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Penny Donnelly (right), RN, MFT, director of the support program for the Infertility Clinic at Stanford, counsels patients on infertility issues.

Suiting up for work was almost unbearable for labor and delivery nurse Gretchen Sewall, RN, LICSW. She had enjoyed bringing babies into the world until she discovered she might not realize that dream herself. Now she was on the fertility Ferris wheel — spinning between the high of waiting for pregnancy results and the low of another failure. A job in obstetric nursing only intensified the swings.

After five miscarriages and two ectopic pregnancies, Sewall knew all too well the subtle — and often misunderstood — emotional trauma caused by infertility. Studies have found that infertile women have the same levels of depression and anxiety as patients with HIV, cancer, and heart disease. Those studies were conducted by a Harvard researcher who knew that these women needed more than IVF treatments. The women were desperate for emotional care to deal with the devastating realization that their bodies seemed to be failing them.

Alice Domar

In 1987 the Harvard researcher Alice Domar, PhD, designed a 10-week mind and body program to help women and their spouses learn techniques to avoid the emotional black holes that can accompany infertility. Couples who participated learned to use yoga, meditation, and communication to stop the negative thinking that fuels depression and anxiety. Sewall heard about the course and felt compelled to learn how to teach the techniques to couples in Seattle. She took Domar’s one-week intensive course four years ago and now offers the program at Seattle Reproductive Medicine.

Sewall is among a select cadre of nurses throughout the nation who are replicating Domar’s mind and body program. These nurses are teaching couples how to slow down long enough to recognize the emotional pain underneath their anxiety and depression. Then the nurses equip the couples with strategies for facing the disappointment that emerges. For the course instructors, the impact of these soul surgeries is nothing short of remarkable.

For example, many of the program leaders have found that more than 40 percent of the women who participate — and roughly half are IVF patients — get pregnant, compared to 20 percent for those who don’t join the program. These numbers support Domar’s findings from a formal study she conducted from 1994 to 1999. The course leaders suspect that this high rate of pregnancy is related to the fact that women learn new ways to manage the stress of infertility.

“Psychological distress is capable of inhibiting the hormones needed for reproduction,” says Penny Donnelly, RN, MFT, director of the support program for the Infertility Clinic at Stanford.

Donnelly had been working with infertile patients for years at Stanford and couldn’t ignore the fact that so many seemed to be depressed. Like Sewall, she wanted to offer them a course that would equip them to approach their disappointment differently, and so a year ago, she took Domar’s one-week class. In September, Donnelly started teaching the 10-week course at the Infertility Clinic in Palo Alto, Calif.

Planning ahead

Donnelly’s class of a dozen women met for two and a half hours a week for 10 weeks and husbands joined them for two of the classes and for an all-day retreat. One of the techniques she teaches is resilience training. She describes the qualities of a resilient person: being optimistic, adaptable, willing to look at situations in a new way, and good at problem solving. The women also learn how to avoid seeing a crisis as insurmountable.

For Carrie, who did not wish to use her last name, the resilience training helped her steer clear of a spiral toward despair when she discovered after the second class that her IVF treatment had been unsuccessful.

“My husband and I have had little bad news in life, so it was devastating [when we found out the treatment failed],” Carrie says. “It was all so scientific until the moment we found out it hadn’t worked. That was a dark week.”

Though she was tempted to sink into negativity, she remembered Donnelly’s discussion about the power of translating circumstances positively.