Anxious about trying for a baby? Here's how to deal

Trying to get pregnant can feel like being stuck on a stressful hamster wheel. Between monitoring your cycle, dealing with your family's probing questions and navigating medical ups and downs, conception is rarely straightforward and often anxiety-inducing. This episode, reporter Andee Tagle shares tips on dealing with conception anxiety no matter your pregnancy journey. Follow us on Instagram: @nprlifekit https://www.instagram.com/nprlifekit/?hl=en Sign up for our newsletter here. https://www.npr.org/newsletter/life-kit Have an episode idea or feedback you want to share? Email us at [email protected] mailto:[email protected] Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. This show’s perks include sponsor-free listening and convenient playlists of popular help topics like personal finance, getting healthy, and more. Learn more at plus.npr.org http://plus.npr.org/. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:01Speaker 00

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• 0:24Speaker 07

  When you're trying to get pregnant, there is just so much waiting involved. It's just, it's just room for your thoughts. And there's so much of that when you're trying to conceive, right? There's waiting for the day that you're ovulating. There's waiting for your period. There's waiting just that few minutes for that pregnancy test. All of that anticipation can, really understandably, be inherently anxiety inducing, nerve wracking. For some people, they're feeling this anxiety even before they're trying to have a baby. It's people who are seeing people around them struggling, and they hear people struggling. So they're not even on the train yet, but they think it's going to be them.

• 1:00Marielle Segarra?

  I call that borrowing trouble from the future.

• 1:02Speaker 07

  Yeah. Someone told me once that worrying is like a rocking chair. It's something to do, but it's not going to get you anywhere. Yeah.

• 1:10Marielle Segarra?

  Now I'm trying to picture somebody trying to actually get somewhere in a rocking chair.

• 1:16Speaker 07

  Rocking their way down the street, inch by inch.

• 1:24Marielle Segarra?

  Hey, it's Marielle Segarra. You're listening to Life Kit. And I talked to Life Kit reporter Andy Tegel about the anxiety that can come up when you're trying to have a baby. It's especially difficult for folks who are having trouble conceiving when they get invited to, say, a friend's baby shower, or when their sibling gets pregnant. And it's like, you know, you're happy for them, but you're also just really sad that it isn't happening for you. And I bet social media amplifies that.

• 1:57Speaker 07

  Definitely. I mean, I think the contrast can really turn up the volume. And social media is really, really good at that. But, you know, I think there's also another side of that coin, and it's that social media can spread awareness, it can spread visibility. The sources that I spoke to said that, you know, as hard and lonely as this process can be, can you imagine how much more siloed you might feel if you were dealing with this infertility even a few decades ago? So I talked to reproductive endocrinologist Lucky Sekon about this.

• 2:24Speaker 10

  There are these legions of women online, and they all know each other's story. Their profiles will have, like, how long they've been trying, how many miscarriages they've had. Like, there's this whole subculture online of fertility warriors. And if one of them makes it through to the other end and gets pregnant, and you're left behind, I think that's really hard mentally.

• 2:49Speaker 07

  So on the one side, you don't have to deal with the anxiety of it alone, which is nice, but it can also give you a lot more things to be anxious about. Maybe you see your friend going through one thing or another, and you're like, oh, I didn't even, I haven't thought to do that, that wasn't on my to-do list. Now I'm worried about that, you know? Right. And it can make it a lot easier to compare your life to someone else's, like you were talking about.

• 3:08Speaker 10

  We're social beings. You need community. But if the community is going through the same thing that you are, it can get messy. And there's a lot of comparison and, I think, negative self-talk, and people feeling like, oh, so-and-so looks like they're handling it better than I. And I think that's really the key, is like, take the community and the connection, but it's really a game of mental fortitude and discipline to say, I'm in my own lane. I'm on my own journey.

• 3:41Marielle Segarra?

  On this episode of Life Kit, Andy walks us through the realities of conception anxiety and what we can do when we're feeling it.

• 3:55Speaker 04

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• 4:47Speaker 03

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• 5:11Marielle Segarra?

  Does conception anxiety look and feel the same as generalized anxiety?

• 5:17Speaker 07

  Conception anxiety isn't a diagnosable condition that you'll find in, like, the DSM V. It's kind of a general umbrella term that we've been using to talk about the stress and the nervousness that can pop up around fertility and conception. Online, you might hear people use the word fertility anxiety. Pooja Lakshman is a psychiatrist and professor specializing in women's health, and she's the author of the upcoming book, Quantum Shifts.

