The unexpected ways anxiety shows up in family planning

Before I start, I want to say that I checked with the dude about writing about this topic and would not have done so if he wasn’t ok with it. And there are definitely things I won’t be talking about because of privacy. I’d also like to say upfront that I’m pretty blunt here about my health history and topics like miscarriage and fertility; it’s important to me to tell you that before we get into it so that you can do whatever you need to do and avoid things you don’t want to read about. Lastly, I want to acknowledge that so far everything seems to be ok, and my discussion of my own anxiety is not meant the diminish or dismiss what others are going through in their journey to parenthood. This is just what it’s been like for me as a person with Generalized Anxiety Disorder, and honestly, this is to help me process the whole thing much more than it is for anything else.

Around the time of the wedding, the dude and I started talking about when we wanted to start a family. It took us a few conversations, and I talked about it A LOT in therapy – like, every session from September to now – and eventually we decided that we wanted to start this winter. Mostly, I was the one balking at it. I’ve had a conviction for as long as I can remember that being a parent is the most important thing I will ever do, but I wasn’t sure I was ready for my life to change, and between moving and then the wedding I really just wanted life to go back to normal for a while. Having watched a few friends go through the process and having been really involved in my sister’s pregnancy, I had a relatively good idea of what I’m in for. Obviously every pregnancy is different and I can’t assume that what happened to someone else is going to happen to me, but there’s no denying that pregnancy has a huge affect on your body and labor is a form of physical trauma. For a while, I had a really hard time remembering the good things, like, you know, there would be a baby whom I would love so much and I would get to watch my husband be an awesome dad.

I felt a lot of the same anxiety that most people feel when starting a family: big life changes, body changes, relationship changes, the unknown. In that, I feel validated and represented by a lot of what’s out there about pregnancy and parenthood. But there were a few things that were specific to me and my situation that either no one really talks about or the only place they’re really talked about is one of the myriad of websites for women trying to conceive, and those run the gamut between actually informative and offering medically unsound advice. I’m not disparaging places where people can talk about their journeys and find community, to be clear. It was just that sometimes reading stuff on one of those websites felt extreme and it made me more anxious. The simultaneous beauty and horror of the internet is that it provides a ton of information and it can also be really easy to freak yourself out over anecdotes. What I’m trying to say is that I find that a lot of those forums feed my anxiety instead of assuaging it. I’ve found a few that are helpful, but for the most part I stay away from them because my journey is my journey. I’m writing about it here because, as I said to the dude over dinner a few nights ago, I feel like people talk about the anxiety that comes with this process but don’t look at it through the lens of someone who already HAS an anxiety disorder and how their symptoms might show up during all of this. And I want to do that because it will help me process it, let go of it, and hopefully provide some validation for folks in similar situations.

The anxiety I felt about it was compounded by the fact that I have something called a Robertsonian Translocation. Basically this means that two of my chromosomes forgot some stuff when I was conceived, but I’m ok because they combined in a way that provided enough genetic material for me to be healthy. There are different types of translocations involving different chromosomes, and if you have too much or too little of one chromosome it can cause things like Down Syndrome and other severe birth defects. It is rare in genetically typical couples where neither partner has a translocation. But because I already have one, we’re starting from less solid ground. It’s more likely that I’ll pass it on to my kid because my eggs have incomplete material as a starting point. Most of the possible translocations I could pass on result in non-viable pregnancies, so where most women have about a 15% risk of miscarriage in the first three months, I have a risk of about 27%. It’s possible I could get pregnant and never even know because the embryo is so damaged that it never even implants; I could also just think my period was late but it was actually a miscarriage, or it could be that I already know I’m pregnant and have to deal with that loss. It’s also incredibly likely that I’ll have a healthy baby and everything will be fine. But anxiety loves chaos and catastrophizing, so of course I latched onto the 27% chance of miscarriage instead of the 73% chance of carrying a healthy pregnancy to term.

