The Lives We Almost Lived
A note on this essay:
This reflection was prompted by a public discussion in the r/TryingForABaby community on Reddit. Identifying details have been minimized, and portions of the original post are paraphrased rather than reproduced. The discussion is used here as a starting point for a broader reflection on reproductive mental health, not as a clinical assessment of the person who wrote it.
I’m an associate mental health clinician practicing under a fully licensed supervisor who specializes in perinatal mental health as I work toward my own independent licensure, not a reproductive medicine or fertility specialist, and nothing in this essay is intended to substitute for individualized medical care. When I write about reproductive health, fertility, pregnancy, or related medical questions, I do my best to work from current research, evidence-based clinical guidance, and reputable professional sources while staying within the limits of my training and scope of practice. Research evolves, individual circumstances differ, and reproductive medicine is complex. Where medical evaluation, diagnosis, or treatment is concerned, readers should consult an appropriately qualified reproductive or medical healthcare professional.
The psychological questions are where my attention lives: what these experiences can mean inside a person, a relationship, a body, and a life—and how those meanings are shaped by the larger systems and cultures we live within.
Trying to conceive, reproductive grief, and what happens when the present changes the meaning of the past
The period arrives in the morning.
There is something almost offensively ordinary about that. After weeks of monitoring temperature and timing sex and interpreting bodily sensations that, in any other month, might have passed unnoticed, the answer arrives in blood. No ceremony. No phone call. No one standing at the door with an envelope. Just the body doing something it has done many times before, except now the meaning is entirely different.
A man wrote about this recently in r/TryingForABaby, a Reddit community for people trying to conceive. He and his wife had been trying for nine cycles. That morning, she told him her period had started. He had known, theoretically, that this was possible. He had even tried to prepare himself for it, which is one of those peculiar negotiations we make with hope: I will imagine the thing I want, but only a little. I will believe it might happen, but not enough to be devastated if it doesn’t. Then the period came anyway, and whatever emotional bargain he had made with himself collapsed.
Nine cycles is not a particularly dramatic unit of time when written on a medical intake form. In a life, it can become something else entirely. Nine times calculating. Nine times trying. Nine versions of maybe. Nine opportunities for the mind to wander several months into the future before being called back. If it happens now, the baby would come in spring. If it happens now, we could tell everyone at Christmas. If it happens now, this room could become the nursery. There does not have to be a pregnancy for the imagination to begin constructing a life around one.
There is an important clinical distinction here. Nine unsuccessful cycles at their ages do not, by themselves, establish an infertility diagnosis. In the absence of other known concerns, current reproductive-medicine guidance generally recommends beginning an infertility evaluation after twelve months of regular unprotected intercourse when the female partner is under 35, and after six months when she is 35 or older. Earlier evaluation may be appropriate when medical or reproductive history suggests it.¹ This distinction matters because there is no reason to give someone a diagnosis their story does not yet support. It also does not make nine months of disappointment emotionally insignificant.
This is one of the stranger realities of trying to conceive: people begin forming relationships with futures that have not happened. And every month, some version of that future can disappear.
The Private Lives Of ‘Almost’
We have language for certain kinds of reproductive loss. Miscarriage. Stillbirth. Failed transfer. Infertility. Abortion. These words matter because they give shape to experiences that might otherwise remain unspeakable, and because some losses desperately need to be named in a culture that has historically asked people to carry them quietly.
But reproductive life is also crowded with losses that resist clean naming. There is the pregnancy you were certain would happen quickly. The age gap you imagined between your children. The spontaneous sex that became scheduled sex. The confidence you once had that your body would cooperate when you finally asked something of it. There is the month that seemed unusually promising for reasons you cannot quite explain, and the pregnancy test you took two days too early because hope has never been particularly interested in following instructions.
