Mental Health Support: Fertility Edition

Mental Health Support: Fertility Edition

Ariel Taylor is a fertility therapist and 4x (soon to be five!) surrogate. Her area of expertise includes fertility, surrogacy, and postpartum care. She currently practices virtually and is based out of Ontario, Canada.

Mental health is a core pillar of our overall well-being, so it's no surprise that while trying to conceive, dealing with infertility, or postpartum, our mental health is taxed along with our physical bodies. All of these are isolating experiences in their own right, but the pandemic only further threw both couples and individuals alike into further isolation. While resources and support abound, the first step in getting support is knowing that support exists.

We had the pleasure of speaking with fertility therapist (and Ovry ambassador!) Ariel Taylor all about mental health when it comes to fertility. Here’s what she had to say:

The Intersection of Mental Health and the Fertility Journey

“Now more than ever, we are seeing major effects of the mental health crisis happening in this country, and those going through infertility are no exception,” shares Taylor. “Across the board, we're seeing increases in self-reported rates of anxiety and depression and stress.” When it comes to dealing with infertility, in particular, she shares “I think one of the hardest parts is that it comes with the feeling of complete lack of control and the idea that the ability to have children has been completely robbed from you.” 

Social media can often exacerbate these feelings, as you may be watching other people get pregnant and easily move on to their second or third child, meanwhile, you're still trying to have your first. Taylor shares, “there's this unique aspect of trauma and grief that comes from infertility. And those things are often internalized by people where they really feel like it's their fault”. She goes on to say “infertility is one of the only medical diagnoses where the general public reaction is to offer baseless advice such as ‘relax’ or’ think positive’ or ‘go get drunk on vacation’. I think the problem with that kind of dialogue is that those types of comments and advice really make people feel further isolated and alone.” Not only are comments such as these insensitive, but they also imply that the person doesn’t understand what the other person is going through. While this is likely out of ignorance and not malice, it is nonetheless hurtful and can lead to further feelings of alienation. 

Support While Trying to Conceive

Support can look and come in many forms. Taylor shares, “I think that the best way to support yourself is by finding people to support you”. So if you're struggling to get pregnant, “don't wait to refer yourself to a fertility clinic. Don't be afraid to ask questions. Don't be afraid to advocate for yourself, to ask for a second opinion, to ask for testing. Never kind of give up on what you're trying to do,” she adds. 

If you’re just starting to think about trying to conceive, tracking your cycle and learning when you ovulate is a great first step (we’ve got tests for that!). “The number of people that I talk to either on Instagram or in my counselling practice that don't really have much of an idea of how their bodies work is shockingly high” shares Taylor. 

Knowledge is power and the more we can educate ourselves about our own bodies, the more informed and prepared we tend to feel. In addition to getting to know your body, Taylor also adds that “finding local or online support groups, having a close group of friends or family that you can confide in, having a therapist on standby, all of those things really help buffer all of the negative effects of infertility.” She goes on to say, “I also think it's really important to take care of yourself. I'm a big self-care advocate, and that goes far beyond bubble baths and face masks. It's ensuring you’re doing those very basic things like eating well, sleeping well and getting a good night's rest, spending time outside–really enjoying your life while going through infertility as well is really important.”  

Navigating the Capitalization of Infertility 

A lot of marketing in the fertility space can be somewhat predatory. It seems there’s always a new supplement to try, foods you should/shouldn't be eating, online webinars or guidebooks to help you get pregnant–the list goes on. When it feels like there is always one more thing you should try or be doing, it can feel, especially for women, that they aren’t doing enough or there is something wrong with them. Taylor challenges this sentiment, sharing “I think it is so important for people going through infertility to know that infertility is a medical condition and that it’s entirely possible to do every single thing right, and you can still have infertility.” 

She also points out that those things aren’t inherently wrong, in fact, “maybe that extra supplement makes your body feel good. Or maybe that exercise routine or specific diet, especially in the case of conditions such as PCOS, helps you feel better? But it's also important to balance that with the reality that infertility is a medical condition.”

Taylor reminds those dealing with infertility, “you can read all the books, you can take all the pills, you can cut out all the bad stuff, you can be so focused on doing all of the things right, and you could still have infertility and still not be able to get pregnant or get your partner pregnant. So there's got to be that balance of, I'm going to do enough, and that's going to be enough.”

