Through IVF, adoption, and surrogacy, I'm a mom to 7, including 3 sets of twins. Here's how I handle the emotional and mental toll of motherhood.

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Through IVF, adoption, and surrogacy, I'm a mom to 7, including 3 sets of twins. Here's how I handle the emotional and mental toll of motherhood.
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  • Josephine Atluri has 7 kids, ranging in age from 1 to 15.
  • She knew she'd need IVF to have kids, she said, but she wasn't prepared for the emotional burden.
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This as-told-to essay is based on a conversation with Josephine Atluri. It has been edited for length and clarity.

I knew even before trying to conceive that I would need to go through in vitro fertilization. My husband had an injury in college that left him unable to conceive naturally, so when I chose him, I knew I was also choosing a future with assisted reproduction.

But I wasn't prepared for the physical, mental, and emotional toll that building a family over the course of 17 years would have on me.

We now have seven kids, through adoption, IVF, and surrogacy.

Our journey to become parents

After three years of IVF, I got pregnant with twins. I was elated — until a second-trimester loss devastated me. The physical and emotional pain of that loss forced me to pause and think about what I wanted.

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I knew that families were made from love, not DNA, so we decided to pursue international adoption. That's how we welcomed our oldest son, who is now 15.

I spent a year enjoying being a mom. But then we decided to give IVF one more shot. I got pregnant with twins again. Because my previous loss was unexplained, doctors threw everything at me to get my babies here safely. I had my cervix stitched shut and was put on partial bed rest.

I hated every second of that pregnancy. I didn't trust my body and felt the weight of so many failed expectations, from society and myself.

Much later, I realized that I was experiencing what I call "trying-to-conceive trauma." I didn't have a baby shower and took only one picture of my belly, on the day we left for the hospital. I felt like I held my breath for nine months, until my twins, a boy and a girl who are now 13, were placed in my arms. Finally, I could exhale.

For my mental and physical health, I turned to surrogacy

I now had three beautiful babies. But each year, I opened a letter from the fertility clinic where our remaining embryos were stored. Every time, I had to make a decision: Do we store them for another year? Donate them? Add to our family? For a long time, no option felt right, which is why there's a seven-year age gap between my first set of twins and their next siblings.

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Finally, we decided to pursue surrogacy. At the time, I leaned on physical reasons for not carrying a pregnancy. But now, I can acknowledge that another pregnancy would have also risked my mental and emotional health. I couldn't take that chance.

There are no social guidelines for the relationship with a surrogate. When we first matched, I felt stilted and awkward with the woman who would be carrying my children. But as the pregnancy progressed we bonded, and I began to see her as family.

After my twin boys were delivered six years ago, we were fortunate enough to be able to financially consider a second surrogacy. Eventually, we matched with another surrogate who delivered my twin daughters. They're about to turn 1 year old.

During the surrogacies, as I watched the pregnancies progress from the sidelines, I gained a new understanding of the role of a husband or partner. I was invested in the outcome, but removed from the physical aspects of pregnancy.

I used mindfulness to remember who I was

The past 17 years have been a whirlwind of emotion, including processing a miscarriage, deciding how to build our family, and navigating the challenges of adding children two at a time. After the birth of my 6-year-olds, I was overwhelmed. A friend insisted I try meditation and mindfulness, but I had a million reasons not to. I was a mom of five. I couldn't sit still for a second, let alone quiet my mind.

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Still, I started with one minute a day. That minute became my lifeline on the days when I felt like I couldn't keep my head above water. It became two minutes, then three, and so on.

Trying to conceive and parenting can become all-encompassing. It can cut you off from the most important things, including your relationship with yourself. It's healthy to pause — whether for a minute or a day — to remember who you are.

Josephine Atluri is the author of "5-Minute Mindfulness for Pregnancy: Simple Practices to Feel Calm, Present, and Connected to Your Baby," which was released on May 3.

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