Couple gets a consultation

If you and your partner have been trying to get pregnant for a year or longer but haven’t yet conceived, it’s possible you are facing fertility issues. You might already have started talking with your doctor about these challenges and your options for getting pregnant.

Most likely, your doctor is monitoring all aspects of your physical health. But it’s important to take care of your emotional well-being too. People who want to have a child but struggle to get pregnant may face a range of emotions, including anger, frustration, grief, and shame. If these emotions aren’t dealt with productively, they can fester and contribute to pain, resentment, or mental health issues such as depression.

Infertility not only affects you and your partner individually, but also your relationship. Here, we’ll discuss problems you may face as a couple if you’re dealing with infertility and ways you can address them. When difficulties are managed in healthy ways, you’re more likely to grow stronger as partners than grow apart.

Social Stigma Around Infertility

Discovering how common infertility is surprises many people. According to the Centers for Disease Control and Prevention, 12% of American women between the ages of 15 and 44 have trouble getting pregnant or struggle to carry pregnancies to term when they do conceive.

Once a couple marries, it’s often assumed they’ll begin trying to have a child. Certainly, this assumption is flawed in more ways than one, but one main issue is the stigma that often results. Your parents and friends might ask prying questions. Social situations may become uncomfortable if your friends don’t seem to understand what you’re going through. People may avoid inviting you to events like birthday parties or baby showers. Even if they do so out of good intentions, you may still end up feeling excluded.

It’s important to experience your feelings as they come, but it’s also important to avoid blaming yourself or your partner. Blame, self-directed or otherwise, can trap you in a painful cycle that leads to more distress.In the past, women took much of the blame for infertility. While it’s known today that infertility can result from male or female factors, women may still struggle with feelings of failure or shame. Men may deal with similar pain but find it harder to talk about. In society as a whole, there can be a general feeling that couples without children are somehow incomplete, a judgment that can make the distress of infertility even more painful.

In recent years, many celebrity couples have shared their experiences with infertility, including Michelle and Barack Obama. Maybe you’ve talked about your infertility with a loved one and felt empowered and supported by their reaction.

Infertility issues often feel like a private struggle. But reducing the stigma could help more people feel comfortable talking about their own difficulties becoming pregnant. People who don’t feel ready to open up may still draw support from knowing they aren’t alone. No matter which factors contributed to infertility, neither you nor your partner should feel shame.

Avoiding Blame and Shame

Letting yourself experience grief is an important part of coping with infertility. Even if you’re pursuing fertility treatments, facing the reality that becoming pregnant may not be possible can have a heavy emotional impact. Grief and sadness may be your first reaction.

Sometimes the cause of infertility can’t be determined. But finding out infertility issues stem from you can lead to decreased self-esteem, depression, and anxiety. If your partner is the one who is infertile, you may might feel frustrated. You may struggle to keep from blurting out that it’s their fault, not yours.

It’s important to experience your feelings as they come, but it’s also important to avoid blaming yourself or your partner. Blame, self-directed or otherwise, can trap you in a painful cycle that leads to more distress.

Counselors who work with couples dealing with infertility recommend talking to your partner about how you feel, openly and honestly. This might be difficult when you’re angry, but remember: You and your partner are a team, and communication is essential in a good team. Even if you’re angry, hurt, or ashamed, it’s usually better to talk about your emotions calmly, rather than waiting until they burst out during an argument or stressful moment. You may decide not to share your struggles with family and friends, but commit to being honest with each other.

Choosing Other Fertility Options

Assisted Reproductive Technology (ART) helps many couples treat fertility issues. When considering your options, it’s important for you and your partner to agree on how long you’ll pursue treatment, how much money you can spend, and what treatments you’ll try.

Have an honest discussion with your partner about treatments you’re uncomfortable with before planning on any procedures.Your insurance may not cover all (or any) of the cost of fertility treatments. Beginning treatment with a financial limit can help you avoid putting yourself in financial difficulty by continuing indefinitely.

It’s also helpful to decide on a length of time you’ll try treatment for. ART can give you hope, but treatments don’t always work right away. Sometimes they don’t work at all. The uncertainty and stress associated with treatment can have a negative effect on your relationship. Though you may feel renewed grief if you approach the end of the time period and still haven’t conceived, having a limit in place can help relieve some of the uncertainty and emotional distress.

