The title of today’s article is How to Be Emotionally Resilient During Fertility Treatment and I am so delighted to have Abbe Feder on with me. Abbe is a fertility coach and the founder and CEO of InCircle Fertility. She and her husband host the podcast Maculate Conception, and she is the creator of (In)Fertility Cards of Affirmation. She’ll share a little bit more about those as well.
I could not be more excited to have her on the show to talk about how to be emotionally resilient during fertility treatment, and you’re going to give us some tools, tips, and tricks, and talk to us about how we can work with you. Welcome to the show, Abbe.
Abbe Feder: Thank you so much. I’m honored to be here.
Dr. Aimee: Many of the people who work in the fertility field have had a journey of their own. What inspired you to be a fertility coach?
Abbe Feder: Yes. I had an incredibly painful six-year journey through unexplained infertility. It included multiple clinics, multiple doctors, multiple losses, an ectopic pregnancy, four IUIs, four retrievals, eight transfers, a surrogate flaked on us, and a termination for medical reasons. I can only list those off so casually now because I did emerge on the other side with my babies. I have twins.
We were told many times that it would not happen for us. When you think about the word resilience, I don’t think people seek out to be resilient. Resilience almost happens to you from situations you didn’t want to put yourself in. I did not want to go through infertility, and every minute of it was painful, but once I did, it became my life purpose to help other people get through in a more manageable way.
Dr. Aimee: Now you’re a fertility coach. I love that. I would say that maybe two or three years ago, I wasn’t talking to my patients about working with a coach, but I feel like the world has changed and people need as much support as they can possibly get. Can you explain to us what a fertility coach does?
Abbe Feder: What I say is that I hold the hearts and hold the hands of women and couples navigating this journey. The reason that fertility coaches exist now is because so many of us have gone through this and said enough. This could have gone so much smoother. I needed help, I needed guidance, I didn’t know where to turn to make decisions. I was fortunate enough to have access to therapy, to have insurance that covered therapy, to be able to communicate well with my husband and with my family, and I still felt completely lost.
I wished I had, the way I envision it is almost like a lighthouse. There’s all these couples and women on the boats swimming to the shore, and they just need the lighthouse to help them get there. They have a great boat, maybe they have a special kind of motor that helps them in terms of therapy, maybe their nurse is the food they need to keep on the boat, but they just need the lighthouse to hold it all together as a guide. That’s what I do.
Many coaches work in different ways. I had a little bit of trial and error for what works best. The way that I work with people is actually over a minimum of six months, because I really want both sides to commit to being on the journey together. Six months isn’t even that long from the medical perspective because we’re still figuring out what works for your body, what works for your mind, what works for your relationships. But nobody wants to think they’re going to be going through infertility still in six months. If you’re on the patient side of infertility you’re like, “What do you mean six months? Isn’t this going to be I do a round of IVF and I get my baby?”
So, I really like to hold hands and go through the journey for at least six months with the women that I work with and the couples that I work with. It looks like conversations, text messaging, and all of the little ways. On my website it even says you have a guaranteed 12-hour response time, but it’s usually more like 12 minutes, and that’s dead on accurate.
Dr. Aimee: That’s the thing, nothing is guaranteed. For some people, it might be one IVF cycle and you get what you need, you transfer, and you’re done. But I think it’s better to think of it as you’re in that boat and hopefully you’re led to the right path and journey in a very smooth way. No matter what happens, it’s just nice to have that support.
You talk about resilience and helping people with that, and basically being a resilience coach. How can people work toward being more resilient?
Abbe Feder: I think one of the most important ways that human nature goes against and we have to remind ourselves to get back on track is so simple, which is to allow ourselves to feel what we need to feel. A lot of times on the infertility path, you feel jealousy of other people, you feel anger that your best friend is on her third baby when you haven’t had your first, and you feel like it’s not okay to feel that way, like you’re wronging your person for some reason, or you’re betraying them by having those feelings.
