I am peri-menopausal. For most, this seals the reproductive door; only my door was boarded up long ago, marked uninhabitable.
Despite my infertility, I have always had a consistent, predictable menstrual cycle—another reason behind the shock of it all. I have come to consider my period a cruel reminder. Why should I have to suffer through the physical and mental cycles when I never got to reap the benefits?
My body continues in an unremarkable nature to herald the change, as I will soon turn 45. My periods are changing, and my hormones are in flux. It is like puberty all over again, as expected. However, the approach of menopause brings one surprising side effect: a return of my pregnancy dreams.
I am nine months pregnant, due any day now, but I look down to find no visible pregnancy signs. No skin stretched tight around an extended middle. No swollen breasts, preparing to nourish. No movement from within to remind me of a human life umbilically connected. Pleasure and panic meld into a singular emotion while I try to convince myself that everything is just fine. Suddenly, I am in my bed, gripping sweaty sheets as I wake to the vacancy in my uterus. Struck by an urgency to hold onto hope, I transition from dream to reality. My arms move through the nothingness and collapse to my chest. Much like trying to hug a gust of wind, hope disappears. I wring myself tightly, attempting to maintain the presence in my core and will myself back into the dream where, despite the confusion, there is assurance and comfort in my denial. I don’t want to be awake, present in a life where I cannot deny my emptiness.
This recurring dream-wake cycle began in the weeks following my first miscarriage. It continued for six-and-a-half years until I adopted my daughter. In my sleep, I relived the losses countless times. Some dreams replayed the tragedies of my two miscarriages. Other more insidious dreams teased me with storylines where I was healthy and pregnant, at full term, or even caring for my newborn child. These were the dreams that threatened to swallow my will to live. The dreams that made me never want to wake or coaxed me back to sleep in hopes of returning to that alternate reality.
The substance of my current pregnancy dreams is similar. Only this time, the ache has shifted. Today, I am a parent. I am grateful for my incredible daughter. What I have come to understand is that these are separate, parenting, and giving birth. I can do one without the other. I can be awestruck and thankful while feeling dumbstruck and bitter. I can be overjoyed when my daughter calls me “Mama” and overwhelmed when I realize that I will die without giving birth.
Female infertility, unspecified.
It has taken me 44 years to stare this diagnosis square in the face. Not by choice. Not because I thought I might still get pregnant, but because I never processed the grief.
Female infertility, unspecified. I will die without giving birth. Menopause is a billboard on a long, desolate road.
Now entering: Time’s Up, Period.
Population: Irrelevant— you will always feel alone.
My grief is complicated, fed by years of shame. While I grieve two miscarriages, I also grieve for a piece of myself. Pregnancy and motherhood were central to my identity and my life. I never had questions about whether or not I would give birth, but certainty in the essence of my female body. As a child, I sat with my aunt as she breastfed her baby. I mimicked her actions, cradling my Cabbage Patch Doll to my undeveloped chest, and imagined the inevitability of my own milk swollen breasts. I was robbed—the Cabbage Patch doll ripped from my girlish chest. Who gets charged with this aggressive invasion of my womb?
And so, became my life, in contrast, post-miscarriage and living with unexplained infertility, fractured by a deep sense of self-loathing and an intense longing to embrace myself and say, “It is not your fault. You still matter.”
I haven’t yet forgiven my body for this betrayal. But I am finally receiving treatment. Today, I am in therapy and have consistent access to proper mental health care. While I still have ups and downs, progress means gentle undulations instead of steep climbs and slides. As feelings surface, I am better equipped to process the experience. And when I am overwhelmed, I have resources.
Miscarriage and infertility affect everyone differently, but there is ample evidence to validate the inextricable link between mental and physical health. Comprehensive treatment should prioritize a timely, whole-person approach. Anything less is negligent.
To those facing pregnancy loss and infertility: you are not alone. Keep breathing.
To those supporting friends and family experiencing pregnancy loss and infertility: no two people will need the same support, but all will need to feel supported. Keep showing up.
To those treating patients experiencing pregnancy loss and infertility: how are you treating the whole person? Keep improving.
Trapped in an Air Pocket 