Trying to conceive can produce a strange form of anticipatory attachment. A person may know perfectly well that there is no pregnancy yet and still find themselves mentally rearranging the year around a hypothetical baby. This is not irrational so much as profoundly human. We rehearse futures constantly. We imagine conversations before we have them, grieve relationships before they end, worry about children before they exist. The nervous system is capable of responding to possibility with an astonishing amount of emotional seriousness.
The tracking itself is not imaginary busywork. Fertility-awareness methods—including ovulation detection kits, cervical mucus monitoring, calendar methods, and basal body temperature tracking—can help identify the fertile window. Reproductive-medicine guidance generally describes that window as the six-day interval ending on the day of ovulation.² But something can be medically useful and psychologically exhausting at the same time. There is a difference between understanding your body and feeling as though you have become its unpaid project manager.
Perinatal and reproductive mental health are often imagined as concerns that begin once somebody becomes pregnant, becoming especially visible postpartum. Psychologically, the territory can begin much earlier. Reproduction already contains identity, sexuality, attachment, bodily autonomy, grief, family history, medical systems, cultural expectations, money, gender, and questions about who we imagined we would become. The clinical literature on fertility difficulties has documented psychological effects that can include anxiety, depression, fertility-related stress, changes in self-esteem and quality of life, relationship strain, and sexual difficulties.³˒⁴
What the literature can measure, though, is not always what people call the experience while they are living it.
Few people wake up and announce that they are experiencing fertility-specific distress.
They say, I thought we would be pregnant by now.
In the Reddit post, though, there was another detail. Almost halfway through, the story changed.
Two years earlier, the couple had had an abortion.
The Past Does Not Stay Where We Put It
At the time, he explained, they were not financially or emotionally prepared to become parents. The decision had been difficult. He remembered wondering whether there might come a day when he regretted it. Now, after nine unsuccessful cycles of trying to become pregnant, he believed that day had arrived.
There is a temptation here, particularly in American culture, to make his pain mean something politically useful. Abortion occupies such a violently contested place in our collective imagination that individual experiences are constantly drafted into arguments larger than the people actually living them. Regret becomes evidence for one worldview. Relief becomes evidence for another. Grief is treated as proof that a decision was wrong; certainty as proof that there was nothing to grieve.
The research complicates that binary. In a longitudinal U.S. study following 667 women for five years after abortion, researchers found no evidence that negative emotions or decision regret generally emerged over time. Decision rightness remained high, and relief remained the most commonly reported emotion. At the same time, emotional experiences were not identical: difficulty making the original decision and perceived abortion stigma were associated with more negative emotions.⁵
Population-level research cannot tell us what this particular man feels about a pregnancy that occurred in his particular relationship, at a particular point in his life. Nor should it. His grief does not become less real because it is not statistically typical, just as one person’s grief cannot establish what abortion means psychologically for everyone else.
Human emotional life is rarely courteous enough to arrange itself according to our ideological categories.
A person can believe an abortion was the decision they were able or needed to make and later grieve the pregnancy that ended. Someone can feel relief immediately afterward and sadness years later. Another person may never experience regret at all. Someone else may regret the circumstances that made the decision necessary more than the decision itself. These experiences do not cancel one another. They tell us something less politically convenient and much more psychologically interesting: choice does not protect us from grief, and grief does not necessarily mean we chose wrongly.
What caught my attention in this man’s story was the timing. His abortion had not occurred yesterday. It had happened two years earlier, under different circumstances, to two people who understood themselves as not yet prepared to become parents.
What had changed was not the past.
What had changed was the present.
Now they wanted a pregnancy, and it had not happened yet. Suddenly an old memory had new information attached to it: We could conceive then.
And beneath that sentence, almost inevitably, another one appears.
Why can’t we now?
The mind is extraordinarily skilled at this kind of retrospective editing. We like to imagine memory as an archive: the past gets filed away, and when we remember something, we retrieve the original document. Emotionally, remembering is much less orderly. We revisit old experiences from new locations. The marriage we once thought was romantic looks different after divorce. A parent’s behavior acquires another meaning when we become parents ourselves. The childhood we described as “fine” can feel different once we experience safety we did not know was missing.
