June is World Infertility Awareness Month, highlighting infertility issues faced by people around the world each year. There is a misconception that infertility affects only a small part of the population, but as many as 48.5 million couples experience some form of infertility. This is an issue that is close to our hearts at White Leaf, as Meghan suffered from secondary infertility and recurrent miscarriages for almost ten years, following the birth of her first son, Keegan.
To help spread awareness and provide a beam of hope to those currently going through this difficult journey, we teamed up with Dr. Nicole Avena, our in-house nutrition expert who has a very similar story to Meghan. Dr. Nicole is a research neuroscientist and thought leader in the field of diet during pregnancy and baby, toddler and childhood nutrition.
She is an Associate Professor of Neuroscience at Mount Sinai Health System and a Visiting Professor of Health Psychology at Princeton University. Dr. Avena works with us to help educate and provide a leading expert opinion on why buying regenerative is one of the best choices you can make for your family’s overall wellbeing, setting the stage for a vibrant, healthy life. We love her book What To Eat When You Want to Get Pregnant, a science-based 4-Week nutrition program to boost fertility, based on the latest research.
Read on for a vulnerable conversation between Meghan & Dr. Nicole on their experiences and the power of speaking your needs and leaning on the support of community.
- What was your experience with secondary infertility?
Dr. Nicole: I knew I had PCOS because when we decided to start trying to get pregnant with our first daughter. The doctor first discovered this and suggested I start metformin (a drug that can help to support a healthy pregnancy in women with PCOS). So, I started taking it and got pregnant, no problem! When we decided we were ready to start trying for our second child, it didn't go so easily. I was taking metformin, but this time I wasn't getting pregnant.
We started to see a reproductive endocrinologist, and started fertility treatment. I had 2 miscarriages, and then an ectopic pregnancy (that ultimately ended in a miscarriage) that broke me. We had a big trip planned to take our daughter, who was 5 at this point, to Disney, for the very first time, when the ectopic pregnancy happened. Ectopic pregnancy can be dangerous, and sometimes, like in my case, can take several weeks of medication before it is "over.”
I didn't want to let my daughter--who was so excited for this trip--down--so I convinced my doc to let me travel from NJ to FL and we agreed to check in via telemed. I was the saddest woman at Disney, the happiest place on earth, and I had to simultaneously grieve this loss while trying to be happy for my daughter having the best time living her 5-year-old princess dreams.
Meghan: I feel saddened that Nicole went through this as well as I see many similarities to our stories. I had an initial miscarriage before Keegan, our first son, and luckily had a doctor that knew to test why exactly that miscarriage happened, a true root seeker scientist. It was determined that I lacked progesterone, so when we got pregnant with Keegan, she immediately put me on progesterone to assist in carrying Keegan to term.
We thought we would have no problem getting pregnant with a second child. However, we had an issue: We had moved to another state and had to go through THREE OBGYNs before one would “allow” me to take progesterone. Fast forward 3.5 years and we would suffer 4 more miscarriages between then and conceiving Cameron.
- Ultimately, you did have a second child! What do you credit to this?
Dr. Nicole: God. Nature. Both? As a scientist, I believe in nature and science, but I also believe in God. After our last experience, I told my husband I was happy with having our daughter and didn't want to pursue any more fertility treatments. I didn't want to miss out on the joy of the child I definitely had, while yearning for the additional ones I thought we would have. She was now almost 7, so we got rid of all of the baby stuff we were saving "for the next.” And as soon as I had really felt like I had made peace with this, I got pregnant.
Meghan: SAME! God, nature, and science, as we finally were able to put me on progesterone for Cameron. It’s also worth mentioning that I had weathered an exhausting journey as a new mother suffering from postpartum depression (PPD) and anxiety. I really feel that my past trauma with Keegan, from a very difficult birth experience to the almost year long battle with PPD, made it so that I subconsciously was terrified to have another baby. This most likely contributed to our inability to conceive in the years that followed. Who would want to repeat that level of emotional distress? I began to pull myself out of the darkness when I opened up to Keith about my struggles, and found a wonderful therapist who specialized in PPD.
- You mentioned in hindsight you may have also experienced PPD/A. What makes you think so?
