. ~ George, the Dragon and the Maiden in Distress ~
Take a look at this picture for a moment. To me this is an iconic image that epitomises the nature of the relationship between a couple when they are facing adversity.
We see a maiden in distress with a dragon breathing fire over her. The dragon can represent infertility, the inability to have a baby due to miscarriages - or in fact any kind of serious challenge faced by the couple.
Worse still – you see the cave in the background – and in the maiden’s mind is the ever present threat that the dragon could carry her off into his cave and devour her – fulfilling her worst fear that she may never have a baby and may never be a mother - or any other worst fear.
The damsel is very distressed and is weeping copiously.
Then George comes into the scene on his trusty white steed.
He has on his armour, his helmet and his breastplate and he carries a shield – all the things to protect him from the emotional difficulties the world may face him with. And in his hand he wields a lance.
Now there are two things we need to know about George: -
One is that he cannot bear to see his damsel in distress. It pains him enormously to see her like this.
And two . . . . he needs to fix it – to rescue her from the thing that is causing her such heartache, grief and fear (not least because he can’t bear it himself and wants it to stop).
So George tries to slay the dragon. But this dragon is invincible. It will not die. He cannot make his wife or partner pregnant. He realises he actually has no control over the situation and feels powerless in the face of this unconquerable foe. He doesn’t know what to do. He’s tried everything. He’s said everything he knows to say many times before and it clearly hasn’t worked – she’s still crying and upset – again and again.
So what is he to do?
Well he has several options: -
1. He can gallop off and leave her to it – go and play on his PlayStation, go to the pub or watch the telly
2. He can go into the cave himself, shut down and become incommunicative
3. Sometimes he even gets angry with the damsel because she won’t stop crying and it faces him with his own powerlessness and inability to make things better. He waves his lance at her in a threatening way. He just wants her to stop going on about it and stop being so unhappy and miserable (he just wants the return of the bubbly happy-go-lucky, sociable maiden he knew before all this baby making malarkey started
4. But the fourth option – and listen up here fella’s because this is the one that dies the trick – he gets off his horse, he take puts down his lance and shield, he takes off his armour and he goes to the maiden. He takes out a clean white hanky from his pocket and hands it to the maiden then gives her a hug., laying her head on his shoulder and allowing her to cry and sob until the wave of distress passes, saying "There there, it's OK . . . . . We will be OK no matter what happens."
Believe it or not, it is that simple . . .
Now I grant you, George, that sometimes the maiden may not be weeping, she may be in a bad mood, irritated with you and everything and everyone – and she seems to you like a prickly pear – and the last thing you want to do is give her a hug. But if I were you, I’d give it a go – ask her if she’d like a cuddle – an d if she says yes – make it a good one.
~ MISCONCEPTIONS ABOUT STRESS AND PREGNANCY ~
We all know that stress affects the ability to get pregnant and remain pregnant, right?
“But surely,” I hear you say, “everyone knows that you need to be stress-free in order to conceive or maintain a pregnancy?” Why else would everyone you know tell you to relax and reduce your stress levels when you explain to them you’re struggling to conceive, or finding it difficult to stay pregnant?
Many women who are experiencing fertility issues or multiple miscarriages believe that emotional stress and distress, or the tensions arising from difficult life-events, are factors in them not getting pregnant naturally, or succeeding with fertility treatment, or maintaining a pregnancy.
This view is largely based on anecdotal evidence and fertility myths such as 'don't think about it and you'll get pregnant', or “you just need to take a holiday/work less/relax more/think more positively/be less pessimistic” etc. Plus there’s loads of information on the internet that supports these widely-held beliefs.
Nonetheless there is little scientific evidence to support such notions.
Misconceptions about stress and natural conception
It is a widely held belief that if a woman is stressed then this will affect her ability to get pregnant. "You're working too hard" or "You're trying too hard" people will say "You're just too stressed and that's why you're not getting pregnant."
NHS Choices website analysed a scientific study which claimed that the levels of two stress hormones – cortisol and an enzyme produced in response to adrenaline levels (alpha amylase) – affected the likelihood of getting pregnant.
The researchers did find that women with higher salivary alpha-amylase levels were less likely to fall pregnant, compared with women with lower levels, but this was only of borderline statistical significance and they concluded that the study failed to prove the effects of stress on natural conception and fertility.
