By Jason Jarzembowski, MD, PhD
Even under the best of circumstances, pregnancy comes with a wide range of emotions and physical symptoms. This is magnified many times over when your pregnancy comes after a loss such as a stillbirth or an infant death. While a so-called “rainbow baby” is usually a source of happiness, he or she will never replace the baby you lost. A new baby may bring new joy but will not wash away all the grief from your loss. You will always have those memories, but will make new memories, too. Nonetheless, pregnancy following a loss can be difficult. But it is not uncommon – studies show 25 percent of all pregnancies end in miscarriage or stillbirth, but between 50 and 80 percent of women who experience such a loss get pregnant again within a year and a half.
Where many expectant mothers feel joy and excitement, you might feel anxiety, guilt, and/or fear. You may be hesitant to announce your pregnancy or begin to bond with your child for fear of losing him or her. You may worry about every medical appointment, ultrasound scan, laboratory test, or symptom. Sometimes this is a normal reaction, and other times it becomes more severe, much like posttraumatic stress disorder. Sometimes these feelings lessen when your baby passes the age when your previous child was lost, but sometimes they stay just as strong. You can discuss this with your health care provider, who can often suggest coping strategies or refer you to someone who can help you better understand these emotions. This is important because untreated psychological stress can increase the risk of having a premature delivery or a low birthweight baby. In the end, it is helpful to remember this is a different baby, and the pregnancy and outcome are also likely to be different.
There are several steps you can take to prepare yourself for a subsequent pregnancy. Much has been written about the best amount of time to wait between pregnancies, but there is no clear answer. The best advice seems to be to wait until you have recovered from your previous pregnancy (usually between 2 and 3 months), and until the acute phase of grief has passed. Both your body and mind need time to heal before you get pregnant again – for some women this is a few months, for others more than a year. If special tests are being performed to try to determine the cause of your child’s death, including genetic tests or an autopsy, you may want to wait for those to be finished. Your doctor may treat you differently or monitor you more closely depending on the results. Also, having a better understanding of why your child died may help you cope, lessen your anxiety, and better prepare you for the next pregnancy.
So what’s the best thing you can do for your baby when you are pregnant after a prior loss? First of all, take care of yourself, both mentally and physically. Take things one day at a time. Find someone you can talk to – your partner, a friend, a family member, or a support group – so you can share your feelings and find reassurance that your emotions are not unusual. It is also important to check in with your partner to see how he or she is feeling. Make sure to eat right, exercise in moderation, and do not drink or smoke. Keep all your medical appointments and be sure to discuss any concerns you have with your health care provider. And second, remember every woman and every pregnancy is unique. You will have your own feelings and your own experience – that is okay, and you need to do what is right for you.
For online group support during your pregnancy after a loss, visit www.nationalshare.org