Infertility and PMADs: Q&A with Jenn Hesse, Part 1

This is the first of a two-part Q&A with Jenn Hesse, content director at Waiting in Hope, on infertility and perinatal mood and anxiety disorders. Part One focuses on what infertility is, and part two will dive into hope and comfort.

Infertility increases risk of PMADs, with women who have already suffered deeply having more suffering heaped upon them.

Jenn has been gracious to vulnerably share her time and wisdom. She is realistic about the pain, confusion, and heartache, but also about the goodness of the God who carries our burdens and listens to our grief.

If you’ve experienced infertility, you will be encouraged and comforted by this two-part Q&A. If you haven’t, you’ll better understand what women experiencing infertility go through and how you can support them.

What is infertility? How many women are affected by it?

The medical community defines infertility as trying to get pregnant for at least a year with no success. Most people view infertility as a women’s issue, which is a misnomer. About one-third of infertility cases happen due to female factors and one-third due to male factors. The remaining cases are either caused by both female and male factors, or are unexplained. Secondary infertility is when a couple can’t get pregnant or carry a baby to term after previously giving birth.

It’s important to recognize that infertility is a disease. A couple has one or more medical issues hindering pregnancy. The problem can’t be cured by relaxing or going on a vacation.

Infertility affects 1 in 8 couples in the US. Recent data suggests the number is 1 in 6 couples worldwide.

How is infertility connected to “The Sorrows of Eve” (the concept from Genesis 3:16 that childbearing is fraught with toil)?

God’s judgment of Eve touched every aspect of childbearing. The pain described in Genesis 3:16 includes physical and emotional distress, which spans the many details involved in conceiving, carrying, birthing, and raising a child. So infertility came as a result of the fall, along with the sorrows of menstrual disorders, labor and delivery, miscarriage, pregnancy complications, and postpartum struggles.

Eve’s legacy also brings us shame associated with childbearing problems. When pregnancy isn’t happening as expected, many women internalize blame. We view our bodies as broken, and/or assume we’ve sinned and are being punished. My coauthor and I talk about the relationship between infertility, shame, and the fall (and how Jesus redeems everything) in the Waiting in Hope book.

How might a woman struggle with her mental health while experiencing infertility?

The experience of infertility feels like an emotional roller coaster. You go through a cycle of raising your hopes, worrying about symptoms and results, and watching your dreams shatter again and again with each passing month. That process takes a toll on a woman’s mental health. Studies show the psychological distress of infertility is similar to what cancer patients face. Infertility and miscarriage are considered reproductive trauma, which can cause or worsen anxiety and depressive disorders.

I tell people to think of infertility as a life crisis. Trying to conceive affects your whole world, from physical health to finances to relationships to your walk with God. When a woman can’t get pregnant and her desire for a child goes unfulfilled, the disappointment can shake her to her core. Hope deferred really does make your heart sick, which in turn weighs heavily on your mental health.

Infertility is a risk factor for perinatal mood and anxiety disorders (PMADs). Why might infertility make a mother more likely to experience depression, anxiety, OCD, or other PMADs in pregnancy? How about postpartum?

This was news to me! The risk factor makes sense, though. I can see how the mental health issues that arise during infertility could carry over into pregnancy and postpartum.

One study I found suggests that a history of infertility increases a woman’s risk for developing postpartum depressive symptoms. They don’t know the exact reason why there’s a connection, aside from the massive stress present during infertility and after childbirth. If I had to guess, I’d say the struggle to conceive has lasting effects beyond a positive pregnancy test. When your motherhood journey starts through anguish, anxiety and depression are likely companions the rest of the way.

Part two is coming soon! Subscribe to be notified when the article goes live.

About Jenn: Jenn Hesse is content director at Waiting in Hope Ministries and coauthor of Waiting in Hope: 31 Reflections for Walking with God Through Infertility. She leads local Bible studies and has a passion for shepherding hurting women. Jenn and her husband, Colin, and their three sons live in the lush Willamette Valley, Oregon, where they enjoy swimming, exploring parks, and racking up late fees at the library.

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