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Unit 9 Assignment: Final Project

Tina Krause

Purdue University Global

HW410 Models of Health & Wellness

Kristin Henningsen

July 19, 2022

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Unit 9 Assignment: Final Project

Stress can be described as a reaction to something that a person believes is a threat to

their mental, physical, or spiritual well-being, resulting in physiological changes and responses

(Seaward, 2022). And while everyone may experience it throughout their lives, not everyone

knows how to handle it. A stress management program is designed to teach people how to

prevent and reduce stress and what to do when faced with it. One population that can benefit

from this program is women who have infertility. Studies have shown that stress and anxiety

resulted in decreased pregnancy rates with IVF treatments and increased the amount of time

needed to become pregnant (Yahya, 2013). Stress may not be an exact cause of infertility, but it

can interfere when trying to conceive.

Ten Stressors

Seaward (2022) describes a stressor as "any real or imagined situation, circumstance, or

stimulus that is perceived to be a threat." Women who struggle with infertility are faced with a

number of things that can lead to stress, including their diagnosis. If a woman has not

successfully become pregnant after several months, she typically talks to her doctor to find out

why. After numerous tests, her doctor diagnosed her with infertility. This causes stress because it

opens the door to a multitude of new stressors, such as temperature charting.

Women are often asked to record their basal body temperature (BBT) in a fertility chart

every morning to determine if they are ovulating. If ovulation has occurred, a woman will see a

rise in her temperature of at least four-tenths a degree for at least three consecutive days.

Temperature charting can be stressful for several reasons. At least four hours of uninterrupted

sleep is needed, temps must be taken at the same time each morning before moving or getting out

of bed, and a consistent series of temps must be recorded (Gurevich, 2020). The results of
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temperature charting can also cause stress because women find out they are not ovulating and

turn to the subsequent stressor fertility treatments.

Some women may need to undergo fertility treatments like medications to help with

ovulation or IVF to achieve pregnancy. Taking these medications can be stressful for women

because of the adverse side effects and the mood swings caused by the changes in hormones.

Fertility treatments are also stressful because, unfortunately, there is no guarantee they will work

and may require multiple treatments, which leads to the following two stressors cost and

location.

Fertility treatments can be very costly and may not be covered by insurance, causing

women to pay out-of-pocket. The average price for medications is around $1,182, and IVF

ranges from $24,373-$38,015. The average cost of a successful IVF treatment is at least $61,377

(Katz et al., 2011). Unless the woman is rich, the cost of these treatments can cause a significant

amount of financial stress. Another stressor a woman may face when undergoing fertility

treatments is the location of the treatment facility. According to the CDC (2021), there are

around 489 facilities in the U.S. that perform IVF. Many women may not live near one of these

clinics and will have to travel hundreds of miles for their treatments. This can cause even more

stress to the already existing financial burden, and it can lead to the next stressor of time

management.

Having to drive to a location miles away can be very time-consuming. Depending on the

speed limit, a woman can spend five to eight hours just in the car alone for a roundtrip visit to a

clinic 200 miles away. The amount of time needed for the treatment itself can be anywhere from

one day to several weeks. This can cause a great deal of stress for those who are employed
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because they may fear they will lose their job. The lack of time can also cause stress within a

marriage due to a lack of intimacy, which is also a stressor.

Starting a family should be exciting and joyful for a couple, not worrisome and stressful.

Because of some of the stressors listed above, intimacy can become a stressor itself. When a

woman has infertility, sex has to be scheduled around the time of ovulation, making it feel more

like a chore rather than something special. This can cause a significant amount of stress between

the couple, making it even harder to become pregnant.

Unfortunately, one stressor is inevitable for women with infertility, and that is their age.

As if it was not hard already having numerous stressors to worry about, women also have the

pressure of becoming pregnant by the age of 30, at least. The chances of becoming pregnant for

any women start declining around 30. By their mid-30s, the probability diminishes even faster.

By the time a woman is 45, it is very unlikely a natural pregnancy will occur (American College

of Obstetricians and Gynecologists, 2020). This can cause women to become afraid and worried

that they will never have the chance to be a mother.

Another stressor is the constant wondering from friends and family. At some point in a

marriage, couples are asked by friends and family when they are going to start having kids. This

question can cause stress because not only is the woman feeling like she is pressured to have a

child soon, but she is also faced with deciding whether or not she should reveal her diagnosis to

everyone. The last stressor is being around mothers and their children, especially when they are

newborn babies. Seeing a mother hug, kiss, and interact with her child can bring a smile to

another woman's face, but it can also cause stress to someone with infertility. Witnessing a loving

moment like that can be a reminder of how a woman may never have the opportunity to feel and

experience what that mother is feeling, which can cause a state of depression.
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Importance of Stressors

Getting pregnant on the first try may seem like a simple task to some, but for others, it is

a task that comes with a diagnosis and a price; the price of stress. Since stress can prolong or

interfere with getting pregnant, and not being able to get pregnant causes stress, women with

infertility are trapped in a vicious and what seems like a never-ending cycle. Between receiving

the diagnosis and trying to take their temperature every morning around the exact same time,

women can feel like there is no hope. Fertility treatments may seem hopeful, but the adverse side

effects of the medication, the cost of the procedures, and the location of the facility just prove

even more how stressful this can be for a woman. The amount of time required of her causes fear

of losing her job and puts distance between her and her husband. Each birthday feels as if she is

one step closer to failure, and she wants to hide from family, friends, and fun from any mother

she sees with a child. Reducing and managing stress may not guarantee a woman will fall

pregnant, but it can help boost and improve the chances of a successful pregnancy. One study

concluded that 55% of women with infertility participating in mind/body programs became

pregnant, while only 20% of those not in a program achieved pregnancy (Yahya, 2013).

