When One Isn't Enough

Infertility after a baby? SELF explores the challenges faced by the millions of women who are struggling to have a second child.

Two years after laura mancini,* now 38, gave birth to her daughter in 1996, the Easton, Connecticut, counselor and her husband decided it was time for baby number two. She was elated when she conceived, but 13? weeks later, she suffered a miscarriage. Mancini and her husband tried for another child again and again over the next three years, only to get pregnant and miscarry three more times. Even after her third miscarriage and an infertility workup, which came back normal, doctors told her to just keep trying.

Six years—and thousands of dollars in tests and procedures—later, the Mancinis are still waiting to complete the family they envisioned. "When you've already had one child, as much as we love her, it's hard to accept that you can't have another," she says. "You keep pushing it another week, another month, another year. It's hard to rewrite the script you had for yourself."

More than 3 million couples are currently experiencing secondary infertility, the inability either to conceive or bear a subsequent child, according to Resolve, a national infertility education organization in Somerville, Massachusetts. Secondary problems are significantly more common now than they were in the mid-1990s, in part because couples are delaying first pregnancies. And while the condition evokes all the trauma and grief of primary infertility (the inability to have a first child), women facing secondary issues often don't get the same compassion and sympathy afforded those who've never given birth. Yet, as Mancini puts it, "just because you have one child doesn't mean that's enough."

Economist Sylvia Ann Hewlett's landmark study chronicling the childbearing patterns of professional women confirms the growing phenomenon of infertility after having one baby. Although 30 percent of her high-powered subjects had only one child, just 8 percent had intended to, says Hewlett, author of Creating a Life: Professional Women and the Quest for Children (Hyperion). "In most cases, the women had the child pretty late, then tangled with the infertility challenge the second time around and failed," she says.

Whatever the reason, one thing is certain: "Secondary infertility is a complicated dynamic," says Linda Applegarth, Ph.D., who counsels infertile couples as the director of psychological services at the Center for Reproductive Medicine and Infertility at Weill Medical College of Cornell University in New York City. "Couples feel embarrassment and shame for wanting another child so desperately because they've been blessed with one. And because they have a child, they really have a good understanding of how wonderful that is."

Only can be lonely

As with primary infertility, women who deal with the problem after a first child experience every permutation of pain. The reasons, however, often differ. Many feel guilty for not producing a sibling for their son or daughter—and then worry they're neglecting their child when they become so focused on having another. "It was a constant struggle," says Melanie Brooks,* 35, a health-care consultant in Atlanta who grappled with unexplained secondary infertility for four years. Her son, who is now 6, began asking for a sibling at age 3. "It hit home over a year ago when Jason's preschool class drew pictures of their families," says Brooks. "He said, 'Mommy, I'm the only one who doesn't have a brother or sister.' That broke my heart." But that was hardly the worst of it: "Sometimes I felt so depressed, I couldn't play with him," says Brooks. To ensure that her son felt cared for, Brooks quit her job three years ago and began working from home. "I wanted to enjoy the child I had," she says.

Compounding women's emotional pain is the indifference they feel from friends and family. "Well-meaning friends have made insensitive comments like 'You have your one daughter—be thankful,'" says Mancini. "Or if you have one child, people assume you can automatically have another. People have even said to me, 'Why are you being so selfish, not having a sibling for your daughter?' After a while, you start avoiding people." Adds Brooks, "My friends have said, 'You have a child and he's healthy. What more could you want?'" Brooks's story has a happy ending. After two in vitro fertilization (IVF) attempts, she had her second child, a daughter, in November.

"When we couldn't have a second child, my husband said, 'Let's love what we have and have a life.'"