Some of the most common questions we receive at Star Legacy Foundation deal with prenatal care during a pregnancy after a loss. Thousands of families every year enter into pregnancies knowing first hand that too many pregnancies don’t have a happy ending. Their past experiences shattered their sense of innocence and they face months of emotions swinging between paralyzing fear and vulnerability, to overwhelming excitement, love, and appreciation.
Many people may wonder why a family would choose to endure such a process. I can’t speak for anyone else, but for me, it was because I always wanted to be a parent. When Garrett was stillborn, it only heightened my desire to raise a child. It doesn’t have to make sense or be logical because everyone will have their own reasons or desires.
As for managing a subsequent pregnancy, there are many different schools of thought. The bottom line is that it needs to be what the parents/family and the health providers have discussed and are all comfortable with. If you are not comfortable with the plan recommended by your OB/midwife, it may be worth talking to some other providers to get other opinions or find someone whose philosophy better matches your needs.
Below are some of the suggestions I have personally given to families. It is a collection of what I learned in my 3 subsequent pregnancies, from other women during their rainbow pregnancies, from the medical research and literature, and from what ‘feels right’ to me. This is in no way medical advice that is appropriate for everyone or every situation – but it is intended to give you an idea of some of the things to consider and discuss with your health professional.
Timing of a subsequent pregnancy is based on what you need. It can be complicated by grief, medical conditions, postpartum depression, other children/extended family, spiritual beliefs, finances, practical concerns, etc. First, talk to your doctor about any recommendations they may have. If they want you to wait a certain amount of time – ask why. Some women will benefit from more time to do additional testing about the cause of their loss or to treat/manage any health conditions or risk factors that are present. Sometimes a recommended time frame is an arbitrary number based on how long the provider thinks is an “appropriate” amount of time for a woman to heal emotionally. Emotional readiness does not have a time table and cannot be predicted by anyone – including the parents! This is something that each couple must identify for themselves.
Emotional readiness depends on the personalities, experiences, and needs of the family. Some families do very well when they quickly have something to remind them of the joy, hope, and excitement in life. Some families do well if they can process their grief in their way and to the extent they need without the additional emotions or concerns regarding another baby. Either is fine – it depends on what feels best to the family.
“Replacement syndrome” is often brought up in those who desire to have another child soon. The thought is that the parents are trying to “replace” the child who died with a new child. While this may be an issue for certain people, I have not encountered this to be a significant problem. The majority of the parents I work with (myself included) feel that a parent’s heart is large enough for ALL of our children and that none of them could ever replace another.
Throughout the pregnancy, attention needs to be given to the emotional health of the entire family. Often, our reactions to these emotions are not what we could anticipate or expect. Give yourself permission to be who you are. But seek out help when it’s needed. This may be professional counseling or group therapy, but it can also be support groups online or in informal/social circles. It can be talking to another loss parent/rainbow parent. It could be letting your partner or friends/family know what you are feeling and needing. It can also be therapies such as art, music, yoga, writing, etc. Don’t hesitate to mention your emotions to your OB at each of your prenatal visits. Your psychosocial well-being is an important part of this care – particularly so in a pregnancy after a loss.
There are a number of books available that talk about the conflicting emotions of a subsequent pregnancy. I found them to be extremely helpful simply because it helped me realize that I wasn’t the only person who thought these things or that I wasn’t going crazy. I was just a grieving mom and an expectant mom – and that is a very complex person to be!
If you are interested in learning more about emotional care in pregnancies after a loss, please consider attending the Stillbirth Summit this June! For example, Dr. Deborah Simmons will be talking about treating grief including PTSD and other complex aspects of pregnancy/infant loss, Jessica Killeen will present information on the value of online support groups, Dr. Joanne O’Leary will talk about bonding with baby in subsequent pregnancies, Dr. Jennifer Huberty will discuss using activity to cope with grief and prepare for rainbow pregnancies, Dr. Marian Sokol will address sibling grief, and much more!! Visit here to see more details, the full agenda, and to register before June 1 to get early-bird prices.
The medical management of a subsequent pregnancy is another huge issue that I’ll address next time! Until then, comment below to tell us what was helpful to you in your rainbow pregnancy!