I’ve known I had a translocation since I was a teenager, but I didn’t really know the details. When my mom was pregnant with me, they could tell I had this but testing wasn’t advanced enough to be able to tell my mom if I was going to be ok or not. Thankfully, technology has changed a lot in 34 years, so I followed in my big sister’s footsteps and went in for genetic testing before we even started trying so that the dude and I could have as much information as possible and talk through what we might do with regard to various outcomes. I met with a counselor who was like “well we don’t know which translocation you have so I can’t tell you exactly what’s happening, but here are the possibilities for each one,” and proceeded to outline all possible outcomes and be like “it could be fine or horrible because we don’t know which one you have.”(They didn’t say it that way but that’s basically the gist.) They also talked about trying naturally in a way that made it sound like it was unlikely that I’d get pregnant and that if I did it was up in the air as to whether I’d have a healthy pregnancy. At the end of the appointment I was like “so how do I find out which one I have?” They were like “oh, that’s easy, we do a blood test” blah blah blah. I was sitting there thinking I just went through that whole 45 minute appointment where you told me you didn’t know and gave me information I didn’t need and freaked me out and you didn’t offer this blood test to me?! Who doesn’t offer a test that can provide the information you need?! I mean, honestly, at best that’s being bad at your job and at worst that’s medically negligent. But I digress.

Waiting for the results – even though I already knew the biggest pieces of information, like a higher miscarriage risk – was such a mindfuck. I’d never really thought about my body in this way before. I’d never put together that this space I live in every day might be the thing that’s standing in the way of a lifelong dream. I’m lucky in that I don’t really think about my body: I’m not in love with it, but I don’t hate it, and so far it hasn’t let me down in any appreciable ways. When I do think about it, it’s usually because anxiety has physical symptoms that can be really difficult and I’m trying to manage them. The psychological symptoms are rough, too. But something about this was different, and it took me a long time to figure out why it felt like such a punch in the gut: it’s because I can deal with anxiety. I can accept it, I can manage it, and I can literally change my brain structure. The physical symptoms are fleeting and they might disrupt my day or my sleep, but they don’t really impact my future now that I’ve figured out how to deal with them. The translocation is different because I can’t change my genes. There’s absolutely not a single fucking thing I can do to improve this part of things.

Even though nothing had even happened, I found myself ruminating a lot and eventually getting to the point where I was like you had one job, body! Can’t you just do that right?! I (preemptively) felt betrayed by my body, and it was really hard to stop spiraling. I was also wrestling a lot with the fact that I’d probably pass this on to my kid even if they were healthy, which meant they would have to deal with this if they ever wanted to have biological children. I didn’t really talk about this part with the dude – I’m sorry, dear – because I knew this was catastophizing. I didn’t even really bring it up in therapy, even though it would have been helpful to talk through. I knew I was worrying with basis, but without any real ability to control the outcome, and that’s the kind that I’m really trying to not do anymore. Ruminating has always been part of my life and it’s always been the anxiety symptom that I have the hardest time with. It’s why I do yoga. It’s why I cross stitch and embroider. It’s why I write here. I did all of those things during this time, and I worked a lot to get to the point where every time I thought about it I also thought there’s nothing I can do about it. These are my genes. The end.

Eventually I got the results back, but my counselor’s explanation was basically worthless(can you tell that I was really unhappy with the experience?). But because my big sister is awesome, she’d recorded her genetic testing meetings from before she had my nephew. She sent them to me, and I finally got some answers about percentages and how early miscarriages usually happen if there’s a translocation and all of the things that my person wouldn’t tell me.

I spent a lot of time talking about this in therapy, trying to process it before beginning the whole shebang. I had A LOT of feelings about the possibility of miscarrying, and remember telling my therapist that I knew I would feel guilty if it happened. I’ll never forget the look on her face when I said it: it was like she had just realized this really sad thing and it could never be unrealized. We talked through that a bit and I know we will more if it happens, but to keep myself from spiraling, I’m not going to talk about it any further here. Mostly, I really wanted to have worked through the things I was feeling about the testing results and to set my expectations in a way that was hopeful and realistic at the same time. I wanted to avoid catastrophizing as I had done earlier but to also be real about that fact that loss and other complications were a possibility. I know that everything will go out the window when I’m pregnant and then a parent – best laid plans, right? – but that’s not the point. The point is to really do the work: what am I feeling, why am I feeling that way, what might I do if certain things happen, etc. I didn’t want to make a rigid plan, I just wanted to have done some thinking so that when the dude and I talk about this part of our lives, it doesn’t feel so raw. We need to talk about stuff and I don’t want to end up avoiding it because it hurts. I want to be able to talk about it even if it hurts.