I really like to be the place to hold that venting space for you and validate that you are allowed to feel it, that it’s very natural to feel it, and to actually let yourself sit in that feeling as long as you need. I truly believe that if we force ourselves out of feeling what we need to feel, it doesn’t actually resolve itself. By actually working through the bad feelings, that is how resilience is developed.
I can also give a super simple tip that I have said in many arenas long before I was even a fertility coach, which is to keep a love file. At work or in your family or if you help a friend and anyone is like, “Oh my god, thank you so much. You made my day,” you made my life, you kicked ass on that project, just put those in a file for a bad day. I will do this for myself all the time from even old notes from 10 years ago. Sometimes I just read those files because I need a little hope from the outside world that I don’t feel inside.
Dr. Aimee: I do that, too. When people write me a thank you card, I take a picture of it and I keep it in a folder for that exact reason, so that I’m just reminded that no matter what is going on, I’m making the world a better place by helping people have babies and become parents.
Let’s talk about emotional wellness. Emotional wellness also benefits from being able to navigate triggers or difficult situations during treatment. How do you coach people through triggers?
Abbe Feder: Triggers, I’ll tell you I’m on the other side of my fertility journey, three and a half years, my twins are three and a half years old, and I still get triggered. I still hate pregnancy announcements. If I see a pregnant belly on a website related to fertility, I get angry. Why would you put that pregnant person’s picture on there?
Again, we go back to normalizing that it’s okay to be triggered, but also learning how to talk yourself out of this is unreasonable or the rage. Let yourself rage for a minute. Sometimes I’ll be like you have an hour to rage and then it’s over. You have an hour to have a pity party and then it’s done. You have two days and then the pity ends, and we move onto the next thing and find a way to bring hope back in.
Again, allowing yourself to feel what you need to feel. Just know we are all triggered, and we were not taught really as children. There’s so much, “You’re crying? Look at this toy. Let’s get you out of the trigger.” No. Let’s talk about the trigger, acknowledge the trigger, become aware of the trigger, and then figure out what works best for us to get out of the trigger.
Just know that they’re going to come up. I don’t think I’ll ever see a pregnancy announcement and be purely happy for the person. It’s just not possible. The trauma is real. Therapists are amazing at unpacking trauma. I work more in the trigger field, in the day to day, in what can we today, not necessarily go back to past trauma and experience, but what can we today to get through this part of the fertility journey in a manageable way where we feel in control.
Dr. Aimee: That’s why you’ll never see a picture of a pregnant belly on my website, you won’t see a picture of a baby on my website, ever, and I don’t talk about my own pregnancies, I don’t post pictures of my children, you’ll never see that on any of my social media pages, because I’m very sensitive to that.
Abbe Feder: It is so triggering. This week I had to do some work on a fertility benefit site, and the first picture is a giant pregnant belly. I wanted to cry for myself, and I’ve made it through, so I can only imagine what it feels like to yearn for that so deeply and see the pictures everywhere. That is not going to help anybody going through this.
Dr. Aimee: What about other triggers closer to home, like nosy family or friends, or dismissive comments from people you’re close to, or uninformed discussions and myths that might be offered as helpful but they’re really not, how do you deal with that, or at least help your clients deal with it as well?
Abbe Feder: This was one of the hardest parts of my journey. I think everyone has well-meaning intentions, but often misses the mark. I can’t make a blanket statement on the best way to deal with it. For me personally, I had to really examine my boundaries and decide at a certain point I didn’t want to share my fertility journey early on.
But once it became year after year… Honestly, the reason my husband and I started our podcast was because we were holding in and biting our tongue at all the things we wanted to say to our family and friends that were so wrong and missed the mark, or if they ignored it all together, if they knew were having treatment and they never followed up to say anything because they’re terrified, they don’t want to say the wrong thing. To me, I’m like you’re not even acknowledging that maybe I’m really in pain right now. So, we got a recorder, and we would make lists like people we want to punch, or Uncle Salvador (I’m very Jewish, we have no Uncle Salvador, it’s just a name that came to my head) said this awful thing to me. We just needed to talk about it.
