There are a lot of things to consider when thinking about the prospect of pregnancy after a loss. There’s the physical side of things, the emotional toll, what caused the loss, how your partner is feeling. When a couple is ready to try again is going to vary a lot, and will likely even vary between the couple themselves. This is my story.
My pregnancy with Alfie officially ended Monday May 5th, 2014. I got a positive pregnancy test July 30th, 2014, at around 4 weeks pregnant. Obviously that’s not a lot of time in between, which coincidentally, is what a lot of people decided to mention when hearing the news. In my humble opinion, “Congratulations!” is really the only appropriate response, but I know a lot of people, myself included, don’t always realize what’s coming out of their mouths until they say it.
As for the physical part of pregnancy after my loss, we had an autopsy done on Alfie which took about 8 weeks to complete. The hope was that it would be able to tell us the cause, which is something that a lot of people who experience stillbirth don’t get. It’s pretty rare to have a definitive cause. Our concern was that our doctors told us that they believed his death was either caused by an infection, or by Neonatal Alloimmune Thrombocytopenia (NAIT), which is a disease caused in fetuses and newborns by the mixing of maternal blood and fetal blood and an incompatibility between the two. The specialists seemed pretty split, with our main doctor believing it to be an infection, and the team of immunologists believing it to be NAIT. If it was NAIT, future pregnancies would likely be affected and I would not be writing this blog post. On July 1st, we got the call from our doctor that the autposy results showed Alfie’s cause of death was Cytomegalovirus. The doctor called it, “the best possible outcome,” which is a weird thing to hear when someone is telling you about your baby’s death, but what he meant was 1.) we had a definitive cause for what happened to Alfie and 2.) that cause was not genetic and would not affect future pregnancies. He told us we could try to have another baby “whenever we felt ready.” My body resumed it’s normal routine within 4 weeks of Alfie’s death, so physically, we had nothing stopping us.
The emotional piece of the puzzle is much more complex. Obviously, given the timeline above, we got pregnant right away. I can definitely say, however, that that choice was made in a very dark place during the depths of our grief. It is not a decision that I mulled over and that Brent and I discussed at very great length. Quite honestly, I don’t believe I even had a single rational thought regarding it. I had only desperate thoughts and a lot of tears. Only 2 months after losing Alfie, and being surrounded by near constant reminders of that loss and friends’ healthy pregnancies and babies, it was really grief and jealousy that launched us into this pregnancy. That’s not to say that I regret it at all. But when people ask how I knew we were ready to try again, the answer is quite simply, “I don’t think we were.” At the same time, maybe if I had been thinking more rationally, I might’ve been too gripped by fear and anxiety to take that leap again. Who knows, but here we are. I am so thrilled to currently be halfway through this pregnancy and expecting a healthy baby boy, but the fact that our decision to get pregnant again was made while still very much in the midst of our mourning for Alfie made the beginning of this new pregnancy full of very conflicting emotions.
I am positive I would have been overly emotional and terrified regardless of when we got pregnant again, but additionally, I felt a lot of guilt for getting pregnant so soon. I felt like I couldn’t and shouldn’t be happy about this new pregnancy because in my head this baby should not exist. Alfie was to be our last and he was due in the beginning of September. For me to be pregnant in August meant that this baby only existed because Alfie died. So I simultaneously felt guilty for not mourning Alfie enough and for not being happy and appreciating this new baby. Because of all that inner turmoil, I didn’t want to talk about this pregnancy with people, and I got quite upset when people started gushing about the new pregnancy and how excited they were for me. I took it to mean that they didn’t care that Alfie had died, that everyone had forgotten about my loss, and that no one realized how terrifying this pregnancy was for me. Obviously that’s not the case, and I was projecting my own guilt onto my very well-meaning friends and family, but it made the first trimester particularly difficult for me. I’m fortunate to have such a wonderful husband and truly some of the most supportive friends anyone could ask for. I asked a lot of my support system, and I couldn’t be doing this without them.
