This week, we have a guest post from Anna Jefferson.
National Infertility Awareness Week is April 23-29 and Lauren asked me to write a guest post about infertility and yoga. My expertise is both professional and personal, as a trained yoga teacher and person who spent five years increasingly desperately trying to get pregnant. And assuming infertility is as prevalent among yogis as the general population, I am like 1 in 8 women who show up to a prenatal yoga class.
In the dozen years that I’ve practiced yoga, I’ve often described it as my therapist, my gym, and my church all in one. Of course I expected that my practice would continue to be my bulwark and problem solver for me as we started having trouble getting pregnant. It both was and it wasn’t over the next five years as we went ever-deeper into fertility treatments and emotional turmoil. My practice most often provided solace and a few painful times it felt like a liability and a traitor.
For the first three years we tried to get pregnant, I carried on with my practice mostly like normal. Up through our first three IVF cycles, we were operating under the assumption our infertility was male factor, so why would I have to change anything? Except for a few medically-indicated modifications because of the stimulation meds:
- Starting after about a week of stimulation, drop inversions and don’t do lots of jumping (i.e., ashtanga vinyasas and the like). These guard against ovarian torsion, a pretty rare but serious event where ovaries that are made top-heavy by producing many eggs at once might flip over, kinking the fallopian tube like a garden hose. It cuts off the blood supply to the ovary and most often requires surgery and losing the ovary. I was disproportionately scared of this.
- Up until the pregnancy test (or after, depending on how bloated you are), go easy on deep twists, lying on your belly, and a lot of core work. These modifications are for comfort not because they’re dangerous or, so far as I can tell, because they have any effect on potential implantation. You just get bloated from your body producing many eggs (the more eggs, the more bloating) and from all the drugs.
- Lastly, you might want to do restorative and cooling poses during the two-week wait until the pregnancy test, less because there’s any physical danger and more because those weeks are among the most stressful of your life and you’re taking massive doses of hormones. As Alice Domar, of the Domar Center for Mind-Body Health, says, “stress doesn’t cause infertility but infertility causes stress.”
As yogis and yoga teachers, we espouse that yoga helps us refine our sensitivity to what’s going on in our bodies. The insight to push our limits or nourish a depleted body, the ability to detect minor misalignments and imbalances before they explode into emergencies like knee or rotator cuff surgery, sensitivity to the subtle qualities of the breath. It’s awesome–except when it’s not. Infertility also trains you to pay attention to the most minute sensations of the body: did I feel a twinge in my uterus? What does that fleeting cramp mean? Am I thirstier today than I was before ovulation? Wasn’t I a little dizzy three days ago, too? Do I feel nauseated (please say yes)? This raging moodiness is probably early pregnancy hormones and not PMS washed in the disappointment and rage of failure (again), right?? I wondered if the extra sensitivity I’d gained through yoga was making the inherent obsessive body-scanning of infertility worse. (If I wasn’t so in touch with my body, maybe I’d need a bludgeon like weeks of morning sickness to wake up to a pregnancy?)
After three IVF cycles, the three reproductive endocrinologists we consulted agreed on one thing: the problem was actually me. My eggs were terrible. My feelings of abundant health, anchored in my yoga practice, felt thin and false. My practice hadn’t protected me in this most fundamental way. I started scouring deep pockets of the infertility community to assess what I could do to fix my body. There is, to put it mildly, a shit-ton of magical thinking, science, and pseudoscience women and couples will try out to resolve infertility.
“Have you tried doing yoga? It will help you relax.” “Don’t do yoga, it will over-stress your body! Take a three-month break.” “Meditate every day.” “You can keep up with whatever you normally do.” “Just do restorative poses.” “The restrictions are the same as pregnancy: no jumping, twisting, or core work.” “Do deep, belly-heating core work.” These are the broad outlines of the conflicting and crazy-making advice I got, unsolicited and solicited, about doing yoga while dealing with infertility, from people who know nothing about yoga to reproductive endocrinologists to master yoga teachers.
Two made me bristle the most. Modify my practice the same way a pregnant woman should? This is like telling a divorcing person to throw herself an engagement party every week. NO THANKS!
The other was the suggestion to drop my asana practice for three months. One fertility researcher I met believes that some unknown fraction of unexplained infertility might be caused by exercise, even if women are not amenorrheic. She suggested I give up asana for three months–”it’s just three months”–as an experiment, but to continue meditation and relaxation practices.
I was apoplectic. After four years of trying to pregnant and three pretty miserably failed IVF cycles, here was the suggestion that my practice, my rock in this shitty storm, was to blame. At the same time I was being told to blame yoga the way I did it, I was also being told to meditate (which I already did nearly daily) and do restorative yoga (which I also did).
I’m not a religious person but I imagine this is what it would feel like for an anguished believer to be told she had brought her infertility on herself by not worshipping the right way. That if she would just “pray on it” the right way–all the while feeling she had been forsaken by her god–she would be healed. It hurt not only to think about giving up the kind of practice I wanted. It also cut deeply because it threatened the idea that I was in touch with what my body needed through practice. And yet, despite my anger at having to throw this one last sacred refuge on the pyre, I did it. I mostly gave up asana for months to not drain my body’s apparently insufficient biological resources away from the chance to reproduce.