The event has not changed.
The person looking backward has.
That distinction becomes especially important around reproductive decisions because the stakes feel irreversible. A decision made at 24 can be interrogated by the person who exists at 26, who now possesses desires, circumstances, knowledge, and grief that the 24-year-old did not have. The later self looks backward and asks the earlier self to explain themselves.
How could you let go of something I would give anything to have now?
It is an emotionally devastating question.
It is also an impossible one.
We Make Decisions Without Knowing Who We Will Become
There is a particular arrogance the present sometimes develops toward the past. From here, everything looks obvious. We know which relationship ended. Which job mattered. Which friendship disappeared. Which decision became consequential. We forget that the person standing at the original crossroads could not see the road from where we are standing now.
They had only the life around them.
The money they had then. The relationship as it existed then. Their health, safety, age, housing, family support, education, fear, ambitions, access to childcare, experience of their own body. Reproductive decisions do not occur in an abstract laboratory of individual preference. They happen inside systems, relationships, economies, histories, religions, families, laws, and bodies.
A feminist framework is useful here precisely because it resists treating distress as though it originates entirely inside an individual. It asks what is happening in the body, certainly, but also what is happening relationally and socially: what choices were actually available, what power a person possessed, what roles they were expected to occupy, and what meanings their culture attached to sexuality, reproduction, parenthood, gender, and family.
That doesn’t give us a neat answer about whether the man in the post “really regrets” the abortion. I don’t think we should give him one. Perhaps he does. Perhaps what he regrets is losing a pregnancy he now knows he was capable of creating. Perhaps he is mourning the imagined child attached to it. Perhaps his current fear has reached backward and illuminated an old loss differently. Perhaps if his wife becomes pregnant, the memory will shift again. Perhaps it won’t.
The more interesting question is why we demand that grief deliver a verdict.
Sometimes grief is not a verdict.
Sometimes grief is simply what happens when we understand the cost of a choice, including a choice we would still make.
“I have to be strong for my wife and myself.”
There was another sentence in his post that could almost disappear beneath the abortion story, but I think it reveals something equally important. Describing the monthly disappointment, he explained that he felt responsible for being strong for both his wife and himself. He comforted her. He tried to reassure her that their time would come.
And meanwhile, he was suffering too.
The sentence contains an entire gender education.
His wife suffers; he supports. She needs reassurance; he provides it. She gets to be devastated; he has apparently appointed himself head of the Department of Future Optimism despite having no more information about the future than she does.
This arrangement is understandable. The physical asymmetry of reproduction is real. One partner may be menstruating, monitoring ovulation, undergoing examinations, taking medication, experiencing pregnancy or pregnancy loss. To notice the non-gestational partner’s suffering is not to pretend those experiences are interchangeable.
But somewhere along the way, couples can quietly decide that the person whose body is undergoing the most is also the person who owns the grief.
The other person becomes support staff.
Research on men’s experiences of fertility difficulty has begun documenting some of this quieter burden. Systematic reviews describe depression, anxiety, grief, inadequacy, fertility-specific stress, changes in self-esteem and quality of life, relationship difficulties, sexual concerns, and avoidant coping among some men experiencing infertility or fertility treatment.³˒⁴ Research examining masculinity specifically also suggests that fertility problems can become entangled with cultural expectations around manhood, procreation, adequacy, and gender roles.⁶ The evidence is not a reason to universalize men’s experiences; it is a reason to stop treating them as psychologically incidental.
There are gendered expectations embedded here long before anyone walks into a fertility clinic. Many men are still taught that love is most legible when translated into usefulness. Fix something. Protect someone. Keep everyone calm. Know what to do next. If your partner is already suffering, do not become one more problem she has to carry.
The intention can be profoundly loving.
The consequence can be profound loneliness.
Because where does the strong person go with the part of them that isn’t strong?
