Before trying again after miscarriage and loss, prioritise self-care

Photo: Shutterstock
Photo: Shutterstock 

Question: In the past six months, we had a stillbirth of our first, tried again four months later and had a miscarriage at eight weeks. I know I need to give myself time to recover before trying again, but I'm worried about being ready to put myself through this.

I have been conditioned to associate pregnancy and babies with fear, grief and loss. It's not just getting myself through the nine months of pregnancy that I'm worried about. I'm afraid I won't be able to turn the fear off once my theoretical baby is born since I'm a naturally anxious person. Going through post-loss depression has made me feel like my mental health is fragile.

I am petrified of a postnatal depression scenario where the responsibility of keeping a baby alive (with sleep deprivation, etc.) is so crushing that I don't enjoy being a mum.

With conditions such as SIDS, most people feel like getting struck by lightning (that level of statistical probability, that is) won't happen to them. Well, after living through having a kid with a 2 to 5 percent-chance fatal birth defect, I know it does.

Answer: I am so sorry for your loss. As I read your letter, I could see the anxiety and fear covering and touching every future hope and thought. I understand every moment of it; you are completely normal. Because there is so much I do not know, I am going to offer the most basic and compassionate advice I can.

To experience both a stillbirth and a miscarriage in such a short time is extraordinarily traumatic. Unfortunately, there can sometimes be a message in our culture that when a pregnancy doesn't "work," this is the body's way of doing what it should, letting go of a baby that wasn't healthy, and that a woman should be relieved or grateful. Although this may be scientifically true in many cases, this is not the emotional reality of women (and their partners) who experience this type of crushing loss.

This message can compound your grief and trauma. How can a woman feel this is "appropriate" or "right" when all it feels like is failure and pain? This is all to say: Do not allow anyone to shame you or guilt you out of your grief and suffering. You have the right to feel any emotions.

You do not mention it, so I must: What is your physician saying? Before you try conceiving again, I would strongly recommend creating a plan with your trusted doctor. Whether it be tests, other opinions or bringing in a specialist, there is no reason to even think about trying to get pregnant again without a more comprehensive plan.

You also do not mention a partner, but this partner should absolutely be a source of support and reason. In our grief, we can make decisions out of panic and fear, but when we have good people in our corner, they can slow us down and help us weigh our options. A good doctor and partner will also help assess when the grief and anxiety are too great - that trying to conceive is too much for you.

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Now, on to your anxiety.

I was reminded of a conversation I had with Karen Maezen Miller, a teacher and author of Momma Zen: Walking the Crooked Path of Motherhood. I had shared some difficult personal news with her and, while not deadly, the news was both shocking and life-altering. Everything in my life had shifted overnight and though I was coping on the outside, nothing felt solid or safe. Maezen Miller said something along the lines of, "Now you have seen the other side. Your eyes are open. Now you see your life fully. Your priorities have shifted and nothing will be the same. There is no way through but forward."

I had unconsciously wanted her tell me how to go backward; to go back to before - before I was scared, before things were hard, before I felt lost, before I was grieving. But there was no moving backward. This was my life and I was either going to accept it, with all of its messiness, grief and hope, or I was going to become paralysed with fear. I didn't want to move forward; that didn't feel safe or good. I wanted promises and ease. I wanted out.

So, here you are, having suffered the physical loss of life, as well as the emotional loss of potential parenthood. You have seen the other side, and you are afraid your life will be nothing but loss on top of loss. If you have a baby, he won't be healthy. If he's not healthy, you will not be able to cope. And if you cannot cope, you will go off the deep end, utterly losing control of your mind and heart. Everything good will be destroyed.

What can I tell you? That none of this will happen? Can I guarantee health and ease to your unborn children? To you? No. Remember, you have seen the other side. You have been in the deep water, and once you swim there, you are changed. You know that ease is not guaranteed, and that yes, bad things happen.

Your mind is trying to protect you from pain, so you imagine everything bad. Your mind is saying, "That's enough of that pain," and continues to traumatise itself as a way to stay alert and vigilant. You have every right to agree with this part of your mind. Some people experience loss like this and say, "Nope! I am finished with this hardship. Let's find another way." Or people quit trying to conceive altogether. The beautiful thing? You have that right to choose how to move forward; never forget you have a choice.

Some people experience this type of loss and pretend it didn't change them. They forge on, smiling and putting their best foot forward. Some people will watch the anxiety bleed into every aspect of their lives, and if they do have a family, the anxiety follows them into parenthood. Some people will dance with this loss, witness how they are changed, and decide to be vulnerable and brave. These people know their path will be sometimes frightening, but they decide to walk it anyway.

Your capacity to move forward depends largely on understanding that you have been changed by this loss and that you do have choices. You can grow, you can move forward, you can stay in your panic. But you are still changed.

To move forward, you need to be gentle with yourself. The support groups and helpful articles are not supportive or helpful if you come away feeling jittery, panicked, despondent or frantic. Thinking about a future pregnancy also does you no good because it leads you down a rabbit hole that has nothing to do with your life right now. Instead, you need a breather.

Rather than diving into the next pregnancy attempt, take some time to figure out what these events have taught you. Give these experiences a minute to be digested and processed. Whether it's a therapist, a guided and mediated loss group, or a religious leader, find someone who can walk you around and through this trauma.

While you find this supportive person, please do the simplest of things to take care of yourself: Feed yourself well, sleep the hours you need to feel awake (not more), move your body in ways that feel enlivening and joyful (walking and stretching do the trick), and surround yourself with people who will not ask you for any emotional heavy-lifting (needy friends and family must take a back seat).

Say strong "yes's" and "no's," and keep a consistent routine (routine equals safety to the brain). None of these simple steps will cure you, but they will create room for your body to heal and find its rhythm again.

I wish you all the luck and healing.

The Washington Post