Supporting Pregnancy After Loss
The final part of my doula training was to complete a post course research project. This could be on any subject I chose and presented in any form I decided on. The decision to focus my research on supporting pregnancy after loss comes from a personal desire to know and understand more. I am very fortunate to have never had any problems conceiving and have never experienced loss so it’s a subject I don’t have personal knowledge of. However, over the years many of my close friends and family members have suffered miscarriages and difficulties conceiving and while I’ve always tried to be as supportive as possible it’s inevitable I was going to get it wrong sometimes. It’s human nature to want to make things better, take away the pain and focus on the positives. I’ve learnt though that sometimes that can do more harm than good.
During my Developing Doulas training the subject of baby loss came up for me a few times and made me quite emotional when talking about it. I was nervous that if I was supporting a family who were pregnant after loss that I might say the wrong thing, or not know how best to support the emotions involved in being pregnant and have a baby after losing a baby or multiple babies and how labour and the postnatal period may look. I’ve spoken to various people who have lost babies at different stages of pregnancy, both early and late and how the support differs based on this. I’ve also tried to speak to people in different locations in the country to see how it differs between hospitals. I also set up an Instagram poll to get a broader idea of how supported people felt and what could have been better. It’s been so emotional talking to so many brave people who have been so strong telling me their stories. I won’t be sharing those stories here, they are private and very personal. Instead I will be sharing an overview of how they felt and what we can do to make things easier for people who are going through loss and subsequent pregnancies.
To get an understanding of statistics around support during pregnancy, labour and postnatally for families who have experienced loss I set up a poll on my Instagram. The results were not surprising, however I was interested in the huge percentage of people who didn’t feel supported postnatally. I think there’s a big misconception that just because you finally have your baby you should just be happy and find it easy. Admitting you’re struggling seems to come with judgement or guilt. Also more support in early pregnancy and early scans, appointments would massively help anxiety in being pregnant after loss. There was a huge percentage of people who didn’t feel excited when they were first pregnant and some never did until their baby was in their arms.
Through my Instagram poll I asked if families felt supported by medical staff during pregnancy after loss. I received several messages saying they wished medical staff would read their notes so know the history rather than them having to explain it at every appointment. This did also differ depending on the stage of pregnancy at which the miscarriage happened. For later pregnancies women felt much more supported by medical staff and additional early scans are offered, these are not currently offered for marriages before 12 weeks. This pattern continued during labour, women who had had earlier miscarriages weren’t give any additional support or acknowledgement of their previous loss during labour, for some this was hugely traumatic. All of this comes down to empowerment, choice and communication. As we know, everyone is different, what one family may need to make an experience better may be the opposite of what another family needs.
Asking the questions, listening, supporting and holding space for each individual is all that is needed. Not just from medical staff but from friends & family. Instead of feeling the need to fill the space, say reassuring things, make it better. Take a breath, listen, support and ask what they need and give them that – no questions asked.
There are some wonderful groups to offer support, from people who have experienced loss and truly get it. If you don’t know what to say just signposting to some of these groups can be the biggest gift you can give. I’ve listed some below with links and information.
The Worst Girl Gang Ever.
The Worst Girl Gang Ever was created by 2 women who had both experienced loss and wanted to create a safe space for people. They have a Facebook group, both for loss and another for pregnancy after loss. They have an Instagram page and have just released an amazing book. They also run lots of courses and have live Zoom support groups. They are doing really great things and helping to raise awareness around baby loss. When reading about pregnancy after loss in their book this quote stood out to me:
‘New dimensions of grief will continue to unfold as time passes and sometimes you can be caught off-guard with the thought that someone will always be missing. If you become pregnant again after baby loss you might start to think about the fact that the baby you are carrying now will never meet his or her other sibling. There will never be a moment in time when all of your children co-exist, which is the reality for many who have children following the death of a child. It’s a feeling of never quite being whole. Because every family get-together, every family photo, every family holiday and every family celebration, there will always be someone missing. So, while a new baby brings you hope, it’s also a stark reminder of all the things your family will never get to be’
Tahnee Knowles, The Mindful Grief Coach
Pregnancy After Loss
Zoe Clark-Coates has created a book aimed as a day-by-day plan to reassure and comfort. She starts in her introduction by saying:
‘Pregnancy post-loss if very different from pregnancy pre-loss. Once you have encountered the heart-shattering experience of losing a child the terrain of subsequent pregnancies changes forever. Instead of waking up each morning expecting to sit in the sun, you are instead nervously peering through the curtains, dreading the sight of rain.’
