Catherine Mcleod-Moya, RN

Deciding to start or expand your family is an exciting time. There is so much thought process and planning that goes into it (unless you have a surprise baby)!

Hopeful parents spend a lot of time, energy, and money into making room for a future baby. That process comes with a mix of emotions: excitement, joy, hopefulness, anxiety, sadness, and so many more!

Alongside this rollercoaster of emotions, you can have physical manifestations of stress potentially getting in the way of optimizing your bodily health for a future pregnancy.

Picture this

You and your partner have long dreamt of having a little one to raise, and are finally ready to invest yourselves mentally, physically, and financially.

You set up a room ready to be converted into a nursery, you peruse the aisles and online marketplaces for adorable newborn onesies, buy ovulation testing kits to start tracking your fertility, start daydreaming about baby names.

Then, once you start trying to conceive you wonder whether you’ll fall pregnant right away or whether it will take a couple of cycles. After a few months, the excitement starts wearing off, and the reality of the hardships involved in planning a pregnancy begins to set in.

Combine this with your everyday stress, such as work, your home, your pets, and your family. Eventually, it gets to the point where you worry that added stress may be affecting your fertility, and that worrying and worrying is only going to make it worse.

Sound familiar?

You’re not alone. Approximately 1 in 8 couples have trouble conceiving and 15-30% of couples will be diagnosed with unexplained infertility (Quaas and Dokras, 2008).

Multiple studies have also pointed out this quandary. There is a connection between the hypothalamic-pituitary-axis (HPA) and hypothalamic-pituitary gonadal axis, which demonstrates that physical stressors can negatively affect menstrual cycles (Lynch et al., 2014).

Preconception perceived stress adversely impacts the length of time to become pregnant, likely due to the effects of stress on ovulation and implantation (Schliep et al., 2019).

But here’s the bombshell on top of all this: the 2020 Covid-19 pandemic.

Many provider offices and fertility care centers are offering limited services and support during this time, per public health recommendations.

The American Society for Reproductive Medicine (ASRM, 2020) initially urged for the avoidance of new treatment cycles for infertility patients as well as ceasing all but the most urgent and time-sensitive services in the early days of the pandemic.

Currently, the task force within ASRM has suggested relaxed restrictions, now that it’s certain that hospital resources are not overwhelmed and there is enough personal protective equipment available (ASRM, 2020).

Although this paints a picture of dread and fear, our recommendation is quite the opposite.

Here are some positive news:

Full-term newborns delivered from mothers with active COVID-19 infections have done well overall (Shalish et al, 2020).
Women affected with COVID-19 that delivered via c-section did not show viral RNA in the amniotic fluid, cord blood, or breastmilk (Chen et al, 2020).
Pregnant women make up a small fraction of the infected cases and deaths within the U.S. (ASRM, 2020).
The American Academy of Pediatrics recommends breast milk as the best choice for feeding newborns delivered even to women with COVID-19, as it an unlikely source of transmission (American Academy of Pediatrics, 2020).
There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive (Ovia Health, 2020).

Here are some perks or silver linings that couples have pointed out regarding trying to conceive during the current pandemic:

Spending extra time together
Getting more rest at home, giving them a chance to slow down
Avoiding the hustle and bustle of waking up early, traffic, and being in large crowds
More opportunities for self-care
Considering a more intimate home birth setting

With fertility care providers offering limited support, self-care is now more important than ever.

Here are some actionable tips to help cultivate a fertile mindset:

Nourish your body, nourish your mind

Healthy fats, for example, are not only good for your mood, but also support sex hormone production. So, enjoy those avocado toasts!

Stop the scroll

Social media can potentially become a harmful tool for your mindset. It’s easy to feel disappointed when you see photos and videos of gender reveals, pregnancy announcements, and all the cute newborn photos. Be mindful of how much time you spend on social networks and mute accounts or avoid social media, altogether.

Date your partner, date yourself

With all the extra time couples are spending at home, make time to “date” each other with a nice meal or a hike together. Don’t forget to “date” yourself and maybe pick up a new hobby that’s been on your list for a while, or create a new morning ritual. This is a good opportunity to introduce positive affirmations!

Connect

Surround yourself with a supportive network and set up virtual or local hangs. There are many online TTC groups you can join (Facebook groups or Peanut are some good resources).

Meditate

Nourish your spiritual side and try meditation. You can use apps like Calm, Headspace, or Expectful, which offers guided meditation programs based on research that illustrates the benefits for your fertility, pregnancy, and parenthood journey.

Talk to someone

Get in touch with someone other than your partner or friends and family. A trusted professional health coach or counselor can help you navigate the difficulties during the preconception period.

A comprehensive solution

It’s easy to become overwhelmed and disappointed. We see you and we hear you. Remember that you are not alone and that there are a plethora of resources to reach out for support.

Holistic Health Code is committed to helping women along their fertility journey, which is why we created the Holistic Preconception Plan, an eight-week program introducing holistic preconception planning with special focus on holistic hormone-balancing solutions, gut health, prenatal nutrition, detoxification, and prenatal yoga and meditation.

References

American Society for Reproductive Medicine (ASRM). (2020). American society for reproductive medicine patient management and clinical recommendations during coronavirus (Covid-19) pandemic update #6. Retrieved from https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforceupdate6.pdf

Lynch, C. D., Sundaram, R., Maisog, J. M., Sweeney, A. M., & Buck Louis, G. M. (2014). Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study--the LIFE study. Human reproduction (Oxford, England), 29(5), 1067–1075. https://doi.org/10.1093/humrep/deu032

Ovia Health (2020). COVID-19 and pregnancy: Your questions answered. https://www.oviahealth.com/blog/2020-03-16-covid-19-and-pregnancy-your-questions-answered

Quaas, A., & Dokras, A. (2008). Diagnosis and treatment of unexplained infertility. Reviews in obstetrics & gynecology, 1(2), 69–76.

Schliep, Karen C.a; Mumford, Sunni L.b; Silver, Robert M.c; Wilcox, Briand; Radin, Rose G.b; Perkins, Neil J.b; Galai, Noyae; Park, Jihyea; Kim, Keewanb; Sjaarda, Lindsey A.b; Plowden, Torief; Schisterman, Enrique F.b (2019). Preconception perceived stress is associated with reproductive hormone levels and longer time to pregnancy, Epidemiology: 30, S76-S84.

Fertile Mind: TTC During a Pandemic