Emotional Support

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Before I formed you in the womb I knew you.
–Jeremiah 1:5

Pregnancy begins psychologically, long before it does physically. From an early age, children have imaginative play about having babies and being parents. Teenagers fantasize of love, marriage, and family. Young couples talk, plan, and dream about birth and how many children they will have.

If you are trying to conceive, it can seem like you already know this child well – the wished-for baby in many become pregnant, bonding increases. This is facilitated by information learned from new medical technology, which just not so long ago would not have been know until after birth. Today, blood tests can let a woman know she is pregnant before she misses her period. Sonograms provide a window into the uterus and a picture of your baby before any physical changes have occurred to make others aware of your pregnancy. Genetic blood testing can let you know the sex of your baby and genetic make-up before you are even wearing maternity clothes. Because of these factors, the fetus is seen as a baby/person much earlier and bonding occurs much sooner than in years past.

The magnitude of miscarriage – to lose a baby within the first few months of conception – can be great. For you to experience the elation of learning you are pregnant, only to feel the despair of discovering you have miscarried, is a multifaceted loss. It is the loss of a baby, a part of yourself, your health, control, innocence, potential, relationships with others, possibly your reproductive capacity, and on and on.

The same kinds of feelings can be experienced after an unsuccessful IVF cycle. You may view each fertilized egg, whether transferred or not, as a baby. When a cycle fails to achieve a confirmed pregnancy it can feel like a miscarriage.

In our society, we measure grief by the size of the coffin.

– – Sherokee Ilse, Empty Arms

It is often difficult for people to understand what a profound loss a miscarriage can be for a couple. And yet the grief can be like a tidal wave that sweeps over you when you lose your baby, no matter how far along you were. Feelings such as disbelief, anger, rage, blame, guilt, sadness, and depression may engulf you, growing and cresting with time. The feelings can recur and are highly individual, based upon your own personality and life experiences. Grieving is a uniquely personal experience.

The size and depth of the tidal wave will depend on a number of factors, primarily concerning your psychological investment in this pregnancy. For example, often the longer one has been trying to conceive, the greater the sense of loss that results from miscarrying. The wave of grief seems to crest somewhere between three to nine months after your loss.

When the crest has passed and the water seems to have calmed, there can still be swells. These are rekindled feelings and are often triggered by reminders of your baby – your due date, holidays, or times of the year. Each person has his or her own triggers which are related to real memories and what you wished or imagined about your baby.

A person is a person no matter how small …

– – Dr. Seuss, Horton Hatches the Egg
Grieving is the way to heal emotionally from the loss of your baby. Here are some positive steps that can help you in the healing process:
  • Recognize that your miscarriage is a significant and real loss. It is the death of a baby, with all the hopes and dreams. Find ways to acknowledge your baby’s existence: have a memorial or religious service; give a donation or gift to a special charity; plant a tree or flowers; put together a memory box; engrave a charm to wear; or give your baby a name.
  • Understand that you and your partner will feel and deal differently with the loss. Be patient and understanding of each other’s feelings, realizing that different doesn’t mean better or worse. You will each need time to integrate this loss into your life. Keep communication open.
  • Let people know how you feel and what they can do to help you. You may find that one of the most difficult tasks after a miscarriage is facing the people who knew you were pregnant. Sometimes they may say things that are hurtful, however well intended. Often people want to help but don’t know how.
  • Prepare ahead for such “reminder” days as your due date, holidays, and the anniversary of your miscarriage. Make some gesture of commemoration, such as lighting a candle, attending a religious service, or making a memorial donation. Have a special dinner or send flowers in your baby’s memory to someone who has been especially supportive.
  • Seek support from others who have had similar experiences, through support groups and friends, or by reading books on the subject. Organizations such as Resolve, Share, MIS, and Return to Zero offer groups and resources specifically for pregnancy loss. Professional counseling with a mental health professional trained in reproductive loss can also help you get through a difficult period.
  • Find creative ways to express your feelings. Use art as a medium to channel emotions, such as writing a letter or journal to your baby, drawing, composing music, or sculpting. This beautiful poem sums up the magnitude of miscarriage:
A Pray for Baby
Never to have known you, but to have loved you.
Never to have held you, the way mothers do.
With you I bury my hopes and dreams
For an unknown child I’d never seen.
But also I bury the love in my heart
And the sadness of knowing that we must part.
And I pray to God to do for you
All the things that I would like to do.
And to keep my baby safe from harm
To laugh and frolic in springtime’s arms.