Depending on your specific fertility issue, a range of treatments may be available. Options include medication, in vitro fertilization, and intrauterine (also called artificial) insemination. You might also choose to use donor eggs or sperm or have a surrogate carry a fertilized egg to term.

Some of these options may not work for you due to religious, ethical, or personal beliefs. For example, some people consider freezing embryos to be unethical. Have an honest discussion with your partner about treatments you’re uncomfortable with before planning on any procedures.

Addressing Infertility in Couples Counseling

Though it’s possible to maintain a strong, committed partnership while navigating infertility issues, taking preventative steps can help keep your relationship healthy. Research suggests infertility is a highly stressful and upsetting experience, and any type of stress can affect a relationship negatively. Couples therapists recommend seeking help early on instead of waiting until the crisis you’re facing starts to significantly affect your relationship.

A 2017 study found evidence to suggest couples with compatible coping methods had better communication and were more likely to develop a stronger relationship despite infertility. In other words, it is often better to deal with the issue as a team, even when your instinct may be to deal with your pain alone. Therapy can help you and your partner develop strong coping strategies and quit maladaptive behaviors such as avoidance.

Therapy also provides a safe space for you to talk about your feelings regarding infertility and mental health symptoms you’re experiencing. (Talking about these in individual therapy may also be recommended). Your therapist can support you and your partner through finding helpful ways to cope, relate, and connect during infertility challenges.

If you aren’t already working with a couples therapist, it can help to begin seeing one, even if fertility issues aren’t affecting your relationship at the moment. Some couples therapists may even have specialized training in infertility counseling. You can begin your search for a couples counselor in GoodTherapy’s directory.

References:

  1. Fertility treatments. (n.d.). Planned Parenthood. Retrieved from https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments
  2. Glenn, L. M. (2002). Loss of frozen embryos. AMA Journal of Ethics. Retrieved from https://journalofethics.ama-assn.org/article/loss-frozen-embryos/2002-12
  3. Infertility FAQs. (2019, January 16). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/reproductivehealth/infertility/index.htm
  4. Infertility. (2018, March 8). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317
  5. Itkowitz, C. (2018, November 9). Michelle Obama is one of millions who struggled with infertility. Here’s why her broken silence could matter. Washington Post. Retrieved from https://www.washingtonpost.com/politics/2018/11/09/michelle-obama-is-one-millions-who-silently-struggled-with-infertility-heres-why-her-broken-silence-could-matter/?noredirect=on&utm_term=.8d2645a61c30
  6. Pasch, L. A., & Sullivan, K. T. (2017). Stress and coping in couples facing infertility. Current Opinion in Psychology, 13, 131-135. Retrieved from https://www.sciencedirect.com/science/article/pii/S2352250X16300902
  7. The psychological impact of infertility and its treatment. (2009). Harvard Mental Health Letter. Retrieved from https://www.health.harvard.edu/newsletter_article/The-psychological-impact-of-infertility-and-its-treatment
  8. Volmer, L., Rösner, S., Toth, B., Strowitzki, T., & Wischmann, T. (2017). Infertile partners’ coping strategies are interrelated – implications for targeted psychological counseling. Geburtshilfe Frauenheilkd, 77(1), 52-58. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5283173

Close up of couple kissing

Many couples experience a surge in sexual excitement and activity when they begin to try for a baby. They may be suddenly free from hormonal birth control methods or the barrier sensation of condoms and often feel they have a closer and more intimate connection than before.

However, after a short time, if a baby has not been conceived, this heightened sense of intimacy and sexual excitement may fade. What typically replaces it is a sense of monotony and routine—sex by schedule, goal-oriented sex, sex under pressure—as well as anxiety, grief, and loss and lowered self-esteem. The emotional ups and downs can be hard for people to endure time and time again. Hope is erased by the first sight of your period, and then sadness and grief take over.

Sometimes, partners experience guilt on top of all these other emotions. Is it my fault we are not getting pregnant? Is it his fault we are not getting pregnant? Are we doing it wrong? Could we have done something differently? Is it because I did X, Y, or Z? Many people also feel guilty that they want sex only in order to conceive. What’s wrong with me that I don’t desire my partner sexually except to make a baby?

This can be an extremely difficult time for couples. They often feel alone, especially when they see “baby bumps” and strollers everywhere they go. The pressure to conceive often colors the mood and trajectory of the sexual relationship.