Additionally, two weeks after my positive pregnancy test, the day before my first ultrasound, I began bleeding. A lot. I very naturally assumed I was miscarrying, so I had two glasses of wine and cried myself to sleep. The doctors told me over the phone that it sounded like an early miscarriage but to still come in for my scheduled ultrasound to make sure my body was handling it properly. Well, at that ultrasound the next morning, they told me that it didn’t look like a miscarriage should. It looked like an early pregnancy, but the heart wasn’t beating, so it could be too early or it could be a miscarriage, but the cause of my bleeding was identified as a large subchorionic hemorrhage, which can be asymptomatic and no big deal or it could cause problems. The doctor said due to my large amount of bleeding and the size of the hemorrhage that mine came with higher risks for miscarriage, and later on, premature labor and/or stillbirth. I indeed felt like I had won the shittiest lottery in the world. Everything felt very cruel and extremely unfair. After a week or so, my bleeding tapered off, and my ultrasound the following week showed a baby with a heartbeat. For the next several weeks I went to weekly ultrasounds and doctors appointments. I was miserable and in a near-constant state of panic.
Around 8-10 weeks pregnant, I realized that continuing to go to my perinatologists, who were extremely nice and very good at what they do, was really causing me much more stress than I could handle. These were the same doctors who had given us the devastating news about Alfie, and I’d be delivering on the same floor that we had to lose Alfie on. Brent, amazing man that he is, was accompanying me to all these appointments and also having flashbacks to that horrific time. We jointly agreed that we needed to separate this pregnancy from Alfie’s and that meant finding new providers. Given that what happened to Alfie was extremely unlikely to occur again, as scared as I was, I needed to feel like this new pregnancy was a normal one, not a high-risk one fraught with a million extra tests and ultrasounds and specialists. So, on the recommendation of several friends, I found my current providers, a group of five midwives who deliver at an entirely different hospital. They were willing to take me as a patient, but because of my history, they have a maternal-fetal medicine specialist from the University of Washington reviewing all my tests, ultrasounds, and chart notes to make recommendations and check that everything is going well. That switch made a world of difference for my mental health. I feel listened to, and I feel treated as a complete person (with a difficult history), rather than as one of many high risk pregnancies that a specialist sees all day long. At my 12 week ultrasound, the subchorionic hemorrhage showed no growth and seemed stable, and my midwife said it may be clotting off and my body might reabsorb it. My 18 week ultrasound showed no sign of the hemorrhage!
Around the same time as my switch to the midwives, I started attending a Pregnancy After Loss support group as well. Brent and I already attended a loss support group for those who’ve dealt with stillbirth and this is sponsored by the same organization. More than my individual grief therapy, this group has been so beneficial to me. The value I get from talking about my experience to people who have been through the same emotions is really not something I can quantify. It is, however, a double-edged sword. I am now not only familiar with the one-in-a-million thing that killed my baby, but I am now made aware of each of the also one-in-a-million things that caused my friends to lose their babies. It can certainly be overwhelming, particularly for a pregnant woman. So while I was freaking out about my upcoming anatomy ultrasound two weeks ago, I made the decision to skip group since it would likely be very triggering for me. But most of the time, I find a lot of comfort in it. The women I met at the PAL support group have really helped me embrace this pregnancy and get excited about it, rather than embracing the fear and anxiety. I bought some new maternity jeans, and I treat myself to cupcakes and naps, and overall try to appreciate each day that I get to be pregnant with this baby.
We’re now at the halfway mark, with a great anatomy scan behind us. All of baby boy’s genetic blood tests have turned up completely perfect and he is measuring exactly one week ahead. I was pretty sick up until 10 or 12 weeks or so and I’ve felt fine since. It’s pretty rare to experience hyperemesis gravidarum with two pregnancies like I did and then to feel fine for a third, but my midwife said not to question it and just to assume my body deserved the break and to be thankful.
Here’s some stats, and an awkward halfway there bump selfie from my bathroom because I thought I should take one while I was thinking about it. I’ve got like none from this pregnancy.
Baby’s Size: The length of a banana, apparently.
Weight Gain: 8 pounds
Symptoms: Hip pain, occasional heartburn, crying at everything, finally feeling tons of baby kicks
Cravings: Everything. Really I’m just thrilled to be able to eat. Specifically, donuts and chocolate. I am also getting really excited about making country-ass noodles for Thanksgiving next week!
Name: Honestly we were both burnt out on names so the thought of coming up with a third boy’s name was daunting, but we’re like 90% sure we decided on one this week!
Planning: I’m finally feeling confident enough to think about his arrival next year and clear out the boxes and brewing equipment from the third bedroom and turn it into a nursery. I’ve got some paint colors picked, but Brent won’t let me do any painting, so I’ll probably be bugging him to do that sometime after the holidays.
We still have a long way to go, but we’ve already come so far!