Experiences of miscarriage can be haunting, brutal and profoundly life-changing. They are also, sadly, common: one in four women will experience one, at some point. While most people who do go through this will go on to have future full-term pregnancies, the spectre of this past pain, of course, might lead to feelings of anxiety – especially while expecting.
Here, writer Amy Abrahams details how an earlier loss coloured her subsequent pregnancy.
When I found out I was pregnant, I felt invincible. My body, it seemed, was magical and the world glowed with the love I felt for my future family. It never occurred to me that I would lose that baby eight weeks in; a shock discovery during a routine scan. And it never occurred to me how deep and consuming the pain of that loss would feel.
When I fortunately become pregnant a few months later, everything felt different. I wasn’t the same person any more. The glow was gone, and in its place an anxiety that crept up on me with such stealth that at first I did not understand it enough to give it a name. All I knew what that a fear beat into my every day that caused me panic, tears and endless worrying. Everyone kept telling me to 'just relax and enjoy it,' but doing that felt impossible.
Anxiety in pregnancy is common, affecting one in 10 women, but following a miscarriage that number doubles to one in five. This can manifest in myriad ways – from a quickened heartbeat and panic attacks to a heightened sense of risk, rumination and preoccupation with possible risks to the baby.
'Many women feel there is little or no understanding of how vulnerable they feel after miscarriage,' says Julianne Boutaleb, consultant perinatal psychologist and founder/clinical director of Parenthood in Mind, 'and many of the women I see feel embarrassed about how anxious they are.'
I’d had something called a missed miscarriage – I had no bleeding or other signs, and my body still thought it was pregnant, which meant I needed to have a surgical procedure to remove what was there.
Afterwards, I found it hard to trust my body again and put pressure on myself to control the uncontrollable. Everything I ate or drank was scrutinised. In fact, every choice, taste, twinge or feeling was intensely researched. Google became a petri dish for my feverish anxiety.
Miscarriage is, sadly, common and will be experienced by one in four women. At times, I felt like this caused my (singular) experience to be dismissed during early antenatal appointments. What I wanted, I only understood later, was for people to take my feelings seriously rather than telling me everything was fine now. 'While no amount of antenatal care is likely to stop or prevent anxiety entirely, acknowledging and showing empathy can make a real difference,' says Ruth Bender Atik, the national director of the The Miscarriage Association. 'Reassuring someone that while it is very hard to live with, anxiety is understandable and it won’t harm your baby. It’s about the balance between reassuring someone that most pregnancies after loss are healthy, and acknowledging that some aren’t, which is why anxiety is normal.'
Boutaleb notes that as miscarriage and ectopic pregnancy can give rise to post traumatic stress disorder, staff attitudes towards patient anxiety during pregnancy and postnatally matter. 'Early adaptations to standard antenatal care, such as longer appointment or a referral to specialist counselling can improve pregnancy outcomes for both mother and baby,' she says.
We live in an era of Instagram pregnancy announcements – hands positioned lovingly on tiny bumps, black-and-white photos accompanied by big smiles. This is usually done around the 12-week mark, after the first scan. But when I reached that point, my husband and I only told those closest to us. Revealing my pregnancy to the world felt reckless; I wasn’t ready to go public. But three weeks later at a family member’s birthday party, the news travelled slowly around the room. As relatives came up to give me a squeeze of joy, I grew tense. At home, I burst into tears. To allow myself to have hope in this pregnancy meant doubling up on the heartbreak should it go wrong again.
I would have gladly gone my whole pregnancy and not mentioned it online if I’d be able to – but around five months I was launching a health event and knew there would be photos taken. Rather than risking speculation, I pressed 'share' on an Instagram post with the news. Putting it out there was scary, but people’s happiness and supportive words were more soothing than I’d expected.
It was around then that I did start to relax: the more my bump grew, the more I loved my body, and soon I could feel the baby move, which provided daily reassurance. I had also, crucially, put into place enough strategies to successfully manage my anxious feelings.
Talking about my feelings was vital. Exercise, too, was a lifesaver – yoga helped me connect with my body and my baby, and reminded me to take deep breaths, plus I splashed out on a trainer who specialised in women’s health to help me safely thrash out my frustrations and fears in the gym. I have always found meditation challenging, but I tuned into the Headspace app most mornings.
By the time my nine months were up I had eased into pregnancy, though subconsciously an undercurrent of fear meant I wasn’t as prepared as I should have been: when my water’s broke two weeks early, my hospital bag wasn’t packed and the 'nursery' still resembled an office. Holding my baby to my chest, I couldn’t believe he was here. He was the most perfect, precious thing. But my anxieties didn’t suddenly dissipate – I just transferred them onto motherhood. For weeks I worried over everything. I doubted myself. His birth, not the most streamlined, didn’t help. But a support network did. The wisdom of other mothers. People I could cry to. And of course, time.
Now, 18 months on, with thoughts on if there will be a second baby, I feel more prepared for a future pregnancy, though I can’t guarantee it will be anxiety-free. But now I know what it is, why I need to talk about, and what can help. Anxious feelings may be common, but they shouldn’t be ignored.
If you're pregnant and feeling anxious, try these tips
Boutaleb suggests these techniques to help ease anxious thoughts:
Feel your feelings: A good cry helps us move into the parasympathetic or ‘rest-and-digest’ part of our brains and releases soothing neurochemicals such as oxytocin.
Talk it out: Speak to someone – whether a trusted friend or a therapist specialising in perinatal issues – who gets these feelings and will help you hold them and make sense of them.
Hobby up: Crafts or a decorating project, for example, can help distract you from anxious feelings.
Try affirmations: Such as 'I am doing all I can to look after myself and my baby'.
Take a breath: Breathing exercises, such as the 4-7-8 technique, help you cope in the moment with surges of emotion.
Find support: You can find groups via the Miscarriage Association and Tommy’s, which also has a specialist midwifery helpline.
Get help: If your levels of anxiety are not decreasing despite support, see your GP. If you have a previous history of anxiety or depression, it is not unusual for this to re-emerge if you are going through a stressful pregnancy. You can be referred to a perinatal specialist who will look at options such as talking therapy and even medication if this is needed.
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