Couples dealing with infertility often have to deal with the emotional aspect of trying to conceive-from the hormone treatments, disappointments, and, hopefully, the eventual joy of pregnancy. LoveToKnow Pregnancy recently spoke with Jennifer Harned Adams, Ph.D., a Denver-based psychologist specializing in women's reproductive health and wellness.
About Jennifer Harned Adams, Ph.D.
LTK: Tell us a bit about your background and how you decided to focus your practice on mental health related to pregnancy and fertility.
Dr. Adams: I have a Ph.D. in clinical psychology from the University of Houston and have always been interested in psychological aspects of women's health. As a grad student, I focused my research on women diagnosed with breast cancer. My interest in pregnancy and fertility developed while at a career seminar during my internship year when a speaker mentioned that there was a great need for clinicians to specialize in working with persons undergoing fertility treatments. I started reading on my own and realized I found my niche.
After completing my fellowship at MD Anderson Cancer Center in Houston, I took a faculty position at the University of Colorado at Denver in the Psychology Department, where I taught and conducted research. In 2008, I scaled back my work at the university to do clinical work in a local postpartum depression intervention program and to develop my own practice. Currently, I work exclusively with women and couples who are facing issues related to fertility, complicated pregnancy, pregnancy loss, postpartum adjustment, work-life balance, as well as those who are making lifestyle changes related to serious and/or chronic health concerns such as cancer or autoimmune disease.
Fertility and Emotional Health
LTK: What are some of the most common emotions women are dealing with during fertility treatments?
Dr. Adams: When women are coping with fertility treatments, they may experience a range of emotions--there is no "right" way to think or feel during this stressful time. Most women expect that they might experience feelings of anxiety, sadness, or loss, but are surprised with the amount of anger they feel. For many, this anger can be really upsetting, as women are socialized to dampen down those feelings. Finding a safe place, and a safe way, to express those uncomfortable emotions can really help women manage stress while going through fertility treatment.
LTK: How do the hormone shots and medications affect a women's emotional health?
Dr. Adams: Treatments can impact a woman's emotional state on several levels. First, the hormonal treatments can trigger emotional changes--everything from teariness, sadness, and anxiety to having a "short fuse"-- kind of like PMS x1,000.
Side effects of hormone treatments can also have a negative impact on emotional health. Many women complain about bloating, acne, and other problems that impact how they feel about their looks. Some women report feeling guilty for being annoyed with these symptoms, since they are relatively minor things to endure when considering the end goal of having a baby--but it is OK to be bothered by them!
Finally, the process of having to use such treatments can lead to frustration, anger, and resentment for many women- -and the shots, pills, appointments, and other aspects of treatment serve as daily reminders of one's struggle to get pregnant. These reminders may trigger negative feelings towards one's partner, the medical team, or friends and family who don't seem to "get it."
LTK: What are some of the signs that a woman might need to speak with someone about her feelings and emotions?
Dr. Adams: In a perfect world, I'd love to see all couples meet with a counselor as soon as they receive a referral to a fertility specialist. This way, the therapist could meet with the couple--together and as individuals--to see how they are feeling about the process of going for fertility treatment, to offer a neutral and supportive space for having difficult conversations about medical decision making, and so that the therapist can offer the couple (again, together and as individuals) resources and skills that will help them get through their fertility journey. I think that this approach would help minimize stress about treatment before it even begins. This sort of approach wouldn't require a traditional ongoing weekly commitment to therapy, but would look like an initial assessment of the strengths and struggles of each couple and each partner--education about the "normal" feelings while going through fertility treatment and ways to manage them along with some additional meetings to find solutions or help with decision-making as the need arises. This would also prevent women and couples from having to find a therapist when they are at the height of distress.
Typically, however, I see women (with or without their partners) when they are well into fertility treatment and have reached an emotional breaking point. This breaking point usually involves the woman having trouble focusing at work (possibly to the point where it becomes a job security issue), pulling away from family and friends, and lots of strife in the marital relationship. Women typically feel helpless and without hope and completely stressed out. Although having a stress-free lifestyle isn't necessarily going to solve one's fertility problems, it is really hard to make a baby when all of one's energy is going towards managing emotional stress. Reach out for help before you get to this point!!!
LTK: What are some resources (websites or books) that you recommend?
Dr. Adams: For patient education materials and provider referrals:
- American Society for Reproductive Medicine
- Resolve--The National Infertility Association
- Fertile Hope (for cancer survivors)
- Hope for Two (for women diagnosed with cancer while pregnant)
- Conquering Infertility - Alice Domar, Ph.D.
- Love and Infertility: Survival Strategies for Balancing Infertility, Marriage and Life - Kristen Magnacca
- If at First You Don't Conceive - William Schoolcraft, M.D.
- Waiting for Daisy - Peggy Orenstein (memoir)