by: Amira Posner, pregnantish.comcontributorThis essay about Secondary Infertility was originally published on pregnantish.com and addresses the reality that some people in this community face: wanting to have another child and feeling misunderstood, guilty or upset that it’s not happening as easily as the first. “When are you having another child? Don’t you want a sibling for your daughter?” Welcome to secondary infertility—one of the most difficult challenges of my life. Now that I am on the other side of it, I can finally talk about it. In fact, ten years later, now a mother of three, I can’t stop talking about it. I want others to know that secondary infertility, which is the inability to conceive a second child after a first child was born naturally, is experienced by millions of people around the world. Most people have never heard of secondary infertility, and don’t know what to do when they hear the diagnosis. Family and friends who can’t conceive of it don’t know how to support those who struggle with it. My husband and I conceived our first child effortlessly, but the second time around, our attempt to expand our family became like a science experiment. I remember well my very first consult at the fertility clinic where the doctor stated: “You have secondary infertility.” I was in shock and denial for a long time. I couldn’t acknowledge the fact that something that had worked so well for our first child just didn’t work anymore. I felt defective, depressed, and defeated. Every time I ran into and elderly neighbor, she asked when we were going to add to our family. I would make up lies and say that we weren’t ready yet. Eventually, I tried to avoid her. Then I tried to avoid everyone and everything that could potentially trigger me. Pregnant women were a trigger. So were strollers, babies, baby toys, baby apparel and families. My “less than” feelings took over and sometimes the anxiety felt too much to bear. I felt broken physically and mentally. I carried the weight of this complex, which I now call the infertility inferiority complex. A heaviness of pain accompanied me every where I went. Secondary infertility raises many of the same emotions that couples with primary infertility experience, but perhaps in a slightly different way. One clear difference is that most people think that if you can conceive one child, you can conceive another and all is well. But as time passes, there is a hidden anguish that permeates everything. Secondary infertility creates an invisible duality: on the one hand your grateful for what you do have, but on the other hand, you’re still craving more. This “wanting more” part is tricky and can bring up feelings of guilt or of being ungrateful. Avoiding triggers with secondary infertility is difficult. Because there is an older child, this fact often places you and your partner in situations where you mix with other parents whose children are at the same school or programs as your child. It’s hard to avoid your community and the outside world when you have an active toddler and you are forced to get out of the house. Eventually, my daughter started school. I was faced with the reality of meeting other mothers expecting their second and even third child. These encounters were brutal for me. I remember feeling a tremendous, almost constant sense of grief. Every time I got my period, it was as if I had failed; it was another loss. Moreover, even though my daughter was so young, I sensed she knew exactly what was happening. In hindsight, I recognize this was a very strong, over-the-top projection. I wanted this second child so badly—for our family, as a sibling for my daughter— that I thought I was failing my daughter on top of everything else. Infertility, in all its forms, creates a secret suffering. People don’t want to discuss their reproductive challenges because it is such a personal matter. Thus, many women and men suffer in silence. Whereas other illnesses are out in the open with support groups and much more public awareness, silence truly reigns in the area of secondary infertility. This is all the more surprising given 1 in 6 couples suffer with infertility and it is far more common today than ever before. With all of this said, here is what I have learned from my experience. I got stronger and more resilient as I made my way through tests, injections, and a whole spectrum of emotions. It took over a year until I was finally able to get pregnant with the twins. We did three unsuccessful IUI treatments and then one IVF. Throughout the process, I tried to cultivate acceptance and patience. Once I successfully achieved my pregnancy with the twins, the feelings of brokenness slowly melted away and were replaced by relief, gratitude, and excitement. However, even within the bliss of becoming pregnant again, I did experience doubts. “Would the pregnancy last? Would I have pre-term labor? When the twins were born at 36 weeks—are they breathing? Will I be a good mother?” It became acutely clear that a feeling of “lacking” really can exist or surface throughout our lives. If we come to terms with that, learn the coping mechanisms to deal with life’s setbacks, even though they can be devastating, like with secondary infertility, we can seek support and find solutions that help us move forward. When I see families today, I look at them with a recognition that each of us has life-changing challenges at some point in our lives. I try not to assume anything about how or why families take the form they do. Secondary infertility was our challenge, but it also forced us to be clear about what we wanted for our lives and how we would make that happen. Every family is unique, every family struggles. That’s what helps them grow stronger.