So why do so many people truly believe that stress can affect natural conception? I regularly hear people say that cortisol and adrenaline produced from being stressed must have a negative impact on the woman's reproductive system and that this is why you shouldn't be stressed if you are trying for a baby.
You know what? If a couple are very stressed for some reason (for example one or both of them are experiencing difficulties in their work life - like facing redundancy, or overwhelming work pressures or interpersonal difficulties with bosses etc; or maybe they are facing severe financial difficulties in their lives and are very anxious about how they will cope; or maybe there are serious health problems with a family member etc) then the stress they are experiencing causes them to go off sex. They are simply too emotionally exhausted, physically tired or too worried to feel like doing it. The failure to get pregnant when stressed is therefore a mechanical thing - and has nothing to do with stress hormones affecting fertility.
Which is why, when a couple go on holiday, or have a nice meal and a glass of wine and relax then they are more likely to have sex . . . and therefore more likely to get pregnant!
Misconceptions about stress and miscarriage
The NHS Choices website outlines some misconceptions about miscarriage and concluded that “increased risk of miscarriage is not linked to a mother's emotional state during pregnancy, such as being stressed or depressed”.
In the Guidelines of the European Society of Human Reproduction (ESHRE) on Recurrent Pregnancy Loss in November 2017 they state that 'Stress is associated with RPL, but couples should be informed that there is no evidence that stress is a direct cause of pregnancy loss."
In my infertility work I see many, many women in the very early stages of pregnancy, having become pregnant after a couple of years of trying naturally (without success) and then after various numbers of assisted reproductive treatments (IUI, IVF, ICSI). They are of course highly delighted and utterly thrilled that finally, at last, they are pregnant. They are over the moon and feel so relieved and happy that they are now on their way to having the baby they have so longed for. They are not at all stressed - quite the opposite. And yet, tragically, after a few weeks they can lose the pregnancy or find at the six-week scan that the pregnancy is not viable and that, for some reason, the foetus has stopped growing. Sadly a miscarriage inevitably follows.
These women were not stressed at all, far from it, and yet they lost their pregnancy. Possibly no reason can be given but, sadly, this does not stop them trying to attribute the loss of their baby to something they've done. This seems to be a natural human response to tragedy. But of course, it is absolutely nothing they've done.
Equally I have seen extremely anxious women who worry every minute that something will go wrong - sometimes for the best part of their entire pregnancy - and yet they deliver a healthy full-term baby. These women could not be more stressed, they could not have more stress hormones in their bloodstream and yet this does not result in pregnancy loss.
So what to make of it all? I guess it is hard for women to accept that they are not in control of the one thing that is more important to them than anything they have ever wanted in their whole life. Perhaps women's assertion that stress can affect pregnancy and cause miscarriages is a way of imagining they might be able to gain some control over it - by de-stressing themselves. Who knows?
But if it were me I would try and accept that it truly was nothing I had done. It is hard enough to experience such a loss without blaming yourself for it as well.
Misconceptions about stress and fertility treatment
Again, the notions about stress affecting the outcome of fertility treatment also do not stand up to scientific scrutiny.
Professor Jacky Boivin from the Cardiff Fertility Studies Research Group, investigated links between stress and the success of fertility treatment. She undertook a large-scale review (known as a ‘meta-analysis) of all the studies that had been done on the impact of stress and distress on fertility treatment outcome. *
Fourteen studies with a total of 3,583 infertile women were included in the review. The women were assessed before fertility treatment for anxiety and stress. The authors then compared data for women who achieved pregnancy and those who did not.
The results show that emotional distress was not associated with whether or not a woman became pregnant.
Professor Boivin therefore argues that "these findings should reassure women that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise their chance of becoming pregnant."
It is an understatement to say that it’s stressful trying for a baby when all around you seem to do it so quickly and effortlessly, but stressing yourself about getting stressed and fearing your stress levels are the cause of your difficulties is soul-destroying and only serves to make women feel responsible and to blame for their lack of a family.
It is of course a good idea to reduce stress in your life if you can – through mindfulness, yoga, relaxation, gentle exercise, counselling or whatever helps you cope with the difficulties you are experiencing – but only because it makes a sometimes long and emotionally difficult journey more bearable. And the better you cope with this challenging and testing life-event the more likely you are to keep going until you succeed in the end.
So the one thing you can do is stop stressing about the stress your difficulties are causing you and tell anyone who says otherwise where to get off!
*J. Boivin, E. Griffiths, C. A. Venetis. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ, 2011