The next step was to actually start. A lot of people don’t know this, but there’s actually a pretty small window of time in which a person can get pregnant. About 10-15 days into a woman’s cycle(day 1 is the first day of her period), she ovulates. Something called her Lutenizing Hormone surges, and this is what signals the ovary to release an egg. It needs to be fertilized within the next day or two or else it will dissolve and come out with the next period. Realistically, you’ve got about 3-4 days in which its great idea to have some alone time with your partner. Before that, it’s unlikely you’ll get pregnant, though possible, and for the last two weeks of your cycle it’s basically impossible.

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I’m about to get pretty real(but not graphic) so if any folks don’t really want to know about my birth control history, you should skip to the paragraph that starts: Because I am my father’s daughter…

Ok. So, I figured out that the whole timing thing was important and how it worked, but I had a problem. I’ve had an IUD since the month before I graduated from college – that’s eleven years. I got lucky and was one of those people who didn’t get their period with an IUD and it. was. awesome. I saved SO much money, I never had to deal with the physical management, and I never had to think about it. It also meant I had no idea what my body would do when I got it removed. I’ve been using the Clue app for about six months even though I didn’t get a period, and it was pretty clear that I did still have a cycle and go through hormone fluctuations that affected my mood, energy, etc. The problem is that when you stop birth control, your body doesn’t necessarily stick to that schedule, so when I got it removed I honestly had no idea what would happen with my cycle: what the timing was, if I would get a period, if I would ovulate. And boy, did I spiral. Now when I read that sentence, I’m like duh, the IUD thins your uterine lining so obviously without it you’re going to get a period. And you’re an idiot for thinking you wouldn’t ovulate. But then? I got myself all sorts of worked up. I ruminated. I catastrophized like it was my job. I was texting my sister and my friend about it multiple times a day. I was really struggling with not knowing and having zero control and just having to wait(I’m gonna do great during labor, guys). I was taking an ovulation test every day because I needed a baseline for timing – those cheapy strips, for anyone familiar. If you’re not familiar, the strips can be kind of hard to read because they’re not always clear, you have to judge the results yourself, and it’s easy to convince yourself that your results are or are not what they should be(I’ve since started using a digital reader than analyzes results for you and it’s SO much better).

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These can be hard to read, especially because the lines aren’t always this clear.

Anyway, this had the effect of reminding me daily that I had no control while being simultaneously disappointing because I kept peeing on that damn strip and it kept coming up negative. Now I know that the LH surge is actually pretty short and it can be easy to miss if you’re not testing at the right time, but I didn’t know that at the time so I just kept assuming I had never ovulated when I actually had.

I finally got my period while I was at work, and I’ll be honest, I cried in the bathroom. It was such a relief that at least this part was working, so I could reasonably assume that everything else was ok, too. I patted my tummy and said “thank you” to it before I went back to grading tests.

Because I am my father’s daughter, the data helped a lot. Now that I had a starting point, I knew when I should start taking ovulation tests again, and it felt like I’d gotten over a hump. Anyone whose been pregnant is probably laughing right now because as they know, and as I’m learning, it’s nothing but humps(heh heh). The physical stuff for this stage wasn’t really a big deal anymore, but I was not prepared for all of the feelings I would have now that it wasn’t really a guessing game. I had feelings about the administration part of it – I know it’s my body so I’m the one who gets the information about what’s going on with it first because I live there, but damn, it’s another fucking thing that I have to keep track of and plan for and I was not enthused about having more mental load to carry. I felt really isolated for that exact reason: it was like the dude just got to show up but here I was with charts and peeing on sticks every day and it felt like the least sexy and fun thing. And I resented being in charge of it. I also found myself feeling weird if we didn’t maximize our chances; I simultaneously feel glad that we kept it fun and didn’t stress too much but also kept thinking ugh if the test is negative in two weeks I’m going to be disappointed in myself. Not disappointed, which I would be but that’s different. Disappointed in myself. Because even though I resented having to be the gatekeeper and planner, I still wanted to do the best job I can do(which is a great quality, it just felt like it was getting in my way). It’s also weird to say to your partner “hey, this is happening, chop chop buddy.” I was just generally feeling weird and resentful and I was upset because that’s not really what you want to be feeling when you’re starting a family. I talked to my therapist about it, which was helpful, but sometimes in session it can feel like something is missing – mostly because they don’t tell me anything about their life so, while they can validate, I never know if they’ve been through a similar experience. I talked to my sister about it, and she confirmed that feelings of isolation are pretty common when you’re trying/pregnant/when the kid is small. And I finally broke down and talked to the dude. I hadn’t said anything to him about the anxiety I was feeling after we got the results of the genetic testing or how overwhelming all of the prep was feeling. I was always just like “well, we’ll see!” and he had no idea about what I was thinking and worrying about and feeling until I came home from therapy one day and ended up sobbing on the couch. I did us both a disservice with that, and I’m trying to be more forthcoming when I feel worried or overwhelmed by the whole thing.

