The silent suffering of secondary infertility

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“Is that your daughter? She's adorable. So you just have the one child?”

I overhear a mom speaking to another mom and cringe. Even before the other mom tells me that she's been trying to get pregnant for years, even before she tells me about her failed attempt at IVF.

According to the Mayo Clinic, Secondary Infertility is the inability to conceive or carry a child to term after already having a child. Secondary infertility, much like infertility can lead to feelings of: isolation, dissatisfaction with your body, anxiety, feelings of sadness, problems with your relationships and grief.

Secondary infertility also presents a new set of challenges:

  1. Feeling like a bad mother-There are different reasons why you may feel like a bad mother. You might be feeling this way because you cannot get pregnant again. You might feel this way because infertility may be causing anxiety or depression and may effect your parenting. You may feel like a bad mother because you want to give your child a sibling.

  2. Disconnection from your child- You may feel disconnected from your child. It may be hard for you to make sense of parenting a child that is here and grieving the one that you do not have. Infertility can be all consuming. You may have trouble staying present with your child.

  3. Feeling split between wanting more kids and wondering why you had them in the first place-It is hard to have a child. Really hard. You may be having opposite feelings of wanting another child and at the same time feeling not cut out for parenting all together. It is really hard to think about having a child when your current child is taking all of your energy and mental space.

  4. Feeling shame because you already have a child- You may be feeling shame about wanting another child. It is common to hear comments like “well at least you already have one” or “some people can’t have any”, “appreciate what you have”. You may also have trouble connecting with others that are struggling with infertility because you have a child and they may not.

If you are struggling with these symptoms you are not alone.

Ways to cope with secondary infertility:

  1. Find support- Find someone that you can talk to about your feelings. Whether this is a professional, a support group, a family member or a friend, it is important to talk about your feelings and get validation that those feelings are real for you.

  2. Make me time- In a culture that prides itself on being “so busy” take some time for yourself to do self care. Self care is not selfish, it is not a luxury, it is necessary. Taking time away from being a mother, partner and trying is important. Finding something for just you is important. This could be exercise, massage, getting your nails done, taking a class, sometimes even just grocery shopping by yourself can feel therapeutic. Make this a habit and set boundaries so that it happens on a regular basis.

  3. Make special time to connect with your child- Find some time to spend time with your child in the moment. Whether this is reading a book at night or playing a game time find to be present with your child and connect.

  4. Take some time with your partner-Spend time together outside of trying for another child. Go on a date. Have dinner without your child around. Make time to talk to each other.

  5. Take a break- You may feel that it is necessary for your mental or physical health to take a break from trying.

  6. Sit with the discomfort- know that these feelings will dissipate. Let them wash over you. Name them, acknowledge them, and let them pass. It is common for women going through infertility to feel a lack of control. This can be one of the hardest things for women to process, especially when they are planners and are used to being able to achieve goals. It is hard to sit with feelings of discomfort. Using grounding and mindfulness exercises can help with sitting with these feelings.

If you are struggling with secondary infertility I Can Help.

If you would like to learn more about coping with secondary infertility contact Julie at 608.239.4807 or julie@kullcounselingmadison.com for a free 15 minute phone consultation.

#miscarriage matters...my story

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October is pregnancy and infant loss awareness month. I hope that sharing my story may help someone else find comfort and strength.

This Thanksgiving will mark 4 years since I said goodbye to one of the men that I respected most in this world, my grandfather. As the priest mentioned later at his funeral, it was so fitting that he died on Thanksgiving because he was the most thankful and giving man despite facing many challenges in his life. It was difficult to say goodbye to him, and bittersweet, as I had a secret that only my sisters knew, I was pregnant with my second child.

Fast forward 5 days later and I was sitting at the doctor’s office with my husband and one year old waiting for our 8 week ultrasound. I remember thinking how lucky I felt and how it almost did not feel real. I could not wait to show our daughter that she had a sibling on the way.

The doctor’s office confirmed my pregnancy with a blood test, so it was on to the ultrasound. As the tech started to move the wand around she was silent. I looked at the screen and knew immediately that something was wrong. I had seen what a 8 week ultrasound looked like with my first child and I knew this baby did not have a heartbeat. What happened next is a blur of talking with the doctor, crying, and feeling so empty. I will never forget the nurse that sat me down to go over my options with me telling me how sorry she was and that she had had 4 miscarriages. In that moment, hearing her story gave me strength to get through that day.

