The Invisible Grief of Secondary Infertility

So many aspects of building a family “shouldn’t” be talked about. Awkward and uncomfortable stories don’t exactly make for casual dinner party fodder. But they are happening, constantly, to so many people you know and love. While it’s easier to hear a story about a parent seamlessly adding another sibling to their family, that is not the case for those who suffer from secondary infertility. And talk of a postpartum sex life (or lack thereof) or the messiness of adult friendships may not leave the confines of your voice notes, but they’re important conversations nonetheless. All the shame, all the secrets, all the shoulds—they only grow bigger in the dark. So here’s to shedding a little light on what many consider taboo. We’ll all see more clearly that way.

By Karen Kearney

My journey to “complete” my family felt a lot like whiplash. When my husband and I decided to try to have our first baby, everything—and I mean everything—went exactly how it should. I got pregnant right away and had no complications, besides placenta previa that ended up resolving itself. (At the time I thought this was awful, which feels crazy in retrospect.) The birth of my first daughter was as close to perfect as it could have been. My husband and I knew we wanted to have at least one more child. We knew how easy it was with our first, so we just thought we would wait to try until the time was right. Our firstborn was almost 18 months, and we both were like, “Now is the time!” That first month where I did not see two pink lines was frustrating, but nothing could have prepared me for what was to come.

We tried for months and months to get pregnant. I was so confused by how it could be so easy and then so hard. The concept of secondary infertility was actually not new to me. My mom went through it and suffered greatly. Similar to me, she had my older brother with no issues, and then really struggled to have another baby. After 10 years and with the help of IVF, my twin sister and I were born. Somehow, I was blissfully unaware that this could also happen to me. 

I fell into the rabbit hole that is all things desperately trying-to-conceive, which many women know can be all-consuming. Every month matters. Every negative test is devastating. The age gap for my daughter and her future sibling kept getting wider. About nine months into the process, I talked to my OB-GYN and they decided it was time to intervene, suggesting I do a “Day 21” progesterone blood test, which checks to see if you are ovulating. I was vacationing in the Outer Banks with my family and the closest lab was five hours away. I took the trip because waiting another month was not an option. The test revealed that I was not ovulating, and hearing this was such a relief! A simple medication would help me, and then I would get pregnant. It worked right away. I got pregnant on the first try. We told family and friends and anyone who would listen that I was finally pregnant again. My husband and I both got to hear the heartbeat at the eight-week scan, and everything looked perfect. We hung the ultrasound prints on the refrigerator. My daughter would go up to them and give the printouts a kiss. 

I went alone for my 12-week scan. Why would we need to find childcare for our daughter when everything was already fine? I remember sipping coffee in traffic on the drive there, listening to my favorite music. Once I arrived and was on the table, everything felt like it went in slow motion. It took maybe 30 seconds for the ultrasound tech to say, “I’m going to go get the doctor.” I felt my soul leave my body—I knew it. I knew it, but I had to hear the doctor say it: “There is no heartbeat.” On the screen, I could see my baby seemingly asleep. I remember crying uncontrollably, the two women walking me out of a back door instead of the lobby, and me putting one Ugg boot in front of the other to get to my car. I had what is called a missed miscarriage. My baby silently died and showed me zero symptoms, which is why this was so shocking. He was a boy, and I will always miss him. This was more devastating than any negative pregnancy test, and by far the most devastating thing that had ever happened to me.

Seven travel items making my life easier

I have taken exactly one roundtrip flight with Cole, which of course makes me extremely qualified to recommend travel gear to all of you. But, for real, I do count every time we are out and about with him as a little adventure, considering how much prep and forethought it takes to leave the house. I’ve never been more grateful for rechargeable batteries, lightweight gear, and colorful distractions. So here are some items that might make life easier on your next vacation, or just a quick trip to the grocery store. —Jess Mayhugh

Pelvic therapist and sex counselor Dr. Rose Schlaff discusses navigating postpartum sex

We always find it a little bit comical when, immediately after giving birth, a doctor or nurse will ask you about your birth control plan. Like, ma’am, things will be controlled for a while down there. And then, again, at your six-week postpartum visit when your doctor gives you the all clear for exercise and sex. But every new parent knows that it takes a long time for your body to feel “back to normal,” whatever that means in this new reality.

