Annalisa Barbieri 

How can I stop worrying about not having a second child?

Try to understand what’s going on, says Annalisa Barbieri, and take control where you can
  
  

Ask Annalisa illustration
‘Secondary infertility can be every bit as painful as primary infertility.’ Illustration: Lo Cole for the Guardian Illustration: Lo Cole/Lo Cole for the Guardian

I am 35, married, with a five-year-old. I have been trying to get pregnant for three-and-a-half years. In that time, I have had a miscarriage and an ectopic pregnancy, for which I received nonsurgical intervention.

My husband has come around to the fact that it may never happen for us again. He seems to accept we may be a family with just one child, and I want to be able to accept that, too. I know it’s out of my control, but I can’t stop worrying. I feel that trying to get pregnant has made me anxious and controlling, and taken much of the joy out of our sex life. I don’t want to be like this and I’m sure the anxiety isn’t helping when it comes to our chances of getting pregnant.

I want to be able to focus on my lovely daughter and enjoy her childhood, instead of spending every month hoping and then being hit with disappointment when my period arrives. IVF and other fertility treatments are not a financial option for us, and the doctors I’ve spoken to don’t seem to think I was high risk for the ectopic pregnancy (they don’t think it would happen again). I have been seeing a therapist, who is very helpful.

I’m not ready to stop trying for another baby altogether, but I would love to hear your advice on ways to stop stressing about it so much.

I think trying to stop stressing about something that matters so much to you is asking a lot, and maybe you need to allow yourself to be who you are at this time. Some women find it helps to take a break from trying to conceive (TTC), during which time they “let themselves off the hook”; others can’t do this, because they worry even more that they might have got pregnant during that time. For people like me (an overthinker), it’s the “what ifs” that screw me up, and if I can minimise those, then I can reduce some of the stress and anxiety. What I like are facts, which I can use as a springboard to an informed choice.

I contacted Catherine Hill from the Fertility Network . The FN deals with all aspects of in/fertility, and Hill has personal experience of infertility. “Secondary infertility [after having a child] can be every bit as painful as primary infertility,” she said. “And, unlike primary infertility, you often don’t have access to NHS testing and can’t get NHS-funded fertility treatment.”

Hill also felt that having some more concrete information (insofar as you can get it) may help you. You don’t say whether you’ve had any tests. Your GP can advise if any are available on the NHS. If there are none, you might want to consider having them privately (tests cost a lot less than fertility treatments); contact the Human Fertilisation & Embryology Authority to find a clinic. Also, has your husband had his sperm count checked?

Forgive me for mentioning this, but I’d kick myself if I didn’t: are you fully aware of the signs of ovulation? There’s a great book called Taking Charge Of Your Fertility, by Toni Weschler, which I recommend.

You say you feel alone, but how much have you let your husband into this? How honest does he feel he can be, and how honest are you with each other? Sometimes couples in this situation are afraid to say what they feel for all sorts of reasons, perhaps because they try to second guess what the other wants, or don’t want to appear needy. Your husband could be worried about the impact another pregnancy may have on you. The sex can become mechanical when you are TTC, but don’t worry now. It is what it has to be. “If you did decide not to go ahead trying to conceive,” Hill advises, “you need to grieve for the child you never had.”

I’m glad you’re having therapy. For anyone else in this situation, the British Infertility Counselling Association has lists of counsellors; the FN also has a support line (0121-323 5025), which is staffed by a former fertility nurse and trained counsellor, as well as support groups.

You don’t have to give up, if you don’t want to; but I think you need to take control where you can. Try to understand what’s going on with your (and your husband’s) fertility. I’m sure you’ve thought of all the usual things such as meditation, yoga and exercise to help you relax (they do help). Talk to people who have been in your situation – their viewpoint may be invaluable. I’d love to hear what others in this situation found beneficial..

• Send your problem to annalisa.barbieri@mac.com. Annalisa regrets she cannot enter into personal correspondence

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