You might think that patients who have struggled to conceive would be overjoyed when the baby finally arrives.
You have your baby—why would you be depressed? But that isn’t always the case.

How many times have you told yourself that life will be better once you bring home your baby? You feel strong, resilient, you can overcome difficult times. You have been through trauma and stress; you have endured the roller coaster of infertility! Hundreds of doctor’s appointments, fertility treatments, ups and downs, successes, and losses. Bringing home a baby should be the easy part, it’s the ultimate goal, it’s what this has all been about!

Recent research shows that patients who have been through fertility treatment might be uniquely vulnerable to postnatal depression. We don’t realise how much an individual’s mental health has been impacted. Postpartum depression affects as many as one in ten new mothers, according to the American College of Obstetricians and Gynaecologists. One would think that a successful IVF outcome would be the end of the story – it should be a happy ending! But for some, this is not the case, something just doesn’t feel right. One may feel anxious, depressed, triggered and more emotionally vulnerable than ever imagined.

A study published in Fertility and Sterility, shows greater evidence that mild to moderate psychological symptoms associated with infertility may persist even after a woman conceives. These findings emphasize that infertility is a clinical condition with complex underlying psychological issues and suggests that conception through fertility treatments may be associated with an increased risk of depression-like symptoms during pregnancy and after. The trauma of infertility can be likened to a normal reaction to abnormal circumstances – since one is “supposed to conceive naturally but the circumstances surrounding the conception often feels abnormal”.

“Feelings of stress, worry and disappointment with my body didn’t just evaporate when I found out I was finally expecting or when my long-awaited baby arrived. There were unresolved feelings that festered in my head and heart. I was screaming inside and felt so alone, the dark cloud lingered.” These words ring true for so many patients.

Pregnancy after infertility is everything that you wished for and spent years trying to achieve. You are shocked, elated, scared, tearful, joyful and in disbelief. Now what? Before your infertility diagnosis, your identity was defined by many different roles such as your role in your family, marriage, work, interests and hobbies. When you found out that you were infertile, your identity and life became increasingly defined by your infertility. Then suddenly, you find out that you have crossed over to the other side. You are expected to be grateful for whatever pregnancy brings and not to complain about it. Having a baby solves the problem of not having a child, but it doesn’t resolve the reproductive losses, the intangible grief and trauma experienced.

We know postnatal depression and feelings of anxiety are common for many new mothers, whether they conceive naturally or via fertility treatments. If infertility is viewed as a life crisis and an intense emotional process filled with ongoing intangible grief and trauma, then we need to look at the fact that postnatal depression and infertility are inextricably linked on many levels.

They both seem to involve similar processes of treatment, diagnosis, emotional triggers and reactions. The infertility journey as we call it, can only be described as one of the most difficult journeys of life. Emotional pain is so much greater than the physical pain and while infertility is certainly not a cause for postnatal depression, it can be viewed as a uniquely vulnerable time that may exacerbate the emotional impact of this journey. As Viktor Frankl mentions, everything can be taken from a man but one thing:

the last of the human freedoms - to choose one’s attitude in any given set of circumstances, to choose one’s own way.

“For the secret of man’s being is not only to live, but to have something to live for.”

Tanya Rubin