Pregnancy After Stillbirth: What to Expect and How to Cope
Having a stillbirth can change your outlook on pregnancy forever. Doctors and moms who now have their own rainbow babies tell you what to expect.
About 1% of pregnancies end in stillbirth, which is spontaneous fetal death after the 20th week of gestation. These pregnancy losses are often random events due to placental issues, chromosomal abnormalities, or other complications, and the chance of recurrence is low. Still, couples who’ve experienced stillbirth may obsess about their baby's health in future pregnancies.
Maternal-Fetal Medicine specialist Rob Atlas, M.D., from Mercy Medical Center, told Parents.com these feelings are not unusual. "There can be quite a bit of fear, anxiety and many (women who are pregnant following a loss) have some degree of depression," he explained.
Read on to learn how real moms and doctors have dealt with pregnancy after stillbirth, with tips for getting through the nine months ahead.
How Will I Feel About the New Baby?
NICU nurse Stacy Schultz, who lost her twins when they were born at just 20 weeks, is familiar with powerful emotions. When she became pregnant with her son six months after the devastating loss of Emilyn and Hailey, she understood this baby wasn't immune from death. The first time, "Nothing could go wrong," Schultz says. This time, she explains, "I wasn't just worried about what ended up killing my girls, prematurity, but every other complication that can befall a pregnant woman."
"Fear was the most difficult aspects of the post-loss pregnancy," she continues. "Fear of losing my baby, fear of bonding and trusting that I would bring him home. If I expected to bring him home, then it would jinx things, and I would lose him too."
Schultz further explains the tangled web of emotions one can expect to face during those long nine months. "I felt like I needed to cherish every moment, but let's face it, pregnancy is tough!" she says, adding, "The first day I was grateful for nausea, but before long I couldn't wait until it was over. Then I felt guilty, like if I wasn't thankful and happy for it, I was disrespecting the memory of my girls, as they showed me how easily it could all be taken away."
Lara Friel, M.D., OB-GYN at the Division of Maternal-Fetal Medicine at The University of Texas Health Science Center at Houston/McGovern Medical School, and author for Merck Manuals, tells Parents.com guilt is also a normal feeling to have after miscarriage or stillbirth.
Seeking Help for Pregnancy After Stillbirth
Ultimately, Dr. Atlas has found the emotional challenges of stillbirth to be significant, and encourages women to get help. "Speak openly with your practitioner and seek professional care and support for as long as you need," he recommends.
Dr. Friel seconds that notion, telling us, "I strongly recommend counseling or therapy for patients who experience a stillbirth. There are also support groups for parents who have had a pregnancy loss, or siblings who have lost a new member of the family."
"My saving grace came through March of Dimes' online community, Share Your Story," Schultz shared. As for me, it is a combination of support from my husband, my family, a therapist, and our pastor that has slowly helped me face every aspect of life after loss, including this pregnancy.
No matter where you seek help, just be sure to find that support. Know that you aren't alone, and everything you are feeling post-loss, and during a subsequent pregnancy, is normal and expected.
When to Get Pregnant After Stillbirth
Dr. Atlas cautions there are potential birth complications women need to be aware of after loss, especially if they get pregnant again quickly. "We call it short-interval pregnancy. Patients who conceive quickly after a loss, usually within 6 months, run a higher risk of prematurity," he says. "This is usually related to a patient who has had a late loss (after 20 weeks)."
"Many women want to get pregnant again after a loss, quickly," Dr. Friel acknowledges. "However, short inter-pregnancy intervals have been found to be associated with a number of harmful outcomes for both mother and child, including increased risk of preterm birth, low birth weight, and preeclampsia. Women who attempt to get pregnant again quickly may also be at increased risk of anemia."
She advises women to allow time for physical and mental recovery before trying to get pregnant again, and explains, "Every pregnancy requires a lot of resources—iron, folic acid, calcium—which need to be restored prior to the next pregnancy. It's recommended that women continue to take a prenatal vitamin daily."