Here are some recommendations that may help you continue to enjoy sex while going through the process of trying to conceive:

  1. Even if sex is planned or scheduled, don’t forget the foreplay, take your time to turn-on both you and your partner. Sex doesn’t have to be rushed just because you “have” to do it. Try setting a timer for 30 or 45 minutes and don’t begin intercourse until that timer goes off. This may help you focus on becoming aroused, touching each other, and enjoying one another. Take time for sexual arousal to set in explore your partner’s body and pay attention to all of your partner’s erogenous zones for a better sex experience.
  2. Focus on pleasure and the female orgasm. Many women struggle to orgasm through penetrative sex alone and require clitoral stimulation. This is nothing to be ashamed of and most of the time can even highlight both partners’ sexual experiences. Though many assume the male ejaculation is all that’s really needed to create a baby, there are a lot of benefits to focusing on pleasure and even female orgasm. In one study, researchers R. Robin Baker and Mark Bellis found that female orgasms that happened between one minute before the male ejaculated up to 45 minutes afterward led to higher levels of sperm retention. Furthermore, getting into the habit of having sex only for procreation may bring about reduced interest in sex on the part of both parties. Once a couple gets into the habit of having sex as a matter of routine and without much arousal, it can be hard to get out of that habit.
  3. Try something different. Many couples get in sexual ruts from time to time. Consider changing the environment. Even having sex in the shower, in another room, or adding some new lingerie or candles can enhance the experience and make it feel less routine. Consider adding sex toys such as a vibrator to enhance her sexual pleasure. Consider starting with a different sex position than you normally would new positions can take good sex, to great sex. Other ways you can make your sex life feel less routine are adding lube, roleplay, and even oral sex can help reawaken your partners sex drive.
  4. Remember it can take time. It’s important to know that, for many couples, it can take several months to a year or more to conceive. Try not to get discouraged, exercise self-compassion, and give yourself the benefit of patience.
  5. Talk to your partner about your experience and listen to your partner’s experience. Grieve together. Share feelings. Remember people experience loss differently. Although your partner may not cry in front of you, it does not mean he or she does not feel sadness. Share your feelings, but don’t expect your partner to feel the exact same way you do. Listen and be compassionate. Relating on this shared experience grows emotional intimacy, which will help you have greater sexual intimacy as well.
  6. Consider taking a break from “trying.” Take a break from scheduled ovulation times and just have sex when the mood arises. Not only might this kindlesexual desire, it may relieve some of the pressure and anxiety you both feel.
  7. Talk to someone in your support system outside of your partner. Be selective about who you talk to because some people may not be as helpful as you may like. Some people may give you all sorts of unwanted tips and “old wives’ tales” about what they heard will help you get pregnant. Some may be overly intrusive. Select a few trusted people to talk to, such as close friends, family members, or a therapist, who can help meet some of your emotional needs. Remember that your partner is also going through this difficult time and may not be able to fully support you the way you need because he or she is going through his or her own process as well.
  8. Schedule date nights or other fun activities you enjoy outside the bedroom. Having more fun together may remind you that you’re not just “partners”—you really like and love each other. Those positive feelings may carry over into sexual activities. Be sure to take the time to cuddle and embrace each other afterward.

If you’re having difficulty conceiving, you are not alone. Reach out to your support system, get the medical attention and therapeutic support you need, and focus on what you love about your partner. Sustain emotional intimacy and focus on the pleasure of being together by not rushing to the male ejaculation. Extend foreplay and remember that just because sex may be scheduled does not mean you cannot also experience pleasure and even orgasm.

Reference:

Baker, M. M., & Bellis, M. (1993). Human Sperm Competition: Late Manipulation by Females and a Function for the Female Orgasm. Animal Behavior, Vol. 46, 887-909.

© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Mieke Rivka Sidorsky, LCSW-C

Couple hugging and holding handsAccording to the Centers for Disease Control and Prevention, in the United States 6.7 million women between the ages of 15 and 55 experience either problems getting pregnant or carrying a pregnancy to term. That is more than 10% of women in this age range. Chances are you or someone you know has experienced or will experience challenges related to fertility.

Infertility often has biological causes, but the emotional effects can be especially devastating for a couple trying to conceive. The National Infertility Association discusses these emotional effects, which may include:

In addition to these symptoms, I have noticed the people I work with in therapy experiencing the following:

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Infertility is traumatic. In addition to depression symptoms, it is quite common that couples experiencing infertility will experience anxiety in response to certain situations or triggers (such as seeing pregnant women, pregnancy tests, babies on TV or in person, etc.). They may experience intense emotion around certain times of the month, particularly the times near ovulation and when a period is due. Going in for fertility treatments may become very triggering and anxiety provoking, particularly if previous interventions failed. Sadness and grieving are common, particularly around holidays and other important life events.