• 5:43Speaker 05

  You can become preoccupied with your menstrual cycle, with ovulation. You can be sort of compulsively Googling different symptoms and have high distress every month around the time where you're going to know that you're going to be taking a pregnancy test without meeting criteria for generalized anxiety disorder.

• 6:03Marielle Segarra?

  Okay. So you can have this kind of conception anxiety, or you can have anxiety about trying to conceive without having been diagnosed with a generalized anxiety disorder?

• 6:16Speaker 07

  Yeah, exactly. In order to meet criteria for an anxiety disorder, your functioning needs to be impacted. So trouble performing at work, taking care of your family, things like that. Pooja says the majority of her patients aren't there, and they're not going to develop a full-blown anxiety disorder during this time. But it's still really important to talk about these feelings, because trying to conceive is still a major pain point for a lot of people.

• 6:40Marielle Segarra?

  Yeah.

• 6:40Speaker 07

  Do we have any idea how many people this affects? She told me it's really hard to quantify this type of thing, but some studies have shown up to 40% of women that are trying to get pregnant will feel some level of psychological distress. And in my own non-expert opinion, that honestly feels a little bit low.

• 6:58Marielle Segarra?

  I mean, it just makes sense to me that anytime you're striving for something, anytime you really want something, that opens up the door to anxiety.

• 7:08Speaker 07

  Yeah, like you said, you know, anytime you really want a thing, it opens up the possibility of not getting the thing. And I think that's where that anxiety spiral can start.

• 7:16Marielle Segarra?

  Right.

• 7:17Speaker 07

  But the thing about conception, what makes it distinct is there are a lot of other times in our life that are stressful, where we might be going through anxiety, you know, maybe it's trying to graduate from college, and you're, you have to pass all your finals, or it's switching careers, or breaking up with somebody. What Pooja told me is that most of those times of acute stress have a beginning, middle, and end, right? There's like light at the end of the tunnel that you can work your way towards. But when it comes to conception, it can feel like you're on this never-ending, monthly hamster wheel.

• 7:47Speaker 05

  It's like this cycle of hope, and then you're constantly hypervigilant. Do I feel a little bit nauseous? Maybe I do, maybe I don't, I'm not really sure. That cycle of waiting and hoping and waiting and grief is because of the nature of how repetitive it is, and then the nature of not having control and not having an end date in sight, becomes even more difficult to deal with.

• 8:16Marielle Segarra?

  Okay, so if you are in it for the long haul, and you don't have that specific end date to look forward to, how can you learn to cope with that uncertainty?

• 8:28Speaker 07

  First thing they said, just educate yourself. Don't just ask Dr. Google your questions at 3 o'clock in the morning and then worry in isolation. This is something that we've talked about since the How to Get Pregnant episode, something we keep talking about, is how health literacy for the average American, especially when it comes to fertility, is sorely lacking. Lucky gave me this analogy that I thought was pretty striking. She compared trying to get fertility treatments without proper knowledge to trying to get somewhere in a hurry without any navigation.

• 8:56Speaker 10

  You have no Google Maps. You're just going at breakneck speed and hoping to, like, squint and see the right exit, and it's chaotic. People are veering in and out of lanes, and they're not always making the best, most measured decisions. And they're kind of just going based on whatever they think is the right next step, but they don't really have that roadmap. And to make matters worse, you're in a rocking chair.

• 9:21Speaker 07

  I had to.

• 9:23Marielle Segarra?

  After the break, Andy shares more tips on how to deal with uncertainty and anxiety when you're trying to get pregnant.

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• 10:36Marielle Segarra?

  We've been talking about what you can do when you or a partner are trying to get pregnant and you're living in this period of uncertainty. There's a lot of misinformation about fertility. So first things first, you want to make sure you trust your provider and you feel comfortable around them.

• 10:52Speaker 07

  Another thing we talked about with my sources was interrupting the negative self-talk. Lucky was talking about how much blame and shame and guilt goes into this process when, like we keep talking about, you have very little control over the process. So she says something that can help with that: journaling, affirmations, all the things we love here at Life Kit. Let me introduce you to reproductive psychiatrist Sarah Ork.

