After struggling to get pregnant, I have 'next child' anxiety

I want to give my child a sibling, but I worry about the process. I don't know if my insurance will cover treatments and how my body will react to them.

• I was diagnosed with endometriosis and polycystic ovarian syndrome. 
• I knew it would be complicated to get pregnant.
• As soon as we had our first my husband and I started planning to have another baby. 

A decade before I decided to have a baby, I was told that there would be complications.

I was diagnosed with endometriosis and polycystic ovarian syndrome (PCOS), and my doctors were concerned about egg quality, anovulation, and other fertility issues. So when we did not get pregnant after a year, my husband and I began artificial reproductive treatment (ART).

Even though my health insurance was exceptionally good and covered IVF with a few copays, the treatments failed over and over again. I experienced ovarian hyperstimulation syndrome (OHSS) and had to take weeks of bed rest to reduce the amount of fluid in my abdomen. This meant weeks out of work.

Because of our insurance and extremely understanding and supportive employers, we did not have to worry about losing our jobs or accumulating medical debt. Nevertheless, we began to fear a reality where we did not have children.

We switched clinics and I got pregnant

Eventually, we decided to switch clinics after our first told us there was nothing left that they could do. At the new clinic, I had laparoscopic surgery to remove endometriosis lesions on my organs and to perform ovarian diathermy. The latter is a procedure during which your ovaries are lasered to lower your ovarian reserve with the hopes of the ovaries producing fewer but higher-quality eggs.

Two cycles later, as we waited on my period to begin egg retrieval three, I found out I was pregnant. Terrified and overjoyed, we cautiously navigated a surprisingly uncomplicated pregnancy. After nine long and anxious months, I had a whirlwind four-hour labor, and we met our son.

But in the recovery room, my husband and I both began sharing anxieties about how we needed to structure our lives to have another child.

I have anxiety about trying for another child

I know this is not my reality alone. I have spoken with people in various support groups I have joined throughout my infertility and pregnancy journey about the next child anxiety.

Next child anxiety is a fear of being retraumatized. It is a scale where we weigh the benefits of giving our child a sibling and the joys of having another child to love against the crushing reality of infertility and its treatments. It is figuring out how far you are willing to go into ART again and what the limits would look like. My surgery's effectiveness is typically two years, and over nine months have already been spent.

As someone recently postpartum, it also feels unfair. My body has not been my own for two and a half years of treatment and nine months of pregnancy. But here I am, trying to plan.

Then there is the career anxiety. Will we have infertility benefits? After my parental leave, I switched to remote work and lost the wonderful health insurance that had helped to change our lives. We have insurance now, but I am unsure how far it will go. I will always wonder if I left the chance to have another baby.

In the infertility community, when you try to have a baby, you have to structure your entire life around this goal. It can mean a life of medical debt, moving to another state, or changing jobs or careers. And you are never guaranteed a child.

The other day, I was thinking about my son in six years on vacation with us and an imagined sibling who would chase after him on the beach. But today I help him stack a tower of cups, watching his eyes dart in delight between me and the colorful toys. In a few months, I will call the clinic again and proceed on an uncertain path.