Coping with Miscarriage and Infertility
I lost my father suddenly when I was in college, and I wish I had the book Option B at that time to help me cope. It’s been over twenty years since his death, but grief never really leaves you. It comes in waves, in and out of your everyday life — sometimes soft, gentle reminders of the loved one you lost and sometimes crashing down like a giant tidal wave that knocks you off your feet for a little while. Grief is one form of adversity discussed in Option B: Facing Adversity, Building Resilience, and Finding Joy, by Sheryl Sandberg (COO of Facebook and author of best-selling book Lean In) and Adam Grant (psychologist and Wharton School professor).
As a fertility and miscarriage specialist, I help people dealing with grief every day. You may not think of infertility and miscarriage as things to grieve, but they are. Struggling to complete your family is loss, and loss is grief. Lost ideals of how you would conceive, lost joy with a positive pregnancy test when all the others have led to miscarriage, lost years spent in fertility clinics and going through tests and procedures when all you want to do is start the life you’ve dreamed of, a life with a family. Infertility and miscarriage are a unique type of adversity many couples face every day.
Published in 2017, Option B is a guide to building resilience through adversity. The authors weave Sheryl’s personal journey of losing her husband suddenly with other stories of people facing difficult challenges and advice on how to breathe in the loss and pain and come out on the other end more resilient than ever. With each point the authors make in the book, I reflected not only on my own grief and how it affected me but how my infertility and recurrent miscarriage patients could benefit from reading this book too.
Here are a few of the lessons I learned from Option B that can help those struggling with infertility and miscarriage:
1. The importance of resilience. The authors define resilience as the strength and speed of our response to adversity. They describe it as a skill set we build over time that we can call upon when we face adversity. We can practice building resilience by practicing how we process negative events. One skill they describe is thinking about how things could be worse than the adversity you are currently facing and appreciating the ways in which things are not as bad as they could be. This sounds strange at first, but it’s a way of practicing gratitude. An example could be, “Even though I am struggling to complete my family and I feel ashamed, alone, and heartbroken, at least I have my health, a home to live in, and loved ones who care about me.” Finding gratitude in the face of grief can build resilience, and this is a skill you can practice over time.
2. The elephant in the room — talking about loss and hardship. People tend to have a difficult time talking about adversity and are often silent during a tragedy. Psychologists call this the ‘Mum Effect,’ and the authors refer to this phenomenon as ‘the elephant in the room’ — we know someone is suffering, but we don’t know what to say. The silence can make the person dealing with grief feel more isolated. The authors recommend ‘opening up’ for the people in distress and asking “How are you today?” when you know someone is suffering. Miscarriage and infertility are surrounded by shame and guilt, and people often suffer in silence, feeling isolated and alone in the process. If you are struggling through this kind of adversity, try to find someone to share with — friends, loved ones, a support group, or a counselor. And if you know a friend or loved one is struggling with infertility or miscarriage, don’t be silent or afraid you’ll say the wrong thing. Try asking “How are you today?” or make a gesture to acknowledge them, like a card, flowers, an email, or text — “Thinking of you, take care.” The more we can share and support each other through infertility and miscarriage, the closer we come to shattering the stigma surrounding these adversities.
3. Fighting permanence — pain will not last forever. One of the ways the authors recommend building resilience is to fight the feeling of permanence. It’s common for us to think that feelings of sadness and depression will last forever. Sheryl Sandberg writes that she felt like she would never find joy again after her husband died suddenly. The authors encourage those struggling with adversity to avoid those feelings of permanence since they may become a self-fulfilling prophecy. Instead, try to change ‘always’ and ‘never’ to ‘sometimes’ and ‘lately.’ Knowing in your heart that the dark times will not be permanent and that you can find joy again allows you to make it through infertility and miscarriage and get to happiness again quicker. Fighting the burden of permanence can build resilience.
4. Platinum Rule of friendship — treat others how they want to be treated. We all know the golden rule: treat others how you wish to be treated. However, this doesn’t always work when dealing with trauma. Everyone is different, and grief comes in stages. There are times when someone may wish to be alone to heal and other times they need to share. The authors of Option B recommend the Platinum Rule: treat others how they wish to be treated while they are dealing with adversity. The authors give tips for those of us who are wanting to give support but do not know how. They recommend against asking broadly “How can I help?” or “What do you need?” because this puts the burden on the person suffering to figure out what they need. The authors suggest ‘just do something’ like bring a meal, offer a hug, reach out. It’s less about the actual thing you’re doing — it’s the gesture of reaching out and acknowledging the person in need.
5. Take back joy. The authors discuss how people recovering from trauma or in the middle of adversity can feel guilty about having happy moments. They encourage those people to take back joy by finding joyful moments throughout the day and reflecting on them. This reminds me of the process of mindfulness — taking time to slow down and be present, especially in times of joy. The authors define happiness as the frequency of positive experiences, not the intensity of them. If we can notice, reflect, and enjoy even the smallest moments of happiness, we can ultimately allow ourselves to find joy again. So many of my patients give up so much that they love while trying to complete their family. They change their diet and their exercise routine, they cancel trips and make other choices about all aspects of life to focus on menstrual cycles and possible due dates. Trying to conceive can be all-consuming. I encourage people to take back their lives and their happiness while trying to conceive. In my practice, I do recommend some lifestyle changes to optimize overall health, but nothing that will ultimately make the patient less happy. I tell my patients, “Everything in moderation” and “Do not suffer through the process of completing your family.”
Option B is an empowering guide for anyone dealing with adversity now or anyone who wants to learn how to build resilience. The authors provide concrete life skills that can help someone cope with many types of adversity, including infertility and miscarriage. These resilience-building skills include practicing gratitude, sharing hardship and needs with others, recognizing that the pain is not permanent, and taking back joy every day. Whether you are personally struggling with completing your family or you know a loved one who is, the lessons shared in this book can help!
This post was written by Dr. Shahine and orginally appeared on Medium.
The first thing I put in my baby's baby book was a pasted in sheet of paper showing that we were pregnant, from PNWF. Below it I wrote, "Mom and Dad worked HARD for you." We deserve it even more, I say. Because the baby that comes from PNW Fertility and their crew of helpers is one loved baby. That is a pretty amazing legacy to be able to tell that kid someday.