Stress Management Techniques and Benefits

One technique that can be used to help manage stress is writing in a journal. When a

person takes the time to transfer their emotions and thoughts on paper, it allows them to start

processing what they are feeling and thinking and why they are feeling and thinking that way.

Journaling can give a person permission to let go of the negative thoughts that have taken over

their mind and draining their energy (Seaward, 2022). For example, if a woman blames herself

for her infertility, she can develop low self-esteem or depression. Writing in a journal can help

her give herself the permission needed to let go of this internal blame and begin to love herself
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again. Rereading journal entries can also help a person discover stress patterns or other stressors

that may have been missed and need to be addressed (Seaward, 2022). The second technique was

created in India thousands of years ago by imitating the movements of the nearby animals (Stahl

& Goldstein, 2019). There are many benefits to practicing yoga, including promoting healthy

reproduction in women and men. Other benefits of yoga are strengthening the body, decreasing

stress, depression, and anxiety, balancing hormones, increasing IVF pregnancy rates, and being

safe to perform (Marcin, 2020). The last technique that can help reduce and manage stress is

massage therapy. The physical touch during a massage stimulates the nervous system, releasing

chemicals in the brain. Circulation and lymph flow are increased, awareness is brought to the

body, and digestion is improved. Massage therapy also relieves stress and promotes one's overall

health and wellness (Lindberg, 2020).

Implementation

The execution of this program is first to inform these women with infertility that help is

available. This can be done through social media and flyers throughout the medical centers and

clinics. Journaling is a stress management technique that may be free, but women may not know

the benefits of it. Educating these women on the benefits will be available on social media

platforms. Since yoga is available at no cost on YouTube, links will be provided on the flyers

and on social media. Free yoga sessions can also be available at the park, weather permitting.

Massage therapy will be offered, for free, by the students at a local massage therapy school.

Overcoming Obstacles

Implementing this program's most significant obstacle would be getting the massages

done for free. For most schools, the students charge for their services, but at a discounted price.

One way to overcome this obstacle is by talking to the schools, letting them know what it is for,
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and seeing if they are willing to give a 10–15-minute massage to help these women relieve some

of the stress held in their bodies. Another way to try and overcome this obstacle is to ask for

small donations on social media.

Professional Support

There are many health professionals that would support this program and help women

with infertility learn how to reduce and manage stress. Yoga instructors would be involved

because they will be offering the classes at the park. Reproductive endocrinologists would also

support this program because they know, understand, and have witnessed the stress these ladies

have gone through on their pregnancy journey. Another health professional that would support

this program is a licensed therapist. They can help these women during the challenging and

stressful moments of fertility treatments and provide them with any resources if needed.

Program Evaluation

A questionnaire form is one way to evaluate the program to determine what adjustments

and changes need to be made. This form will be available one, three, six, and twelve months

after the program become available. Another way to measure the program's success is by

offering surveys to the women and one for their families. A survey can be done before the

woman starts the program to help determine her stress levels. Families have the option to take a

survey to help provide an outside perspective of how the program is working for their family

member.

Summary

Infertility is a devastating diagnosis that no woman should hear. Between the charting,

medications, treatments, lack of time, peer pressure, and a disconnection with their spouse,

women with infertility endure a lot of stress and deserve help. The proposed program offering
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these stress reduction and management techniques may not help a woman become pregnant, but

it can offer her some peace from a very challenging time in her life.
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References

American College of Obstetricians and Gynecologists. (2020). Having a baby after age 35: How

aging affects fertility and pregnancy. https://www.acog.org/womens-health/faqs/having-

a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy#:~:text=A%20woman's

%20peak%20reproductive%20years,is%20unlikely%20for%20most%20women.

Centers for Disease Control and Prevention. (2021, December 27). Assisted reproductive

technology (ART). https://www.cdc.gov/art/state-specific-surveillance/index.html#

Gurevich, R. (2020, October 6). How basal body temperature charting can help you get

pregnant. https://www.verywellfamily.com/basal-body-temperature-charting-get-

pregnant-faster-1960300#:~:text=Because%20the%20shift%20you're,at%20the

%20pharmacy%20does%20this.

Katz, P., Showstack, J., Smith, J. F., Nachtigall, R. D., Millstein, S. G., Wing, H., Eisenberg, M.

L., Pasch, L. A., Croughan, M.S., & Adler, N. (2011). Costs of infertility treatment:

Results from an 18-month prospective cohort study. Fertility and Sterility, 95(3), 915-

921. https://doi.org/10.1016/j.fertnstert.2010.11.026

Lindberg, S. (2020, April 22). Trying these self-massages for fertility can't hurt – but may not

help. https://www.healthline.com/health/infertility/self-fertility-massage

Marcin, A. (2020, April 23). Try these yoga poses to increase your fertility.

https://www.healthline.com/health/infertility/fertility-yoga

Seaward, B. (2022). Managing stress: Principles and strategies for health and well-being (10th

ed.). Jones & Bartlett Learning.

Stahl, B., & Goldstein, E. (2019). A mindfulness-based stress reduction workbook (2nd ed.). New

Harbinger Publications.
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Yahya, F. (2013, October 14). Infertility and stress.

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/infertility-

and-stress