Dr. Nicole: With my first daughter, I felt like I didn't know what to do. I felt like I wasn't doing anything correctly. I felt like I didn't know how to manage my time. This was not like me, as I am usually very organized and confident in my abilities. I was being really hard on myself--to be some version of a "perfect mom/wife/neuroscience professor" that I had constructed in my mind that would be my new identity. I thought things would fall into place once we got used to our new routine, but they didn't. I was feeling guilty if I was working, and then felt like I was damaging my career (that I worked so hard to build) when I wasn't working.
Meghan: I was also very much not myself. I had always been an over achieving go getter. During this time, though, I was having trouble starting anything, finishing anything and even simply getting out of bed was a hellish endeavor. What stands out are the hours I spent sobbing, unable to get dressed, walk our dog, or even brush my teeth. Where was the woman who once woke up each morning at 6:30 am to go on a run? I felt unmoored. I was the one putting the pressure on myself, Keith didn’t demand it, no one did. And yet, I was in a dark place. I had numbness, zero feeling, zero attachment. For 38 percent of sufferers of PPD, the condition becomes chronic, and mothers who expected it to pass as their children aged can struggle to find effective treatments. This was the case for me.
- If you did not seek any help or resources, do you think there was any internalized shame due to the societal pressure on mothers?
Dr. Nicole: I talked about my feelings to friends and people at work, who all assured me that it was "normal" and I was just adjusting to things. Then the sadness hit. I felt so sad, even though I technically had everything on earth to be happy about. I didn't know why I was so low, but it was a sadness that I had never experienced before and I can't really explain. I got through it, and things ultimately got better and then truly joyful, but in hindsight now I know that what I was feeling was not normal. I regret not speaking out about it back then.
I think there is a tremendous amount of pressure on mothers to be super women--we can "do it all". That is the worst thing anyone could have ever told us! We can't do it all, and why on earth would we even want to? I have learned over the years how to set limits, focus on what I want to do with my life and time (not what I feel like society tells me I should do), and to be realistic. I have also learned to ask for help from others.
Meghan: I hit rock bottom just after Keegan turned one. Even though I was overpowered by anxiety and depression, a small internal flame told me that I needed to and had the ability somehow to make a change. After about five months of therapy, I entered a stage of peace as a wife and mother. None of this insight was publicly discussed or found in books or online at the time; I discovered it by listening to my inner voice and letting it guide me to seek professional help.
- Was there a difference with your experience with your daughters? Post during and post pregnancy, emotionally and physically?
Dr. Nicole: Absolutely! My pregnancies were basically the same, but I felt much more confident in my abilities and how to navigate life with a new baby with my second daughter. I learned a lot in 7 years!
Meghan: Agreed. My second go-around with Cameron has been incredibly better, though still imperfect. I went through a period of being petrified that history would repeat itself. Then, I went through a period of sheer fear that there could not be a way that I could split the love between the two, especially given that Keegan has been our only child for so long.
However, overall, I have been blessed with a positive experience. The most important factor was that I was not alone this time around, and that I had a village of support surrounding me. My previous time in therapy provided me with inner resources to assist in understanding the triggers to look for. In the eight years that had passed, the conversation and awareness around PPD has also been so prevalent that I now have had not only my OBGYN, but the lactation consultant, the doulas, the pediatricians and the nurses screening me every time I see them with a questionnaire. It is so amazing to see the awareness around this affliction.
- Looking back, are there any words of encouragement you have for women and parents going through the same journey?
Dr. Nicole: None of my friends would ask about what was happening when I was struggling to get pregnant. They didn't want to bring up a sore subject. But I think we need to change that, and to be more confident to know what to say to someone who is going through infertility. Ask them how things are going! Ask them if you can do anything to support them. It can be a very lonely time, and having others to support you can make a big difference.
And for people who are struggling with infertility, please try to not let it define you. It can be an all-consuming process, and take over your identity. Don't let it. Do other things that bring you happiness and joy. You have to find the light in what can quickly become a dark, dark tunnel.
Meghan: Yes! I was just talking about this with a friend. It has taken me the two full years to feel like myself, from years past. Obviously, being a mother to two wonderful boys in my 40’s, I am different from who I was at 31 before I started this whole journey of becoming a mother.
I am finally free from this weight of wanting to become pregnant and free from the ever annoying cycle tracking… It's liberating. And for those who are currently going through this journey, please know you are not alone, and speak to whomever you trust about how you are feeling. So many professionals are now highly aware of PPD's prevalence, and I feel the rise of social media has helped normalize it as well. It is a horrible disorder that sneaks up on you, but it is 100% treatable with the right care, and there is nothing to be ashamed of!