How To Cope With The Anxiety Of Pregnancy After A Loss

As Chrissy Teigen said in her recent pregnancy announcement, there's no escaping anxiety when you're expecting a rainbow baby.
Contradictory emotions are a part of pregnancy after loss.
StefaNikolic via Getty Images
Contradictory emotions are a part of pregnancy after loss.

When Chrissy Teigen shared last week that she and husband John Legend are expecting a baby after the tragic loss of their son, Jack, in a second-trimester miscarriage two years ago, she was met with an outpouring of support. Many people related to the family’s loss and were eager to hear of this development in their story, especially after Teigen shared that she had done an in vitro fertilization cycle in March.

“Joy has filled our home and hearts again,” the model wrote on Instagram, posting a picture of her curved belly. Explaining that she put off announcing the happy news because she was “too nervous,” Teigen said, “I don’t think I’ll ever walk out of an appointment with more excitement than nerves,” encapsulating the feelings of the many parents awaiting the arrival of their “rainbow baby,” as some refer to the child who comes after a loss.

An estimated 10% to 20% of known pregnancies end in a loss, according to the Mayo Clinic. Most people who miscarry are able to carry a subsequent pregnancy to term, with only 1% of patients experiencing repeated miscarriages. Parents who have endured a miscarriage, stillbirth or infant loss may experience a jumble of conflicting emotions when they become pregnant again.

“It’s its own kind of pregnancy,” Amy Klein, author of “The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind,” told HuffPost. Klein had four pregnancy losses before delivering her daughter, and after each one, she tempered her hopes upon learning that she was pregnant again.

“It’s like, OK, we hit the first step, [but] we have to reach a lot of hurdles,” Klein said. “It doesn’t feel like the first time [when] I was over the moon.”

Like Teigen, Klein became pregnant via IVF, so she was monitored carefully in early pregnancy, with regular blood draws to ensure that hormone levels were rising correctly, as well as early ultrasounds.

Though such procedures can offer patients reassurance, awaiting them may also foment its own kind of anxiety.

“You’re waiting for the numbers to go up, and then you’re waiting for the heartbeat, then you’re waiting for the first trimester,” Klein said. “As much as you don’t want to get your hopes up, you can’t help but feel attached to this child growing inside of you.”

Samantha Gassman, author of the forthcoming picture book “Dear Rainbow Baby,” experienced a loss in between the births of her two children, making for a third pregnancy experience that was vastly different from her first.

During her most recent pregnancy, she explained, “I was hyperaware of anything that could go wrong, any spotting, any cramps,” compared with the first time, when “miscarriage didn’t even cross my mind as a possibility.”

Becoming pregnant after miscarriage, “I had to learn how to trust my body again,” Gassman said.

If you’re experiencing the joy wrapped in fear that is pregnancy after loss, here are a few things to consider as you ride the emotional roller coaster of the coming weeks.

Advocate for yourself.

If you’re not a fertility patient with access to lots of early ultrasounds and you need the reassurance of seeing the baby’s heart beat, talk with your doctor, advised Jacqueline Fernando, a California psychotherapist who specializes in fertility issues. Some will say, “We’re going to sneak you in for a quick ultrasound,” Fernando said. “Those doctors are priceless.”

Find a place to share your feelings.

You may or may not want to share your news with family and friends, depending on how much you lean on their support, but that doesn’t mean you can’t find safe spaces to talk about what you’re going through. Consider finding a support group.

“Hearing another mom say, ‘You know what, I’ve been there,’ there’s so much power in ‘me, too,’” Fernando said.

Another option is finding a therapist who specializes in these issues. Your doctor may have recommendations, and Resolve: The National Infertility Organization maintains lists of mental health providers and support groups. Hospitals may also facilitate groups for pregnant people based on due dates.

“All the women are having some sort of worry, right?” said Fernando. “There’s so much power in being vulnerable.”

While it’s not specific to those who have experienced loss, a prenatal yoga class can offer another kind of community — with the additional bonus that they’re people you don’t know, so you can focus on being pregnant in the moment and not worry about what you would say if you were to miscarry.

Create a ritual or memorial.

It’s not for everyone, but some people find comfort in creating a ritual or memorial to honor the child they lost.

“Typically, we don’t have anything to honor this life,” Fernando said. “It’s a very weird grief. There’s nothing tangible,” she added, but that doesn’t stop you from making something.

Planting a special plant or tree, for example, can “provide an opportunity for [partners] to take a more active role in that healing process.” Other children can participate as well. Fernando recalls women telling her that while their partners may not talk about the loss, they can sometimes be found caring for the tree the family planted.

Gassman created a memorial for herself using the images from her only ultrasound during that pregnancy.

I think that helped me compartmentalize,” she said. “We could still grieve the baby, I could do that when I wanted to,” while at the same time she was “also able to move on.”

Writing was another outlet for Gassman. “It helped me look forward,” she said. “I feel like it forced me out of my grief.”

“Those writings became this letter to a baby we didn’t even have yet,” she explained, and “eventually turned into the manuscript for ‘Dear Rainbow Baby.’”

Give yourself permission to set boundaries.

In addition to deciding when and how to share the news of your pregnancy, you can set boundaries to protect yourself during this emotionally vulnerable time.

“Give yourself permission to take care of yourself, if that means laying low for a while, not talking to people,” Klein said, “that’s what you have to do.”

“You have to protect your emotional space,” she continued. You do not, for example, need to attend any baby showers. Just give yourself permission to not be happy for others’ pregnancies.”

Happiness about your own pregnancy is enough of a challenge, Klein said. “The longer the pregnancy progresses, people expect you to be happy, and you’re not happy.”

Don’t pressure yourself to perform a happiness you don’t feel.

Klein’s doctor reassured her, “You’re not going to be happy until you’re holding this baby in your arms.”

“It’s OK to wait for your happiness,” Klein said.

Practice self-care.

Klein and Fernando stressed the importance of taking things one week, or one day, at a time. Forty weeks can feel like an eternity. So can those first 12.

Fernando suggested setting small goals and prioritizing stress-reducers, such as nourishing food, exercise and sleep.

“Sleeping is so paramount in fighting anxiety,” she said.

Simple deep breathing and meditation are ways to help get you through the day, Fernando said, noting that meditation can take many forms. Swimming, for example, helps you to focus on your breath and your body and allows you to count strokes, all of which are meditative.

Honor whatever feelings you are experiencing, and don’t feel pressured to change them for others’ expectations, or your own.

And if a sliver of happiness does sneak its way into your psyche?

“Sometimes I remind the women that it’s not finite,” Fernando said. Preventing yourself from feeling happiness now won’t blunt the pain of a future loss. “So why not allow yourself that joy?”

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