I decided to wait hoping that the baby would come out naturally on its own. I spent the next few weeks trying to heal and also let go. I went to my grandfather’s funeral, showing little emotion, fearing that any emotion would lead to a breakdown or trigger the miscarriage.

The baby did not come out on its own. The miscarriage took an entire month to complete. It was a month filled with pain, bleeding, and doctor’s appointments.

After the physical symptoms had subsided, the emotional ones had kicked in. Every person that has had a miscarriage is different and everyone reacts differently. I was embarrassed, ashamed and heart broken. I felt like my body had one job in life and it failed. I told a few people in my support circle. Some people were great, some people had a hard time relating. Support came from surprising places. Even with this support I felt really lonely. I looked for resources in the community and nothing was the right fit. Based on the challenges I had finding help in the community, I made a promise to myself that when I was at a place to help others with pregnancy loss that I would. In 2016 I started taking trainings and doing research on psychotherapy and pregnancy loss. In October of 2017 I started offering a support group for miscarriage.

Having a miscarriage can make someone feel so alone. If you or someone that you love has had an early pregnancy loss please share this resource with them. No one should have to go through this alone.

For more information on pregnancy loss or to sign up for the free monthly support group please contact julie@kullcounselingmadison.com or 608.239.4807.

The importance of self care

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Self care. Do you feel like you are hearing those two words everywhere? Have you ever wondered what self care is and how to do it? Self care is defined as any activity that we do deliberately in order to take care of our mental, emotional, and physical health according to  Psychology Today.

Self care is not just exercise or meditation but it certainly does include these things. Self care includes all the different areas in your life: Physical, Spiritual, Social, Cognitive/Mental. 

Physical- How can we physically take care of our bodies? One way is through movement. Exercise is a great form of self care. Examples include: Running, Walking, yoga, pilates, tai chi, stretching, dance, cleaning, hiking, kayaking, swimming, bicycling, getting a massage, and gardening are a few examples. The second physical way that we take care of our body is how we nourish it. What food are you putting into your body? Are you eating a balanced diet? How are you eating? Do you rush through your meals? Do you rely heavily on meal replacements? Are you cooking your meals? Or if you cook often can you take a break to eat at a restaurant? Self care and nutrition can look different depending on your dietary needs.

Spiritual- Are you nourishing your spiritual side? For some that may mean organized religion, for others that may be more spiritual or even philosophical. Examples include: going to church, volunteering within your religious community, taking time to be in nature, connecting to your spiritual side, taking a day of rest, prayer, meditation, or devotions.

Social- Self care for our social side can include social activities and social support. Social activities can include taking a class with others, going to a movie, going out to dinner, playing a sport together, going for a walk or joining a club, volunteering, joining a board, and hanging out with friends to name a few. Social support can include: friends, family, neighbors, religious community, colleagues, 

Cognitive/Mental- Cognitive self care involves stimulating your mind. This can include: reading, learning a new skill, taking a class, learning about something new. This also includes getting enough sleep. Mental self care is nourishing our emotional health. Examples of this include: mindfulness, meditation, journaling, painting, drawing, listening to music, playing an instrument, seeing a psychotherapist, and practicing relaxation exercises.

There are many ways to care for your self and self care will look different for each person. Many of these examples cross over to other categories. It is important to care for yourself in many different aspects of your life. Self care is important to your overall wellbeing. It does not need to take long but even incorporating a few minutes a day or trying one or two examples from above can make a big difference. 

For more ideas on adding self care into your life contact Kull Counseling at 608.239.4807 or julie@kullcounselingmadison.com.

 

Going back to work after a miscarriage

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Miscarriage affects 1 in 4 people. Most miscarriages happen in the first trimester. While it is common to have a miscarriage, how it affects you looks different for each person. A miscarriage can take a toll on your wellbeing. Many women struggle with how and when to return to work after having a miscarriage. Below are some considerations for deciding when to go back to work and some coping tips that may be useful at work.

