I would describe myself as a 'cup is half full, happy in the morning before coffee' kind of gal. But after a second-trimester miscarriage, I was anything but those things. After losing my son, my world-view and disposition changed for a while. And when I became pregnant after my loss, with my rainbow baby, I had a mix of emotions.
Pregnancy after a miscarriage, infant loss or a stillborn baby is anything but easy. Many people have a perception that becoming pregnant (again) will make the pain of the loss lessen or go away. For me and mamas I counsel as a clinical psychologist, rarely, if ever have I seen this happen.
As a clinical psychologist who supports women after pregnancy loss, stillborn and infant loss, I can share this observation: Being pregnant after a loss is genuinely heroic. Nothing will rock a mama to the core more than losing a child, working through the grief and becoming pregnant again.
From my heart, here's my perspective on what you need to know about being pregnant after a loss:
1. Create space for grief
The process of grief is often a journey, it isn't something to work through methodically in a timely, structured way. Grief is messy, unpredictable, raw and uniquely expressed. I frame grief as a process with varying moments of intensity popping up in unexpected ways.
Grief can show up in surprising ways when a woman becomes pregnant after a loss—crying in the market walking by a baby, trying to hide physical changes of showing so you can keep the secret of being pregnant just a little longer, preoccupied with thoughts of something going wrong with this pregnancy.
If you experience grief that catches you off guard when you're pregnant, this is entirely normal. Be gentle with yourself and let go of any judgment. Grieving the baby you lost and feeling excited about the new pregnancy is understandable.
Allow yourself to experience the roller coaster of emotions you may have without judging yourself or thinking it should be a certain way. Instead, accept what you are feeling and move through the grief as it happens.
2. Expect worry
For mamas who've had a loss, anxiety can be off the charts intense, overshadowing joy. If you're experiencing significant worry during your pregnancy, please share how you are feeling with your medical provider.
When worry gets in the way of everyday activities or prevents you from sleeping, eating, or taking care of your family or functioning at work, it is time to get support. Reach out to your OB/GYN, midwife or therapist and discuss how you are feeling and how worry is impacting you, and your pregnancy. There is help, talk about it.
Over the years I have found when women share with medical professionals their concerns and fears, the response is incredibly supportive, thoughtful and accommodations are made to help mamas work through grief during pregnancy. For some that may mean more frequent monitoring or appointments.
3. Know you might feel relief passing milestones
A trend I've observed in myself and others is feeling a sense of relief when the current pregnancy moves past the gestational week of the pregnancy loss, such as seeing the heartbeat, heading into the second trimester, feeling the baby move and making it to the minimal week of viability for a baby. It is not uncommon to feel more worried, tense or be reluctant to connect to the pregnancy until passing the gestational week of the lost pregnancy.
4. Or be cautiously connected to the pregnancy
Many women I've worked with after loss feel cautiously connected to another pregnancy. This experience is understandable. Being tentatively connected has a lot to do with protecting the current pregnancy.
Be kind to yourself if you notice feelings of disconnection, protection and fear. If any of these feelings persist or become disruptive to your everyday functioning, please reach out and talk to your medical provider.
5. Having guilt in unexpected ways
Many women feel in some way responsible for the loss, but remember pregnancy loss happens for many reasons and is rarely, if ever, your fault.
Feelings of guilt during pregnancy after a loss can catch some women off guard. You may notice feeling guilty at times for being happy, excited or connected to the new pregnancy. Positive feelings during pregnancy can be stressful because there may be simultaneous fears of being disloyal or forgetting the baby you lost because you feel happy.
Here's what I want you to know: You can feel happy for the new baby and sad for the baby you lost at the same time; you can feel both emotions.
Just observe them and understand that a mother's heart is vast enough to feel a complex range of emotions from guilt to joy and everything in between.
6. Feeling like innocence is shattered
Many pregnant women never worry about all the things that could go wrong in pregnancy. I bless them. I'm in awe of them. Maybe at times slightly jealous, wishing I could be like them.
I was never worry-free, blissfully excited and unaware of all of the things that can go wrong in pregnancy and delivery. After pregnancy loss, naïveté is shattered; you can never go into the next nine months casually.
Women who announce their pregnancy before the first trimester, have gender reveal parties or share on social media every sonogram can make your heart sink and your stomach drop. You think to yourself, "I don't know how they do that, I sure hope everything goes okay," as what-if scenarios' race through your mind. Know you're not unhappy for them, you have intense feelings of protection, a reminder of the reality you've experienced loss.
7. Prepare for insensitive comments
Well-intentioned, yet often upsetting and hurtful comments from family, friends and strangers can hurt. We live in a culture and society uncomfortable with death.
We applaud those who've experienced loss for being strong, stoic and holding composure. Death makes people uncomfortable, and nothing makes a conversation more awkward than when talking about miscarriage, stillborn and infant loss.
When someone says something thoughtless, remember, while it's directed at you, it has nothing to do with you. And, they just gave you a lens into their world of thoughts, beliefs and discomfort with pregnancy loss.
8. Continued grief is normal
Any woman who has experienced loss knows in her heart no other pregnancy or child can replace the one she lost. So there is a bittersweet feeling to pregnancy after a loss: Gratitude, excitement, anticipation, sadness and anger.
As you move through your pregnancy and welcome a new baby, there is a strange feeling of thinking or wondering: Would this new baby even be here if I hadn't had lost my other baby? What I have found helpful is to find a way to honor and remember the baby that was lost, a concrete gesture of keeping the lost baby part of the family.
9. Embrace the new moments and challenges
Children are a great distraction from grief. The blessing of being a mother when you have a pregnancy loss and become pregnant again is that you have to keep moving forward taking care of your family.
When I had a miscarriage, my twin girls were 2-years-old. There was no time to slow down or take time to grieve. When I felt the tears or anger come on, I had to push through it and focus on the girls.
My daughters kept me so busy that some days all I could do was make it to their nap time. Other days, I dreaded nap time because I had to face those intense feelings in the silence. Some days I would spend the entire hour and a half crying or agitated cleaning the house or napping myself because I felt so sad.
Another challenge of having children and going through loss and pregnancy is sharing the news with them. Depending on your child's age and if you've shared what's happened, be prepared for questions, lots of them.
Your child's questions may catch you off guard. Rest assured, this is entirely normal; your child is processing the loss and pregnancy in their own way. Don't be surprised to receive some variations of the following questions: Why did the baby die? Will this baby die too? How come the baby couldn't get better by going to the doctor? Where do babies go when they die?
My advice: Follow your child's lead, answer questions lovingly, knowing their curiosity isn't meant to upset you. They're trying to process in concrete ways the loss and pregnancy. And if you don't know the answer, it's okay to say so. When I am at a loss for how to respond, I ask my children, "What do you think?"
Whew, it's a lot to consider, isn't it? You are not alone in what you are going through and you will get through this. Reach out to supportive friends, family and medical professionals, talk about your feelings and move through the grief, worries, and embrace the joy and excitement. What I can share is this: rainbow babies are unique and teach us lessons we never knew we needed to learn.
My third daughter is my rainbow baby, and she is indeed the most loving child I have known. She has the biggest heart and has incredible love for everyone, especially animals. Perhaps she's like this because of birth order, genetics or parenting, but I've always wondered if it's because she's a rainbow baby. She brings hope and is a reminder that after incredible storms, rainbows do appear, permitting us to open our hearts to heal and grow in love.
A version of this article appears in The Motherly Guide to Becoming Mama: Redefining the Pregnancy, Birth, and Postpartum Journey.
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