Now that we’re kind of in a groove, I feel a lot better. I don’t know why I wasn’t expecting anxiety, because I should have been, but oh boy. I was not, and Lenny saw an opportunity and got reeeeeal comfy. Fortunately I didn’t make myself sick or give myself a panic attack, but it was definitely rough there for a while. I know there’s a lot ahead of us still: ups and downs in every part of the process, sometimes feeling great and like I have a handle on things and sometimes feeling like I’ve done everything I can and nothing can fix it and I just have to wait it out. I’m really thankful for Bird because she recommended the Sanvello app, which as been amazing. It’s basically just an app full of Cognitive Behavioral techniques, but it’s the best one I’ve tried by far. It actually helps because it takes you through the individual steps of the technique. Instead of just directing you to try reframing your thoughts, it has you type out your thought, identify extreme language and the issue like catastrophizing or future predicting, and then has you actually change the language in the thought. Then it shows you the thought with the new language. It’s awesome. I’ve been using it to help me reframe anxious thoughts, and it really helps provide relief.

Because this was my experience during the first part of my cycle, I assumed that the two week wait between ovulating and finding out if I was pregnant would be a nightmare. Normally I take CBD to help me when I’m ruminating, but that was out of the question, so I tried to steel myself for being trapped in my own thoughts. Fortunately, it wasn’t that bad. I had basically no anxiety until the two days before I planned to take a pregnancy test(more peeing on sticks! Yay!), and then it really only showed up as a bit of tight chest and some trouble sleeping. Compared to what I thought it would be, it was a breeze. Seeing the negative test was rough, though; I wasn’t anxious, but I was sad and disappointed even though I had been assuming I wasn’t pregnant. But now that I kind of know the shape of how the month goes, I feel like I know better what to expect and when to make sure I’m really doing a lot of yoga and other management strategies to keep me from ruminating. I don’t know what subsequent months will feel like or how long it will take, but I do feel like having had some exposure to what I might feel during each stage will be really helpful the next time around.

I would like to take time here to say that I feel fortunate that so far everything has basically been ok. I don’t know what the future holds, and it’s possible that road will get harder; I just don’t know how yet. For some people I know, the journey to parenthood has been strewn with grief and loss and disappointment, and after having experienced just a taste of it, I honestly don’t know how they’re still standing. I wish that our culture talked more about miscarriage and struggling with fertility. I wish that we were more open and up front about it. I wish that we lived in a society where women don’t feel like failures if they don’t get pregnant right away or at all. We are conditioned to believe that that’s where our value lies, and I really hated having those feelings that I was letting the dude down or failing, and then continuing to have them even when I knew I had no control over whether or not I got pregnant. Our society is structured to expect us to be mothers and then to punish us for it. It punishes us when we make the choice not to be, and it punishes us when we’re dealing with infertility because it whispers and implies and sometimes outright says that it’s our fault. We exist in a space where it’s impossible to feel anything other than contradictory feelings and we’re not supposed to talk about those or even have them(cognitive dissonance? I don’t know her). We aren’t supposed to talk about the fears, the losses, the thinking patterns our brains get into. We’re supposed to want to be pregnant even when it’s unplanned and disruptive and detrimental to our health or the baby’s quality of life or any other entirely possible and valid reasons.

And I get it. As someone who spend my entire adult life to date making choices that would make pregnancy nearly impossible, trying to conceive on purpose feels incredibly strange. I consider myself so supremely fortunate that I’ve been able to control when and if I get pregnant, to the extent that that’s possible. There are millions of women for whom this journey is at best not the way they wanted it and at worst, a subjugation. How anyone can be against reproductive choice is beyond me.

I don’t know what your experience with this is like, but if you or someone you know has been through this and you want to talk about it or share some advice or even just have someone to agree with you about how mind-boggling it is, please comment or drop me a line. It’s nice to know I’m not alone.

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