Considerations to make before returning to work:

1. Is your body physically able to return to work?

Having a miscarriage can be a painful experience. It can drain you not only emotionally but physically. It is common that your hormones may be out of whack and is common that you will still have pregnancy symptoms and you may still feel pregnant. The miscarriage may take a few weeks to complete. You may need to take time away to schedule a D & C. You may need to consider what your job asks of you physically. Do you have to do any heavy lifting or be on your feet all day?

2. Are you emotionally ready to return to work?

Do you feel well enough emotionally ready to return to work? You might be having a hard time concentrating. You also may find that your emotions are consuming you. It is common to feel like your emotions are on a roller coaster often feeling more than one emotion at a time. It is common to feel sadness, anxiety, depression, loss of interest in things, isolated, and feeling disconnected from your body.

3. Will you tell anyone?

If you took some time off after/during your miscarriage your boss may wonder while you are out. Will you tell your boss? Have you thought about how you want to tell them? If you decide not to talk about it at work have you thought about what you might tell your coworkers if they ask where you were. Do you have anyone at work that you can trust or that your feel like you want to tell?

4. What can you do if you are feeling upset at work?

When you have a miscarriage it can affect you at different times. You might be feeling okay but then something may trigger thoughts of the miscarriage and feelings of sadness, frustration, isolation ect. Do you have coping skills at work when these feelings come on? Is their someone that you can talk to? Would you like some alone time? Where can you go? Your office, a bathroom, outside for a walk? Does deep breathing help you? A simple method is called four square breathing. Breathe in to the count of four, hold it to the count of four, exhale to the count of four, hold it and repeat. Can you do a grounding exercise? An exercise that is easy to remember is to just feel your feet. Put your feet flat on the floor and bring awareness to any sensations that you feel in your feet for the next minute.

5. When do you have to be back at work?

Do you know your work policies about how much time you can take off? Have you contacted the correct departments if you need more time off of work. Most companies have a human resources department that can help to guide you through this process. Can you work from home?

If you do not feel ready to return to work it is important to speak with your doctor. If you are feeling depressed or anxious most days it is also important to talk to your doctor or identify a psychotherapist that you can talk to.

For tips on returning to work and early pregnancy loss contact Kull Counseling, LLC at 608.239.4807.

Unplug and Hug to reduce Anxiety

I was honored to be a guest blogger for unplug and hug. This is a repost of the article.

Electronics can be great. We love having our gadgets connected to us and we love having what our gadgets connect us to.  The amount of information available at the touch of a finger (thanks to the internet) is life changing.  FaceTime with family has changed the way we interact and stay close to distant relatives. Social media connects us with friends and family that we don’t get to see often. There are wonderful mental health and meditation apps on phones and computers these days.  Connectivity anywhere, anytime allows flexibility at work to check and manage email when out-of-office.

 

As a psychotherapist that focuses on helping those with anxiety, I see a lot of college and graduate students in my office.  Many of these young adults use their phones and social media in a way that increases their anxiety.  Being active on social media can attribute to the fear of missing out. It can also lead to constantly comparing your lives to others. It can also provide a false sense of social support. It can reinforce those negative thoughts in our head that we are not good enough or that others are better than us.

 

While not all use of social media is negative it is important to unplug once in a while. Instead of grabbing for your phone in a moment of anxiety make time for mindfulness and bring yourself into the present. Focus on your breath, notice your discomfort, observe and let is go. When you are using social media be aware of how you feel. If you notice your anxiety symptoms arising or getting worse it is time to set a boundary and put your device down.

 

Besides practicing mindfulness when you are feeling anxious it can also be helpful to take a walk, spend time in nature, connect with a friend, exercise, read a book or practice another form of self-care.

 

Best practices for helping women after a miscarriage.

A miscarriage is pregnancy loss before twenty weeks. Early pregnancy loss is estimated to occur in 1 out of 4 women. Most miscarriages happen between 6-12 weeks gestation. Early pregnancy loss is considered a loss but also a trauma. I recently was asked by Kat Schuknecht to give a presentation to the Madison Postpartum collective on best practices in helping people through early pregnancy loss. Here is a summary of my presentation.