When someone is experiencing infertility, negative beliefs about one’s inadequacy or defectiveness may come up. Both partners may question why their bodies are not functioning like seemingly everyone else’s, especially when those around them are having babies, apparently without any trouble.

If there has been past pregnancy loss, other triggers for anxiety, depression, and intense emotions may come up, including the date a baby was due or times of year associated with the loss. Triggers can seem unrelated or random but still have a profound effect on the emotional reaction of the people going through this difficult situation. For many, infertility feels like riding an emotional roller coaster of anticipation, worry, sadness, grief, and anger.

When someone is experiencing infertility, negative beliefs about one’s inadequacy or defectiveness may come up. Both partners may question why their bodies are not functioning like seemingly everyone else’s, especially when those around them are having babies, apparently without any trouble. People struggling with this issue may question their value and their self-worth can take a major hit, resulting in magnified depression and hopelessness.

The stress and trauma that result from infertility can also have a negative impact on a relationship. Because both partners experience their own challenges in infertility, they may be more prone to snapping at each other, taking things personally, or feeling disconnected.

There are steps people who are experiencing the emotional complications of infertility can take in order to cope and eventually thrive through this major life challenge.

1. Seek Professional Assistance

A mental health professional can help address the symptoms one is likely to encounter when experiencing difficulties related to infertility. Coping skills, trauma work, and couples counseling are just a few of the areas a therapist can help someone to work through to make this difficult path more bearable.

When working with people with infertility issues, I often utilize eye movement desensitization and reprocessing (EMDR) therapy to address negative beliefs about worth and defectiveness. EMDR has also been helpful in addressing and reducing disturbance related to fertility treatments, pregnancy loss, and worries about the future. When trying to get pregnant and while pregnant, stress management is essential in helping the body to be at its best to conceive and carry a baby.

2. Give Yourself a Break from Social Media

Social media can be wonderful, but they can be triggering for someone who is going through infertility. People love to make pregnancy and birth announcements through social media. Someone experiencing infertility may be much more sensitive to these announcements, as they can feel like a reminder of the pain that person is bearing.

If such announcements are triggering, give yourself a break and stay off social media for a while. Work with a therapist to decide when and how you will begin to engage in social media again. Working through some of the trauma and practicing coping skills regularly can help reduce the triggering effect of social media.

3. Acknowledge and Feel Your Feelings

Emotions are meant to be felt. One of the main jobs of an emotion is to alert us that we need to pay attention to something. Emotions can do what they are supposed to do only if we are willing to acknowledge and feel them.

The human body and brain are very good at working through difficult material when we stop avoiding emotions and allow ourselves to feel fully. A therapist can help with learning to tolerate and regulate emotions.

4. Celebrate and Enjoy the Little Things

Infertility can consume your life. From your thoughts to your time to your emotions and your relationship, it seems that there is not an area that infertility does not impact.

With your partner, find reasons to celebrate life. Engage in fun activities that you wouldn’t or won’t be able to do while pregnant or with a newborn. Try to soak up the moments of joy, calm, and fun as they come up. Seek out new hobbies or activities you have wanted to try. It is important to find joy and meaning in life, even when you are going through a difficult time.

References:

  1. Centers for Disease Control and Prevention (2006-2010). FastStats: Infertility. Retrieved from http://www.cdc.gov/nchs/fastats/fertile.htm
  2. Dunkel-Schetter, C., & Lobel, M. (1991). Psychological reactions to infertility. In A. L. Stanton and C. A. Dunkel-Schetter (Eds.), Infertility: Perspectives from stress and coping research (pp. 29-57). New York: Plenum.
  3. The National Infertility Association (2014). Emotional aspects of infertility. Retrieved from http://www.resolve.org/support/Managing-Infertility-Stress/emotional-aspects.html

Couple on benchIt’s the big question women and men who experience infertility or secondary infertility (infertility after the loss of a baby through miscarriage or stillbirth) ask: “I can’t have kids, so now what?”

Common questions and fears people have when they learn they can’t have kids include:

I always expected to have children and all my life plans included them. What do I do now?

