Somewhere Over The Rainbow…..

May 7, 2014
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by Lindsey Wimmer, RN, MSN, CPNP


somewhere over the rainbow

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!

One Comment

Sherry@OurSweetLoveStory

Thank you so much for this post and this whole blog! I am really hoping our rainbow baby is in our near future. We experienced our tragic loss last June when our daughter unexpectedly passed away during labor at 40 weeks 6 days from what could only be assessed as a cord compression accident because her cord got above her head and appeared to be compressed. We were completely ready for her arrival. She was our third child but first daughter. Our sons were expecting a baby to be coming home. Our oldest was 6 years old and held his sister in his arms. He is such a sensitive boy, but I felt that if he didn’t get to meet her face-to-face, he would regret it his whole life and possibly blame his parents and feel bitterness and anger towards us. I had never gone into labor on my own before and had two previous successful inductions post 40 weeks. I was anxious about waiting so long for this baby to be induced after our due date and still feel that my physician did not take my concerns seriously. He didn’t even want to do more regular check ups or NSTs in my final week of pregnancy. I was scheduled for induction the next day at 41 weeks, but my contractions started early that morning and just progressively got more intense and closer together through the day. I didn’t have any real cause for concern as my water had not broken so I monitored through the day and prepared to head to the hospital on my doctor’s instructions when my contractions were 5 minutes a part. By the time my contractions timed 5 minutes a part and we called my physician (it was a Sunday), the contractions picked up and started coming 3 minutes apart and then barely 2 minutes by the time I got to the hospital. The nurses in Labor and Delivery Triage attempted to find her heartbeat when I arrived and searched and searched without saying a word. My physician finally arrived and hooked me up to ultrasound and said those dreadful words “There is no heartbeat.” I was especially upset by the pretty callous and unemotional way he said it as if he didn’t even care. It was his decision to not see us for more regular check ups and to make us wait over the weekend for induction. I have been dealing with anger on top of grief for the past 10 months. On top of that, we haven’t gotten our rainbow baby yet due to other medical conditions that suddenly came up with me developing hypothyroidism after the pregnancy and missing several cycles. I wish I could attend the Stillbirth Summit in June. That is when we will be experiencing the sadness of our daughter’s first birthday, and I am sure it would be very helpful to us. Please keep this blog going as more people need to be informed about the very real risks of stillbirth. I was so naive before this happened!

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