What happens when the playbook that’s always worked for you? You work harder, put more time, energy, or even money into it, and suddenly that’s not enough.
For so many people I work with, that moment arrives unexpectedly in the middle of a fertility journey. Or sometimes, it arrives in the rawness of early parenthood, when the “right” sleep schedule, the “best” resources, and sheer exhaustion still don’t add up to the outcome you need. After all, you can’t make someone else eat or sleep, nor can you force your body to do something it’s not ready to do, but that doesn’t mean it’s not disorienting in a way that’s genuinely hard to describe to anyone who hasn’t lived it.
If you’re there right now, I want you to know something important: the fact that it hasn’t worked yet does not mean it won’t. And the way you’re feeling makes complete sense.
The Privilege of the “Work Harder” Formula
Life throws us so many curve balls - it’s often hard to keep up. But most high-functioning people learn, early on, that effort is the answer. Work harder. Hire the right doctor, find the right clinic, read every study, optimize every variable. And for a long time, that formula holds.
Often times for women and men who come from any form of privilege - whether that’s financial resources, educational access, professional networks, or simply the lived experience of watching effort pay off - they’re given a springboard to work harder and get what they want. They’ve built a life on it. It’s not arrogance; it’s a deeply learned truth.
And then infertility arrives. Or a pregnancy loss. Or a newborn who won’t latch, or postpartum anxiety that won’t quiet. And the playbook doesn’t work anymore.
Sometimes, for the very first time, a person is up against a situation where they cannot outwork the outcome. Where money helps but doesn’t fix it. Where research and specialists and optimized protocols still don’t guarantee a baby. Where the body simply does not comply, no matter how many resources are thrown at the problem.
For many of my clients this is the first time in their lives they have experienced this kind of helplessness. And it is profound.
Why This Particular Loss of Control Hits So Hard
The American Society for Reproductive Medicine (ASRM) estimates that infertility affects approximately 1 in 8 couples of reproductive age. But statistics don’t capture what it actually feels like when your sense of agency dissolves.
When you’ve built your identity around being capable, productive, and solution-oriented, infertility doesn’t just challenge your body, it challenges who you think you are. Research in perinatal mental health consistently shows that infertility is associated with elevated rates of anxiety, depression, and grief, comparable in intensity to other major life stressors (Domar et al. or Cousineau & Domar, 2007).
I have a passion for helping people navigate the anxiety and shifts in identity that each new change brings. And this particular shift, from “I can make this happen” to “I cannot control this,” is one of the most destabilizing identity transitions there is.
It doesn’t mean you’ve failed. It means you’re human, in one of the most human situations there is.
The Myth of “Trying Harder”
Here’s something I see happen often, and I say this with so much compassion: when the usual tools stop working, many high-achievers respond by intensifying those same tools. More research. More appointments. More tracking. More supplements. More optimizing. More doing.
And sometimes, more doing is appropriate - there are real medical interventions worth pursuing, and informed advocacy for your own care matters enormously.
But there’s a difference between informed action and compulsive control-seeking. One comes from a grounded place; the other is an attempt to outrun grief and uncertainty. When we’re in the second mode, we’re often running from the very feelings that most need our attention.
This is where therapy can make a meaningful difference, not to tell you to “just relax” (please, no), but to help you metabolize what’s happening emotionally so that your decisions, medical and otherwise, come from clarity rather than panic.
Holding Grief and Hope at the Same Time
In psychotherapy, one of the most important truths we explore with individuals and couples navigating infertility is that grief and hope can exist at the same time. Holding space for both may feel contradictory at first- even dangerous, as if allowing grief means giving up, or as if holding hope means denying how painful this is.
Neither is true.
You are allowed to grieve the timeline you planned, the pregnancy that didn’t continue, the months that have passed. And you are allowed to keep going, to keep hoping, to keep taking the next step that feels right.
It just hasn’t worked yet. That “yet” is not toxic positivity. It’s a refusal to let the present moment write the whole story.
What Support Can Actually Look Like
If you’re in the middle of a fertility journey, here’s what I want you to consider; not as another item on your to-do list, but as genuine care for yourself:
Give yourself permission to not be okay. The most capable, high-functioning people I know have sat across from me and said, “I don’t know how to do this.” That’s not weakness. That’s honesty.
Talk to someone who gets it. Perinatal mental health is a specialty for a reason. Therapists trained in fertility and perinatal issues understand the specific grief cycles, the medical complexity, the relationship strain, and the identity disruption that this journey brings. General support is wonderful; specialized support is something else entirely.
Tend to your relationship. Relationships are at the heart of everything life throws at us. Fertility struggles have a profound effect on partnerships: the pressure, the grief, the intimacy challenges, the diverging coping styles. Couples work, or even just open conversations with a therapist, can keep you from drifting apart when you most need each other.
Let “yet” be enough for today. You don’t have to know how this ends. You just have to get through today.
You Don’t Have to Figure This Out Alone
I’m thrilled to be able to offer support to individuals and couples navigating fertility challenges, pregnancy, and early parenthood across New York, Connecticut, Massachusetts, and Florida via telehealth. Whether you’re just beginning to process what’s happening or you’ve been in the thick of it for years, there is space for you here.
If this post resonated with you, I’d gently encourage you to reach out. You’ve probably spent a lot of energy trying to solve this. Let someone help you carry it for a while.
Ashley Mead, LMHC, PMH-C is a licensed mental health counselor specializing in perinatal and fertility mental health, serving clients in NY, CT, MA, and FL via telehealth. Learn more at ashleymead.com.