimacy through closeness, rapport, and companionship just to name a few. These literal textbook definitions form the foundation of your relationship, deep stuff… my point is you might not be ready to have sexy sex, but by opening yourself to intimacy, the kind that starts by touching in the kitchen, a kiss before running out the door, and sharing your feelings (open book is my philosophy!). This just might allow for a deeper connection between you and your partner, something I imagine is needed now more than ever.
If you can do anything for each other this Valentines day, more important than giving a box of chocolates (I can’t believe I said that…) is giving your time to each other. Try a free couples massage, acupuncture, essential oil, and aphrodisiac snack included Date Night event at Pulling Down the Moon! Try this fertility-friendly Dinner for Two at home! In all seriousness, remember to make time for each other, give each other a break (you are a team after all) and get back to your sexual roots and reconnect. Start, by thinking about sex again…now make it sexier.
*Visit Cassie in Buffalo Grove on Feb 28th at 6pm for the FREE “Yoga for Fertility Intro Workshop“! Learn breathing and relaxation techniques featuring Q&A with Dr Alison K Rodgers of Fertility Centers of Illinois!
by Alison Lautz, LCSW, CYT
Hi all! Happy February aka the ‘Love Month’ or for all my friends living in Chicago the ‘Get me the Heck Out of this Frozen Tundra Month’. I come to you not as a fellow fertility patient, but as a therapist, yoga teacher, support, and girlfriend.
It’s no secret that trying to conceive can take a real toll on your sex life and relationship. Struggling to have a baby when you want one can transform sex from a fun and pleasurable activity to just another task within our very busy lives. Mix in the complex emotions that infertility can cause for both partners, and it’s not a shock that many find their relationship adversely affected by the feat of getting pregnant. The co-founder and owner of Pulling Down the Moon, Beth Heller, once told me “A strong partnership can survive even the most difficult of fertility journeys”. Please take a moment to think about what that means to you. Then take some more time to think about some of the moments when you have felt stress or tension build with your partner during your journey to conception.
The stellar news is that you don’t have to let infertility destroy your sex life or negatively impact your relationship. You can keep your relationship strong, no matter what the outcome of your infertility treatments are, by putting your love and friendship before anything else. Don’t neglect the spark or butterfly feelings that you’ve always had in your relationship, that ‘tingle’ that made you want to commit yourselves to only each other. Keep having sex just for fun, respect your partner’s privacy, and look for other ways to cultivate intimacy and fun between the two of you.
- Keep the Fun in Sex
Many couples who are trying to conceive get so wrapped up in the baby-making logistics of sex (ovulation strips, basal body temperature, supplement regimen, fertility friendly positions) that they don’t remember that they actually used to enjoy sex before they decided to try for a baby. Even if you’ve been trying unsuccessfully to have a baby for years, you should still have sex just for fun. Make a clear distinction between sex that you’re having for procreative purposes and recreational lovemaking. Reserve specific positions for procreative sex, or only have procreative sex when you’re fertile. Spice things up by having recreational love making in other rooms in the house and leave the procreative sex for the bedroom
- Respect Your Partner’s Privacy
When you’re experiencing any major life struggle like infertility, it’s healthy and normal to want to vent with your friends, co workers, and family. Please proceed with caution as sharing with your personal support networks could lead you to divulge aspects of your sex life or relationship that your partner wants to keep private. First of all, talk to your partner before you talk to your friends or loved ones. Ascertain whether your partner is uncomfortable with the thought of others knowing the details of your fertility struggles. You should still be able to talk about your frustration, sadness, guilt or other feelings about infertility, without divulging private details that could potentially embarrass your partner.
- Put Your Relationship First
Whether or not your fertility treatments are successful, you and your partner still want to stay married and happy, right? That won’t happen if you don’t put the relationship first. Of course, becoming parents is important, too, but you should make nurturing your relationship the main priority throughout the course of your infertility treatments. Continue to bond over trying new things together, taking trips (but avoiding the Zika), cuddling, cooking together, or just a much needed date night (try the FREE Valentine’s Day Date Night at Pulling Down the Moon!) on a regular schedule.
- Have some fun with something like a ‘Spontaneity Jar’
What does this mean? Each partner lists ten fun, random, yet still attainable things that they enjoy on slips of paper. When you have a free hour, it’s one partner turn to draw out of the jar. These “activities” can be as simple as go on a neighborhood walk for a glass of wine (I will be hosting a yoga & wine night March 7th!) or ice cream, massage each other (here is a how-to couples massage video!), watch a stand-up comedian on Netflix, or take a yoga class together. Or you can get really goofy, the possibilities are endless.
- Self Care
What does this mean to you? Please don’t neglect your body and mind during your fertility journey. You may need time with your girlfriends, a hot bath, an hour of quiet reading, a ‘sick day’ from work, a massage or spa day, a regular yoga practice, a support group (Shine is great), or talk therapy with a therapist outside of your inner circle who can offer unbiased insight and support.
