Becoming pregnant following a miscarriage is often highly yearned for but can quickly feel like strapping in for a terrifying rollercoaster ride! Joy and relief to be pregnant, mixed with an overwhelming fear of something going wrong, make it a very challenging time.
While every Mum’s experience and response to this is different, there are some commonalities in the way in which we all cope, and the things that are challenging. Here are some common experiences we have come across and some recommendations on how to cope.
Anxiety, anxiety, and more anxiety
Unfortunately, pregnancy anxiety is very common when following miscarriage. This anxiety can play out in numerous ways, but often presents as:
- A thirst for facts and figures regarding the pregnancy and fixation on concrete evidence (e.g. HCG numbers) to suggest that this pregnancy will be successful.
- Hypervigilance regarding pregnancy related symptoms such as nausea. These symptoms are focused on as a sign that the pregnancy is progressing well. The flipside however is that any reduction in these symptoms can cause distress as it may be interpreted as something being wrong.
- A high level of anxiety at ultrasound appointments or in medical settings where the fate of a prior pregnancy was revealed (see below on the trauma of miscarriage).
- A need to behave in a particular way (e.g. only eat certain things or sleep a specific amount each night) to help support the baby’s survival. This increased rigidity can be difficult to maintain and cause greater anxiety if Mum is not able to maintain the regime.
The common thread in all these cases is that we are looking to gain control and certainty over something that is almost completely out of our control and is inherently uncertain. And when we want the outcome of a healthy rainbow baby, that lack of control and certainty is very hard to deal with. The tricky thing is that there isn’t anything we can do to reduce the uncertainty in those early stages of pregnancy – even if we know all the stats, monitor our symptoms, and eat all the right things, things still may not turn out how we want them to. And in the meantime, we have increased our stress levels and anxiety by fixating on all these things.
The only antidote to this anxiety is acceptance. Acceptance of the uncertainty and of the lack of control and making space for the anxiety that this uncertainty and lack of control brings. This is easier said than done – so how to achieve this acceptance in practice?
- Take one day at a time – try to focus on being present in your daily activities.
- Turn down the volume on negative thoughts. Saying, “thanks mind, that’s unhelpful for me right now!” to any unhelpful stories that your mind tells you about this pregnancy – your mind doesn’t have a crystal ball and so these are just stories, not facts. And, they are fuel for your anxiety!
- Acknowledge and make space for your anxiety. Sometimes labelling it can help reduce the impact (e.g. “I feel really anxious today, but that’s ok, I can allow my anxiety be there…it might make my day harder but I can still go about my day and be the person I want to be…”)
- Refrain from fact-chasing. Googling for facts regarding your pregnancy or monitoring of bodily symptoms won’t help change the outcome, and it takes you away from being mindful and engaged in your day-to-day activities.
The trauma of miscarriage
One month after a miscarriage 1 in 3 women show symptoms of post-traumatic stress disorder (PTSD), and 1 in 5 women still have PTSD symptoms after 9 months.
Activities such as revisiting the same doctor’s surgery or having an ultrasound can trigger these past traumatic memories, and may be very upsetting. Trauma responses can often feel overwhelming and be difficult to control as they stem from a deeper, more primitive part of the brain. One strategy that can help is to practice grounding techniques. If you feel triggered or very fearful about an ultrasound, you could use them on the way there, in the waiting room, and even when on the bed during the ultrasound.
Fear of getting excited or making plans
It is very common to be nervous about getting excited or making plans regarding the pregnancy and the arrival of your rainbow baby. To protect yourself from getting hurt again, you may try and not get attached to the pregnancy or baby. This is understandable! Putting your heart on the line again is scary. But the question is… will protecting yourself make a negative outcome any less heartbreaking? Sadly, the answer is that it probably won’t make much difference. So, as scary as it is, I encourage you to gradually allow yourself to feel excited. Start making plans and thinking about the little baby growing inside you. You can acknowledge the fear that things won’t work out, and at the same time start making space for joy and excitement.
Will my entire pregnancy be this stressful?
The anxiety and different challenges of a pregnancy following miscarriage can be draining and bring feelings of sadness. Mums may wonder – will I get to enjoy any of this pregnancy? Again, this varies, but many Mums find that once they are out of the first trimester, or past the point at which a prior pregnancy ended, that their anxiety levels decrease, and they start to relax and really enjoy their pregnancy.
If you are struggling with high levels of anxiety in pregnancy following a miscarriage, we are here to help. We help Mums of all sorts with similar issues. In most cases a little extra support makes things a lot easier and helps Mums enjoy their pregnancy.
Written by Pip Johnson, Clinical Psychology Registrar