Pregnancy ImageWhen two women who have become close friends through the shared experience of infertility find themselves in the situation in which one woman becomes pregnant and the other is not, this may provoke a crisis that may feel too difficult to share, a kind of taboo topic. For some women, this shift in common ground may feel as though a deep crevasse has opened up between them, separating the two, and placing each person in a perilous position. This change may feel as sudden and extreme as switching sides, turning friends into enemies. Although pregnancy provides hope, it also may elicit powerful emotions of competition, envy, abandonment, loss, anger, betrayal, which can infiltrate and contaminate what was once a powerfully protected relationship. For some women, this situation may feel like too much to bear.

I have been asked to write about this difficult experience in an attempt to help those women who find themselves in this situation and address a dilemma that has implications not only for some individual RESOLVE members but also for the organization as a whole. RESOLVE’s mission is to provide help and continuing support for all of its members, including those who become pregnant. I will limit my focus here to an acknowledgement of the difficulty followed by an explanation and suggestions for how to proceed. My goals are to help women understand what is going on and find a way to use this potentially disruptive experience for individual, mutual, and by extension, organizational growth. In the overwhelming crisis of infertility, which pervades all areas of people’s lives, interacting with past difficulties and exacerbating current problems, words and language provide a powerful force to recognize, comprehend, and detoxify, to enable people to tolerate and integrate profoundly primitive emotions, and to find a way forward through life.

It would be rare to find a woman experiencing infertility who has not, at one time or another, found herself feeling unwanted emotions such as anger or envy toward other women for their pregnancies. Many women find this aspect of infertility the most difficult. Women in general tend to have great difficulty with experiences such as competition and envy; they are more comfortable connecting with each other through collaboration and support. The experience of infertility often results in women suddenly feeling separate and “on the outside,” without the support and understanding that they have grown to rely upon from trusted friends. Women experiencing infertility are often unable to provide support to their pregnant friends because it is simply too painful to do so. The onslaught of painful, primitive emotions that women experiencing infertility may feel in response to other women’s pregnanacies can be quite shocking: Some women may feel that they no longer recognize themselves. Often, women pull away and isolate, suffering in loneliness and silence. It is this isolation and pain that often drives people to find RESOLVE.

Through participation in RESOLVE, women find a way to be seen and known, to be accepted, and to be the same. This provides them with a much-needed experience of being on the “inside” again. There is immediate relief and “normalization” as life becomes bearable again. Finally there is a safe place, a haven, in what may have come to feel like a hostile, unfriendly, and indifferent world. Friendships formed in RESOLVE may be powerfully forged through powerfully deep connections. Women going through infertility together meet each other’s needs and provide each other with something that is missing. And it is in this safe context that women share how infertility has affected them, including their deepest, most difficult feelings about the pregnancies of long-standing friends, siblings,co-workers, and the rest of the fertile world. This support, these connections, can feel essential, like lifelines.

When pregnancy enters this safe haven, the friendship, which may be almost entirely founded on the common experience of infertility, may suddenly be threatened. From the perspective of the person who is pregnant, she may feel guilty about her good fortune yet simultaneously fearful of losing essential support at a vulnerable time. Many women who are pregnant after infertility feel on shaky ground, with multiple new concerns, caught between two worlds, as they continue to identify with the experience of infertility, and yet also feel different from the easily fertile. For the woman who is not pregnant, she may genuinely feel happy for her friend and hope that she may also become pregnant, but she may feel so envious that she is incapable of providing support, and feel anger at a felt pressure (either external or internal, or both) to support the pregnant woman. Both women may fear abandonment and loss; both may feel betrayed. These feelings are not logical, they may not feel civilized, but they are deeply human and very real, and must be acknowledged, respected, and felt.

The experience of infertility plunges people into contact with the outermost reaches of their humanity. Infertility is a profound crisis that threatens identity, relationships, and continuity. It threatens one’s sense of the world, it disturbs beliefs and assumptions, and it belies safety and security. It is an emergency that uses up coping skills, and depletes resources; people start to run on empty as their chronic stress levels move into the area of trauma. Infertility can shut people down emotionally, it necessarily limits and narrows; people are functioning in “emergency mode,” a black and white vantage point that oversimplifies for the purpose of survival. This is not the best place to understand the complexities of human interactions, or the perspective of the “other;” this is a time to survive, and everything else may feel inessential, a luxury.

