Why Grief is Normal Throughout the Fertility Journey
By Emily Ginn, LMSW
The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.
Grief is a normal emotional response to any perceived loss. Most people associate grief with the death of a friend, loved one, pet, or something similar. This relatively narrow view of grief, and what causes grief, does a disservice to those who are on a prolonged fertility journey that can be filled with endless trips to a fertility clinic, the physical and emotional weight of infertility treatments, and negative pregnancy tests.
Understanding the Ways Grief Can Show Up in Your Fertility Journey
The multifaceted nature of a fertility journey can bring up different areas of potential grief, such as:
Loss of a Dream
Many individuals and couples have a deep-seated dream of parenting and having biological children. An infertility journey challenges this dream, leading to a profound sense of loss. Each failed attempt to conceive or unsuccessful fertility treatment can feel like a loss of what could have been—a family as they had imagined it.
Recurring Disappointment
The monthly anticipation of pregnancy, as well as different methods of trying to conceive (TTC) such as intrauterine insemination (IUI) or in vitro fertilization (IVF), often involve cycles of hope and disappointment. Each cycle often starts with optimism, followed by anxiety, and usually ends in disappointment if unsuccessful. This emotional roller coaster can lead to intense feelings of grief each time the desired outcome is not achieved.
Loss of Control and Uncertainty
Navigating a prolonged fertility journey can often make individuals feel like they have lost control over their bodies and their life plans. The uncertainty about the outcome that each month brings, mixed with fertility treatments, unpredictability, and lack of guarantees, can all amplify feelings of helplessness and grief.
Societal Pressure and Stigma
There can be significant social pressure and stigma associated with a prolonged fertility journey, which compounds the grief experienced. People undergoing fertility challenges may feel isolated or misunderstood by family, friends, or broader social communities, especially in cultures where fertility is highly valued. This isolation can intensify feelings of loss, sadness, and anger.
Financial Stress
Fertility monitoring systems (that help track menstrual cycles and ovulation) and fertility treatments can be very expensive and often require a significant financial investment without any certainty of success. The economic burden can lead to additional stress and grief, especially if treatments do not result in a pregnancy.
Physical and Emotional Strain
The process of undergoing fertility treatments can be physically demanding and emotionally draining. The hormonal changes caused by fertility medications can affect mood and well-being, while the invasive nature of certain treatment options can be physically uncomfortable or even painful. This strain can contribute to a sense of grief over the loss of physical and emotional comfort.
Impact on Relationships
Fertility issues can strain relationships, whether with a partner, family members, or friends. The stress and emotional turmoil might lead to conflicts or misunderstandings, further contributing to loss and grief as interpersonal dynamics change.
Coping with Miscarriages
Miscarriages happen more commonly than most people think they do, and there may be a higher risk for miscarriage with certain medical conditions or advanced maternal age. The grief associated with pregnancy loss is profound and can greatly impact individuals and couples, compounding the overall grief experienced on the fertility journey.
Grieving Multiple Losses
The fertility journey often involves multiple types of losses—biological, financial, emotional, and relational. Each aspect contributes to a cumulative, complex, and ongoing grief experience.
Secondary Infertility
This occurs when you’re unable to get pregnant or carry a pregnancy to term after previously giving birth. This type of infertility can bring up all of the grief associated with primary infertility, in addition to grieving additional circumstances, such as the inability to give your child a sibling.
The Life You Had Before This Journey
It is expected to grieve the person you were and the life you had before such losses. Maybe you felt as though you were more carefree or that your life now revolves around your fertility planning, and that is a valid grief experience.
The Invisibility of Fertility Grief
Fertility grief is a type of “disenfranchised grief,” which is a term coined by author and mental health counselor Kenneth Doka in his 1989 book, “Disenfranchised Grief: Recognizing Hidden Sorrows.” Disenfranchised grief occurs when a loss does not conform to traditional cultural norms and is, therefore, not openly acknowledged, socially mourned, or publicly supported. Although deeply felt by the individual, these losses may remain invisible and unrecognized by others, leading to a situation where the grieving individual feels their emotional pain invalidated by society. The losses felt during this journey are often not seen by others.