I think you need to have “your person.” It can be me, it can be a friend, it can be a partner, where you can be like, “This was a completely inappropriate thing for them to say.” If it’s someone like me or someone who has been through it, we just get it. We get it. We can make a list of all the horrible things our family said. I can’t tell you how many people were like, “When it’s your time, it’s your time. When it’s meant to be, it’s meant to be.” Those people always went on my list of people I wanted to punch. I’m not a violent person, but that is how it made me feel at the moment.
I’ll never forget, my best friend was throwing a birthday party for her husband. We live in Hollywood, and there’s Hollywood Hills, and there were only two parking spots available. I had to come late. I was like, “Can you save me one of the spots? I don’t know if I’m going to be able to park.” She said, “So sorry. The spots are only for people with kids.” She knew what I was going through, she meant nothing by it, she just knew she had to hold that space for someone who had kids and was going to need to unload.
At that moment, I was like my husband and I had to put this podcast out into the world because people don’t understand that saying something like that to someone who is going through infertility is so painful. It’s seven years later, and I still think about when she said that to me. I’ve since of course told her and we’ve talked our way through it. But it’s like this is why we need to navigate this not just with the people going through infertility, but the people supporting the people going through infertility.
Even within my practice, there are times where I’ll get a text from a client who is like, “My husband doesn’t understand why I want to XYZ,” something fertility related. I’ll say, “You know what? He doesn’t need to understand it. You need to just tell him I can’t explain why, you don’t have to understand it, this is just what I need right now.” I need you to not talk to your parents about what we’re going through. I need you to not go out on Saturday night. Whatever it is.
Finding a way to communicate your needs is so crucial during this process, and so many women, strong women, are reluctant to do that and don’t feel empowered to do that. That’s one way that I think coaching can really help.
Dr. Aimee: Yes. I think also communicating with your clinic can be an issue because there are so many triggers there also. The triggers aren’t just with the people that are around you day to day. Sometimes things can come up. For example, you’re over 40, you already have one baby, and people just don’t have as much compassion for you. Or you’re having a miscarriage, you’re over 40, and people are like, “What did you expect? You’re over 40,” so they don’t have the empathy that they really should have for you.
That’s really hard for me to see because most of my patients are over the age of 37. It’s hard for me. I have all the love in the world for them, but when I hear these stories of what’s happening to them elsewhere, how would you say someone in that type of situation should advocate for themselves if they’re not getting the type of response that they need from a clinic, for example, when they’re going through something like that?
Abbe Feder: Such a good point, such a good question, such a huge frustration for me and my clients. We don’t know what we don’t know is the worst of it. Some people don’t know that being talked to that way at a clinic is actually not okay, so they assume that it is okay. All I can say, honestly, in that situation, and I’ll get into how to actually manage it, is this is why you need a coach because they have resources to know that it is not okay to be treated like that by a clinic.
The squeaky wheel gets the grease, and that’s just the way it can be. When it comes to clinic management, I wish that every doctor and every clinic were as amazing as you. You know all of your people love you for this, in terms of getting back in communication and response, empathy and emotional, being delicate with one’s emotions. I see clinics where a doctor won’t get back to you if you’re doing IUI, but if you’re doing IVF they will. If you’re going through IUI, it is brutal, it is painful, and it is emotionally triggering to not be able to do what your body should be doing naturally. The doctor or the clinic doesn’t get to make the call on whether that is important enough for the doctor to call you back. These are pet peeves that I have.
