We’ve all heard stories of women getting pregnant after years of trying the moment they finally decide to adopt. Ever wonder why? We asked that very question of Tracy Harrison–a powerhouse of applied functional medicine and founder of the School of Applied Functional Medicine in Asheville, North Carolina who has an uncanny ability to explain all things physiological in terms that mere mortals can understand. Like integrative medicine, Functional Medicine seeks to identify and address the root causes of disease, and views the body as one integrated system, not a collection of independent organs divided up by medical specialties.
So when we asked Tracy about patients who are struggling to get pregnant, she gave us insight into her approach: focus on getting at the inner-connectedness of that individual’s systems, nutrients, lifestyle, history and genetics to figure out what’s actually going on.
Forget one second about the reality of someone’s biological ability or inability to get pregnant in the end, what is most striking to you about a woman’s state of mind when getting pregnant doesn’t happen as easily as she might have expected?
The topic of infertility is interesting because it is so often taken in my clinical experience as a reflection on worthiness. Getting pregnant has become like getting a job or a promotion. If you do all the things you are supposed to do and check all the boxes, you should get the job, right? Or, it becomes like ‘I’ve been a good girl, why didn’t I get the job promotion?’ Which is, of course, the way most of us think.
How do you combat this very human tendency that we can all relate to?
I’d like to steer the conversation away from the impression that there is any way of doing it right, to tie any sense of one’s worth or achievement to this thing that one craves. I say let’s not make it a medical problem. And think about more just in terms of practical wisdom. When you think about it, it’s only recently that we’ve started to think again about fertility, pregnancy, and birth in terms of midwives and medicine women versus part of the disease process that needs these heavy duty interventions. I would like to see us embrace earlier on in women’s lives just the traditional female wisdom of being a woman–also by the way true of menopause–of getting out from under a guilt or fear-based platform or a medical disease platform and that promote feelings of guilt and fear—both of which are stressful. Because whatever promotes strong or sustained stress is in the way of fertility.
We kinda know what you mean but break it down for us.
It is a bit of a direct line in that sense – not just in fertility but all sorts of physiological challenges, disease, it can be because of genetics or legitimate deficiencies. But less understood is the fact that a lot of people in our culture are making choices, knowingly or unknowingly, in their day to day lives that are leaving them in a place of being pressed, unrested, malnourished, infected, with chronic simmering infection, inflamed, toxic, and from a more primal sense of what the body is doing. They are prioritizing work over sleep, eating while running down a hallway, prioritizing cheap quick meals over healthy ones. By taking pain killers and meds, we are quieting the symptoms temporarily but what’s happening is that we aren’t listening to our body.
So what happens then?
We are, in short, doing things to our making choices in our lives that are communicating to our bodies that our survival is not so assured. What that does is puts us in a sympathetic dominant nervous system mode. You see the human body is really really good at surviving. It will choose to prioritize the biochemical process that promotes survival when it’s not assured.
What’s wrong with that?
Well, nothing when survival isn’t assured. But as humans whose survival isn’t threatened, we want to have a thriving experience not a surviving experience. Our choices are in effect triggering sympathetic nervous system, but what we want is to have an aparastymaptethic experience. These are crossed expectations. Our body is actually responding optimally when you think about it.
Is the sympathetic response what is otherwise known as “fight or flight?”
Yes, sympathetic is fight or flight, whereas the parasympathetic is the rest and digest and make babies mode. That’s when we do things like make growth hormones so we can heal; have optimal ovulation and digestion of nutrients to support all of these processes. So when we talk about infertility it’s often a misnomer to suggest something is wrong with the body. The body is not weak. Not broken. Medical culture is promoting fear and a sense of failure in so many women when in fact the body is doing exactly what it should be doing based on signals from the lifestyle behaviors.
While many of us are working on reducing stressors, stress is a factor of life that can’t be fully controlled. Surely some stimulation is healthy and necessary?