Suggested Reading

The Miscarriage Map: What to expect when you are no
longer expecting. Sunita Osborn, 2019.

Support Resources

Resolve
Miscarriage, Infant Death and Stillbirth (DMV
area)
SHARE
MISS Foundation
Return to Zero

Used with permission of:
Sharon N. Covington, LCSW-C
August 2022

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Facing the challenge of infertility can be a stressful time for couples, but it does not have to be a strain on your relationship. Working together as partners can help you form a strong bond and allow you to move through the infertility journey as a team. It’s important to find ways to support your partner so you can recognize their feelings and needs.  

Four ways to support your partner during infertility: 

  1. Ask your partner how you can help decrease their stress.  
    • It is important to note that stress is likely not causing infertility, but it can be helpful to have coping mechanisms in place to reduce stress throughout the journey. The American Society of Reproductive Medicine (ASRM) offers a Stress and Infertility Fact Sheet. Listen to your partner’s guidance on how you can help your partner reduce stress and follow through with their requests.    
  2. Have open and honest conversations about treatment plans.  
    • When a treatment plan changes or doesn’t go as planned, be ready to discuss preferred next steps with your partner. Check in on how your partner is feeling about these adjustments. Learning more about treatment options can be a great place to start in supporting your partner. SGF provides a stepped-care approach to treatment and provides support throughout the process.  
  3. Plan fun activities together.  
    • Don’t forget to prioritize spending quality time together. Since dealing with infertility can feel like a full-time job, it is important to take time off by consciously making time for each other. Have regular dates where you can have fun and take a break from infertility. Do some of your favorite activities like taking a long walk, enjoying a good meal, or watching a favorite movie or show. SGF’s psychosocial team offers some ways to enhance your relationship during infertility.  
  4. Encourage your partner to join a support group or seek counseling and join them, too, if helpful. 
    • SGF offers patients a wide range of support services, including support groups, online communities, and resourceful articles. SGF is proud to have an in-house team for psychological support and can recommend other preferred partners. Attending one of our support groups is a highly effective way for you and your partner to learn different techniques for managing the stress of treatment in a supportive and open environment. 

Nurturing your partner throughout fertility treatment can ease the bumps and inevitable stresses of the journey. When you and your partner feel supported and heard, you will both be better prepared to handle obstacles that might come your way.  

Find a support group near you. 

Contributed by:
Mia Joelsson, LCSW-C

Mrs. Joelsson is a licensed clinical social worker in Pennsylvania, Virginia, West Virginia, and Maryland. She has a special interest in working with individuals and couples facing reproductive challenges of infertility, pregnancy, pregnancy loss, and postpartum adjustment. She sees clients virtually and in her Gaithersburg, MD office.  Mrs. Joelsson is passionate about helping infertility graduates who are adapting to the new realities of pregnancy and parenting after struggling with infertility. She leads the virtual miscarriage support group that SGF offers.  

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To learn more about how to support your partner during infertility or to schedule an appointment, please call our New Patient Liaisons at 1-877-971-7755 or click here. 

Editor’s Note: This article was originally published in December 2016 and has been updated for content accuracy and comprehensiveness as of July 2022.

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Finally, seek the help of a mental health professional familiar with reproductive health problems as you go through infertility can be useful whether you are in the beginning phase of testing and treatment or whether you have been at it for a long time. Meeting with a counselor in the early stages of infertility treatment can help prepare you for what may lie further down the road, and help you to know what feelings are normal and expected as you go through the process. If you have been going through infertility treatment for a long time, counseling can help you take stock of where you are, reassess your goals, and help you to set a reasonable time frame for continuing treatment versus pursuing other options like adoption. Counseling can also help to focus and restore some of your feelings for each other as a couple – something that often gets lost in the intense pursuit for a baby.
In sum, if you are feeling depleted by the process of going through infertility, counseling may offer you the support you need to feel energized enough to continue. It is important to realize that you need not be at the breaking point to feel that you should turn to counseling for support. Even if you are coping well, it can help you to clarify your goals and set reasonable expectations and limitations. Having a regular place to “leave” your emotional burdens can also help free you up to enjoy life more fully and spend less time obsessing about infertility.
Last, but not least, joining a RESOLVE support group or one through your clinic can help ease the isolation of infertility by connecting with others who truly understand and share your feelings.
In general, I see going through infertility as a time to think about your own needs and to take care of yourself. Turning to others for support, whether it be friends, family, your spouse, or professionals, can help you feel less burdened, less isolated, and better able to cope with what lies ahead. You have the right to decide what kind of support can help you most. Learning to ask for it in some of the ways discussed above can help you make use of support without leaving you feeling vulnerable and out of control.
The following articles provide guidelines that you can use in turning to others for emotional support in a way that can leave you feeling back in control:
Importance of Seeking Psychological Support
Talking to Friends and Family
Talking to Your Spouse
Contributed by: 
Patricia Sachs, LCSW-C