I was angry at the insinuation I’d brought infertility on myself. My existing disdain for certain tendency in the broader yoga world (albeit not a part I frequent much anyway) also got much more acute. It’s a sort of faux earth-mother-goddess thing that talks about positive thinking and “manifesting.” While nobody said anything like this to my face, there exists a sanctimonious undercurrent in the yoga scene that you won’t get sick or frail or depressed if you do yoga; or if you do, that yoga should be able to cure all your ills. Clearly the counterpoint is that if you get an illness or you don’t recover that you’ve brought it on yourself. It’s the same toxic mentality that makes some yoga teachers reticent to say they’ve even caught a cold. I started to resent people who had healed themselves through yoga, those who believed that I could, and anyone who suggested I could use this as an awesome chance for spiritual growth—simply by deciding not to get upset as we ground into the fourth year of infertility. Pro tip: detachment isn’t the same as not caring or pretending not to care.
I went deeply into Ayurveda, yoga’s sister science of holistic medicine and lifestyle. Working closely with a gifted practitioner, I changed my diet to address my imbalances. According to Ayurveda, the body has seven layers of tissue (dhatus): plasma, blood, muscle, fat, bone, bone marrow and nerve, and reproductive tissues. Ayurveda posits that the tissues are accessible in this order and they break down in this order, so reproductive disorders are the result of deep imbalances. Happily for me, this involved eating tons of avocados, ghee, and other sumptuous fats. Once I was more balanced and I had gained a few much-needed pounds, I did an initial cleanse before my fourth IVF cycle. While the results were better (more eggs!), the embryos still weren’t strong and the cycle failed.
Emotionally and practically, we started thinking about donor eggs. I thrashed emotionally harder than I ever have in my life: hating the idea, feeling it like an inevitable pull, resenting prospective egg donors, and wanting to do everything in my power to just make infertility stop. In meditation one morning, I saw myself standing in front of a waterfall in my native east Tennessee. Like many of them, it had a tiny cave behind the water, a special mossy hideout. My emotions had been, as usual, racing about donor eggs. Suddenly, I was pulled into the little cave and I sat there, cool water a shield between me and everything outside and I felt it: I understood that my despair, clinging, frustration, anger, regret, and resentment were what my desire to have a child felt like. There was no joy, no positive vision in it. It was then I realized, I don’t want to have kids. I want us to be parents. An egotistical drive to replicate my genes didn’t have to drive the train anymore; I could get what I most wanted out of parenthood without biological kids.
Our fifth IVF cycle was going to be our last one using my eggs; we would save the final one covered by our insurance (bless you, infertility coverage mandate in Massachusetts!) for a donor egg cycle if needed. I put everything I could into it: I took a leave of absence from work, I did all the recommended daily Ayurvedic self-care–oil massage (abhyanga), alternate-nostril breathing (nadi shodana pranayama), dietary guidelines, soothing yoga. It felt fantastic and I loved how this new regimen made me feel. But I didn’t get pregnant. Instead I got told I probably had an unidentifiable genetic condition that meant I could never have children.
The clarity of the waterfall was gone. The finality of it, the pronouncement that no matter what I did our efforts would be futile was one of the most anguishing moments of my life. I felt so many things. One of them, particular to yoga, was the sense of confronting abhinivesa, “clinging to bodily life,” which the Yoga Sutras identify as one of the obstacles to spiritual growth (kleshas). In all our years of trying, all the failures had pushed me from an ambivalent maybe-mom to fervent clinging to the idea that I could do this. Being told that I could never reproduce, no matter what, felt not only like a slap in the face of my agency and ability, it felt like being erased from the human family. It felt like dying in an evolutionary sense.
Along with the devastation I felt a deep sense of relief that I would never subject my body to the hormone stimulating cycle again. I went to a workshop at Kripalu with the gifted, soulful Angela Farmer. She is the teacher of my dear teacher Barbara Benagh, with whom I was completing an advanced teacher training–with no small motivation being to have a space for a positive, not-fertility-focused time with my body. In the workshop, Angela asked us to talk to our bodies and tell them what they needed to hear. Immediately, without thinking, I said to my body, “I’m sorry. I’m so, so, so sorry.” Not that my body couldn’t get pregnant but for all the flogging she went through. I recommitted to having a sweet, kind relationship with her and nourishing her in any way she needed.
Another morning in meditation, I saw a room filled with votive candles. We’d had a habit, partially adopted from my stepmother’s childhood Catholicism, of lighting a candle for each embryo we were wishing along in an IVF cycle. I marshaled all my resources of intention and mindfulness to create a ceremony I shared with a few family members and a friend. Together we meditated. We talked about the love for our children we hadn’t been able to express publicly. We lit a candle for each of the 116 eggs that had not become our children. We grieved my genetic contribution to our future children, and lit the way to welcome the idea of donor eggs.
Even as we moved on, I regained a rock-bottom belief in my body. I kept up my Ayurvedic diet, herbs, and self-care; I did a spring cleanse. I started doing unrestricted asana again, feeling a challenging practice as a gift and slow, contemplative practices as a comforting friend. I kept seeing a really gifted acupuncturist.
Six months later–when, after a series of unlikely setbacks we were exploring a third prospective egg donor–I got pregnant. Along with extraordinary good luck, I credit my acupuncturist, the physical boost and self-care of Ayurveda, my reproductive endocrinologist for putting me on vitamins I needed due to genetic markers I have, my therapist, my husband for his endless support, and a few friends who supported me with the donor egg plan. And myself: for years of work, dedication, self-care, and emotional healing. It was partially the yoga–as a holistic framework for my life. It wasn’t doing or giving up specific poses or seated meditation or pranayama or Ayurveda that got me pregnant. I learned I couldn’t barter these practices in exchange for a pregnancy, no matter how subtly or sophisticatedly I tried to mask the trade. Just after I got pregnant, I wrote in my journal: “If this sticks and if I have this baby, I could rewrite my story as one of inevitability but that’s not how it felt at the time. I want to be truthful to the radical contingency of things and not rewrite it into a more facile story line.”