Others might not even acknowledge the losses felt during this journey. For example, each month that doesn’t lead to pregnancy, or each IVF cycle that doesn’t work, feels like a significant loss. These moments can feel as deep and genuine as grieving someone who has passed away. In addition to being invisible, society often underestimates the impact of these losses, which can invalidate and further isolate those grieving.
The Grieving Process Isn’t the Same for Everyone
Many people are familiar with the concept of the five stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Swiss-American psychiatrist Elisabeth Kübler-Ross researched and articulated this framework in her seminal 1969 work, “On Death and Dying.” Dr. Kübler-Ross’ contributions were pioneering at the time, introducing a new perspective on how individuals confront death and dying. It is crucial to note, however, that her research primarily addressed the experiences from the dying patient’s perspective, rather than the bereavement processes of their loved ones. Despite this, her model is widely adopted to encompass all types of grief, deeply embedded within cultural attitudes toward mourning.
Later in her career, Dr. Kübler-Ross wrote an accompaniment to her earlier work, “On Grief and Grieving: Finding the Meaning of Grief Through The Five Stages of Loss,” which acknowledged that this misrepresentation led to widespread misconceptions about the nature of grief, which have persisted for decades. This rigid structuring of grief into stages has inadvertently contributed to a culture of shame around the grieving process. When individuals do not experience these stages in a sequential or expected manner, they can feel as though they are grieving incorrectly.
This misapplication of the five stages can be particularly harmful in contexts such as infertility grief, where personal losses are often invisible and deeply personal. The societal expectation that grief must conform to a set pattern intensifies feelings of inadequacy and failure among those who are already struggling. It is imperative to recognize that imposing such structured frameworks on the deeply individual experience of grief does not serve those who are mourning; instead, it can hinder their emotional processing and healing.
Moving Forward with Your Grief
As you move forward with your grief, here are several recommendations for normalizing and processing grief associated with a fertility journey, even when those losses might be invisible to the world at large.
Validate Your Feelings
The importance of validating your feelings, regardless of whether they are understood or acknowledged by others, cannot be overstated. Recognizing that you may be experiencing grief and validating that as a normal part of a prolonged fertility journey is an essential step in the grieving process.
Embrace Your Personal Perception of Loss
Grief is a profoundly personal experience and varies in presentation and intensity from person to person. What might seem like a minor or insignificant loss to one could be devastating to another. That does not make one experience less valid than another. Your grief experience is your grief experience. No one gets to tell you differently. The more significant the loss was for you, the more intense the emotions will be. And that’s all unique to you and to your perception of the loss.
Avoid Making Grief Conditional on External Validation
Don’t make it a condition that other people need to understand your feelings for you to recognize or process them. If you make your grief dependent upon other people’s support, then you may continue to feel invalidated and unsupported. We can’t control or change other people, so don’t make your feelings conditional upon the support or understanding of others.
Own Your Grief Process
This grief is your grief. You get to decide who you share it with, how you navigate it, and how you integrate it into your life. Owning your own grieving process doesn’t make the grief more painful or difficult to process; it makes it yours. It gives you agency and power in a situation where you might otherwise feel powerless.
Focus on Self-Compassion
Grief often brings intense emotions, including sadness, anger, and guilt. Self-compassion or self care helps in soothing these feelings by encouraging a kind and understanding attitude toward yourself. Self-compassion involves recognizing that suffering and imperfection are part of the shared human experience. This understanding can help people feel less isolated in their pain, making emotional healing more accessible. It allows individuals to hold their grief without rushing the healing process, acknowledging that it takes time and cannot be forced.
Reach out for support
Remember, you are not alone and grief is a normal part of the wild emotional rollercoaster of a fertility journey.