That is where the advice from pelvic therapist and sex counselor Dr. Rose Schlaff can really come in handy. “What worked for you in a childless relationship is not going to work for you when you’re sleep-deprived—and physically, hormonally, and emotionally in a different place,” she says. “It’s really important to be honest and open about what you have capacity for and what you have interest in.” Here, she discusses the importance of pelvic floor health, you and your partner’s different “desire styles,” and why sometimes nothing is sexier than cleaning the kitchen. —Lauren Bell Martin

Where do you begin to try and reignite your sex life postpartum? 
There are a few scripts that I really like offering to my clients. One is, “I miss when we were able to connect with a little bit more free time and it’s still important to me today, but it’s gonna look a little bit different.” It might look like taking the pressure off of penetration and orgasm. It might look like little connection moments that are a little bit less outcome-focused and a little bit more pleasure-focused. Our love languages change: [For example,] “I might have really liked touch prior to having a newborn that needs a lot from me. You cleaning the kitchen is the sexiest thing to me in this season.” I call it chore play. So it’s just about opening up the door to state your needs. There are few times in life that change your needs more than having a newborn. I mean, what a transition.

What are some factors that contribute to a lower sex drive postpartum?
From a physiological perspective, breastfeeding absolutely changes things. It’s going to change your estrogen level and your prolactin level, which can both impact desire. It can also have a huge impact on certain erogenous zones; [areas] that used to work really well might not work as well. We also see a lack of sleep and different nutrient density postpartum. Just one hour of sleep can significantly increase desire and sexual frequency in couples. 

Also body image changes after being pregnant for nine months. The body doesn’t just snap back overnight. There’s a huge healing process and there might be pain, there might be discomfort. There might just be this feeling that physically I don’t feel connected to my body in the way that I used to or I don’t feel confident in the way that I used to. You can love your partner deeply and also be touched out. You’re tired, you feel insecure in your body. It’s going to take different things to get you in the mood to be open to intimacy. You can still access your authentic desire, but might need a little bit longer of a runway or more time to preheat the oven, so to speak. That might mean listening to a sexy audio story or an erotic novel, or it might be that you need a little bit more alone time prior to shifting into your desire style.

How does pelvic floor health play into all this?
I recommend that anyone pregnant or in postpartum get a pelvic floor screening. There is a huge myth where people think, if they had a C-section, then they can’t have pelvic floor dysfunction. You are still at a place where we want to address it. We need our pelvic floor to be able to relax and lengthen, to let our poop and pee out, to allow for pain-free penetration, to allow us to have a vaginal delivery and to allow us to take a deep breath in. We also need our pelvic floor to contract and squeeze to help support our core and our back. We know that 95 percent of people with low back pain have some kind of pelvic floor dysfunction, which is kind of wild. 

The other side of this is if we’re holding a lot of tension and stress. Our pelvic floor and our shoulders are the first muscles to contract under threat and we see that they actually are contracted after somebody’s had a traumatic experience. When they look at folks with PTSD, even after they have received mental health treatment, you will still see a 2.7 times increase in pelvic floor muscle dysfunction. So that’s a really important thing to note here, because you think about so many people who have had birth trauma, or you think about the stressors of being a parent. We should be thinking about our nervous system during this time and paying attention to what our pelvic floor is doing as a result. 

We also know that the pelvic floor rhythmically contracts with orgasm and if we don’t have pelvic floor muscle strength, it’s going to impact that. Pelvic floor muscle rehab, and even just increasing mindful awareness of the genitals, can significantly increase ability to orgasm, desire, [and] arousal, and significantly decrease sex-related distress. So, it is something that can give us a lot of bang for our buck, postpartum. 

