Wednesday February 25th, 2009 11:02 AM

Patricia Mendell, LCSW, April 2008

Whether couples are survivors of the fertility wars or miraculously become pregnant the Aold fashioned way@, the experience of pregnancy, and it's aftermath, is often filled with unexpected surprises.

It is not unusual to experience a feeling of joy and fear at the same time when one learns that a pregnancy has occurred. A sense that life will never be the same is a common feeling among women. There may even be a question whether the pregnancy will ultimately destroy their lives and those around them; by upsetting the life that they now know. For those with multiples, donor eggs, sperm, or embryos, the question of what have we gone and done?, can often surface and feel very troubling to the pregnant woman and her partner. This is particularly true for those who have often spent years, much money, and emotion trying to reach this prized pregnant state. Few have thought about being pregnant, and even fewer have considered what it means to become a parent, and be a parent and a family of more than two.

For those fearful of pregnancy loss due to past losses or other concerns, the need for constant attention and reassurance may feel endless. Even with the most caring staff in an OB/GYN office, it is not uncommon to hear newly pregnant women complain that the medical staff is not giving enough attention to their fears. In actuality, often in the first few weeks of pregnancy, there is very little that can save the pregnancy if a major problem arises. For most pregnant women this fact is not acceptable. Spouses, partners, friends, family and even co-workers, seems to freely administer bedside medicine. Their advice tends to only compound the guilt and frantic feelings of the newly pregnant woman. This pregnancy seems to take over her life; particularly when the pregnancy symptoms are strong and interfere with her activities of daily living and working. Bonding with this a baby often seems foreign and remote to the woman and overwhelming to her partner. For those who have suffered the trials of infertility, being able to complain about their misery is unacceptable to others who have supported their struggles. This often leaves the newly pregnant person more isolated. They are neither in the fertile world or the infertile world.

The most important piece of information for these individuals is to know that any or all of these thoughts and feelings are normal. Being pregnant is so different than trying to become pregnant. As a psychotherapist who has waded in these waters herself, I know just how nuts you can think and feel. It is not surprising how often I hear women talk about being overwhelmed. They may have children already, or be faced with being a first time mother; no matter what it is they may find this new challenge overwhelming. Being able to listen to their fears and direct them to ask the right questions of their medical team can aid in making the pregnancy move to a better place in the person's life.

Often, women find themselves only able to relate to the pregnancy when they begin feeling the baby move. It suddenly begins to become real when the symptoms of the first trimester have calmed. Others, who have had previous losses, can't let themselves begin thinking about a baby for fear they will jinx the pregnancy. If bed rest or hospitalization is required, the ability to remain calm and hopeful may continue to be overshadowed by the ever-present fear that they will lose the pregnancy. Birth is the only event that will enable them to fully believe that they have succeeded.

There is an expectation that once the baby is born, the new mother will instantly bond, be excited and happy. Yet, there are many women who feel they have failed in motherhood 101 when their feelings turn to sadness. They find bonding difficult and they can't stop crying. A difficult delivery and/or a multiple pregnancy will only compound the fragility of the new mother even more. Those with donor egg or sperm automatically feel that having a donor baby is at the cause of these feelings. Hormones, postpartum depression, lack of sleep or feeling inadequate, are usually the main reasons for these feelings of disconnect and dismay. Again, counseling, medications, home helpers, and time can enable a woman to work out her feelings and begin understanding the magnitude of the change that has happened to her. For couples, the new demands now placed on the marriage and on the supportive partner can be difficult. Old issues of how the division of labor has been handled or mishandled in the past become even more glaring. Husbands who feel they are contributing, find their wives' anger and constant criticism difficult in an already uneasy situation. Help with the marital relationship can enable a couple to move into these unchartered territories with less stress, resentment and more ease.

Getting help at this critical crossroad can allow this transition into parenthood to develop into a positive experience. What many new parents don't realize is that this transition is only the beginning of the demands of parenthood. Being armed with the right tools enables new parents to gain a sense of confidence that they will be able to rise to the many challenges ahead. Unlike pregnancy, parenthood lasts a lifetime.