Sometimes nowhere. They reassure their partner and then search the internet alone. They calculate probabilities. They read message boards at midnight. They say next month while privately wondering whether there will ever be a next month that ends differently. They become the person holding the flashlight and forget that they are also standing in the dark.
There is a relational cost to this. Intimacy requires more than taking turns being caretaker and patient. It requires some capacity to remain visible to one another inside distress. The question isn’t whether both partners suffer identically. They won’t. The question is whether the relationship has enough room for more than one person’s reality at a time.
Maybe “being strong” sometimes means saying, I don’t know what happens next, and I’m scared too.
The Exhausting Performance Of Hope
I think we underestimate how much emotional labor is involved in maintaining hope during reproductive uncertainty. Hope sounds lovely in retrospect. In practice, it can be brutal.
To keep trying is to repeatedly reopen the possibility of disappointment. You cannot fully protect yourself from that by becoming cynical, because some part of you still has to participate. You track the fertile window because maybe. You have sex because maybe. You take another test because maybe. You notice the cramp that feels slightly different from the cramp last month because maybe.
Then the period comes, and for a while maybe becomes not this time.
Eventually the cycle begins again.
There is something almost mythological about this rhythm: building a future, losing it, returning to the beginning, building again. The repetition itself can become exhausting. Not simply sadness, but the fatigue of having to manufacture emotional investment after disappointment.
This is where well-meaning reassurance can become strangely cruel.
Just stay positive. It’ll happen when you stop stressing. Everything happens for a reason. At least you know you can get pregnant.
That last one must be particularly complicated when the evidence being offered is an earlier pregnancy someone chose to end.
People reach for these sentences because uncertainty is difficult to witness. We want to give suffering an ending. We want the person we love to stop hurting, and if we cannot change the situation, perhaps we can at least provide a narrative in which everything eventually makes sense.
But sometimes love is not optimism.
Sometimes love is accuracy.
I don’t know. I wish I knew. I wanted this month too. I’m still here.
There is intimacy in refusing to manufacture certainty for one another.
The Imagined Child
What moves me most about trying-to-conceive spaces is how populated they are by people who aren’t there.
The baby someone expected to have by 30. The sibling a child keeps asking for. The pregnancy that ended years earlier. The child attached to the name saved in someone’s Notes app. The version of oneself who was supposed to be a parent by now.
These imagined people are not interchangeable with living children, nor are unrealized pregnancies equivalent to pregnancy loss. But psychologically, imagination matters. Human beings attach meaning to possibilities. We build identities around anticipated futures. When those futures become uncertain, something real can hurt even when the object of grief is difficult to name.
Perhaps that is why this man’s post feels larger than nine unsuccessful cycles.
He isn’t only asking whether he and his wife will have a baby.
He is standing between multiple versions of his life.
There is the life in which they continued the pregnancy two years ago. There is the life they actually lived afterward. There is the life in which his wife becomes pregnant next month. There is the life in which it takes much longer. There are probably others he is afraid to imagine.
Most of us accumulate these parallel lives as we age. The person we almost married. The city we nearly moved to. The pregnancy we ended. The pregnancy we wanted and never had. The career we abandoned. The parent we might have been under different circumstances.
Usually they remain quiet.
Then something happens in the present and one of those unlived lives begins knocking.
There May Be Nothing To Resolve
Therapy culture sometimes has an unfortunate appetite for resolution. Find the lesson. Reframe the thought. Close the loop. Make meaning and emerge transformed, preferably before the insurance authorization expires.
But some experiences are not asking to be solved.
They are asking to become more bearable to know.
This man may eventually decide that he regrets the abortion. He may decide he does not. He may discover that regret was the closest word he had for a more complicated mixture of grief, fear, longing, helplessness, and retrospective tenderness toward a pregnancy that once arrived at the wrong time.