Miscarriage is an invisible loss. It is the loss of your baby but also the loss of your dreams to come. Many people wait until the second trimester to share pregnancy news. When pregnancy is unknown by others it can feel invisible to the couple that is grieving. There is no one asking how you are doing or checking in with you. It can be difficult to share your news with others because of the sense of shame and guilt that surrounds the stigma of miscarriage. Many women blame themselves even though it is not their fault. In most cultures there are no rituals or ceremonies to help people grieve. It is normal to grieve with others, you may grieve miscarriage alone or with only a few people and you may feel very isolated.  It can also feel very abstract. If you do decide to share the news of a miscarriage it can feel abstract to the people you are sharing it with. It can even feel this way for your partner. Women tend to connect with their pregnancy and baby early on while partners often connect later in the pregnancy or once the baby is born. This type of loss can feel very uncomfortable for people and you may find them shying away or not knowing what to say.

If you have had a miscarriage you have experienced a major loss. An earlier loss does not equal less grief. Grief does not go away, it becomes part of a new normal that you carry with you. Grief is not linear it is actually quite messy and make look different every day. Grief is different for each person. You have a right to your grief. Your partner's grief will be different from your own.

Miscarriage can lead to feelings of shame, guilt, anxiety, depression, isolation, emptiness, failure, feeling disconnected from your body and sadness. No two people feel the same way. We cannot assume that we know how someone is feeling.

Miscarriage can lead to women feeling disconnected from their bodies. It may lead to difficulties with intimacy. Because women may be feeling disconnected they can be unaware that they are holding trauma in there body. It is important if you do bodywork with people that you are taking a trauma informed approach.

A miscarriage is a loss but also a trauma. Having a miscarriage can trigger post traumatic stress disorder. Symptoms of PTSD to look for our: fatigue, trouble sleeping, hyperarousal, nightmares, lack of concentration, anxiety, depression, loss of appetite and frequent crying. Pregnancy after a loss can be triggering for people.

Women who experience a miscarriage can have postpartum depression or anxiety. Anytime a woman goes from pregnant to not pregnant there is a shift in hormones that can affect brain chemistry.  It can be difficult to identify what is grief and what is anxiety or depression.

How Can Professionals Help

Holding Space - Professionals can help by holding space for clients. Holding space is being present with clients. Starting where a client is and remaining non judgmental. It is providing an environment that honors your clients needs.

Communication - How we communicate with people about early pregnancy loss can greatly impact our work. By opening dialogue about early pregnancy loss we can normalize and help reduce stigma. Ask. Include questions about early pregnancy loss in your assessment.  Take cues from clients when addressing early pregnancy loss. Refer to it as your client does. Whether they call it a pregnancy, a baby or even a name. If you meet with couples acknowledging a partner's grief.

Advocacy - Advocate for your client's needs on different level. At a micro level address their needs within your office. Are there pictures you may want to take down in your office or waiting room? Does this client have to wait in a room full of pregnant women? Is it possible for them to wait in the office? If you have someone that needs support validating and normalizing that it is okay to need support. Connect them to resources in the community. Therapy and Support groups are a few sources of support.

What do clients want us to know? I surveyed a group of women that had experienced early pregnancy loss and this is what they wanted providers to know.  They wanted providers to:

  • Be present with the client and loss
  • To listen
  • To validate
  • To understand that grief is a lifelong process
  • To be told they are a mom

If you are a provider or someone that has experienced miscarriage and our looking for resources Kull Counseling provides therapy and a free monthly miscarriage support group. Contact Julie at 608.239.4807 for a free 15-minute consultation.

 

The guilt of miscarriage

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It is estimated that 1 in 4 women will experience a miscarriage.  For many, having a miscarriage is a devastating loss that leads to a roller coaster of emotions. One common emotion many women hesitate to talk about is guilt. When you have a miscarriage there is a large amount of guilt associated with it because you feel like you did something wrong.  

 

Different types of guilt with a miscarriage:

1. The Guilt of It was my job. You may feel that that having a baby is part of your role as a woman and a wife. You might feel guilty that this is your job and since this is your job and you did not give birth to a healthy baby you have failed your job. You might have been taught that pregnancy and motherhood come naturally (and easily might I add) so when you are not able to maintain a healthy pregnancy there are strong feelings of guilt.

