Pregnancy after loss can be an extremely complicated path. It combines hope with fear. It is natural that women who find themselves pregnant after a loss often struggle to make sense of a universe of nuanced emotion. For those who surround the woman, it is sometimes difficult to know how one can be most helpful.
My son was stillborn in 2005. Months later, there I stood holding the positive pregnancy test. I was flooded instantly by the innumerable emotions that coursed through me all at once. I was seized with panic at the idea of having to actually endure being pregnant once more. I was flooded with relief at the possibility that I could. How could these two things coexist?
I wish I had known just how common this response was. Intense anxiety is endemic in post-loss pregnancies. Lindsey Henke is the founder of Pregnancy After Loss Support , whose mission is to support women who are expecting again after a previous loss.
Members of the PALS community have suffered losses at all stages from miscarriage through to infant death, and support one another in their subsequent pregnancies. Research shows that grief is not linked to the gestational age at which the loss occurred and "early" losses may be wholly devastating, as bonding begins at different times for different people. It is impossible to know or to judge the backstory to a pregnancy or a loss, and those in need should seek understanding from a community that shares their experience.
Henke's first daughter, Nora was stillborn in 2012. Following her second pregnancy and the birth of a healthy baby girl, Henke was moved to start PALS:
"Women who are pregnant again after loss often feel out of place. You feel like you don't fit in the mainstream world of pregnancy anymore but you also don't feel welcomed in the loss community either because the grief there is so new and talking about another pregnancy almost seems insensitive to those with such recent losses. You, as a mom who is pregnant again after a loss feel left without a home. We created PALS so that women who are pregnant again after a loss can celebrate their joy while also acknowledging their grief."
Henke encourages those who wish to support a woman pregnant again after a loss to consider the following points.
1. A pregnancy subsequent to loss does not magically fix everything. Efforts to be sensitive to the complexities of the emotional landscape of loss help tremendously. Leave the door open to discussions around her emotional state that allow for nuance.
2. Bringing a healthy baby home after a loss does not mean that she has forgotten the baby that died. The more space she is given to explore this natural grief response, the better for her postpartum state.
3. Understand that women who have a healthy baby subsequent to loss are at higher risk for perinatal mood and anxiety disorders. The trauma of a previous loss combined with the added stress and anxiety of another pregnancy creates a perfect storm for having symptoms during pregnancy or after, of postpartum depression.
4. Make yourself available. Underscore that while you may not understand how she feels exactly, you are available to her to listen as she tells you.
5. Remember that pregnancy after loss affects the fathers as well. Don't forget to ask about their emotional state. Validate their sense of grief.
I experienced tremendous guilt over my efforts to have a child subsequent to my loss. It felt as if this emergent reality threatened what precious little memory remained of the baby who had died. I felt trapped in a moment possessing little, and yet terrified to imagine more. I was afraid that my fear for this new pregnancy itself imperiled it. I was unable to move either backwards or forwards in time.
For women who are pregnant again after a loss, there are wonders -- but there too are challenges. For those who care for the woman and the man at the center of the loss journey, knowing this is far more helpful than is generally understood.
For more information on how to support women and men on their loss journey, visit PALS.