This book is really wonderful and I will definitely be recommending it to friends and clients who are pregnant after loss. It works like a diary with each day having a section with different prompts to fill in. Such as ‘My worry right now is..’ ‘I am going to try to overcome this worry by doing…’
She also did a survey of 232 asking various questions. The results are very similar to my Instagram research and these ones stood out most to me.
‘Was your doctor helpful in offering support to you in pregnancy post-loss?’ 64.22% said no
‘Did friends and family understand the fear you carried in pregnancy?’ 64.38 said no
‘Do you still battle with anxiety about your child’s health or well-being?’ 66.38 said yes
Birth-ed podcast
Megan Rossiter has a great podcast series about all things pregnancy, birth and postnatal. She has an episode based around pregnancy after loss where she speaks to midwife Kate Marsh who works with Tommy’s Baby Loss Charity. They talk a lot around miscarriage and stillbirth and then about experience pregnancy and birth after a previous loss. One area that interested me is around the extra support given during pregnancy based on the gestation the previous pregnancy ended. Pregnancy lost before 24 weeks is classed as miscarriage and pregnancy after 24 weeks is classed as stillbirth. It is standard practice that most support is given in subsequent pregnancy if the previous baby was lost after 24 weeks. You get extra scans and consultant led care if you’ve lost a baby after 24 weeks. For families who have experienced late miscarriage during the second trimester extra scans are given and some extra support but this depends more on if they know the reason for the baby loss or not. For people who have an early miscarriage extra support isn’t provided as standard, however this depends on the area and trust you’re under and you can ask for more scans and appointments if you want them.
This is something I’ve noticed when speaking to people, the later in pregnancy you loose your baby the more support you get for subsequent pregnancies.
Finally Pregnant
@Finallypregnant is an Instagram account with lots of advice and support. They also run online classes for women who are pregnant after a previous loss.
Tommy’s Charity and Sands Charity are both baby loss charities doing amazing things.
For anyone who has lost a baby with siblings Emma Poore wrote a beautiful book aimed and young children and helping to try and understand the death of a sibling. Emma very generously gave her time to talk to me about her daughter Lydie who was born at 23 weeks. Lydie’s is the reason Emma wrote her book to help explain her death to her brothers. It’s really beautiful and all proceeds go to baby loss charities.
Completing this post course work has been a long process and difficult at times. Speaking to so many amazing women who have been through some truly awful experiences has been humbling and has made me appreciate what I have and how lucky I am to have never experienced any loss of my own.
I decided to researched pregnancy after loss to open up my knowledge so I can support families who are going through it. I’ve learnt so much, especially around the language to avoid and what to say to offer empathy and support. I’ve learnt that loss is valid at any point in a pregnancy, that as soon as you see the positive pregnancy test you start to imagine your life with that child in it and that even early miscarriages you are mourning the loss of that life.
In terms of support in pregnancy after loss I’ve found that the later in pregnancy the baby dies the more support you get, I understand why this is but it’s a shame not more is done for those who have had early miscarriages. The same is true during labour and more support was given for the later miscarriages during labour.
The area that has surprised me most is the lack of support postnatally for families who have had a baby after a previous loss. The idea that they should just be thankful and not admit it’s hard or ask for help is shocking. I’d love to be able to support families in this area and get the message out there that it’s ok to ask for help, there shouldn’t be any guilt associated in admitting it’s hard.
I hope that I can offer appropriate support to families who are pregnant after loss and I definitely feel more confident in my ability to do so.