Really Worried Now

Friday, August 29, 2014

Question

Dear Patrick: I put off having children for several years because I wanted to be sure that I had reached a point in my career where I could really provide for my half of a good life for our children. Now my husband and I agree that if we don’t start taking time to have our babies now, it isn’t going to happen at all. But I am having trouble getting pregnant. I confided this problem to one of my girlfriends, and she told me that my life is just too stressful for me to be able to conceive. She basically implied that unless I am willing to quit my job and take a year off to focus on getting pregnant, I won’t be able to become a mother. Do you think this has any validity? I was already wondering what was wrong with me and kind of blaming myself for not being able to perform this basic, biological task, and after talking to her I can’t say I feel a lot better.

Answer

Wow! You did say this woman is a friend? You know that is the opposite of an enemy, right? You didn’t keep her off the cheerleading squad in high school or steal her tickets to a concert  when both of you were 16, did you? Where is she in her life when you compare it to yours? Would you say she has reached the goals she set for herself, compared to how well you are doing? Would she have any reason to be jealous of you, any reason to want to bring you down or rattle you? Or is she just a New Age crazybrain who thinks alien angels wearing dolphins on their heads are going to land their space ships on top of the pyramids and save the polar bears from global warming, drown everyone in the Tea Party, and then allow the Worthy Among Us to go back to the Pleiades to eat kale with them and read Harry Potter out loud?

            Grumble, grumble, grumble.

            Okay. I found a study. Researchers took saliva samples from 274 women for six menstrual cycles (or until they got pregnant, whichever came first). They were looking for the enzyme alpha-amylase, which correlates with stress. They found that the women who had the highest concentrations during their first cycle were 12% less likely to conceive than the women with the lowest levels. These were women who had no record of infertility. You can read the whole study in the journal of Fertility and Sterility in August of 2010.

             Researchers speculate that the hormones secreted during stress may reduce blood flow to the uterus, reduce the uterine lining, or affect a woman’s reproductive biology in ways we do not as yet understand. I am going to pipe up here and say that it’s possible there is an effect on her partner as well.

            A much smaller 2003 study found a high level of the stress hormone cortisol among women who had stopped ovulating for six months or more. This was conducted under the aegis of Sarah Berga, head of the Dept. of Gynecology and Obstetrics at Emory University School of Medicine. Berga and colleagues found that stress management therapy restored ovulation in 7 out of 8 participants. In another group where the women received no such assistance, only 2 out of 8 began ovulating again. 

            This is far from conclusive research. Nevertheless, it does seem to be a trend in infertility treatment right now for doctors to offer stress-reduction as a way to tip the odds in favor of their couples who are trying to conceive. I am suspicious of the fact that these efforts always seem to focus on the mother, which seems kinda sexist, and I sure would like a little more objective data before a lot more people pay for these expensive services.

            I do think, however, that it’s way too easy for making a baby to turn into just one more job. How long has it been since you and your husband got to have sex without worrying about birth control? This is a chance for the two of you to connect with some primal male and female energies, a potential second honey moon before diapers and night-time howling from the baby’s crib create a few months or even years of sleep deprivation and other less-than-hot things for the two of you to manage. Do you still want him, as a man, without worrying about his sperm count? If the very worst thing happened and you could not have a baby, would you want to spend the rest of your life with him? Celebrate him? Enjoy him? Think about him during the day? Long to be with him as soon as you could after work? Or is the baby kind of a consolation prize for a marriage that has gone sour? Is your body trying to tell you that this is not a man you should count on to stay with you through the potential vulnerability and sickness of pregnancy, and all of the extra work of raising a baby and a toddler?

            There is a lot to think about here. I don’t necessarily think taking a year off from work is a good idea. Even if it was economically feasible—which it would not be for most  couples—I’m not sure it would give you any answers to the questions above, or help you to really relax.

            I do understand that when you want to have a baby, it can be super-difficult when you are not able to conceive right away. It does feel like a test of your womanhood. Here is this thing that you are supposed to be able to do automatically, right away, and it’s not going according to plan. Fear slips in. And of course there are voices that say, why did you wait so long? You should not have done that. You deserve to be punished! But in today’s world, few women have completely free choices about work and money. It might not have been responsible to have children when you were younger. Waiting may have made the difference between putting your children through high school and putting them through college.

            While I don’t know if relaxation makes a difference when trying to conceive, I do believe that ideally, creating a child is a joyous occasion (even if you have the darn thermometer and a chart so you can keep track of ovulation). So if you are finding it hard to relax and enjoy sex with your husband, or if he is having a similar problem, maybe the two of you need to take some time away from The Schedule. Forget about ovulation and just enjoy each other. Have sex for the sake of desire, and see what happens. If high levels of worry, anxiety, or stress persist, consider going to see somebody who can help you to learn how to relax. Cognitive-behavioral therapists are great at helping their clients to trace the patterns of thought that create negative feeling states, and creating interventions to allow more positive emotions to flow.