Pregnancy after infertility:
Making sense of guilt and mixed emotions
By Saff Mitten
Becoming pregnant after infertility can bring a range of feelings you may not have expected. Alongside relief, hope and happiness, there may be guilt, sadness or a sense of uncertainty about where you now belong.
In my work with women navigating pregnancy after infertility and IVF, I have been thinking a lot about an experience which a client so aptly described as “survivor’s guilt”. For some women, becoming pregnant and seeing that pregnancy progress after a long and painful time trying to conceive can bring a sense of guilt that is difficult to speak about or understand.
Whether your pregnancy follows IVF, another form of fertility treatment, or conception without treatment, it can take time to make sense of this change and everything it brings with it.
You may have wanted this for years. You may feel relieved, grateful and increasingly hopeful. And alongside those feelings, there may be something more complicated: an awareness of the women who are still waiting, those whose treatment has failed, or the people for whom this may never happen.
It can be hard to explain why something you wanted so deeply also feels painful. You may even feel guilty for struggling with it, knowing how much your earlier self would have given to be here.
Feeling connected to those still going through infertility
For those who have been through infertility, there is often a strong sense of connection to this community. There can be something deeply important about being understood by people who know what the waiting, uncertainty and repeated disappointment feel like.
Perhaps these relationships have helped you feel less alone through some of the most difficult experiences of your life.
Becoming pregnant can change how you experience that belonging. You may be aware that you now represent the very thing you once found so challenging and painful, and which other women still going through infertility and IVF continue to find painful.
You might find yourself hesitating before sharing news, wondering whether to mention a scan, or feeling uncomfortable when a conversation turns towards your pregnancy. You may want to protect people you care about from the pain you remember so clearly.
There can be a feeling that your happiness carries a responsibility towards those still struggling. That allowing yourself to enjoy this might somehow mean leaving them behind.
A sense of responsibility towards your earlier self
There may be a sense of responsibility towards your earlier self, too. The part of you who spent so long longing, grieving, hoping and trying to keep going.
As you begin to embrace your pregnancy, it can feel strangely painful to find yourself moving further away from her experience. Perhaps enjoying this feels a little like forgetting. Perhaps you worry that you will become someone who no longer understands, and you never want to be that person.
You may remember moments when someone else’s pregnancy announcement felt unbearable, or when an apparently reassuring comment left you feeling more alone. Those memories can stay with you as you consider how to speak about your own pregnancy.
And yet you do want to move towards motherhood too. You want to feel excited, make plans and allow yourself to become absorbed in what is happening to you. You may want to talk freely about your baby without examining every expression of happiness afterwards.
This can create an internal conflict.
How do you let yourself inhabit a life you wanted so deeply, while remaining connected to everything it took to get here?
When your circumstances change before your sense of yourself does
Infertility may have impacted and reshaped your relationship with your body, your sense of belonging, your friendships and your sense of self. So much of life may have become organised around trying to conceive, waiting and managing the possibility of another disappointment. If you have had fertility treatment, appointments, decisions and treatment cycles may have shaped your life for a long time too.
Becoming pregnant and seeing that pregnancy progress can take time to make sense of within the context of what you have been through.
You may know that your circumstances have changed before you feel that change in yourself. You might feel different from other pregnant women and want that difference understood. You may want people to recognise the history you are bringing into this pregnancy, even as you begin to experience joy within it.
Well-meant comments about everything having worked out can feel uncomfortable if they seem to close a chapter you are still trying to understand. There may be losses you continue to grieve, experiences you have had little opportunity to speak about, or parts of yourself you are only now beginning to reconnect with.
There may also be fear alongside the guilt. Allowing yourself to feel hopeful can feel exposing when you know how much can be lost.
These feelings may shift throughout the pregnancy. A reassuring scan might bring excitement, followed by sadness for someone else, followed by guilt about feeling excited at all. It can be tiring to keep trying to work out what you are allowed to feel.
Making room for happiness and compassion
Part of the psychological work here may be allowing your sense of yourself to grow around this new experience. Finding a way to become a mother that makes room for the woman who went through infertility, and everything she still feels.
That might include honouring the infertility community in your choices, in how you share your news, and in the compassion you bring to relationships with those still struggling.
It may also involve recognising the limits of what you can protect others from. You can be thoughtful about how you share your pregnancy and still find that someone needs distance. Their pain may be understandable, and the distance may hurt you too.
There may be no way of making this transition entirely painless for everyone involved. Finding your way through it can mean allowing other people their feelings while gradually giving yourself permission to have yours.
Your understanding of infertility can remain part of how you relate to others as your own life changes. You may need time to discover what that connection looks like now.
How therapy can help during pregnancy after infertility
In my work with women who are pregnant after infertility and IVF, there is often a need for somewhere they can speak openly about feelings they worry will be misunderstood elsewhere.
Therapy can offer space to explore these mixed emotions and how they sit alongside one another. We might spend time understanding the guilt, including what you feel responsible for, what you fear might happen if you allow yourself happiness, and what moving towards motherhood means to you.
Sometimes the guilt is closely connected to particular relationships. We might think together about sharing pregnancy news, navigating a friendship that has changed, or responding when someone needs more distance than you had hoped. This can include exploring your own needs, especially if you have become used to putting them aside to protect others.
At other times, the focus may be on the relationship with your earlier self. There may be grief that still needs attention, anger about what you went through, or a wish for someone to understand just how much this pregnancy has cost you emotionally.
There is room for all of this in therapy, alongside your hope and excitement. You do not have to arrive feeling grateful enough, happy enough or ready to move on. We can work at your pace, making sense of what remains painful and what is beginning to change.
Over time, this may help you feel more able to experience your pregnancy in your own way, with less pressure to monitor or justify every feeling.
It is possible to allow yourself happiness without losing your compassion, your connections or your understanding of what this has cost. But it can take time to grow into this new experience.
If this is something you are struggling with, I offer online counselling and psychotherapy for women navigating infertility, IVF and pregnancy after infertility or loss. A free 15-minute introductory call gives us an opportunity to talk about what you are experiencing and whether working together feels right.
If this article resonated with you…
I'm Saff Mitten, a specialist counsellor and psychotherapist supporting women through IVF, infertility and miscarriage.
My approach is shaped by my professional training and experience, together with the personal understanding I bring from my own journey through IVF, infertility and miscarriage.
Through both my therapeutic work and my writing, I explore the emotional and psychological impact of these experiences to help women make sense of feelings that can often be difficult to put into words and feel less alone.
If you're looking for support with infertility, IVF or miscarriage, you can follow the link below to learn more about how I support women through these experiences. I work online and support women across the UK.