He may also need somewhere he does not have to be strong. Somewhere nobody requires him to promise that next month will be different. Somewhere his wife’s suffering does not make his own embarrassing or selfish. Somewhere the past does not have to be prosecuted in order for the present to hurt.
That, to me, is part of what perinatal and reproductive mental health care needs to make room for: not only pregnancy and postpartum symptoms, but the psychological terrain surrounding reproduction itself. The decisions. The almosts. The changing meanings. The relationships reorganized around hope. The identities that begin forming before a pregnancy does.
Because sometimes reproductive grief isn’t grief for one clearly identifiable thing.
Sometimes it is grief for time. For certainty. For the body you assumed would cooperate. For the younger person who made the best decision they could with the life they had. For a future that keeps arriving in your imagination before it arrives anywhere else.
And sometimes, on an otherwise ordinary morning, it is grief for all of those things at once.
Your partner walks out of the bathroom and tells you her period started. You hold her. You say whatever people say when there is nothing useful to say.
And somewhere inside you, several lives go quiet again.
Final Thoughts
If trying to conceive has started to change the way you relate to your body, your partner, or even decisions you made years ago, you don’t have to wait for a pregnancy—or for things to become unbearable—to consider the emotional impact of what you’re living through.
I work with adults and couples navigating the complicated psychological terrain around trying to conceive, infertility, pregnancy, reproductive loss, abortion, birth, and postpartum life. My approach to perinatal mental health therapy makes room for the parts that don’t always fit neatly into words like anxiety or grief: ambivalence, relationship strain, sexual changes, anger at your body, old reproductive experiences resurfacing, and the exhausting cycle of hope and disappointment.
I provide perinatal mental health therapy in Utah, with care grounded in trauma-informed, feminist, relational, and culturally responsive practice. You don’t need to arrive with a diagnosis or a clean explanation for why this is affecting you. Sometimes you just need somewhere you don’t have to be the strong one.
References & Further Reading
1. American Society for Reproductive Medicine Practice Committee. Definition of infertility: a committee opinion. American Society for Reproductive Medicine; 2023. ASRM defines infertility and describes when fertility evaluation is generally indicated based on age, reproductive history, and other clinical factors.
2. Practice Committee of the American Society for Reproductive Medicine. Optimizing natural fertility: a committee opinion. Fertil Steril. 2022;117(1):53–63. doi:10.1016/j.fertnstert.2021.10.007. This committee opinion reviews the fertile window, timing of intercourse, fertility-awareness methods, and other factors relevant to people attempting pregnancy.
3. Biggs SN, Halliday J, Hammarberg K. Psychological consequences of a diagnosis of infertility in men: a systematic analysis. Asian J Androl. 2024;26(1):10–19. doi:10.4103/aja202334. The review examines depression, anxiety, self-esteem, quality of life, fertility-related stress, general psychological distress, and other mental-health outcomes among men diagnosed with infertility.
4. Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care. The systematic review identified psychological, relational, and sexual burdens associated with male infertility treatment, including depression, grief, inadequacy, avoidant coping, changes in relationship quality, and sexual functioning.
5. Rocca CH, Samari G, Foster DG, Gould H, Kimport K. Emotions and decision rightness over five years following an abortion: an examination of decision difficulty and abortion stigma. Soc Sci Med. 2020;248:112704. doi:10.1016/j.socscimed.2019.112704. This longitudinal U.S. study followed 667 women for five years after abortion. Decision rightness remained high, relief remained the most commonly reported emotion, and decision difficulty and perceived abortion stigma were associated with more negative emotions.
6. Pakpahan C, Ibrahim R, William W, Kandar PS, Darmadi D, Khaerana ASA, et al. “Am I Masculine?” A metasynthesis of qualitative studies on traditional masculinity on infertility. F1000Res. 2023. doi:10.12688/f1000research.131599.1. This qualitative metasynthesis examined how infertility can intersect with cultural expectations of masculinity, gender roles, stigma, social relationships, and psychological well-being.
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