Formerly Infertile

After infertility, pregnancy should be a dream come true. Then why do so many women feel anxious, conflicted or even guilty about it?

An anxious reaction is common, says Amy Blanchard, Ph.D., a psychologist in Cupertino, Calif., who specializes in infertility. “Women who become pregnant after infertility treatments face more complex challenges than those with a natural pregnancy,” explains Blanchard. “They can’t relax; there’s incredible fear and anxiety over miscarriage or birth defects. They’ve usually spent years in infertility treatment, and are used to things not working out.”

Read more: Does IVF put me at risk?

Walking on eggshells

I was certain the worrying and pain of infertility would vanish—Poof!—the moment we got our positive result. Instead, my concerns simply shifted from “Will I ever get pregnant?” to “Will this pregnancy last?”

At the risk of sounding like a crazy person, I managed to convince myself in my first trimester that I had doomed our pregnancy by, in no particular order, eating blue cheese, skipping with my toddler niece, inhaling nail polish remover and having a sex dream about Shaquille O’Neal that resulted in an orgasm. (Yes, I actually called the nurse to ask if I might have “squeezed the pregnancy out.”)

Other former infertiles (FIs) report similarly heightened levels of fear and vigilance right from the get-go. It took Jen Matz, 30, of Tega Cay, S.C., 19 months to conceive, during which she had surgery for endometriosis and took fertility drugs.

“Right after I peed on the stick,” she recalls, “I called my mother and announced, ‘Hi, Mom. I just got a positive pregnancy test. But don’t freak out, because I’m going to miscarry.’ I wanted to protect myself and was sure the test was wrong.” (It wasn’t: Her son, Wyatt, was born late last year.)

Read more: After Infertility

Blanchard blames the reluctance to share or celebrate the good news on the fact that FIs have often exhausted themselves emotionally, physically and financially, creating “a deep-seated fear of losing the pregnancy or of something going wrong with the baby’s development.” Indeed, my husband and I waited until we were 10 weeks along to tell our families, and 25 weeks before posting a Facebook bump pic—all because of the “what-ifs?”

An unexpected identity crisis

FIs must also tackle a critical shift in how they view themselves, transitioning from “infertile woman” to “mother-to-be.” Notes Blanchard: “Your identity used to be defined by your role in your family,your relationship, career, hobbies and friends. Once you realized that getting pregnant would be difficult, your identity became increasingly defined by your infertility.”