• 11:14Speaker 08

  If running is helpful to you, if breath is helpful, meditation, any grounding techniques, a sound bath once in a while, if all of those tools, if therapy, if those are helpful to you, maintaining those while you're trying to conceive, and certainly while you're doing assisted reproductive technology like IVF, is a really, really good idea.

• 11:36Marielle Segarra?

  What about if you're on SSRIs or other psychiatric medications? Can you stay on

• 11:43Speaker 07

  them while you're trying to conceive or while you're pregnant? Yes, it is possible. You should definitely talk to your own provider about what makes the most sense for you. But what they say is that a healthy mother is the most important thing. And for a lot of people, the best treatment is to remain on your SSRIs.

• 12:00Marielle Segarra?

  What are some other ideas that you heard?

• 12:02Speaker 07

  One was to build in breaks from the stress of the cycle. So this is more specifically if you're doing fertility treatments. Lucky said, still take the time to go on a vacation, you know? Or if you're having a hard time, maybe that means you don't have to pretend that you're not, that everything is going well. You don't have to go to every baby shower. The last bit of advice here is having someone on your board of directors. You know, maybe that's your partner, and maybe that's a therapist, someone that can help you decide when to stop trying. Maybe that's a rubric that you decide on beforehand, maybe not. Sarah says this is a very individualized choice because it's a good idea to have that conversation and keep having that conversation. It's not an easy one to have. For some people,

• 12:44Speaker 07

  that line is like, it's my insurance will cover X number of cycles. For other people, it's evaluating quality of life. Right. Asking, is this the only way that we can build a family?

• 12:54Marielle Segarra?

  Yeah, it's like, it's deciding where to put your energy and what family means to you. Absolutely.

• 13:02Speaker 07

  Can anxiety get in the way of conception? The jury's still out on this. Sarah told me that there just hasn't been enough research into this topic. There needs to be more. What has been done points to two different schools of thought. The first is that people have not lost their ability to get pregnant, to have babies during highly stressful or anxious times. So wartime, famine, et cetera. The other side says that they're likely related and possibly bidirectional. Anxiety affects conception, and the inability to conceive can increase anxiety. Ghostways, research inconclusive. But what we do know, what Sarah told me that I really liked, throughout the history of time, never has it ever helped anyone to just tell someone to relax.

• 13:47Marielle Segarra?

  Yeah, it's like, in a way, this can become a downward spiral if you're like, I'm so anxious, and that's what's stopping me from conceiving. I just have to be less anxious. Right. And then you put pressure on yourself to be less anxious. Like, that is not the...

• 14:02Speaker 07

  And then it's another thing you have to worry about. Exactly.

• 14:05Marielle Segarra?

  You know, something that comes up for a lot of couples in this process is that they will get pregnant, but then they lose the baby, or they lose the pregnancy. And then moving forward from there feels so much harder, because then you're worried it's going to happen again, and you're grieving as well.

• 14:24Speaker 07

  Of course. Yeah, of course. What Sarah told me was, the thing that you have to know about pregnancy loss, if you're listening to this and this is something that you're going through, is that it's really common. Current research puts the number somewhere around 15% to 20% of pregnancies confirmed by medical imaging end in pregnancy loss before the 20th week. And what she told me is, as soon as you start to open up about it, people will start coming out of the woodwork. You know, like, oh, it happened to me. Oh, it happened to my grandma. You know, my grandma had three, et cetera, et cetera. It's one thing to hear the numbers. It's another thing when it happens to you and your body, of course, right? You're going to be the most connected to that loss, and that can be really scary, really anxiety-inducing.

• 15:06Speaker 07

  But it doesn't necessarily mean that there's a bigger ongoing problem.

• 15:11Speaker 08

  Whether your reaction is, oh, I'm ready to conceive next cycle, no big deal, or your reaction is like grief of like, what you felt when someone in your family died, I think all of those are totally in the acceptable realm. I think a lot of people are looking for like, I need to be tested, or something's wrong with me, and that's not necessarily the case. And often physicians don't recommend any sort of formal examination or testing of what's going on until about two or three losses.

• 15:41Speaker 07

  Which, of course, is really hard for a lot of people to hear. Sarah herself was someone who carried a pregnancy after loss, and she said it was pretty brutal, the anxiety, that is. But it's something that happens a lot.