Good pelvic health can also prevent the leaking with a cough, laugh, or sneeze, [and] help prevent future back injury. It can heal any diastasis recti—which is that abdominal separation that will happen in the third trimester—and ultimately gives us a better sex life. 

What are the different types of desire styles?
There is spontaneous desire, which is, “Oh, I’m spontaneously in the mood right now.” We’ve got responsive desire, which I call “dessert stomach” desire. That’s when, If you asked me if I was hungry, I would say no. But if you started making fresh-baked cookies and I smelled them, I would probably develop an appetite for those cookies.” So you have to kind of be physically immersed sensorywise in the experience and then it kind of comes. 

Then we’ve got contextual desire, which is where context matters. If I’m on the beach with a Mai Tai, it’s going to be a different feeling than if I’m holding a crying baby. It’s going to affect my ability to access my desire. I kind of split that up into something called rooted desire, where your nervous system really needs to be in a positive place. You need to feel grounded. You need to feel connected to yourself. You need to feel like, “I’ve had some breathing room. I’ve been able to be in my own energy and be my own person and not just this milk machine or this person that people constantly need things from.” 

Lastly, there’s also connective desire, which is focused on if there is an emotional connection first before we try to implement a physical connection. Oftentimes in postpartum, it’s like ships passing in the night. You’re just totally in survival mode. So you don’t have that foundation of emotional connection at this time. In these scenarios, the best thing that you can do is take 10 minutes phone-free and just make eye contact or just kiss with no strings attached and no pressure on the outcome. Let yourselves enjoy each other’s company instead of worrying about the kids.

What advice would you give a new parent who isn’t currently interested in sex?
Treat yourself with compassion. It makes perfect sense why things have changed. You’ve had a physiological and emotional identity change. You are not alone. You’re not broken. This isn’t forever. And there are certainly ways that we can intentionally shift this and retrain things. It’s hard because people think, “I’ll never go back to my pre-baby desire or my pre-baby body.” And honestly, sometimes yes, and sometimes no, but oftentimes it’s better than it was before. 

Oftentimes it’s learning new things about yourself. Imagine that somebody came in and, like, Marie Kondo’d your kitchen. They rearranged everything. All the parts are still there, but you kind of need to shuffle through a few drawers to figure out where everything is. And guess what? It’s gonna keep changing. If you’re somebody who menstruates, it’ll change across your menstrual cycle. If you’re somebody who’s gonna go through perimenopause or menopause, that’s going to change things. 

How do you make it fun again?
There is nothing that will squash authentic desire faster than pressure. So the more we can take the pressure off, the better. Think about if we were taking a road trip and I was like, “We’ve got to get to San Francisco in eight hours, but no bathroom breaks.” Your response would be, “I don’t want to take that road trip with you. That sounds so stressful.” But if I said, “We have all the time in the world and we’re going to stop and look at whatever we want to look at and we’ll just talk along the way.” We want to take the pressure off the outcome. 

Sometimes that looks like putting some protected time on the calendar. People think that means they need to schedule sex, and I’m really not a fan of that because I think it puts intense pressure on it. I am a fan of scheduling connected, uninterrupted time where we’re committed to exploring touch, connection, play, and pleasure. That could look like one hour where we just make out and see what happens, we give each other massages, or we play a game. There’s a card game called Touch The Game, and it’s great because it’s low-stakes and encourages you to start that connection. 

Another thing that I like to have my clients do is create a menu of your favorite things and your favorite ways to connect. This could be taking a walk, kissing, rubbing each other’s heads, whatever it is, whatever you enjoy doing that helps you feel closer. You’re gonna write those things down either on a list or put them in a jar. Your brain already has so much decision fatigue postpartum; you don’t want to come up with one more fricking thing, so having a list of go-to things is super helpful. It doesn’t even have to be sexual. It’s more so about lightening things up to create more play and presence.

“The first time we traveled by plane, which we were nervous about already, we put our son’s pacifier just loosely on top of our coats through the X-ray machine. It never came out the other end.” —Folly reader Ryan D.