The decision to start a family is one marked by excitement and a lot of sex. There’s often a lot of anxiety and stress, too, as, of course, myriad factors come into play when trying to get pregnant. There’s the tracking of fertility windows, the wondering why it hasn’t happened yet, the worry of sex feeling more like “work.” And when couples have issues conceiving, the frustration from being unable to have a baby together can threaten to drive them apart. The ease of which one is able to share their fertility journey on social media only compounds these issues.
Through her work as the co-founder of Haumea Health, a fertility coaching company with a focus on assisting LGBTQI+ families, physiologist Fiona Gilbert has seen firsthand how fertility problems can change and even devastate relationships. Setbacks in starting strip away romance and intimacy, leaving only the shared goal of pregnancy and the joyless commitment to avoiding failure. While navigating pregnancy difficulties is never easy, Gilbert says couples make it harder for themselves — and their chances of a successful pregnancy — when they define their marriage or relationship by those difficulties. Fatherly spoke to Gilbert about the challenges couples face when trying to get pregnant and how they can really be there for one another.
How have you seen conception problems strain relationships?
It’s actually one of the reasons why we started our company. I had a lot of male friends who were going through the fertility process with their spouses and they just were floundering. They just felt like they couldn’t contribute. They were not connecting with their partner and it was devastating for them.
How does the relationship change? Does it become less about the two people and more about the goal of trying to get pregnant.
You forget to have sex for fun. You’re timing sex, and doing all of that. I don’t think people realize the importance of physical intimacy in a relationship. The other thing also is it’s like you become obsessive.
When we started Haumea, I tried joining all of these social media fertility groups to see what people were needing. I think a lot of the stress that people feel at the moment going through the fertility journey is part of the fact that they are on social media. And I remember saying I need a break from this. I’m so depressed and I’m not even trying to get pregnant.
So instead of working with three professionals to help fertility, you now share your journey with thousands of strangers. I don’t know why anyone would do that, but apparently everyone does it. And the thousand strangers all have their opinions. They have their stories. And what’s the science behind it? It sounds awful to say but just because you’ve had a miscarriage and struggled with infertility, you don’t have an expert opinion.
What effect does that social media and internet setting of expectations for pregnancy have on relationships?
I think it’s more than just fertility. I think you need very clear communication and also a level of maturity. I see this with clients and I’m starting to see this with my daughter who is talking about getting married and having a family. There is this whole concept of, well, everybody is doing X. As a parent to sort of say, well, it’s great that everybody’s doing X. What does this mean for you?
Everybody has a different journey. I had a sister in law who could say ‘Oh, we’re going to try for a baby’ and she’d be pregnant in two days. There are people like that. That’s what they’re geared for. That’s how their bodies were made. And then I know people who struggled and who don’t announce their pregnancy until they’re way into their second trimester. And I predominantly work with women who have the most horrific stories when it comes to getting pregnant, staying pregnant, and having a child. I think you have to realize that everybody’s journey is not yours.
In your practice, you often deal with couples who’ve found career success but experience frustration when they can’t start a family. That must feel like whiplash.
Yes, and it’s not a success issue, but we kind of put it as that. Because you want to see the happy family with the baby photos. I see people who have the pregnancy photos and they document their pregnancy and then they have to announce that they’ve had a miscarriage or a termination for some other reason. And I’ve had clients who have spent two, $300,000 on a pregnancy easily. And those babies are absolutely precious but there’s that emotional toll behind those pregnancies that we don’t talk about.
What happens during all of this is the relationship between the partners becomes secondary. That’s because you’re goal driven. The goal becomes priority number one, and it seems so tangible but it’s not because there’s so many factors involved, from age to timing, the science, all of that. By making the relationship secondary, it just diminishes the relationship and it wears down. I don’t have a perfect answer for any of this and I don’t think anybody does. But with relationships in general, if you’re not feeding it, if you’re not making it a priority, it’s going to struggle.
Do couples blame each other when they’re having difficulty with conception?
There’s a level of resentment, but there’s never an all out blame. Because couples now will both go for fertility testing. They will both go for fertility acupuncture and they’ll both be on fertility diets. That’s very unlike maybe 20 or 30 years ago where the women did it and the guy didn’t. And as long as he had good sperm count, it was assumed that she would do all the work. The evolution has become that they’re both on fertility lifestyle changes and they’re both on fertility treatments. But there is this undercurrent of resentment. That doesn’t mean blame as in thinking they’re not doing their part or they’re the one who’s infertile. But the longer this drags out they can, if they don’t focus on the relationship, there is an undercurrent of resentment.
What role does shame about being unable to conceive play?
I think shame for the woman and shame for the man is different. The man feels like he’s not performing. It becomes a performance issue. They have a primal need to provide and they’re not providing. It’s like “We want a baby, here’s my part. And I’m not doing my part.”
I think a lot of women go inward. They’re kind of excited about it, but then they feel that they can’t talk about all their emotions. Usually women go through this kind of as a group, because you all kind of get pregnant at the same time because of that age, we are age restricted. So you start seeing your friends post that they’re pregnant or they’re had their first baby and it’s not, it might not so much be shame but envy.
I think that infertility has become such a public issue now that people are more aware of it so that there is not that sort of shame involved. But there is definitely envy.
What should couples do when conception problems are wrecking their relationship?
Take a break. If you are a couple that has stored and frozen eggs, take a break. The IVF process is very harsh on the body. And you have to remember that most women who have a baby through an IVF process are 10 times more likely to develop postnatal depression because of the hormonal fluctuation — that’s just how harsh that process is on the body. So my first advice is take a break.
And I’ve had people who’ve yelled at me when I’ve said that. They say “Well, you don’t understand, we’re on a time crunch, blah blah blah, there all these factors.” But it’s like with everything else. There are biological speed limits. Give your body a break. Away from the physiology of it, your relationship needs to be nourished. You have to remember why you’re doing this. As a couple, you have to remember why you’re doing this and is it really still that important? Are you okay with just being the two of you?
Is it okay to build a life that doesn’t involve children? Because, you know, kids are tough. I just had my two nephews here. There’s a big age difference between my kids and my brother’s kids. And I forgot how hard it was to have kids. They don’t stop. I’ve been exhausted for a week.
If you decide you want to be parents, you have to reassess. There are other ways of being a parent. My girls are adopted and we never had a fertility issue. We just decided because of medical stuff I was going through at that stage and that was how we were going to have a family. There are couples who go from trying [pregnancy] to surrogacy, to adoption. And you have to figure out what is important. If having a family is important, it doesn’t matter if they’re biologically related to me or not. Do I really need to go through that pregnancy experience? Or do I want a family? Those are tough conversations to have.
You have to decide as a couple what variations there are for you. And it might not look the same for your friends or your community.
How can couples struggling with conception combat helplessness?
Work with professionals who you trust. It’s great to have support from family, friends and thousands of strangers on the internet, but none of them might be nuanced into helping you. You could have something really strange and funky in your biology and physiology and doctor Google was not going to help. Find somebody who knows what they’re doing, but who also fits your lifestyle and your goals and wants to create something personalized for you.