• 15:52Marielle Segarra?

  If someone that you love is dealing with anxiety around conceiving, how can you

• 15:58Speaker 07

  support them? This came up a lot in my reporting. And this process doesn't happen in a vacuum for the person going through it, the people going through it. It can kind of feel like this ever-present elephant in the room, right? So if you're that person's closest to someone, you should be sensitive to that fact. Or if you're in a couple and you're both going through that, if you're both struggling with conception anxiety, don't suffer in silence. Talk to each other about it. The sentiment from all of my sources was that infertility issues can be make or break for couples especially. It can be a source of real intimacy, coming together in this hard time against this common foe-type thing, or it can drive a wedge between people. So it's important to show up. And there's a couple ways to do that.

• 16:41Speaker 07

  One suggestion from Lucky, just practical things. For example, if you're going through fertility treatments, perhaps maybe an egg retrieval, we know that you need salty snacks. Maybe you bring salty snacks after that retrieval. Or comfy things, comfy slippers, pajamas, like little gestures that just show people that you're thinking of them, that you want them to be cared for. Another suggestion, just being very careful with your language during this time. You can be curious, you can invite conversation, but you don't want to assume that this is all somebody wants to talk about. You don't want to push them to be open about it, and you don't want to prescribe any advice, you know? People love to give unsolicited and often unhelpful advice when they hear you're trying to get pregnant, and double, it seems, if they hear you're having a hard time.

• 17:24Speaker 10

  Part of the issue is, we need to educate the general public, the five out of six people that don't have infertility and never have to walk into a fertility clinic, about the things not to say and the things to do. Never tell someone, oh, you just need to relax, go on vacation. Everything happens for a reason. Oh, at least you can do IVF. Don't keep asking, any news yet? Any news yet? Right. What else do you want people to know about anxiety to conceive?

• 17:55Speaker 07

  One last important message. Everyone I spoke to was really clear. You have to keep living your life. When you decide you're getting on the baby-making train, it can become pretty all-consuming, especially if you face any bumps along the road. But making your fertility journey your whole identity makes things worse, not better. Pooja says, when you don't get pregnant after trying to do all the right things, it can feel like another report card where you got an F.

• 18:19Marielle Segarra?

  Yeah.

• 18:20Speaker 07

  That's a really hard place to live, but that's not the only part of you, and that doesn't define you, doesn't have to define you. So one question that I thought was helpful, she often tells her patients to ask themselves, what is this anxiety costing me? A lot of people will put their bodies through a lot in this process. They'll spend a lot of resources to try and have a baby, and they'll tell themselves, it'll all be worth it when I have this family. But she says, you have to remember, you are a whole person as you are right now.

• 18:46Speaker 05

  We can't let our life shrink because of this. So you have to protect the things that you enjoy, the things that bring you happiness. And if you're with a partner going through this, you also need to protect that relationship too, and not let it just turn into an exercise into trying to become pregnant.

• 19:07Marielle Segarra?

  Andy, thank you so much for this.

• 19:08Speaker 07

  Thank you, Mariel.

• 19:12Speaker 07

  Okay, time for a recap. Takeaway one. It's not just you. One in eight couples have trouble getting pregnant or sustaining a pregnancy. Takeaway two. It's normal to feel stressed about trying to get pregnant, especially with today's technology. Takeaway three. Take note of how this anxiety is getting in the way of your everyday life. Takeaway four. It's okay to not be okay during this time. You don't have to go to the baby shower. You don't have to be over the moon for that friend on your feed. But, takeaway five, you do have to keep living your life. You can't make your whole identity about trying to have a baby.

• 19:53Marielle Segarra?

  That was reporter Andy Tagle. And that's our show. One more thing before we go. Do you follow Life Kit in your podcast app? Why not go ahead and do it right now? Just tap Follow so you never miss an episode. This episode of Life Kit was produced by Margaret Serino. It was edited by Sylvie Douglas. Our digital editor is Malika Garib, and our visuals editor is CJ Rikalan. Megan Cain is our senior supervising editor, and Lauren Gonzalez is our executive producer. Our production team also includes Claire Marie Schneider. Engineering support comes from Jimmy Keely. Fact checking by Andrea Lopez-Cruzado. I'm Mariel Segarra. Thanks for listening.

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