2. The Guilt of I did something wrong. If you believe #1, that it was your job to get pregnant and have a baby, than this is usually where the second layer of guilt sets in. If you could not do "your job" than you must have done something wrong. Did I drink too much caffeine? Was I exercising too much or not enough? Was it that glass of wine I had before I knew I was pregnant? You probably have come up with a dozen things that might have caused your miscarriage and concluded that is was your fault. 

3. The Guilt of what if I can't get pregnant again. If it was your job and you did something wrong than you might be feeling it is quite possible that you cannot get pregnant again. You may fear that you have already lost a baby and now you feel the guilt of what if I already lost one baby and I will never be able to have another. You might feel that this was your only chance and you did something wrong to cause this. You might feel that this is punishment for something else that happened in your life.

Guilt is an intense emotion and a very real part of the healing process of losing a baby in early pregnancy. There is help working to challenge these negative thoughts and normalize these feelings. If you have experienced early pregnancy loss it is not your fault, and  you are not alone. To learn more about guilt and other common feelings after a miscarriage or more information about the free monthly miscarriage support group please contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

How to reconnect with your partner after pregnancy loss

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Pregnancy loss can have a profound effect on your relationship. For some, it can be a life altering event bringing you closer, and for others, it can lead to the end of your relationship.

When you lose a baby it can be difficult to cope. There is no handbook that gives you instructions on how to grieve. You may feel like you and your partner created this baby together, so grieving should be a joint process.  However, for many couples this is not the case. People grieve differently; how you process grief, when you process grief, and when you get to the acceptance stage of grief. You most likely felt different the minute you realized you were pregnant, connecting with your baby early on in your pregnancy. Research shows that for many first time fathers, a man does not consider a pregnancy a baby and himself a father until he holds that baby in his arms. www.webmd.com

You may feel emotionally disconnected from your partner when you are processing pregnancy loss, and you may also feel physically disconnected from your partner. It is common that you may also feel physically disconnected from your own body. You may find it difficult to be physically comforted by your partner or may have difficulty being intimate. This is common after you experience pregnancy loss. 

Reconnecting with your partner can be difficult, but it is not impossible. Here are a few things that can help you reconnect with your partner after pregnancy loss.

1. Reconnect with yourself - Before you will be able to reconnect physically with your partner, you need to reconnect with yourself. This can be done using mind-body techniques to reconnect you to your body. Two mind-body techniques that I use in my work include progressive muscle relaxation and the body scan. These exercises are both helpful to identify where in the body we hold pain, grief and stress from the trauma of a pregnancy loss and where we are disconnected. 

2. Communicate - This may not sound difficult in theory, but in practice can be difficult. Discuss your feelings about the loss with your partner and accept that they might not understand and that they may feel different about the loss of your baby. Tell your partner if it is difficult to connect physically. Explore feelings about being intimate and what that means for each of you. You may feel like being intimate again will lead to a subsequent pregnancy that you are not ready for. Your partner may just be trying to comfort  you and connect physically. Identify triggers that lead to feeling disconnected. Continue to check in about how you are both feeling.

3. Honor your loss - Find a way that feels comfortable to grieve your loss. Create a ritual that you can do with your partner to honor your loss together. It is important to find at least one way that you can honor your baby and sharing this with your partner is a great way to reconnect.

 4. Seek help - If the above ideas do not work and you are still finding it hard to reconnect there is help. Psychotherapy can help you reconnect to your partner after a loss. Remember to be kind to yourself. Pregnancy loss is a complicated loss and there is no one way to navigate it. 

For more resources on reconnecting with your partner please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com.

Honoring your due date

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Your "due date". 

If you have experienced an early pregnancy loss, you might be overwhelmed with emotions when thinking about these two words.  It might feel like a deadline for you or a last hurdle you are waiting for to move from depression to acceptance. You might even feel that your due date will be the time that you start letting yourself grieve. If you have experienced an early pregnancy loss an upcoming due date might be weighing heavily on your mind. According to clinical psychologist Kirstin Bouse, via www.essentialbaby.com, "Commemorating your baby's due date isn't just a way to reflect on how important your baby was to you, it's also a vital step in the grieving process."

