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26 January 2022updated 28 Jan 2022 5:21pm

“Just relax!” and other infuriating fertility advice

When friends and family repeatedly told me to stay calm, it had the opposite effect. But linking women’s chances of conception with stress is not only demoralising – it’s dangerous.

By Emma Haslett

There is no easier way to make someone’s brain twist into a pretzel than by telling them to relax. Relaxing, once you’ve been told to do it, is not possible. You start to scrutinise every part of your body for signs of release. The instant your breathing slows, or your jaw unclenches ever so slightly, an inner sergeant major enters stage left. “Hey!” it hollers. “You’ve made a start! Now try harder!”

I discovered this when I began trying to conceive in 2015, and when I told people that nothing was happening, their reactions were eerily similar. I would explain my woes; they would heave a sigh and then, through puffed-out cheeks, tell me: “To be honest, I think you just need to relax.” It was as though a call-centre script had been distributed among my family and friends. There, at the top of the page titled “Responses for People who are Trying for a Baby”, was “just relax”.

There were variations of this, of course – all containing the word “just”: perhaps we “just” needed to go on holiday. A friend’s sister had “just” stopped trying – and poof! Pregnant. “Actually, our little Otto was an accident,” people confided. “We were really drunk. Hey! Maybe you just need to get drunk?”

Even strangers on the internet joined in: one night, exhausted after a long lecture from a family member, I turned to a forum for people trying to conceive. “Does the phrase ‘just relax’ ever drive you insane?” I asked. “Worked for me,” was the first, shrugging, reply. I grew up in the Nineties, when Smash Hits magazine was full of pop stars trilling about how you could have anything you wanted if you only worked hard enough. In the Noughties, the message became “stay positive”: visualise the outcome and it will happen. Today, this has evolved into “manifestation” – think about something hard enough and it will happen.

“Perhaps you just don’t want it enough,” a friend suggested over brunch.

[see also: Trust me, women don’t need to be reminded to think about having children]

It is a deeply isolating experience to sense that the only thing you want is unreachable because of something you are failing to do. Everywhere I looked, people were successfully performing this basic, animal function of conceiving. I wasn’t, and judging by what everyone was telling me, it was my fault. I came to dread social events, where people who had children could corner me and tell me how they’d managed it.

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The strangest thing about the “just relax” phenomenon is that the research into the link between stress and fertility is inconclusive. One 2014 study published in the UK journal Human Reproduction generated dozens of headlines about stress increasing the risk of infertility, but was relatively small (a sample of 401 couples) and failed to differentiate between correlation and causation (were the women stressed because they weren’t getting pregnant, or not getting pregnant because they were stressed?). Meanwhile, a 2011 meta-analysis of 14 studies and just under 3,600 women undergoing IVF showed that distress “will not compromise their chance of becoming pregnant”.

Fertility has long been entwined with myths about femininity, which might explain why these comments are usually directed at women, even though roughly half of infertility cases are “male factor”. Hippocrates was one of the first to conflate the mind and the uterus, suggesting hysteria was a madness caused by the womb wandering around the body. The second-century physician Aretaeus of Cappadocia wrote that the womb “moved of itself hither and thither in the flanks”. Hardly optimum conditions for conception.

This bad science has been remarkably persistent. In the 19th century Edward H Clarke, a doctor at Harvard Medical School who specialised in primary care and the study of the ear, nonetheless published a book entitled Sex in Education: Or, a Fair Chance for Girls (1873), which concluded that if a woman were to “work her brain” in subjects such as maths, botany and chemistry, she may “divert blood from the reproductive apparatus to the head”.

Infertility is hardly the only area of a woman’s life where this sort of victim-blaming is prevalent. If you do become pregnant, but lose your baby, medicine has found a hundred ways to point the finger: for years, many women who miscarried were diagnosed with an “incompetent cervix”. (I’d even argue that the “mis-” prefix in “miscarriage” is unnecessarily accusatory, implying wrongdoing, as if a woman has somehow dropped her baby.) Still, clinicians have at least stopped using the horrendous term “spontaneous abortion”, a routine phrase used in clinical settings until relatively recently.

After two years of trying, I discovered the reason I was struggling to conceive wasn’t my anxious mind but my broken body. When I was ten, my appendix burst – a near-death experience that infected the lining of my abdomen and, as it turned out, left my fallopian tubes so scarred they no longer functioned. There was no way I could conceive without IVF. When I shared this news with a friend, she asked if I’d tried acupuncture. “I’ve heard it’s great for IVF,” she said. “So relaxing.”

“Big Fat Negative: The Essential Guide to Infertility, IVF and the Trials of Trying For a Baby” by Emma Haslett and Gabriella Griffith is published by Piatkus

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This article appears in the 26 Jan 2022 issue of the New Statesman, The Light that Failed