When I suffered a miscarriage before my two children were conceived, I blamed myself. Did I murder my unborn child? It seemed others thought so. Numerous people told me, “next time you will take it easier.” I now know that it was not my fault. That the vast majority of pregnancy losses, especially during the first trimester, are due to random chromosomal abnormalities. At any stage in pregnancy, it is very rare for a loss to occur due to something that was within a woman’s own control.

As an infertility counsellor, I routinely see women who wholeheartedly believe that their inability to get pregnant, or their pregnancy loss, is their own fault. One reason for this is the prevalent myth that stress prevents pregnancy and causes miscarriages.
The first thing a woman usually hears when she confesses she is dealing with infertility is that she should just relax and it will happen – or stop thinking about it so much and take a holiday. This is even more common for women to hear when the cause of the infertility for herself and her partner are unexplained. Unfortunately, it is very common for infertility and even recurrent pregnancy losses to be unexplained. Apparently, no identifiable medical explanation, according to most people, means it must be the woman is too stressed. Never the man though.

Even when a couple is facing male-factor infertility, apparently the woman still has to relax. I call this the 21st Century Hysteria diagnosis. A surprising number of people seem to ignore the fact that men may have any role in reproductive success. Yet in her book on epigenetics, “You are What Your Grandparents Ate” author Judith Finlayson discusses the burgeoning area of research linking sperm health to aspects of fertility and even miscarriage risk. Nevertheless, if anything goes wrong with fertility or pregnancy, it is always assumed – outside of the medical community – to be the woman’s fault.

Clients of mine have been told hurtful and absurd things by loved ones, strangers and various ‘healers’ about how to ‘cure’ their infertility that does nothing more than increase their stress. Most often, they are told it must be their job that is causing the infertility. While a few studies have found shift work and very physically taxing jobs can lower fertility, these are rarely the types of jobs held by my clients who are told to rethink their careers. No, it seems to be the lawyers and managers climbing the corporate ladder, with the audacity to enter into traditionally male-dominated fields that are causing their own infertility. I have had numerous clients take leave from their jobs for extended periods, or even give up their career altogether, because so many people have told them their infertility must be caused by their job.

If it’s not her career, than others usually point to some type of emotional trauma as the cause of a woman’s infertility. Most women struggling with infertility feel powerless, anxious and desperate. This leaves them extremely vulnerable to manipulation and there are people everywhere happy to exploit it for their own good. A number of my clients have been convinced by someone (either a healer of some type they consulted, or through unsolicited advice from others), that their inability to get or stay pregnant is due to unresolved grief after losing a loved one, their negative thinking, or worse, some misdeed they committed in a previous life or their heart and womb are not properly aligned. You might think that hearing that she just has to think more positively, get closure on a past hurt or get over the loss of a loved one will give her a sense of agency, but it does just the opposite. It simply exacerbates women’s anxiety over the infertility and also fosters feelings of shame and guilt on top of it.
Let’s get real for a second here. Neither emotional pain, nor negative thinking, nor stress cause infertility. Physical and extreme emotional stress can disrupt ovulation and hormones, most often in a condition called Hypothalamic Amenorrhea (HA), often experienced by elite female athletes. But this is not unexplained infertility. Unexplained infertility means there are not identifiable causes. HA and anovulation are easily identifiable symptoms. If someone has unexplained infertility, it means these things have already been ruled out.

There have been a few studies in the past that linked elevated stress with having more difficulty conceiving. But more recent research has questioned this link. For one, there are many ways to measure stress (self-report, cortisol levels, etc.) and also just trying to conceive can elevate anxiety. Struggling for a lengthy time to conceive definitely elevates anxiety as does going through fertility treatments and most studies are correlational. A recent meta-analysis that examined 20 different studies, found no relationship between women’s emotional states and fertility treatment outcomes.
Here is what really makes me angry. We have this deeply entrenched belief that modern working women in developed countries are causing their own infertility through working demanding jobs or fretting about something (or just fretting about infertility itself). If women who have experienced abuse, or been surviving in a concentration camp could become pregnant – it is clear to me that those are environments of high stress where it is hard to think positively.

The problem is, we humans really hate not having explanations for why things, especially bad things, happen. That is why we have religion and science. This is one reason why infertility is so stressful for people. It involves three things human beings despise: uncertainty, lack of control, and in the case of unexplained infertility, a lack of explanation. The reality is, we are just at the beginning stages of reproductive science. There are clearly a lot of aspects of human reproduction that are not yet understood. In the meantime, let’s stop telling women their infertility is their fault and simply accept we don’t have all the answers.

If you know someone who is grieving the loss of a baby or pregnancy, here are resources and support groups for bereaved parents. Talking about your emotions with a person you trust, or a counselor may also be helpful.

• Pregnancy and Infant Loss Network
• Support group – PAIL 
• Late Loss Bereavement Support Group – Mount Sinai
• Miscarriage – pregnancy loss before  20 weeks – booklet
• Silent Birth: When a Baby Dies After 20 Weeks of Pregnancy (Stillbirth) – Booklet 
• March of Dimes 

If you have any questions about pregnancy loss, don’t hesitate to reach out, our team of professionals is here to listen and help!

About the Author:

Erica Berman, PhD, RP

Erica is a Registered Psychotherapist who specializes in counselling for infertility and family building using third party fertility options. She has a broad range of experience working with Intended Parents, gestational carriers and sperm and egg donors. Erica is passionate about helping people through the challenges of creating a family and believes in inclusiveness and acceptance.  Erica also does therapy for anxiety, depression, trauma, emotional eating/body image issues, and couples counselling.

Virtual Office: https://doxy.me/ericasberman
ericaberman.ca
erica@healthcounsellingtoronto.com

Anova is running several peer support groups to support patients through their fertility journey. Contact us at supportgroup@anovafertility or fill in the form below to learn more.