Struggling to conceive after having a first child can be absolutely devastating.
Earlier this year, we wrote about miscarriage. After it was published, I had an email from a woman who wanted us to write about struggling to get pregnant or carry a child to term after having a first child, as it’s seen as something of a taboo. When I delved into it, I discovered that it’s very common and just not discussed. It’s called Secondary Infertility, a pretty rubbish name if you ask me, and accounts for about six out of 10 infertility cases.
For those who want a bigger family, it can be absolutely devastating. Some just never conceive again and take it as one of those things, never investigated further. But for some who do conceive and then suffer a miscarriage, or even multiple miscarriages, it can be incredibly difficult – especially in a country where nosey people enquire about “the next one” as soon as your first baby is born.
“Often it’s unexplained, or is caused by a combination of factors in about 40% of couples,” explains Helena Tubridy, a fertility coach based in Dublin. “We’re talking hormone and ovulation problems or tubal damage for women, and sperm issues in men.
Fertility levels shift after a baby. Pregnancy takes a toll and a woman’s body can take a year, or more, to fully replenish and normalise after growing a new human. Thyroid function and insulin processing may be out of kilter after pregnancy. This impacts the ovaries and egg quality. Having a C-section birth makes conceiving again take longer, according to a study by Bristol University.”
Plus there are the emotional issues to contend with, from PTSD to post-natal depression to plain old tiredness. “Sex can be a casualty of new family life. Lack of sleep is a major issue for new parents, along with reduced libido and reduced opportunities for doing the deed. Periods either arrive like clockwork six weeks after the birth, or can stay erratic for a few months as the body reboots the hormone system. Men’s fertility changes, too. Fathering an infant first time around is no guarantee of easy conception in the future.”
But even successful conception is no guarantee, as Aoife Meldon, 36, from Dublin, discovered. “My husband and I got married nearly five years ago, and I came off the Pill pretty much straight away. My period didn’t come back though; I waited and waited but nothing so I went to my doctor and she put me on hormone tablets. This is common, and it brought my period back and I got pregnant right after that, about a year after we got married.”
Aoife had a relatively straightforward birth with her daughter, and she and her husband started trying for number two a couple of years later, in Autumn 2017. They conceived the following February.
“I am really aware of what they call ‘secondary fertility’ so wasn’t expecting it to happen as fast as it did. But what followed was honestly the most difficult year I have ever experienced both physically and emotionally.
“This pregnancy was nothing like my first. I was extremely ill, and I struggled through each and every single day of it. I was booked in for a Harmony scan (to check for chromosomal conditions) at 11 weeks. Things are quite different second time round, and we didn’t have the freedom of doing all the appointments together like the first time. It was 8am, and we decided I’d go by myself. For me this was a quick procedure, scan, blood test, and then back to work. The phone call I had to make to my husband after seeing no heartbeat on the scan was horrific; I could barely breathe.”
When Aoife’s husband arrived, they met with the doctors and scheduled a D&C. It turned out she’d had what’s called a partial molar pregnancy, which meant everything had been accelerated.
What followed hit her hard. “With a normal pregnancy your pregnancy hormones begin to fall after about 12 weeks, but mine remained high and I had to keep going back for weekly tests with my consultant to monitor them.
“Then once they do come down, you’re advised to wait 3-6 months before getting pregnant again. This really hurt. I felt the choice of when we wanted to try for a baby was taken out of our hands; I know it was to protect me, but it wasn’t easy to swallow.” After a few months, Aoife fell pregnant again.
“This time it felt similar to my first, but with added anxiety, which was very difficult to shift. I had a scan at 7 weeks, which went well. Then a few weeks later, some bleeding started. At two days shy of 11 weeks there was once again no heartbeat. I felt like I was drowning. I was devastated and also really angry. I felt like, hadn’t I had my turn? Why was this happening to me again?”
Aoife’s second miscarriage was physically more traumatic with lots of bleeding, and recovery even more difficult. “I cried so much. I took extended leave from work and when I was ready I did a lot of walking and yoga. For my husband it was so hard, but he didn’t take any time off work.
“We talked about it a lot, things are different on subsequent pregnancies, you have more of an idea of what’s ahead and planning does start sooner. This was really tough as all those plans were just taken away from us in an instant.”
“I believe that sometimes it seems even more heartbreaking not to have another child, than it is not have a first baby,” says Helena. “You already have a child you love, you know, hold and watch growing up. Some mothers feel an overwhelming sense of guilt in wanting another child, or feel ashamed and perplexed that it’s not happening now when they fell pregnant so easily first time around. They often feel judged for ‘just’ having one child. When do you stop trying? Who calls it? What will it be like for my child growing up without siblings?”
Aoife went to see a counsellor to help her cope. “Being outside helped me a lot too, lots of walking and listening to really good podcasts. I needed to recover from this, and for once I needed to be selfish and take the time to do that.”
She says the main feeling she’s taken away from all this is “incredible sadness. The day after we found out that we’d had our second miscarriage, we had gone to my brother’s for dinner. My niece and daughter are best pals and it was something nice. On the way home, my daughter asked me ‘Mummy do you have a baby in your tummy?’ I couldn’t stop the tears. I felt I had failed. I wanted this baby so much for us all and I felt my body couldn’t hold on to it. I know that’s not true, but it’s taken time to shake that feeling.
“In my case the fact that my second pregnancy was very rare, it was different as my baby wouldn’t have survived. But for the third pregnancy, it was much harder. I am now working with my doctor on the next steps.
“I want to remain positive. I do feel like my clock is ticking really loudly behind me all the time, and I consciously look after my health and fitness. If it’s the case that [having another child] doesn’t happen, that’s something we will have to deal with, but that is not how I am looking at things for the foreseeable future.”
I ask Aoife her advice for other parents trying again. “Don’t wait. Go to your doctor and discuss what’s going on, there’s nothing to be ashamed of, you are not failing, there are thousands of people going through the exact same thing. I feel there has been a shift in people who have experienced miscarriage talking more openly about it.
“This is a really good thing but there is still such a long way to go. The grief of a miscarriage is overwhelming and really difficult to explain. But it’s important to do so and never belittle the feelings that you have. It’s a loss and that’s something that will stay with you forever, but hopefully over time will become easier to manage.”