Miscarriage and Postpartum Support

Everyone’s fertility journey looks different, but with 1 in 4 pregnancies ending in miscarriage, and with up to 15% of women who do carry to term reporting experiencing postpartum depression, these two factors play a big role in our mental health journey. 

Taylor shares “PPD is something that I treat very, very often in my counselling practice”, going on to say, “we are seeing substantial increases in postpartum depression and anxiety, largely due to the pandemic.”

A study conducted by the University of Alberta found that 40% of respondents who were pregnant or had given birth within the last year, had survey scores indicative of depression, compared with 15% pre-pandemic; while moderate-to-high anxiety was identified in 72% of women versus 29% pre-pandemic.

Taylor shares, “we know that depression is made worse by lack of support and feeling isolated, and then we have a pandemic, which forced all these new parents into isolation. It also meant that many of these parents suffered in silence, as they were unable to access services and the support of their community. And then on top of that, there’s this kind of grief of ‘this is not what this was supposed to look like’, which is a common theme for anybody going through infertility as well.”

When it comes to those who experienced miscarriages during the pandemic, she says, “similarily, that isolation kind of leads to the same outcome [depression]. And that's debilitating, from having to go to ultrasounds alone, to find out that your baby has died alone. It’s just not fair”. 

To those who have never experienced a miscarriage, they are not only physiological, they affect one’s mental well-being as well. Because of this, Taylor finds grief counselling to be so important. “So many women feel that when they experience a miscarriage, societally, it’s just not seen in the same way other losses are. That there’s this kind of idea that oh, well, you can always have another one”. With a hint of sarcasm she adds, “no one says that when your grandpa dies, they don't say, ‘Oh, well, at least you have another Grandpa’.” 

As the stigma of miscarriages still weighs heavy in our society, having a safe space to talk about the loss, to process the grief, is really important. “I mean, it never goes away [grief], we just learn to cope with it a little better,” says Taylor. She urges those who have experienced a miscarriage to seek professional support, as oftentimes “we bury that down, and I've seen it come up in counselling, even years later when you’d least expect it. So being able to process what has happened and move forward from that–I don't think we ever move on but we move forward–is a really healthy step for people.”

When it comes to treatment for PPD, Taylor shares, “interpersonal psychotherapy is one of the main treatments for postpartum depression that has been extremely effective. A lot of people see improvements, even after three or four sessions.” Therapy can help aid the healing process as, “it's about learning those triggers, practicing coping strategies, understanding yourself and your own boundaries, and how to identify when you need a break”, she shares. “Sometimes anxiety is that warning sign that you need to slow down, that you need to stop, that you need to ask for help. And women especially are typically not very good at that. Especially in postpartum when there's pressure to be this perfect new parent and do everything the perfect way.” 

As women, we put so much pressure on ourselves across the board, but Taylor reminds us, “there is no one right way to do postpartum. There are a million ways to do it, and your way might not look like anybody else’s and that’s fine, as long as it works for you.”

Not only is counselling important for loss support and postpartum, but it is also highly beneficial in the prenatal period. Getting the support of a professional in place before baby comes can allow you to do some of the work upfront, and means you have someone to turn to when needed once baby arrives.

Support Comes in Many Forms

If you’re dealing with infertility, it can feel so isolating, as if you were the only person going through it. But there is so much support out there that is available to you. Taylor shares, “research shows us that the biggest protective factor for mental health is a strong support system”. And that's even more crucial for people going through infertility or miscarriage or postpartum depression, “because those groups tend to be the ones that are the most isolated, and they're also less likely to access services,” she adds.

While the pandemic has brought its challenges when it comes to accessing care, virtual counselling has really taken off, of which Taylor’s practice runs solely. “We can meet clients exactly where they're at”, for example, “a postpartum client is not going to pack up their newborn, and then drive to an office and sit through a counselling session, but they will sit on their couch with their phone while their baby sleeps, which is exactly where I meet them.”

Taylor reminds us that a support system might look different for everybody, “it could be friends, it could be family, it could be your medical team, your therapist, Facebook groups or other in-person support groups.” Whatever support is available to you, lean on it. You don’t have to go it alone. 

Please note: if you’re going through a tough time, know that support is out there and available to you. Please seek help. The Government of Canada’s Mental Health Support page may be a good first step. You can also find mental health practitioners in your area or virtually on Psychology Today. Counselling service fees are often eligible for coverage, so be sure to check your health plan for financial support. 

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