Time to make fertility care more trauma-informed

Sharon Martin

Interim Chief Executive, Fertility Network UK

New research from a leading national charity highlights how a lack of trauma-informed care can exacerbate the already distressing experience of infertility and its treatment.

Fertility Network’s research shows the massive mental health impact of fertility problems, with most fertility patients experiencing depression and anxiety, and 40% reporting suicidal feelings.

Infertility-related trauma is more common than previously recognised

What the charity’s latest research highlights is that infertility-related trauma is far more common than previously recognised. A survey of 590 fertility patients found that 41% of respondents met criteria for post-traumatic stress disorder (PTSD) and complex PTSD, according to the International Trauma Questionnaire. The research was co-produced with the British Infertility Counselling Association and researchers at Cardiff University, Cardiff Metropolitan University and Queen’s University Belfast.

Fertility care exacerbates or causes trauma

While some patients reported positive experiences, worryingly, the majority of patients (61.2%) said aspects of the care they received made trauma worse. Only a minority of respondents (16.1%) reported healthcare professionals (HCPs) discussed infertility-related trauma with them, and only 1 in 4 patients (27.6%) said HCPs put in place support to help them cope with infertility-related trauma.

It was the repetitive or cumulative
effect of distressing events that
seemed to exacerbate the trauma.

Events most associated with trauma

The reproductive events most associated with traumatic experiences included ectopic pregnancy, one or more unsuccessful IVF cycles, miscarriage and baby loss, stillbirth and unsuccessful treatment as a whole. In many cases, it was the repetitive or cumulative effect of distressing events that seemed to exacerbate the trauma.

Patients also described how poor care, such as dismissive or conflicting advice, poor or insensitive communication, mistakes and delays and no forewarning or explanations about negative outcomes, compounded the traumatic events.

Trauma-informed care can make a difference

However, the research revealed how trauma-informed care can make a difference. Acknowledgement of the experiences as traumatic, signposting to specialist trauma therapy, better information to manage expectations of success and discussion of the emotional aspects of treatment, all helped.

Patients who were able to access appropriate specialist trauma therapy at an early stage, such as EMDR (eye movement desensitisation and reprocessing) therapy and trauma-informed CBT counselling, also reported less impact. It’s time to make trauma-informed fertility care standard for all.