Who am I if I don’t get to be a parent?

Who am I if I don’t get to raise a living child?

How do I live a fulfilled, happy life when the one I had planned was taken away from me?

Learning you can’t have kids, either for medical reasons or because you just aren’t willing to risk the death of another baby, can create a crisis of identity in even the most balanced and self-assured people.

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So when your plans for life drop out from under your feet and you lose your sense of self, what do you do?

Allow Yourself to Grieve

First and foremost, you need to grieve. Allow yourself to grieve for all the various aspects of this loss. Grieve for:

When children are strongly desired and you learn you can’t have them, it is a deep and profound loss. It requires the process of grieving every bit as much as the death of a loved one does.

Remind Yourself Healing Is a Process, Not an Event

The loss of the dream to have children is big. It leaves an emptiness that feels enormous and endless. Pretending that feeling of emptiness isn’t there would be counterproductive. Lying to oneself never helps matters. Trying to fill that massive expanse in your life left by the children you will never know can feel daunting and overwhelming.

When children are strongly desired and you learn you can’t have them, it is a deep and profound loss. It requires the process of grieving every bit as much as the death of a loved one does.

Be gentle with yourself and don’t pressure yourself to fill that gap immediately. As counterintuitive as it seems, befriend that empty space in your heart. Feel into the spaciousness and find the edges of it. Explore what that loss and emptiness feels like in your body.

This empty feeling is not your enemy. It’s a natural response to this deep and profound loss. This emptiness is a necessary part of healing.

Healing from this loss and creating a life that feels fulfilling and happy won’t happen overnight. It may take years of work and intention. It will be a process of grieving and redefining your life and creating a new identity, but it can and will slowly start to lighten over time.

Find Comfort in the Little Things

True healing is an intentional process. You have to choose to want to heal and take steps toward that. Seek comfort and healing in the little things in life.

Consider starting a gratitude jar and writing down one thing each day that you are grateful for. These don’t have to be big or insightful things; they can be as simple as being grateful for your coffee in the morning or the sunshine on your face.

Allow yourself to notice and appreciate the things about your life that perhaps you wouldn’t be able to enjoy if you had been able to have children. This doesn’t dismiss your longing or love for your children who died or never were. As humans, we are powerful beings, and we have space to both miss what could have been and be appreciative for what is.

Buy yourself flowers.

Sip and enjoy a good cup of coffee or hot cocoa.

Go for a walk in the woods.

Watch your favorite movie or read your favorite book.

Engage in activities that bring even a small amount of light and beauty into your life.

Give Yourself the Gift of Support

If you are fortunate enough to have family or friends who “get” this kind of loss and can be supportive, lean on them. Allow them to be there for you and to love you.

Seek out support groups, women’s groups, or men’s groups to surround yourself with others who can support and encourage you on your journey.

Find a counselor or mentor who will help you walk this rocky, painful path of recreating your sense of self and expectation for life.

Sometimes, finding the right support takes work. You deserve, however, to be supported and loved as you grieve.

Making Meaning Out of Your Life

It’s not about finding a reason why this may have happened. The cliché “there’s a reason for everything” isn’t really all that helpful to many people.

However, choosing to make meaning out of the events of our lives is empowering and healing. Decide what you want to make this loss mean in your life. Decide how you want to use it to create a new life going forward.

Life isn’t what you expected it to be. You may not get to be the person you wanted and planned to be. Choose to make this unexpected and unplanned life meaningful and fulfilling anyway.

You can’t bear children. That is painful and heartbreaking, but it is still possible to live a meaningful, fulfilling, and happy life.

Sad woman staringIn my practice, I see many mothers who have lost their only children during pregnancy or early infancy. They show up at my office struggling with grief and feelings of isolation. Some also grapple with infertility and the prospect of never being a mother to a living child.

Many of these mothers have been to multiple therapists or support groups, yet their search for adequate support continues. They report feeling like outsiders in support groups where other women talk about their living children or who are pregnant again after experiencing a loss. They talk about struggling to find a therapist who understands the unique experience of being a mother without living children.

Again and again, these mothers share feelings of invisibility and isolation and the intense grief of having empty arms with no children to fill them. More than anything, they want someone to acknowledge the pain of their loss.

Having an awareness of the unique experience of being a mother without living children is vital in supporting these women. Here are some things therapists should consider when supporting a mother without living children.

