I read the posts about PPD following the birth of "dream babies" conceived
either through reproductive technology or years of infertility, with great
interest. Though I don't have any background in psychology, I have the
unfortunate claim to secondary infertility. In the years I spent trying to
conceive my baby, I met many other women/couples suffering the same struggle
and followed many through the eventual birth of their babies. I did note a
tremendous amount of mild to moderate PPD. While I did not suffer any unusual
amount of depression after the birth of my baby I can certainly offer
suggestions to why I think there is an increase incidence in these women. I
think it goes far past  >>the loss of attention, drama and status conferred
with this state and the often harsh, unrelenting reality of a baby<<

  Unless one has actually gone through the physical, emotional, financial and
often marital daily stress and disappointment of infertility, it can be
difficult to imagine. When the stress has continued for years, such as the
case for many couples who resort to medical technology, the quest has become
all consuming. Every aspect of their lives is colored by their intense desire
to conceive. They often suffer in silent longing, for the one thing they can
not seem to achieve no matter what they do. This is a terrific blow to self
confidence, to be barren and empty when even young, unwed, illiterate girls
can so easily conceive unwanted babies. What punishment is this? For me, the
betrayal of my body to not grant me a child was the greatest betrayal! (and I
have faced cancer!!) The use of technology to conceive turns what is for most,
a simple act of love, or for some a mindless act of lust, into a medical
procedure. Cold, perhaps painful, often a failure, fertility treatment is a
horrible ordeal. It is humiliating.

   There can be years of failure before a success. A success can sometimes
turn into a failure, and the loss of a pregnancy is especially difficult
because there is no comfort in hearing "You can have another."  So for the
woman who has waited, and struggled and dreamed and finally does have her
pregnancy, it is rarely the ideal experience she has imagined. By this point
she may have all but forgotten the baby at the other end, her quest had become
pregnancy. Now, she is often pushed into a strict medical model of pregnancy.
She may be treated as high risk, she will undoubtedly FEEL high risk. Her
fears are greater than most expectant mothers. She will probably have more
medical testing, perhaps lots of early blood tests, more frequent exams and
repeated ultrasounds. Her conception was a medical event and likely her
pregnancy is as well. She is ultra cautious, afraid to hope, but afraid to
think at any moment this pregnancy may end. Every thought is amount keeping
the baby in. She may be preoccupied, she may be paranoid, and few friends or
family who have not undergone something similar understand the depth of her
worry. She is in an emotional frenzy! She may not relax the entire pregnancy.

  Because her conception and pregnancy have been so medicalized and so
scrutinized, it can be difficult for her to see herself as a "normal pregnant
woman". Her body has let her down before, it might again. Her pregnancy is a
medical event. She needed medical technology to put that baby in her, she'll
need it to get it out. I don't believe the high number of cesarean sections
and induced/medicated births of fertility patients has as much to do with
medical conditions as it does to psychological ones. Sometimes these women
become so dependent on their practitioners and have lost all faith in their
bodies natural abilities to function in their reproductive roles, that they
have road blocked themselves with their beliefs. If such a medicalized birth
takes place, it has the potential to tell the woman, again, that somehow her
body has failed her. This can be very upsetting, since likely she has planned
her birth for years and years and may have certain expectations that are not
met. She may know that it is unlikely she will have even one more baby in
which to achieve her "perfect" birth. This in itself is depressing!

   Since breastfeeding is a natural extension of reproduction, can we even
question why there might be more difficulties? if she thinks nothing else has
gone easily up until this point, why should breastfeeding be any different?
The slightest difficulty can be enough to set that type of thinking off. It
can reinforce her own self doubts, even if it isn't truly the case. Not all
infertile women live out this scenario, but it happens. It helps it understand
it. I think the depression comes, as some mentioned, the reality of caring for
a newborn Vs a dream baby. Sometimes when we have undergone something
extraordinarily difficult we believe we shouldn't have to endure anything
further - like a needy baby! For an infertile couple the birth of a baby is
the climax of a dream they have worked years on. Many of us feel a bit let
down after a simple 9 months. She may doubt her ability to mother her new
baby. She may be afraid to get to attached because she is afraid she will lose
the child. She may falsely believe that the reason she had such a heard time
getting pregnant is because she wasn't suppose to be a mother. There are so
many other psychological aspects to consider after such a long, painful
journey.

  I was very lucky to have had the experience of 3 easy, normal, nonmedical
pregnancy followed by homebirths, and no breastfeeding difficulties before my
experience with infertility. I did note the stark differences, I did note my
own preoccupation and fear, and I almost talked myself into thinking I
couldn't have a nonmedicalized birth. So, I know how this can happen,
especially if one does not have a balance. Don't underestimate the impact of
infertility and feelings of self worth, capability and esteem, even after a
baby has been born.

  Valeri Webber  - wishing she could "just" get pregnant again