The good news is, many people go on to successfully conceive within a year after experiencing a miscarriage, and experiencing a pregnancy loss does not necessarily mean it will happen again. The bad news is, because you’ve experienced a loss, it may be hard to find joy in a subsequent pregnancy. While not true for everyone, feeling scared or anxious in pregnancy after previously experiencing a miscarriage is common and, more importantly, completely normal. We spoke to Dr. Bev Young of BRIA, a virtual clinic supporting women’s mental health, to learn more about managing the complex feelings related to pregnancy loss, in a subsequent pregnancy.
“One of the most common things I see in my practice is women who are feeling anxious after having a perinatal loss, and then they get pregnant again,” says Bev. “Unfortunately, this next pregnancy is often jaded—you know bad things can happen.” But, it’s important to get through your pregnancy in as healthy a way as possible, and that includes minding your mental health. Ensuring you’re managing your anxiety and addressing your fears is crucial as you prepare to welcome a little one into your world.
What are some ways anxiety manifests during a pregnancy after loss?
The waiting game
If you’re an anxious person, it’s normal in pregnancy to experience it in milestones. Getting through the first trimester. Getting your NIPT results. Getting to the anatomy scan. Getting to viability. As you progress through your pregnancy the chances of miscarriage or something going wrong get smaller and smaller, so it makes sense that with each checkpoint, a little bit of relief is felt. But, after experiencing a loss, this anxiety can be magnified, and there’s often a new checkpoint causing stress: making it further along than last time. “There’s always a vulnerable waiting period— a time of looking ahead, and worrying, worrying, worrying,” says Bev.
Obsessing over the medicalization of pregnancy
“Unfortunately, a lot of the time, the pregnancy after a loss becomes very medicalized,” says Bev. “There are more ultrasounds, more blood tests and you may even be constantly looking for bleeding or for things to go wrong.” You may find yourself checking in with your midwife, obstetrician or family doctor often—and Bev notes that’s okay as long as you're getting the information you need.
Resisting the future
You might find it difficult to make plans for the future if you're worried about having another loss. Considering baby names, decorating a nursery, purchasing baby clothes—these are all things that are meant to be joyous preparations for your future baby. But, after loss, it can feel like becoming too attached is setting yourself up for another heartbreak.
A lack of self care
Your mental health is an important part of your overall health and it often relies on external factors to maintain. Once you’re managing your mental health, you might find you’re actually able to enjoy your pregnancy (or at least look forward to planning for your baby). If you find it hard to do simple things for yourself (getting up and dressed, going for a walk, enjoying meals), it’s time to work on bolstering your mental health.
If you are experiencing anxiety and it is affecting the way you are able to experience your pregnancy and connect with your baby, then you might be feeling guilt. “I always say, motherhood equals guilt, and it starts in pregnancy,” says Bev. “You're not going to get this time back in the pregnancy, and it’s easy to feel guilty about the time you've lost with this baby.”
You feel like you’re holding your breath
“Some women really try to get through the pregnancy kind of holding their breath, so to speak,” says Bev. “But then once they have the baby, that's when the anxiety and depression really starts.” Unfortunately postpartum depression and postpartum anxiety are all too common. You may feel like you’re holding it together in pregnancy, but if you feel like you’re holding your breath—just waiting for labour and delivery—it’s best to keep an eye out for postpartum mental health concerns. While holding that baby in your arms signals that you’ve made it through your pregnancy (and all those milestones that were anxiety-ridden), anxiety and mental health struggles typically go away when you’re caring for a newborn—and they often intensify.
How to manage your anxiety when pregnant after a loss:
“I often prefer when women work during pregnancy because I find it helps keep them busy and occupied and it’s a good distraction from the daily worries,” says Bev. (This, of course, will depend on your health status and your doctor’s instructions—not everyone is able to continue to work.) “I think work can be a great way to get through the waiting period and to keep your mind busy while you’re waiting for ultrasounds or milestones in the pregnancy.”
Make time for self care
“If you’re feeling anxious, there are some great apps out there that help with mindfulness,” says Bev. “If that’s not for you, managing self care could be speaking to someone you love and trust so you don’t feel so isolated.” Talking about your fears or negative thoughts about your pregnancy (with a trusted and non-judgemental loved one) can help with processing those emotions and being in a positive social environment can help with distraction.
Allow yourself to live in the moment—and think ahead
While it’s important to process your grief following a loss (more on that here), allowing yourself to live in the moment of this pregnancy will help you connect with your baby. Be an active participant in those ultrasound appointments and feel those kicks (and share them with your partner if you have one). And, dream a little about the future: making plans for the baby can make a big difference in your experience of pregnancy.
Turn to a medical professional
Getting some reassurance from an expert can make a big difference in how you’re experiencing your pregnancy. “It's really important to have a professional you can turn to, even if it means going in to see the nurse who's following you in the clinic to maybe check the baby's heartbeat or to get an ultrasound if necessary. You don't even really need to see the gynecologist—you just need to see someone, even if it's just for anxiety reasons.”
Turn to a mental health professional
“If you find there’s sadness, grief and anxiety that’s unrelenting, and that is leading to obsessive worries or panic attacks, those are times you might need to seek more professional help,” says Bev. You can always start with your primary care physician or your therapist if you have one, but there are also specialists that can address your specific concerns relating to miscarriage and pregnancy. “I also want to stress that medications—in particular antidepressants—are generally considered safe in pregnancy and they can be very, very helpful,” says Bev. Make sure to talk to your doctor about mental health medications, especially if you were taking them prior to pregnancy. “If it’s something that can be considered, it can make a big difference in terms of mental health during pregnancy and also postpartum.”