“Isn’t that something all couples experience?” I didn’t think it would be any different because of your race, ”said Mary *, interrupting me mid-sentence.
She was the therapist at my fertility clinic, and that was her typical combative response whenever I spoke about the complexity of navigating the stigma and silence of infertility as a black African woman. I had been reduced to using analogies to convey nuances.
“It’s the same storm, but a different boat,” I replied. My annoyance with her was palpable. I felt the tension between us as she seemed to blush and tried to avoid rolling my eyes.
The belief that black women are hyperfertile runs deep in my culture as becoming a mother is an expected and coveted achievement.
So when women in my culture suffer from infertility, I feel like there is a threat to our identity and role in social circles, causing a feeling of shame.
My husband and I started our second cycle of IVF in April 2017, six months after we suffered a miscarriage in our first cycle. Right before that, we met our consultant who recommended counseling as part of the NHS funded treatment at the clinic.
I was initially skeptical of telling a stranger about my feelings. Culturally, fertility issues are considered a personal matter and should not be discussed outside of the family, so only our loved ones were aware of our ongoing treatment.
However, having to portray a facade of strength was exhausting and lonely, so taking free advice on finding coping strategies was a no-brainer.
Sadly, Mary’s contempt perpetuated why I had sought therapy in the first place – to find a safe space where my feelings could be heard and validated. It became evident that she struggled with this in the first three sessions.
In June 2017, we had a second successful embryo transfer. However, I was still dealing with the trauma of the miscarriage and was paranoid about experiencing another. I called Mary to let her know how I was feeling and my plans to continue therapy.
We had weekly sessions for two and a half months at this point, as patients are encouraged to receive counseling during treatment.
I explained to her the reasons why I was feeling paranoid – I was bleeding early. I felt that was enough to make her more open, but her response was dismissive given that.
She replied, “It’s normal to feel that way, so first see how you are doing before you come back.”
Once again, I felt rejected. I decided to stop seeing her.
The following February, I gave birth to a healthy baby boy, and life began to be calmer.
But a year and a half later, in September 2019, my husband and I conceived spontaneously before I miscarried again. I had just turned nine weeks old when I visited an NHS walk-in center, having had bleeding and abdominal pain.
When I complained to my GP a month before, I was told it was probably ‘growing pains’, so I left him alone.
Immediately after the appointment, I was referred to the Accident and Emergency Unit at our local hospital and found out that I was having an ectopic pregnancy (when a fertilized egg implanted outside the hospital). uterus, usually in one of the fallopian tubes).
As a result, my fallopian tube ruptured and I had to undergo immediate life-saving surgery, terminating the pregnancy.
As we tried to deal with the loss, we regret that we hadn’t sought help sooner, believing it would have saved the baby – although it is not possible for ectopic pregnancies to survive, it doesn’t matter when it is caught.
This made it harder for us to support each other, and the intensity of the grief alone triggered intrusive thoughts. I always imagine the unthinkable. While shopping, I imagine my toddler has a bad fall, but imagine the worst outcome, like a fatal concussion.
I had bad anxiety for my health – so after I had my stitches from the surgery I was convinced that they were infected and that I had caught sepsis and was going to die as a result. I went so far as to call 111 and after being seen by my GP, I was given the green light.
Months after the loss, I also became insecure of contracting coronavirus, after the news bombarded us with statistics on the Disproportionate rates of Covid-19 deaths among BAME people.
I was cleaning constantly as the overwhelming clinical smell of bleach triggered flashbacks of when I was rushed to the theater in order to remove my ruptured tube and save my life.
I began to relive these moments through nightmares and developed insomnia. I knew I needed help, but was reluctant to pursue therapy after my unpleasant encounters with Mary and my GP, who both downplayed and trivialized my problems.
When I finally sought help in May 2020, diagnosed with post-traumatic stress disorder (PTSD) has been confirmed.
I was shocked. I assumed that black women like me rarely had anxiety disorders; in the media and in our own communities we are always presented as strong and showing no signs of vulnerability to the struggles we face.
Contrary to my belief, research highlighting the impact of ectopic pregnancy has reported that about one in six women experience long-term symptoms of PTSD after the loss.
The odds are against black women, who are 40% more likely to miscarry and are four times more likely to die during childbirth. They also have higher infertility rates, but less success when they start fertility treatment.
This could partly explain why, according to the Mind charity, mental health problems among black people are higher than those of whites. Yet, although blacks tend to have less experience with mental health than whites, whites are more than twice as likely to receive treatment for mental health problems.
I believe the lingering stigma of mental illness in black communities forces women, in particular, to remain resilient and let go of their well-being, resulting in psychological distress.
Shortly after seeing my doctor, I confided in my mother-in-law about my diagnosis, as she is a trained Christian counselor who is aware of racialized experiences and the impact of mental health issues on people. Black. She advised me to continue consultations and put me in touch with Sarah *, a black female therapist in a private practice.
Fortunately, the “socially distanced” method of forced therapy allowed us to begin our sessions two months after my diagnosis of PTSD.
Sarah is a person-centered therapist, which means her humanistic style allows me to lead the conversation. It was different from Mary’s “cognitive behavioral therapy” approach, which aims to help people find new ways to behave, by changing their thought patterns.
My new therapist also has over 10 years of experience dealing with a range of cultural issues. The support she offers is built on the principle of offering empathy and respect, without being judgmental.
When I told her about my fears of conceiving again after losing my left fallopian tube without probing, she showed compassion for the importance I placed on growing my family. She assured me that my fears were rational because having a large family was part of my constructed identity.
She spoke with a calming cadence, which made her feel physically present even though our sessions are over the phone. I can feel our connection – something that I have dreamed of over all these years of dealing with my issues in isolation.
It was essential for me. After many experiences of not being listened to or believed by professionals, I started to think that I just wasn’t tough enough.
In a recent session where we explored vulnerability, Sarah said, “Pain shows different aspects of ourselves, and you have to accept all of the aspects that it brings.
Hearing these words helped me come to terms with my diagnosis of PTSD. I realize that random outbursts such as tearful episodes are just an expression of my emotions and shouldn’t necessarily be viewed as a sign of weakness.
There are many facets of strength that must be represented to help other black women feel “seen”; articulating the message that we have the autonomy to challenge the oppressive systems in our community and in society at large, which have caused us to put everyone but ourselves first.
I still have times of anxiety, like most people. Fortunately, a year of therapy with Sarah significantly reduced the symptoms of PTSD. In the rare moments when I have intrusive feelings, my newfound love for writing encourages me to bring them up as a coping strategy.
It has helped me learn the importance of being comfortable with my feelings, whether they are good or bad.
Having a therapist who shares the same race is beneficial; However, this should not be relied on to improve mental health recovery in ethnic minority groups. The shortage of therapists from ethnic minorities and the high costs associated with private therapy to find one are already a barrier for blacks.
Beyond traditional qualifications, any therapist must engage in cultural training. This could help them feel more comfortable talking about race and learning the importance of sensitivity, as well as being aware of their own biases, in order to provide high quality mental health care.
*Names have been changed.
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