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There Is No Guarantee of a ‘Rainbow Baby’

It’s common in the world of pregnancy loss to hear talk about “rainbow babies” (babies born after loss). Often there’s an assumption that moms who have experienced loss will go on to have such babies. Many support groups include discussion of mothers desperately trying to get pregnant again.

I call the idea that another baby will fix a woman’s grief the “myth of the rainbow fix.” Even if a mother goes on to have a living child, it won’t replace the baby she lost or miraculously cure her grief.

More importantly, not all moms who have experienced loss have the option to have another child. Many moms are dealing with the knowledge that they physically or emotionally can’t have another baby. Others tried for years and are struggling with infertility. For many, the baby they lost was a “miracle baby” after years of apparent infertility and trying. Some have accepted that they may never have another pregnancy and have been on adoption waiting lists for years.

Not every mother who loses her child to stillbirth or miscarriage will have another child. Making the assumption that they can or will may be detrimental to the emotional health of these mothers.

Many Need Reassurance That They Are Indeed Mothers

Many mothers who have lost their only baby struggle with whether they are “allowed” to claim the title of mother. Their idea of what it means to be a mother has been suddenly and unexpectedly altered. Being able to claim the identity of mother even though their baby did not survive can be a valuable piece of the healing process.

It’s important to work with these women to redefine what “mother” and “mothering” means to them now that their baby is no longer physically here. In what tangible and intangible ways can they continue to mother their child?

Early Loss Does Not Mean a Lesser Loss

Far too often when a mother loses a baby early in pregnancy or has an ectopic pregnancy, her loss experience is minimized. Many women whose babies died in their first trimesters often feel that their grief is dismissed or invalidated through statements like, “It was so early,” “You didn’t really know it yet,” or, “You just found out you were pregnant, so try not to get too down.”

However, for many women the love and attachment come the moment they know they are pregnant. For others, the attachment and love were formed long before the pregnancy occurred, through years of trying to get pregnant, fertility treatments, or planning to become a mother.

Depth of love has no basis in time.

Questions about Children May Be Difficult to Answer

Many intake assessments and initial sessions for any kind of medical or mental health provider include the question, “Do you have any children?” or “How many children do you have?” For those who haven’t lost a child, this probably seems like a simple and straightforward question. For those who have lost one or more children, it’s often not so simple. Internal debate immediately comes up:

Do I say yes and explain?

Do I say yes, but then what if they ask how old he/she is?

Do I have the energy to go through the story all over again?

Maybe I should just say no, but I always feel so guilty when I do that.

What is his/her reaction going to be if I say I have a child but he/she is dead?

I want to acknowledge my child, but I don’t want to deal with discomfort and that awkward silence.

Gah, I hate this question!

For therapists, I don’t know that there is a good solution for the pain and uncertainty questions like this bring up. However, asking about living children and deceased children separately may make the situation more comfortable for mothers and help them feel more accepted.

Nothing therapists can say or do will completely take away the grief and pain a woman feels after the death of a baby. We can’t fix the ache of not having a living child to hold, raise, and love. As professionals and compassionate human beings, however, we can be more aware and sensitive to the unique experience of being a mother without a living child. Support without judgment or assumptions can go a long way toward healing, not just for these mothers but for anyone in pain.

You’re deeply in love. You’ve found your life mate and are confident that your future will be wonderful. It’s time to buy the rings. Marriage hovers at your horizon, like a gorgeous sunset.

But there is one teeny problem—really teeny and really giant at the same time. Teeny because it’s about a baby. Giant because this disagreement could mean curtains for your relationship. One of you wants a baby, the other doesn’t.

“No problem,” you might say. “I just know he’ll change his mind. He’s great with his nieces and nephews. Because he loves me and knows how much I want this, he’ll say yes when the time is right.”

“Not to worry,” you might say. “She says she wants a child, but the craving will pass when her newborn niece gets older. She’s always said she didn’t think she could handle children. She works long hours and then heads for the gym. Because she loves me and gets it that don’t I want a family, she’ll change her mind.”

(Please excuse the stereotypes. Many men want children, many women don’t. This example is typical, not universal.)

Often when a couple disagrees, a compromise can solve the problem. But you can’t have half a baby or be parents in odd-numbered years and childless/childfree in even-numbered years. How can you solve the problem?

The good news is that it’s not unusual for someone to change his or her mind.

Partners who have never spent time around young children may fall in love with a friend’s child and imagine themselves as a parent for the first time. A partner who would prefer to have a child but whose work, health, or extended family demands make parenthood less attractive may agree to remain child-free.

