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"Before infertility, there was already a feeling of my body not being 'right' or 'perfect' enough," remembers Jessica, a 37-year-old who has been dealing with unexplained infertility for the past six years. "Infertility only fueled that. After years of trying (and failing) to do what I was told my body was made to do, I felt a lot of anger towards my body."
Infertility changes how you look at your body. There's no way around it. Sara Vaughn, M.D., an ob-gyn, reproductive endocrinologist, and fertility specialist at Spring Fertility says there's plenty of research on the ways infertility can cause feelings of brokenness or inadequacy, create insecurities, and negatively impact body image. Research also shows that compared to women without fertility difficulty, those who've dealt with infertility feel less physically and sexually attractive. Considering that infertility affects 11% of women and 9% of men in the U.S., that's a pretty big problem.
"Infertility can be incredibly difficult for women because it brings to light the societal expectation that they should be able to get pregnant without any challenges," explains Erika Beckles Camez, Ph.D., a licensed marriage and family therapist who treats clients with infertility and experienced her own infertility journey. "These pressures can leave some women feeling like their bodies have betrayed them, or that they're defective in some way." But it's by no means a one-size-fits-all experience — and a changing body image doesn't have to mean worsening.
Much of it has to do with how we look at our bodies at different points in our lives, says Gail Sexton Anderson, a counselor, founder of Donor Concierge and co-founder of Tulip, an online egg donor platform. Before the idea of kids ever crosses our minds, we tend to want to feel good about how our bodies look, Anderson says. "When we want to have a child, we don't necessarily stop caring about how we look, but we're more interested in how our body works."
Of course, not everyone reacts the same way to infertility, but when it comes to how we feel about our bodies, there are several factors that can impact the way we respond.
Pre-existing health and body image issues can either help or hurt, depending on how well the person has learned to cope, Beckles Camez says. For instance, those with disordered eating in their past may find infertility brings it back up. On the flip side, they might find that they're better able to deal with the feelings they're having thanks to the work they did to heal from disordered eating in the past.
Culture can also factor in. "Different cultures have different ideas about reproductive health and what type of relationship women 'should' have with their bodies in trying to get pregnant, going through pregnancy, and afterward," Beckles Camez notes. Some cultures may be more inclined to lean toward a narrative that women's bodies are strong and powerful, and going through something like a miscarriage or rigorous infertility treatment is ultimately a reflection of a woman's strength to endure. "Other cultures may have beliefs and customs that can make a woman feel like her body is a vessel to create life, which could cause a disconnect from a positive body image," Beckles Camez says.
And of course, the intensity of the treatment required can also tank body image. Injections, pills, patches, and suppositories can take a toll on the body and can cause weight gain, bruising, and mood swings, Beckles Camez says. "These types of invasive treatments and sometimes-uncomfortable procedures can leave a person feeling like they're a part of a science experiment."
But the link between infertility and body image may not be as straightforward as it seems. While many struggle in the initial months and years, some women, Jessica included, say they ended up in a better place with their body than where they started — regardless of whether they ended up bringing home a baby.
Why Many Women Experience a Dip — Followed by a Rise — In Body Image
After having her first child, Holly MacKenna, M.D., an integrative psychiatrist, felt great about her body. "I was proud of how strong my body was, and that I was able to heal so quickly," she remembers. But when trying for a second child, MacKenna experienced secondary infertility, which is when a person has difficulty getting pregnant and/or carrying to term after previously having one or more children without any issues.
MacKenna ended up having three miscarriages, and started having mixed feelings about her body. "At times I felt insecure about my weight gain because I had no way to lose the weight as I had so easily while nursing my daughter," she explains. "At the same time, I was so determined to have another child that my insecurities became less of a focus." MacKenna said that when body-image issues popped up, she was able to move past them by focusing on what she needed to do to stay healthy: eating well, exercising, and engaging in meditation or mindfulness. Eventually, MacKenna went on to have a second child.