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An increasing number of lesbian couples are using reproductive technology to become parents. Not having suffered the heartaches of infertility treatment, they generally come to the process hopeful and thankful that there is a way for them to achieve the dream of parenthood. The social landscape for lesbian couples, particularly those in large urban areas, has changed significantly in recent years. Over half of Americans believe that gay/lesbians should be able to marry. At the same time there are still many legal barriers which are particularly frustrating when people have a family in mind. For example, without a marriage license in the state of residence, the parent who did not give birth has to adopt her child to have the legal status of parent.
For some couples it is clear who will carry the child. Other couples need to negotiate this based on age and medical history. A subset of women choose to have one partner carry the other partner’s egg. This has the obvious advantage of involving both partners and the disadvantage of making it more complicated and expensive.
The “other mother” has a challenging role that has no road map. Certainly her inclusion in all parts of the decision making is key for her feeling integral to the process. Couples report that they benefit from having well articulated and flexible expectations about roles. The first year, though wonderful, can also be trying for the mother who did not give birth because the attention is so focused on the baby and the birth mother, particularly if she is nursing. The mother who did not give birth to her child may understandably feel jealous and sidelined both inside her relationship and by others who may not know how to construe her role. With good communication and the passage of time, couples work out their unique way of relating within the new family triad.
For better or for worse, all parents and parents to be have to rework their relationship with their parents. Couples will want to think carefully about how to best handle the news of a pregnancy. Families who have not accepted their daughter’s sexual orientation and/ or female partner will have to revisit the topic when their child or child’s partner becomes pregnant. Some families become more open when a child enters the family system. Other families continue to struggle and it can create heartache and confusion in the midst of an otherwise joyous time.
Because of the variety of hurdles, couples will want to not only work on their family relationships, but also build a chosen family of support. This could include close friends, colleagues, mental health professionals and groups as well as online support through blogs and chat rooms. Eventually it will be important to build a support system of families built in the same way both for the benefit of the parents who can learn from each others experiences and for the children who will benefit from knowing that there are other families like theirs.
Many couples begin the path to parenthood with the idea of using a known sperm donor. If the relationship with the donor is solid and predictable, this can have benefits for all. However people often worry that one or more of the parties – ultimately including the child – will alter their expectations. Because of this, unidentified sperm banks often seem simpler.
Some couples report that accessing a sperm bank for the first time is a surreal experience, leaving them with the initial illusion that they can order a child to specifications. Other couples feel overwhelmed by the number of choices. Couples may find it useful if they begin by identifying what is most important to them- physical attributes, health, interests, and values.
Prospective parents will also want to consider whether they want to choose a donor who has consented to be contacted if the child is interested after age 18. Trying to think back to how it feels to be a teenager will help in making that decision. In the end, the most important variable in choosing the donor may be whether the prospective parents like the person. A genuinely positive opinion about the donor gets communicated to children in subtle ways. Many children are interested in how the person who is half of their genetic make up was chosen so writing down how that choice was made is worthwhile. It is one way of many ways of beginning to prepare for the myriad questions that a child may have about his or her conception and genetic heritage.
The research about how children in two mother families fare has been positive. The children of lesbian moms are as well adjusted and perform as well as their peers in heterosexual families. At the same time, the children will have some extra challenges to deal with. For some children these may be daunting at certain stages of development; for others they will be very minor themes. Temperament, life experiences and parental support all play a role in how a child responds to these challenges. Children may experience confusion or a sense of loss about the way their family was built. They may have an interest in their many half siblings or they may experience prejudice about the way their family was built. Parents can best help their children by simply listening and supporting them in their quest to better understand themselves and their origins. They can also help them by seeking out other lesbian or gay families.
One of the family’s main tasks will be to rejoice in the strengths that come from having a child so intentionally while acknowledging that their children will likely have some extra issues to deal with. Finally parents will want to help their children place their kind of family squarely in the broad and expanding spectrum of modern American families.
Contributed by:
Michelle Hester, MSW
Thanks to Alison Gerig MSW, Women’s Therapy Center, Philadelphia, PA