When stress hormones go up and are sustained that way it’s not good. Mid to mild is fine, necessary even, as it keeps us alert. But stress hormones don’t live in a silo. Hormones inside the body within different systems are orchestrated and effect one another. So while we might think about stress hormones and sex metabolic hormones as medically separate, we have to remember that they influence one another in order to orchestrate the most appropriate response to the environment we are living in. We call this the Hypothalamic-pituitary-adrenal axis, or HPATG axis, The hypothalamous and pituitary brain, the adrenal glands and gonads are all talking to each other and modulating in symphony to response to whatever is going on.
What happens when stress goes up?
So if cortisol levels, which is a stress hormone, go up then the whole access shifts to make lower levels of sex hormones. Infertility is being promoted on purpose by the body through this symphony of hormones because when your choices raise stress levels, your brain is communicating to the rest of your body that your survival is not necessarily assured and that the survival of your offspring is less assured. Survival of a baby doesn’t make sense, doesn’t seem likely to an intelligent adaptive organism given the stressors of the environment.
What do you do to tell your body that it’s not in fight or flight?
You have to convince your body through your choices that you are not in survival mode. That you are calm, confident and prepared to surrender to the natural process of pregnancy. I use the word surrender very much on purpose which is hard for women.
Pregnancy so takes over. It uses our bodies as vessel. Think about a thousand years ago. If your village is being attacked or you are being attacked by wild animals, you wouldn’t want to be pregnant. That would not promote survival. Nature wants to know your pregnancy can come when your energy is focused inward. On nourishing yourself and creating an optimal vessel for this little being rather than an external focus that has to protect itself from various threats. There is a lot of need for inward focus for being ready and comfortable for the uncertainty of the pregnancy process. Building of placenta is period of immense fatigue.
How do you counsel your patients to create optimal conditions for fertility? Reducing stress is easier said than done. Sort of like telling someone to relax!
Keeping in mind that stress is often about perception, it isn’t usually about actual circumstances of life. It’s easy to say that you should be mindful about a more positive outlook on things. Maybe you have spiritual belief system. That matters in a big way. Cultivating an ability to be pleasantly satisfied with how our lives are now is an important fertility skill. Your immune system for example won’t be faked and your hormone axis disrupted if you can’t find a place of peace anywhere. It knows how you feel, so it won’t understand when you say hey let’s get pregnant. Honoring that there is real biochemistry behind that moment of getting pregnant when you stop thinking about it.
What are the biggest barriers to getting pregnant?
There is a big discussion to be had on diet and toxicity. At a minimum. When you look at primary reasons for trouble conceiving and for miscarriage, both have huge impacts.
Is infertility on the rise?
While infertility is not worsening. It’s actually getting better, because of more medical interventions, but maintaining pregnancy is appreciably worse. The body isn’t interested in having its wisdom overpowered.
This seems suspiciously straighforward.
The challenge with this whole topic is what makes it prone to being an eye-roller, is the common sense aspect. The problem is that reducing stress and eating well are common sense but not common practice. The challenge to the foundational aspects of wellness is in making more these healthier lifestyle practices more actionable so that that people don’t disregard for their simplicity
You have to convince your body that it’s safe. That the war is over and the threat is gone. We have become adept at putting on a happy face, but inside is where your truth is and you aren’t going to fake out your body about your level of stress.
If trying to conceive has you stressing, check out some ways to cope:
Hit up a support group:
Sharing your feelings among other women and couples experiencing the same challenges can make you feel like you’re not alone in this, and that it’s way more common than you think.
Talk to pregnant women who've also been through it:
Hearing the success stories might make you feel like there’s light at the end of the tunnel, and will reinforce a much-needed sense of optimism.
Apps like Calm or Headspace are there for a reason. Give yourself 10 minutes a day (at least!) to not be consumed by trying to get pregnant. Take the time to center yourself and you’ll automatically feel better.
Get off the 'Gram
You don’t need to see photos of your bestie’s bump changing by the day, or your high school ex’s beautiful family of five. Give yourself the gift of disconnecting and staying in your own orbit for a little while.
Photos from top to bottom: iStock Filippo Bacci, iStock Marija Jovovic, iStock Jasmina007, Vasyl-s