Want to explore taking care of yourself with therapy or a regular yoga practice? Alison Lautz is a Licensed Clinical Social Worker and Certified Yoga Teacher (including Yoga for Fertility and private yoga at Pulling Down the Moon Chicago) in private practice in River North. Alison has over twelve years of experience working in healthcare settings in the areas of perinatal mood disorders, adjustment to parenthood, loss, grief, infertility, anxiety, depression, chronic illness, sexual assault, domestic violence, life transitions, and relationship shifts. Here more from Alison on staying connected with your partner while TTC at this FREE Shine Together: In Person Meet-up with Shine Fertility at Pulling Down the Moon Chicago on Feb 12th!
Alison specializes in helping clients through life transitions, relationship shifts, depression, anxiety, chronic stress, and self esteem issues. She has a passion for working with women experiencing perinatal mood disorders, infertility, high risk pregnancy, perinatal loss, and adjustment to motherhood. Prior to starting her own practice in Chicago’s River North neighborhood, Alison worked for many years with pregnant and postpartum women at Northwestern Medicine’s Prentice Women’s Hospital.
Alison uses her warm personality, training, and experience to help clients find peace and success. This allows them to become the best version of themselves. She uses a client centered approach combined with a variety of therapeutic techniques including Cognitive Behavioral Therapy, Motivational Interviewing, Mindfulness, and Strengths Based Therapy. She strives to create a comfortable space which allows for individualized growth and change.
Alison is a Psychotherapist, a Licensed Clinical Social Worker, an Accredited Case Manager, and a Registered Yoga Teacher. Alison obtained her Bachelors of Arts from University of Iowa followed by her Masters in Healthcare Focused Social Work from University of Illinois at Chicago. Please reach out to learn more about how Alison can help support you on your journey to parenthood.
222 W Ontario Street Ste. 310
815-341-9244 (call or text)
by Marie Davidson, Ph.D.
As I write this it is actually the Feast of the Epiphany, celebrated in Christian tradition as the day the Wise Men arrived from the East after the birth of Christ, led to their destination by a star. The Merriam Webster Dictionary also offers these definitions of epiphany: “A sudden perception of the essential meaning of something;” an intuitive grasp of reality through something simple or striking;” and “an illuminating realization.”
Many years ago, as measured in ordinary time, but not all that long ago as measured in emotional impact, I experienced an epiphany that made all the difference to me as a suffering fertility patient. I dwelled in distress much of the time, my thoughts haunted by the many challenges of treatment, the succession of disappointments, and, worst of all, the complete absence of any certainty about how this fertility drama would turn out.
One morning, my moment of epiphany arrived quite suddenly. No wise men or wise women arrived, and no guiding star appeared, just a swiftly dawning realization of what I was really going through—right now—in my life. To this day I cannot say for sure what brought on this intuitive grasp of reality at that particular moment. I suppose it was the result of many, many months of efforts to not embrace my situation. My distress had served to only highlight my sadness and anger and to keep me from moving past that. It was just no longer a reasonable option to keep this exhausting process going. So, I had a serious, mildly humorous chat with myself.
This is what I said:
“OK, Marie, this is what’s going on in your life right now—you and your husband have been in a battle against infertility (and against each other, truthfully.) Infertility sucks, but it’s what you’ve got. You didn’t cause it, and you may or may not overcome it in the way you hope. You don’t know the end of this drama you are in because the screenplay isn’t finished. But there is something you can do, and that is to accept the role you’ve been assigned and act it out as skillfully and graciously as you can. Inhabit the script! Be the star in your own drama, dammit!”
Or something like that, it’s pretty close to the internal conversation I had. I definitely know I made a conscious decision to star in my own story. I would be the guiding star leading me to my unknown destination.
My life improved after that. Far from wonderful and still plenty of stress and anxiety, but I had a peace of mind that had eluded me for a long time. I rather think I excelled in playing myself—the woman who happened to be an infertility patient; the woman who accepted her inability to control the next act in the play I was starring in; the woman who was now able to experience the other parts of her life without the dark film of infertility blocking the view.
I did not know then that my life’s work would be a career counseling fertility patients. What a privilege it has been. A number of years ago, I met a woman who had come to talk about family-building options. She’d been through a lot of treatment with no success. I noticed how even-keeled she was as she spoke of her history and I commented, “You seem to be handling all of this pretty well.” She said, “Well, you should have seen me a year ago, when I was a complete basket-case.” I asked, “So, what happened?” Her answer was, “One day I decided to accept the basic background reality of my life.” I smiled. “You had an epiphany.”
Over the years, I have found it very useful to apply the same kind of epiphany to other life situations—the ones you can’t control but must live in and through. Whatever it is I struggle with, I try my best to be as skilled and gracious as I can be, even if I won’t win any Golden Globes. Strangely, the experience of an infertility journey can give you a valuable perspective on how to deal with the inevitable brick-bats of life.
Marie Davidson, Ph.D.
Fertility Centers of Illinois
Dr. Marie Davidson is a licensed clinical psychologist and patient educator. She specializes in counseling individuals and couples who are coping with infertility, and has provided counseling services to patients, donors, and surrogates since 1992. Dr. Davidson earned her doctoral degree at the University of Illinois in 1988. She facilitates patient education seminars on numerous topics such as considering egg donation and cracking the door to adoption, leads several women and couples support groups, and is widely published in the fertility field. She has been an invited speaker at many professional meetings.
Her personalized care and detailed understanding of the treatment process have been a welcome and supportive resource to many couples and individuals as they seek to grow a family.
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