Biologically, we are wired to protect our children, and as many fertility patients can understand, that protectiveness can begin even in the early stages of fertility treatment. The unique challenge with traumatic events on the family-building journey (my shorthand for when you're trying to conceive, are pregnant, are healing postpartum or parenting your child[ren]) is that there are two layers to the trauma. One is the real or perceived danger to yourself and the second is the real or perceived danger to your child.
Traumatic events on the family-building journey can include anything from loss of embryos when you're doing IVF to experiencing pregnancy complications to neonatal loss and anything in between. Thus, the depth of the trauma can be even deeper and pervasive than other types of traumas we experience in our lives.
What makes reproductive and pregnancy trauma different?
The triggers are also complex because they are often internal, body sensations that we can't ignore or avoid. Everyday experiences like going to the bathroom, having a period, experiencing gas or cramps can all re-trigger your unreleased trauma, making day-to-day living that much more challenging.
Very few (if any) other traumatic events have such strong, internal triggers. There's no reprieve, no place to run or take a break. The trigger is your body and that contributes to an elevated and chronically activated stress response that I find to be resistant to most therapeutic interventions.
The problem with the current approach
What most women do is turn to traditional psychotherapy, in hopes to work through their trauma by sharing details, talking about it and mastering the experience through verbal processing. While talk therapy is quite useful in many situations, trauma release is not one of them. Decades of research has shown that trauma causes biological changes in the nervous system (and thus resulting changes to other body systems subsequently) and no amount of talking can undo those changes. Trauma is stored in our brains and bodies not as memories similar to our childhood birthday parties or our favorite date, but as visceral changes in our bodies, something talk therapy cannot address. The trauma is not stored in our conscious, cognitive minds.
This is often why I hear from women who have tried talk therapy, found some relief, but when they begin their fertility treatment or become pregnant again, they fall down the "dark hole" again, as my client once described it, undoing all the hard work they'd done until that point.
In essence, talk therapy is like cutting a weed at the stem and then wondering why it keeps growing back.
No wonder getting and being pregnant after a traumatic event on the family-building journey is so terrifying. It's not in your head. You are not being over-dramatic, overly negative or crazy.
Why a somatic approach to trauma release is critical
This is why I left the field of psychotherapy after my experience with a very high-risk pregnancy and created a somatic training program that I teach to my clients who are preparing for pregnancy or going through a high-risk pregnancy. Releasing trauma is about feeling safe in your body again. And it's also about resetting your body's main control system - your nervous system - which can affect your reproductive & pregnancy health. Research has shown that PTSD in women increases risk of pregnancy complications such as preterm contractions, miscarriage and preterm delivery , among others. (Obstet Gynecol. 2001; JAMA Psychiatry, 2014)
But let's be real.
There are far more women living with unreleased trauma than there are women who are diagnosed with PTSD after reproductive, pregnancy or birth trauma. Whether it's because they don't qualify for the diagnosis or they have not reached out for help, it's not the diagnosis that's the issue. It's what's happening in the body due to the unreleased trauma and what they're not being told about how it impacts pregnancy health.
How can we be surprised that we're having trouble bringing the preterm birth rate down despite being one of the most medically advanced countries in the world?
Where to from here?
Let's be clear that none of this is your fault. Your past pregnancy complications, losses, whatever you've been through, whatever you're going through now. None of it is your fault.
But I do want to validate that if getting or being pregnant feels scary, it's not in your head. It's in your body. Literally. Please know that you can retrain your body to release the trauma at any time. It can be safe and simple to do with the right tools and supports. If you'd like help with this, check out my preparing for pregnancy and high-risk pregnancy programs and join us if it feels like a good fit!