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Going through infertility may be the first major life crisis that a couple faces together, and it may be the time when you need each other most. Yet sometimes couples withdraw from each other at a time when they most need support because of problems communicating. Recognizing that you and your spouse need not (and probably cannot) be in the same place emotionally at the same time, or express or cope with your feelings in the same way. In general, women may feel the need to talk more and connect with others, while men may throw themselves into their work with greater intensity. However, just because you cope in different ways does not mean that you can not derive emotional support from each other.
Merle Bombardieri, M.S.W., suggests a technique for couples’ communication called the “Twenty-minute Rule.” If you find you’re needing to talk about infertility a lot of the time, but your spouse gets overwhelmed by this and shuts down, Bombardieri suggests limiting the talk to 20 minutes per day. This way you know you have your spouses undivided attention for that time and he/she knows at the end of it you’ll stop. Knowing that you have a fixed time each day may help free up your energy and thoughts for other things and yet help you feel connected to your spouse emotionally. It’s hard enough feeling isolated at times from the rest of the fertile world, but it can be extremely painful to feel alienated from your spouse when you perhaps need that person the most.
The following articles provide guidelines that you can use in turning to others for emotional support in a way that can leave you feeling back in control:
Importance of Seeking Psychological Support
Talking to Friends and Family
Getting Counseling
Contributed by: 
Patricia Sachs, LCSW-C

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One reason you may retreat from sharing your feelings with friends and family is that you are afraid that what they say in response may hurt and make you feel worse. You may have heard comments from friends or family telling you just to relax or adopt, and you’ll get pregnant! Or they may repeat stories to you of people they know who spent years in infertility treatment only to become pregnant years later – spontaneously!
You need to realize that people make these comments not to hurt you, but because they want to make you feel better and simply do not know the right things to say. Rather than worrying that you’ll feel hurt and angry at your friends for what they say, you can take control back by simply educating people about what helps you and what does not. For those who tell you to relax or adopt, you can let them know that most infertility has a medical basis and is not caused by stress (though it causes stress, for sure!), and that statistically most who adopt do not get pregnant, not to mention how this attitude diminishes adoption.
For those who tell you stories of all the people they know who eventually did get pregnant, you can tell them that it really doesn’t help you to hear that because every situation is different and for you the chances of success really feel like 0 or 100% in any given cycle. I once told a friend that when she told me these stories it only increased my feelings of self blame, and needless to say, she stopped telling me them!
Realizing that you can educate and raise awareness in those you care about and who care about you can keep them from making insensitive comments in the future and can give you back feelings of power over your situation. Obviously it is important to be selective about whom you wish to talk to in this way, as you may feel worse if you later think you came across as being too defensive or pedantic. You should carefully select those friends and family members who you wish to enlighten and educate in order to help you receive the support you need.
For others, practicing using humor or simply ignoring comments and letting them roll off your back. If you know you have a good support network in place, you won’t need to look everywhere for it.
Finally, rather than feeling anxious that friends or family may bring up your infertility at times when you don’t want to talk about it, try thinking about what you feel you need, and then letting them know. Someone recently recounted to me that she always felt anxious at family gatherings because she knew she’d be asked the inevitable “Are you pregnant yet?” or “What’s happening?” questions, when the problem was that “nothing” was happening!
If anxiety about these questions deters you from family gatherings, try telling others that you’d certainly let them know if something did happen, but otherwise you’d just appreciate being asked about your feelings, or leaving it to you to bring up the subject. However, you should recognize that if your family has not been there for you on an emotional level in the past, chances are they will not be there now. There is nothing magical about infertility that will change family interaction patterns, and realizing this can help you avoid disappointment.
The important point in all of this is that you can gain support from others in ways that feel good to you if you take the time to figure out what you need and to let others know. You needn’t back away from seeking emotional support just because you’ve experienced some insensitive remarks in the past.
The following articles provide guidelines that you can use in turning to others for emotional support in a way that can leave you feeling back in control:
Importance of Seeking Psychological Support
Talking to Your Spouse
Getting Counseling
Contributed by: 
Patricia Sachs, LCSW-C

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