I will say I have a client that I’m texting with today, she can’t get through to her actual doctor. She can get through to a portal, but there’s no way to get to the actual doctor. This is, honestly, a lawyer, somebody who is a go-getter who will go after whatever she wants. I’m like call the clinic and find out how to get in touch with your actual doctor. She’s like, “What if they don’t tell me?” Then you call again. “What if they don’t do this?” Then you do it again.
Sometimes you can’t think clearly when you’re going through this. You need someone to help be that lighthouse for you, get you back on track, and remind you that you have the skills you need to nudge and to get the information that you want. This is why I think it’s so important to have outside help.
Dr. Aimee: That’s one of the things that I teach people when they take my IVF class. I say find out what the phone numbers are so that when you need to reach someone, if you do, that you’ll be able to reach them within a reasonable amount of time. Sometimes the things that you need help with are extremely important and urgent. If you can’t reach someone because, let’s say dropped your HCG and the glass shattered, what are you going to do? Sending a message through the portal is not going to help.
That’s a really important question to ask if you’re starting off on your journey and you’re working with someone, “What is the emergency phone number?” There are some centers that will say, “Well call you back, but we’ll charge you $50 to do it.” Literally, some people reach out to me and say to me, “I know you’re not my doctor, but I can’t reach anyone and I’ve heard that you’re going to reply to me even though you’re not my doctor,” and they’re right. They got my number from a friend or something like that and they’re easy questions, they’re not like big medical questions.
Managing stress and anxiety has a lot to do with being resilient as well. I can see sometimes in the beginning of a journey people are a little bit more fragile, and then as they go along their journey they’re feeling like they’re more equipped with skills, and I wish people had those skills early on. What are some of the ways that a patient might be able to do that from the very beginning in terms of managing anxiety and stress?
Abbe Feder: I think one of the biggest reasons anxiety creeps up in any situation is because we feel very out of control. Control is a big issue for me. Not every personality is different. I like to feel in control of a lot of things. When you go through infertility, so much is out of your control. It’s so frustrating and it is anxiety provoking. Sitting in the unknown is extremely difficult and hard.
I really encourage as much planning as possible. Again, when you don’t know what you don’t know, and you can’t plan. Strategizing with a doctor, maybe also a nurse, maybe an acupuncturist. We always talk about the village it takes to raise a child. We don’t talk as much about the village it might take to bring a child into this world. That village will help you feel in control of your plan.
There is so much resentment that one has to be doing this to begin with because our body is not doing what might come “naturally,” which is a word I’ve grown to hate, but naturally to other people. There’s resentment there, which I understand, so you think, “Why would I build a village to help me on this journey? I’m already annoyed that I have to have anybody help me on this journey.” But if you’re going to do it, let’s do it right. Let’s plan together to alleviate some of the stress and anxiety, to gain control of the situation.
You have your TUSHY method, I have what I call the GLOW method. I want you to glow during infertility. G is for Gain control. L is for Learn what works. O is for ovary love. W is for win. Gaining control is step one because that is what is going to make you be able to manage the day to day of this process. Still, there are going to be times that it feels out of control. You can only do what you can do, but give yourself the best shot at having a resilient experience.
Dr. Aimee: I love that. Gaining control from my standpoint is knowing what the why is. What is your diagnosis? Why are you even sitting in my office talking about fertility treatment? Part of that is a very spiritual emotional journey to have a baby, but there’s also medical issues. Doing IVF, as we all know, isn’t just what you do to fix it. It’s not easy, as you know from your own journey. It’s not just “do IVF” and everything is going to be okay.
You’ve also created these pretty cool cards. Thanks for sending them to me, I love them. It’s the (In)Fertility Cards of Affirmation. I would love it if you would just share more about them.
Abbe Feder: I’d love to. These came out of actually post-my-journey one of my best friends gave me for my birthday a deck of affirmation cards. I picked the first one up, I don’t even remember what it said, and I was like, “I wish I would have read this when I went through infertility.” I started thinking my clients could use this, let me find some for them, I’m going to give them to everyone when they sign on with me, and I realized that none existed. So, I decided to develop them myself.