Beckles Camez had a similar experience. "Personally, experiencing infertility was an invitation to explore my relationship with my body in the context of my health and being a woman," she says. During treatment, she learned how to take care of herself in a way that extended beyond diet and exercise. "I started to look at my body as something that I really needed to take care of whether I got pregnant or not. My body image changed significantly as I started to really ask myself questions like, 'What does my body mean to me?' and not what it means to everybody else." Ultimately, she says facing infertility taught her gratitude — but it was a journey to get there.
For Jessica, the process has had a lot of ups and downs. "Hatred for my body was the predominant feeling all throughout my infertility journey — that feeling of being broken. Every time I got the call that my pregnancy test was negative, it was a fresher, deeper self-hatred," she says. That changed after she got pregnant via IVF with her last viable embryo, but miscarried around 10 weeks.
"I thought I would hate my body more after it all. But I didn't," she says. "I had such love and compassion for my body for the first time. For what it had been through. For its resilience. For what it showed me it was capable of: I could get pregnant." Now, she no longer thinks of her body as broken — even though she's not sure what will happen next. "Every time I look in the mirror, I see a body that has held and nurtured life, had that very life removed, and gone through the ups and downs of IVF and sudden pregnancy loss — without forgetting to breathe or letting the weight of it all crush it." Her biggest takeaway? "I wish it hadn't taken 37 years and the loss of my baby, but I'm so grateful that I didn't go my whole life hating the very flesh that makes this life possible for me."
What these women experienced isn't uncommon, according to Vaughn. "While the negative impact that infertility can have on body image is certainly a problem, a problem that is recognized and addressed is also an opportunity that can lead to a really positive transformation." In Vaughn's experience, going through the steps of coping with infertility can often set women up for success later on when other stressors of body image — such as pregnancy or unsuccessful fertility treatment — emerge.
How to Improve Your Body Image While Trying to Conceive
As evidenced by the stories in this article, most women don't immediately get to the point where they feel at peace with their body. Often, it takes time. Here's their best advice on how to deal in the meantime.
Give yourself some grace.
"If you needed braces on your teeth, would you have felt that your body failed you?" Anderson asks. "You were born with your teeth a certain way and for them to work at their best, you need a bit of correction. Fertility is the same. You were born with the reproductive system that came with your body, and sometimes it needs some adjusting in order for it to work properly."
Treat yourself like you would your best friend.
"Know that what you're feeling and thinking is normal AND if you are feeling sad, depressed, inadequate or struggling with low self-esteem or body image, there are lots of tools you can use to feel better," Vaughn says. Those same tools might both help now and in the future in ways you could never predict, she adds. "The first step is recognizing you're feeling this way and asking for help."
When you're ready, try some activities that bring you comfort.
"These can be simple things like going for a walk, journaling, going to bed early, talking to a good friend, or taking a half-day off from work every other week just to make time for yourself," Beckles Camez says. "A mixture of activities that allow you to consciously and unconsciously process your emotions and experiences can often be helpful." Of course, seeing a good therapist also helps, if that's accessible.
Find role models.
"We often create narratives about how things "should be" or "will be" based on what has been modeled to us," Beckles Camez explains. So, whether it's someone you know personally or a celebrity like Chrissy Teigen or Gabrielle Union, having positive role models to look to is important. "If we see that a woman can both go through something as challenging as infertility treatment and then find her way to being connected to her sexuality or her ability to feel good in her skin, then there would be a great chance that the woman will be able to pull from those role models and create a narrative that's similar, while still unique to her."
Talk to other women.
Rebecca, 43, went on to have a child after spending a year treating underlying health issues that prevented her from getting pregnant. It was a scary, difficult time — something she tries to be vocal about now that she's on the other side. "Many women of color, especially Black women, suffer in silence with infertility issues," she says.
MacKenna adds, "Others have been where you are, and we found a way through. We are here for you."