These changes can happen , but you can’t count on them. Any possible scenarios, depending on personal histories and experiences, could emerge, and suddenly having children will simply not be an option.

The husband with teenagers from another relationship, who said he couldn’t imagine starting over with a second family, not only didn’t change his mind, but also has a chronic illness or college tuition, or a troublesome relationship with a young adult to reckon with. Not only is the answer still “No,” but now it’s in flashing neon. A baby would be even more stressful on the marriage.

The wife who raised five younger siblings because of her parents’ addiction, who had therapy that was supposed to prepare her for a family, concludes with her husband and her therapist, that her breakthroughs, though wonderful, are too fragile for the stresses of motherhood.

Or the wife who loved her husband so much that she told him, “You’ll always be enough for me,” but after her mother’s death and niece’s birth, dreams of babies every night.

Given how much you are in love, that you don’t have a crystal ball, that you don’t want your partner to be miserable, should you marry anyway?

Take with a grain of salt anyone who offers easy answers.

Some people will tell you, “It’s obvious. Don’t get married. Find a partner who feels the way you do.” But maybe this person is your best possible life partner, and giving him or her up might turn out to be an even greater loss than not getting your way on the baby question.

Others will say, “It’s obvious. The other person will come around. Everybody should want children and those who don’t are being immature. Go ahead and marry.” But many responsible people don’t have children, and there has been research that says childfree couples have some of the happiest marriages.

Still others will say, “Love conquers all. You’ll find a solution that works for both of you.” Your family and friends mean well, as do therapists. But only you can decide what’s best for the two of you. If you are ambivalent about parenthood and can imagine a happy life accepting your partner’s choice, then your marriage has a reasonable chance of working out.

Ask yourselves four questions:

  1. Are we exaggerating the likelihood that we might accept the other’s choice, because we can’t stand the idea of breaking up? Is at least one of us relatively confident that he or she can say, “Yes,” to the other’s choice?
  2. If my partner never changes her or his mind, and I wind up childless/ raising a child I would have preferred not to have, could I adapt to my partner’s choice?
  3. Is marrying my beloved more important to me than whether or not we have a child? How might I/we make life enjoyable if I have to make the best of my partner’s choice?
  4. Which would be more painful—realizing that this issue is a dealbreaker and breaking up to search for a partner who shares your parenting goals, or granting your partner’s wish?

What if you decide to go ahead and marry, without any reassuring answers to the questions above, hoping that love will find a way? Choose a specific time to check in with each other in the future about where you stand.

If you’re in your 20s, you can plan to re-evaluate in a few years, after you’re further into your relationship. If you still disagree then, see a therapist who specializes in short-term, goal-oriented treatment of fertility issues.

However, if you are in your 30s or 40s, you will need to be more proactive. See a fertility therapist before your wedding date. You may want to do some noninvasive fertility testing to find out if your fertility is waning. Try not to delay your decision for so long that if you decide to have a child, this may no longer be biologically possible.

Ways that therapy could help:

Other Tips for Resolving the Conflict with Your Partner

Use therapy strategically. Make sure your therapist respects the childfree choice as well as parenting. Don’t be afraid to ask about this before making an appointment. You also want someone who is skilled in short-term, goal-directed couples work, has experience with fertility decisions, and can give you food for thought and homework assignments.

With this skill set, your therapist can offer you the best use of your time and money. It may make sense, after a few weekly visits to get some momentum, to spread out your visits so you have time for reflection and homework.

Speak up if you think the therapist is getting sidetracked by your past. While it may be relevant to discuss your family history, you need therapy that focuses on the tasks at hand: couples communication and decision-making. If you, your partner, or your therapist thinks you are too overcome with emotion related to your childhood or a condition such as depression, get a referral to a different therapist and work with that person individually.

Commit to working together, especially if you decide to get married anyway before finding resolution. Be aware that you are giving higher priority to the relationship than to whether you get what you want regarding a child, and work toward a future solution.

Think “child,” not “children.” Having one child can be a great solution for people who want to experience the joys of parenting without being confined to their homes for years, or having to deal with sibling rivalry. Despite stereotypes, children in one-child families are happier than the rest of us, according to extensive research.

Ask your partner for ideas about how your solution could be made more palatable. Some women agree to take on the major responsibility for parenting–even if this compromises a couple’s nonsexist ethics. Many women see this as a choice to have the pleasures of motherhood rather than absolute social justice.