It was a no-brainer to work with The Glitter Enthusiast, that’s the artist of every single card in the deck. She’s amazing. Her name is Jamie Blicher. She’s another IVF warrior. She decided to gain control of her journey by turning the pain into purpose, making art with sterile IVF injection needles, which is what she does. Each and every card is a complete beautiful handwritten and hand thought out note from someone who went through it themselves, namely me. Each piece of art is from somebody who went through it as well.
I’m just going to pick a random one. This is the one I picked for today. “Hope can always be renewed. It’s okay that sometimes I can’t access it.” This speaks exactly to what we were talking about. If I can’t feel hope right now, it’s okay to let myself feel what I do need to feel. And know that I will hold the hope for you. That’s what we’re here for, to be your village, that’s what we do.
The cards are also because so many people reach out to me constantly like, “My friend just had a miscarriage. I don’t know what to get them.” It’s such a delicate topic. When I went through it, some people sent me flowers. I loved that, but some people feel like that feels like a funeral. Or, “My IVF transfer failed. I don’t know what to say to my friend.” Grab them a deck of these cards.
Even on our website there are four different choices. If you don’t know what to say when you’re gifting them, we give examples of something that you can say because we’ve been there and we know what we wanted to hear when we went through it. That is how each card was designed. What would I have wanted to hear on a given day?
I’ll get messages from my clients. Everyone who works with me gets these. I’ll get a note that says, “Oh my god, this card was so spot on today,” and they’ll send me a picture of it, and I’ll know what they’re going through and it’s such a perfect fit.
They can be on your nightstand or in your bag. I think a couple of clinics put them out in the waiting room, which makes me so happy. I sent you some so that you can put them out as well. It’s just a really great way for a clinic to show that you’re being seen. If you put these out, it’s like we really get what you’re going through.
So, that’s what they’re for. I love them.
Dr. Aimee: I love that message, too. I tell my patients I’m giving you potentially bad news in a certain situation and I don’t expect you to feel ready to just move right into the next thing. Once you feel hope again and hopeful, then it’s time. Until then, let’s just take a pause. That’s so important to do, so I love these. Thank you. Now you’re giving me all sorts of ideas of how I can be giving these to all of my patients.
If anyone wants to find out about your work and how they can work with you, how can they do that?
Abbe Feder: I’m on Instagram @InCircleFertility and my website is InCircleFertility.com. Everybody gets a free 30-minute connection call. I want to make sure that I can help, I want to make sure that we’re a right fit. Much like a doctor, you want to find your team that is going to get you where you want to go. I always talk through, I try to give as much value in that free 30 minutes that I can so that you can see how wonderful it can be to walk along this journey with someone who is holding your hand. Some people bring their partner, some people come just by themselves. It’s completely up to the person who is signing on.
If that feels like a good fit, we go for it with the six months, I call it my signature GLOW package. We commit to six months together. Sometimes people end up needing more. I’ve also had people who get a positive pregnancy test and then decide to work with me for six months because they’re so traumatized by the experience they’ve just been through, so I’m there for them to walk them through the nervousness of the first trimester, potential loss again, all of the things.
Feel free to DM me on Instagram. I’m very accessible. I love that my life is helping other women go through this, so that’s what I’m here for. If you try to find me, you will find me.
Dr. Aimee: Thank you. Is there anything else that you want to add about resiliency for us today?
Abbe Feder: My biggest takeaway from this whole experience is to get all the help where you can, when you can. It will help in the long run and it will really change your journey. That’s what I’m here to do. I want to change your journey for the better.
Dr. Aimee: And I want people to meet you from the beginning, not when they’re struggling. I want people to get a coach just like you from the start and start glowing from the beginning.
Thank you, Abbe. It was such a pleasure to have you back on. Thank you for sharing all of your wisdom about resilience and how to make this journey better for people. Thank you so much.
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