Pregnancy after Miscarriage – Anxiety, Expectations and Hope

So, you’re pregnant again after a miscarriage.  You may have let nature take its course, or gone through another cycle of assisted conception.  Either way, you have achieved your goal, and it was supposed to feel like a triumph, worthy of celebration.  But, now that you are there, how do you really feel about it?

 Start at the beginning – Women, who are trying to become pregnant after having experienced one or more miscarriages, often express desperation to become pregnant again and then experience a huge range of emotions about this next pregnancy, including everything from hopeful but mildly worried, to terrified. Because I often work with women who are still feeling the emotional, and even the physical, effects of their loss, we tend to focus on making sense of facts and recognizing feelings: shock, grief, guilt, blame, loss of hope and confidence. I like to go back and work through her expectations around that previous pregnancy. Then, it is easier to understand the reason for, and the depth of, her feelings about her miscarriage and gain some degree of closure. 

 Shattered dreams, plans and self-esteem – For example, especially if it was a woman’s first pregnancy, the pictures in her mind of how that pregnancy would unfold will have shattered.  She may have spent considerable time, even in the short period of a first trimester pregnancy, falling in love with her baby.  If it was an unexpected pregnancy, she may have had to come around to the idea and begun making mental adjustments to the unfamiliar territory of motherhood. Perhaps she focused on romantic daydreams of herself and her partner experiencing a new, intimate connection with each other over her swelling, pregnant belly.  So, on top of her grief over the baby she will never know, she could also be missing the specialness of that imagined, future time in her relationship.  He may or may not be aware of that aspect of her emotional response to the miscarriage. She may also have expected the pregnancy and her child’s birth to transform her in some way: to give her more significance: mother, mother of his baby, mother of someone’s grandchild, part of the “club” of friends who are mothers, or on the same level as her sisters who have children. Not only could miscarriage mean she had failed in her own eyes, she could perceive that she is a failure in the eyes of others, even when it isn’t true.

Walking on Eggshells – What happens to this couple when they are fortunate to conceive again? In my experience, no matter how often a woman reads or hears that many couples go on to have a healthy, full-term baby after experiencing miscarriage, there is a lot of walking on eggshells in a subsequent pregnancy.  If she excitedly discussed her previous pregnancy with family, friends and colleagues, she may not even tell anyone she is pregnant again. To some extent, it is impossible to suspend fear entirely because we have the negative memories of having placed our trust in God, medicine or both and it resulting in enormous pain.  In the new pregnancy, that trust is somewhat reduced in all except those who have absolute, blind faith that a Higher Power will deliver what is meant to be. The need to exert control over something that is largely out of our control is all so understandable, and at the same time, such a shame because it means that she will experience less unreserved joy.

Achieving a Deeper Level of Understanding – In trying to support a woman through this next pregnancy, I believe that the best route is to go back to the basics: her identity, her values, what she wants out of life, her level of satisfaction with all aspects of herself and her lifestyle, sorting out her wants from her needs, and measuring her competing interests. To each of these areas, I would ask her to reflect upon how any of them was changed by her experience of miscarriage and finally, to anticipate how they will be changed by having the child she now carries.  The progression of the coaching process will reveal, layer by layer, how deeply she believes in herself, where her strength lies and how she will use it, no matter what lies ahead.  Those are the qualities that will make her a good mother and provide them both with a great life. 

Self-Coaching – If you want to do this for yourself, I suggest that you buy a journal with lined paper and set it up for a self-coaching process by putting each of the categories (previous pregnancy, miscarriage, subsequent pregnancy) above at the top of separate pages, with several pages in between each, headed by the sub-categories (ex. Who am I? My values, my aspirations, what I need to be happy, my satisfaction level at the particular time, my strengths, my frustrations, my expectations, how any of this has changed, etc…) Then, write on them at your own pace; whenever a flash of insight occurs, or in purposeful sessions. Don’t worry about your language or whether you are “making sense.” This is just for you. It is not about gaining an explanation for your miscarriage; it is about understanding yourself and what you want, accepting that there are no guarantees in life and opening the door to what is to come.

Supporting Her – This way of going back to the beginning, before the trauma of the loss, can, work for those closest to her as well; encouraging her to talk about her first pregnancy, this one and what makes her to want to become a mother. It is important to pay attention to her signals of being willing, ready and able to talk.  However, you can communicate a state of openness, verbally or through body language.  Looking directly into her eyes will show emotional availability and not expressing any criticism about how she is acting will go a long way toward building trust. Please, don’t ever try to stifle her by saying “Forget about it. Surely it won’t happen again.” You can’t give her any guarantees and may provoke resentment, anger or being misunderstood. She is not looking for you to solve her problems; she may just need you to listen and give sincere comfort.Instead of shutting off those dreams and memories that existed in her with the previous pregnancy, I would encourage them to flow. They are the reason that she is risking her body, heart and mind again.  By remembering and talking about her positive reasons for conceiving and carrying the first baby, she can reach a level of acceptance and underlying strength to move forward into the new pregnancy with renewed courage.  She deserves to embrace and enjoy carrying this child who is, at no other time, more a part of her than right now.

Lisa Marsh is a fertility coach, supporting those who are trying to conceive, experiencing loss, secondary infertility, assisted conception, alternative parenting and loss of fertility through illness, medical treatment and menopause. You can find out more about Lisa’s work by visiting her blog: http://yourgreatlife.typepad.com or contact her directly at lisa@yourgreatlife.co.uk .

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