Some men who persuade their wives to forego motherhood are appropriately gracious about making other sacrifices: “We’ll move to Florence for you to study art for two years, even though it will be expensive.” Or, “I won’t complain if you want to spend Saturdays with your nieces and nephews.”

Treat your partner as the person you love, in all his/her uniqueness, which may include a different take on parenthood. He or she is more than an obstacle to your parenting or childfree goal. Theologian Martin Buber distinguished between “I-Thou” relationships—in which we experience and honor the person in their fullness of being—and “I-It” relationships, in which the other person exists in our minds only as a facilitator of or an obstacle to our goals. The “I-Thou,” qualities of listening and respect are the essence of loving each other. They will bring pleasure and meaning to your life as parents or a family of two.

Baby items“Guess what?” your best couple friends ask when you’ve just sat down at an elegant restaurant. “We have an announcement. Guess who’s not having wine?” You and your partner are jolted. You just found out an hour ago that your third in vitro fertility treatment didn’t pan out, and you didn’t even know your friends were trying.

You and your partner have a quick, furtive look. Your throat is dry, and a tear slides out before you can will it to stop. “Great news,” your husband says.

You can’t think of anything you can say aloud. You know you can’t say what you’re feeling: “Why you, not us? This is your third child, and we may never have a first. Why did you have to tell us here and ruin this expensive dinner?”

You could say, “I’m happy for you, but sad for us,” if your friends know that you’ve been trying.

With more public awareness of infertility, people announcing a pregnancy or birth are sometimes more sensitive to your needs. They might tell you in a private moment and add, “It’s hard to tell you, knowing how much you want this. I hope it happens soon for you.” You may appreciate the empathy, and elaborate on your feelings, and feel supported. On the other hand, you might be embarrassed and not want to talk about it, especially if you’re not emotionally close to the woman or you have reasons not to trust her.

First we’ll talk about dealing with your own feelings. Then we’ll talk about taking some control over how you receive news of future pregnancies.

Your feelings: handle with compassion

Mixed in with feelings of disappointment and competition, you may also feel guilty. You may even fantasize about miscarriages or complications. Your partner may add to your guilt by asking “Why can’t you be happy for them?”

Give yourself a break. You’re a good person, not someone who typically goes around with ill wishes. If you’ve been trying for months or even years to get pregnant or to carry to full term, it makes sense that you would be envious. This is especially the case if your friend is complaining of an accidental pregnancy or doesn’t have as much to offer a child as you and your partner do. A compassionate thought to say to yourself is “I’m happy for her but sad for me.” You wouldn’t expect a 24 year-old whose husband died yesterday to dance up and down about a friend’s engagement. It is understandable to have good wishes for the other person while also having feelings about your own loss or disappointment.

Controlling how you receive the information

You can’t control whether your friend gets pregnant before you do, but you can have a say in how you find out. This assumes, of course, that you are aware that someone is planning a family and that they know what you’re going through. Many of my clients have benefitted from what I call “the card trick.”

Ask your friend to send you a card. Yes, an old-fashioned greeting card via snail mail. Real envelope, real stamp. A phone call is hard, because it puts you on the spot. You need to congratulate the person right away, before you’ve had a chance to digest the information. IM is no better than phone, and e-mail is only somewhat better. Even if you don’t open the message, if its subject line reads “BIG NEWS!” you may feel that you are expected to respond quickly.

Because old-fashioned snail mail is unpredictable, your friend doesn’t know what time or even which day you receive it. This gives you time to tear up the card and stomp on it, have a good cry, or do some deep breathing before you pick up the phone and hit the keyboard. You get to feel like the loving, caring person you actually are and offer sincere congratulations. Even if you don’t have any negative feelings, you still have the luxury of time to respond when you’re ready. Everybody wins. You win because you controlled how you got the news. Your friend wins because you gave her a gentler way of breaking the news. You can both feel good about her new status and sincerely celebrate.

Even though you don’t know when or if your own luck will change, you can avoid unnecessary stress and enjoy your friend’s support and good wishes for your future pregnancy success.

Related articles:
Dealing with Fertility Challenges: Coping Tips and Resources for Parents-in-the-Making
Coping with Holidays While Trying to Have a Baby
Why Should I See a Therapist? I’m Not Crazy – We Just Can’t Have a Baby!

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