This episode features real-life Labor and Delivery nurse, as well as the host of the MommyLaborNurse podcast and Instagram page, Lisel Teen!

Lisel helps shed some light on a lesser-known fertility issue: secondary infertility. This is the title we give to women who already have a child (or more than one!) and are struggling as they try to conceive the second or third time around. This concept can be mind-blowing for so many women since we have often been told since puberty that pregnancy is going to happen the moment you even think about unprotected sex.

This is further reinforced when women get pregnant easily (or relatively easily) with their older children, but then it doesn’t happen as easily the next time around. So why does this happen?

Lisel explains:

Age can be a factor. Remember that you’re now older now than you were when you tried for your first. This certainly doesn’t disqualify you from having more children, but it may mean that your body needs more intentional support than when you were younger.

Your partner - If you have the same partner as before, he is now a few years older too. His semen quality might be vastly different due to his age/diet/lifestyle/stress/sleep than it was when you conceived your older children. If your partner is new, there could be an issue there too.

Birth outcome of your prior pregnancy - if you had a c-section or other uterus surgery it could be that there is scarring or some other kind of structural damage that is making pregnancy more challenging than it was before.

Toddler lifestyle - Eating a steady diet of toddler scraps and waking up several times per night with your older child can tell your body that now is not a good time to get pregnant again.

So what about the transition from postpartum to being ready to conceive again? This is something that really varies from woman to woman. Technically speaking, you CAN get pregnant before your period returns postpartum. Remember, true periods happen because ovulation occurred 12-14 days prior. But what about if you’re breastfeeding?

Some women who are breastfeeding on demand don’t ovulate for many many months. Other women can still ovulate even when they’re nursing! The hormone your body makes to promote milk production often suppresses ovulation (a common problem in women with PCOS) but for some women, ovulation can still happen when breastfeeding. If you’re struggling to conceive or have a regular period postpartum, you may need to consider how frequently you breastfeed your older child. Some women don’t need to ween entirely in order to start ovulation again, while others do.

On the other hand, women who don’t breastfeed can see a boost in fertility very soon after the birth of their older child. This is a biological response to what you body considers the loss of a child. Back before baby formula and bottles, if you didn’t breastfeed your body assumed your baby wasn’t alive. This triggers ovulation so that your body can conceive again and bring another child into your family (because your body doesn’t understand your baby is healthy and thriving, just eating formula!)

Surgical birth can also change fertility. Remember that when you have a c-section, your body is not only going through everything that a postpartum body goes through; but it is also recovering from a major abdominal surgery. Depending on the nature of your c-section, your uterus can have scarring, disrupted blood flow, kinked tubes, or other issues that are making it harder to conceive. Seeing an abdominal massage specialist or pelvic floor physical therapist can help you assess whether or not your surgical birth is contributing to your challenges conceiving the second or third time around.

Another factor can be that sex post-baby can be DIFFERENT! Perhaps now that you already have one (or more) children, having sex the same way as you did pre-baby might not be as comfortable or fun. Many women struggle with painful penetration, urinary leakage, weak orgasms, or other issues that make sex less fun after baby. Pain or discomfort with sex is NOT your fault and there are specialists who can help! Women (Sophia and Liesel included) can feel a lot of shame and guilt around this and feel like the pain and discomfort is due to their own lack of sexy-ness or virility. Your vagina, pelvis, and abdomen are filled with muscles that can get tight, loose, kinked, or damaged just like any other muscle in your body! Seek help if you’re uncomfortable during sex, because help is available!

Disclaimer: Kegals are NOT always the answer! They can, in fact, make some pelvic floor problems WORSE! See a specialist and figure out what’s actually wrong.

Liesel goes on to share her journey getting pregnant with her second baby.

She candidly shares that she did initially get pregnant easily her second time around, but unfortunately she lost that pregnancy at 6 weeks. The stress and lifestyle/work/grief issues she was going through impacted her greatly, and it ended up taking another 6 months to get pregnant again.

Liesel also shares about the mental health struggles that came along with trying to conceive as well as dealing with the loss of her second pregnancy. She struggled with anxiety and a lot of over-vigilance that included torturing herself with dozens of pregnancy tests. Taking a pregnancy test can seem fun at first, but over time you can become legitimately traumatized by seeing all the negative tests.

She eventually started really prioritizing her mental health, nutrition, and stress relief and that’s when she was able to conceive and carry to term again. For her, she was able to make these changes by focusing on one thing at a time. She would start with something small like “eat a healthy breakfast”. Then, once she had that happening she would bring on another task like “2 workouts per week”. Slowly, she was able to build healthy habits that eventually lead to her body being ready for another baby.

We also want to highlight that just because there are some things you *can* to improve your fertility the second (or third) time around; it does NOT mean that your struggle is your fault. There are controllable factors in your life that impact your fertility, but that is not the same thing as being blamable for the struggle or loss that you experience.

Liesel shares more of how she helps mothers by offering paid courses, as well as her blog, instagram, and podcast which are resources available to everyone for free! You can find her @MommyLaborNurse on instagram, as well as follow her blog and her podcast for even more free info on all things labor and motherhood!

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