Infertility friends separated by pregnancy may feel caught in a bind, a lose-lose situation, because their mutual source of support is now simultaneously a potential source of pain. In order to protect themselves from pain, they may feel the need for distance, but separation also causes pain. Women experiencing infertility have already suffered so many losses, that to lose an infertility friend may feel like losing a lifeline and becoming adrift and alone again. There is an opportunity here to find a way to bridge from the lonely island of survival, to connecting to others in spite of difference. This, too, can be learned through RESOLVE. Safe havens are meant to be temporary places, where people are sheltered, before returning to the rest of the world. This is also part of being human. We all need lifelines and safe havens sometimes, but we all need to also find ways to stay connected when ties are threatened.

In order to move from individual survival to considering the needs of both people, what is required is an expansion, an active creation of a shared space where there is room to acknowledge two people with separate and equally valid, although now quite different perspectives. This is hard, but possible. I am frequently asked what to do in this situation. Here are some suggestions:

First, I suggest you start with the common ground: Both women feel discomfort and pain, both women feel the loss of the shared bond and know that their friendship may not survive, and both women have to tolerate the uncertainty of not knowing what will happen next. Women who start by recognizing this shared experience may find a way to navigate this experience safely, with mutual respect.

Next, women need to give each other time and space after the initial sharing of the pregnancy news. A period of adjustment must be allowed. It is important for each woman to find ways to work through their difficult feelings towards each other during this difficult time. In my opinion, it may be asking a little too much to expect each other to be able to share their feelings about the situation at this time. For the pregnant person, it is very important to remember how difficult it was when she was in the other woman’s shoes and to expect that her friend may have some difficulty in hearing her news. She needs to find support for her experience of pregnancy after infertility elsewhere, either through other women in RESOLVE who have achieved pregnancy after infertility, or through a RESOLVE support group, or by seeking short-term professional help. She needs to keep her comments about her pregnancy brief and not try to share her fears or compensate by talking about how difficult pregnancy is. The woman who is not pregnant also needs to find similar support elsewhere. She may need to keep her congratulations brief and not try to compensate for her difficult feelings by asking questions about the pregnancy if she is not prepared to handle the answers. In short there needs to be room for both women to have their own separate experiences without having to apologize or explain.

After this period of adjustment, there needs to be room for the possibility of withdrawal, either temporarily, or by permanently ending the relationship. This option needs to be respected and accepted, and done with as much mutual sensitivity and grace as possible. Both women need to be mindful that everyone has personal limits, as well as a past history and current reality that the other person may know little about. It may be helpful to remember that not all relationships last and to recognize that this does not diminish the value of the relationship. There is an opportunity here to have a good ending, with dignity and mutual respect.

Naturally, the option of ending the relationship will cause the most pain when it is not mutually chosen. If this should happen, I recommend that both women consider working through difficult feelings such as rejection and abandonment elsewhere, as it may not be possible to do so with each other. It is important to follow each other’s lead, and be sensitive to what  may not be spoken.

For women who choose to remain friends, I recommend finding other ways to connect and remaining sensitive to areas of potential difficulty between them. Often, women find themselves reconnecting again later on when both have found their path forward in whichever direction is right for them. Infertility is an ongoing, lifetime experience, and RESOLVE benefits from people who stay involved, many of whom become pregnant. Finally, regardless of whether women decide to stay in contact or not, the struggle to work through difficult feelings and to understand the other person’s perspective will stretch each person’s capacity for understanding themselves and others. The experience of infertility, like all other crises, provides an opportunity for self-transformation, redefinition, and a greater capacity for intimacy and relatedness with others. We all need the capacity to recognize and tolerate the conflictive state of ambivalence, where greatly contrasted emotions may be present simultaneously. We all need to learn how to reflect and gain clarity rather than moving straightforward to an action we may later regret, because it may have been solely motivated by part of ourselves, rather than on a careful consideration of the complete picture. We all need to find a balance in relationships that always include some differences; and we need to learn to accept and tolerate imperfection. Ultimately, everyone experiencing infertility needs to live and relate to others in a world that is largely fertile. And ultimately, the most anyone can do with personal crisis and tragedy is to learn more about what it means to be human, to expand one’s sense of self and personal identity, to become a little kinder to each other and to oneself and to join with others in the shared journey of life.

Contributed by: Dr. Malavé, PhD, is a clinical psychologist specializing in infertility and adoption who maintains a private practice on the Upper West Side of Manhattan.