While everyone must find the best way to grieve and honor their baby on their due date, here are some ideas that have helped others:

1. Find something that memorializes your baby.  You may find that it is healing to have something that memorializes your baby. You may find that a piece of jewelry that you can wear is meaningful- an initial, name, date or symbol can be printed on necklaces, rings or bracelets to help you remember your baby. You might find that getting a tattoo would help you to honor your baby. Other ideas include a statue, stuffed animal, plaque, or plant are ways that you might honor your baby. You might find it to be healing to create a memory box adding any pictures, poems, toys, outfits, or other momentos that help you to remember your baby.

2. Donate. Whether this is your time or money, you may find comfort in making a donation to a charity in honor of your baby on his/her due date. Donating can be a wonderful way to not only memorialize your baby but to also help others.

3. Surround yourself with family and loved ones. You may fine it helpful to surround yourself with loved ones on this day. Those who know and will help you to honor your baby. It may be helpful for you to talk about it with others, to have a celebration in your baby's honor or simply to just be surrounded by love.

4. Spend time alone. You may find it comforting to be alone.  You may want time to process what this day means to you by yourself. You may not want to talk about the day. You may find it comforting to write about your baby or use art to process your feelings about the day.

5. Take a vacation or a staycation.  You and your partner may enjoy taking time off from work to go out of town or to have a mini vacation in town. It might help you to celebrate the day by making some happy memories or it just might be a good distraction to get through the day.

These are a few suggestions that have helped others. Everyone grieves differently and you have to find what is right for you. If you are having a hard time processing your grief or are feeling stuck there is help.

For more information about grieving after a pregnancy loss please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com

 

Surviving the holidays after early pregnancy loss/miscarriage

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In 1963, Andy Williams sang, "It's the most wonderful time of the year."

If you have experienced an early pregnancy loss you may feel differently. The holidays can be a difficult time of the year for many, but can be especially difficult if you have experienced a  miscarriage.

You may be dreading parties because people do know and are uncomfortable about what to say or  people do not know and are asking when you are planning on starting or growing your family. Or maybe you are dreading opening holiday cards of pictures of friends and family with their children or you may be dreading sending out your own without your child. 

You might be celebrating the anniversary of your loss, a due date or your child's first holiday. Perhaps you were waiting for Christmas to announce your upcoming birth. You might have already made plans for what this holiday would look like with a new baby.  It is easy to feel triggered around the holidays when much of it is centered around family and children.

Wherever you are in your journey, and whatever stage you are at in your grief, here are a few ideas to help through the holiday season.

Tips for getting through the holiday season after an early pregnancy loss:

1. Get extra support - You need additional support during this time. Whether this is doubling up on support groups,  additional therapy sessions or just making plans with those that support you and your loss. If you are  religious, this may include attending services or seeking support through other church members. 

Support groups for miscarriage in the Madison, WI area:

https://www.kullcounselingmadison.com/miscarriage-support-group/

http://www.bereavedparentsofmadison.com

2. Say No - You do not have to do everything. It is okay to say no, whether this is to a party, a family gathering or sending out holiday cards. You especially do not need to do anything that triggers you or that is not a good space for you right now.

3. Practice kindness - During the holidays you tend to practice gratitude and kindness towards each other. Practice kindness and gratitude towards yourself. You may feel like you should be over your grief by now or that you were doing so well and that you took a step backwards-be patient with yourself. Do extra self care during this season: cooking, going for a walk, yoga, practicing mindfulness, reading a book, talking to a friend, or going on a date with your partner are just a few ideas.

4. Honor your baby - you may find it comforting to start a tradition to remember your baby during the holidays. This may look like buying an ornament that honors them or lighting a candle on your holiday to honor their presence. It could be volunteering or buying a gift for someone in need. Whatever this may look like for you, if you want your baby to be part of your holidays you can do it and let the important people in your life know what you need to honor your baby so they can support you.

Please remember if you are grieving a miscarriage you are not alone. If you need help during the holidays, Kull Counseling can help. Please contact  608.239.4807 or julie@kullcounselingmadison.com for more information.