Are You Ready? Trying to Conceive after StillbirthJanel Atlas
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While my husband and I were waiting at the hospital for our stillborn daughter, Beatrice, to be born, I turned to my husband. “I want to try again soon,” I sobbed. He nodded through his tears. I was so relieved that he, too, felt that only another baby could fill the emptiness after the death of our daughter. It was never a question of replacing Beatrice—just of fulfilling the dream we had of a little brother or sister for our other child.
Trying to conceive (TTC) after a stillbirth (defined by the medical community as any pregnancy loss between 20 weeks gestation and birth) is intensely personal, and something that each couple must decide on their own. There are many things to consider before setting off down the path toward conception and a subsequent pregnancy. What considerations come into play? This guide outlines the steps of recovery and helps decipher whether trying for another baby is right for you.
Are You Physically Prepared?
Perhaps the most important gauge of the appropriate timeline for TTC is what your doctor or midwife recommends. According to Ann Douglas and Dr. John R. Sussman, MD, authors of Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss, many doctors and midwives recommend “that you wait at least two to three menstrual cycles before you start trying to conceive again if you’ve experienced a miscarriage, stillbirth, or full-term delivery, and at least six months if you’ve experienced a Cesarean delivery.”
Even if you experienced an uncomplicated pregnancy and a normal delivery, your body needs time to recover from the task of growing and supporting a baby. For example, your vitamin and mineral stores become depleted during pregnancy, and it takes time to replenish them. Continue taking your prenatal vitamins to restore these reserves.
Another consideration is weight gain from a previous pregnancy. Jill Czajkowski of Ashburn, Virginia, had a stillborn daughter, Catherine, in February 2005. Her doctor gave her the go-ahead to try to conceive whenever she felt ready, but Jill and her husband, Andy, decided to wait. “We knew immediately that we would try again, but agreed that we’d wait six months to let me focus on losing some weight; I had gained over 55 pounds while pregnant with Catherine,” says Czajkowski. By the time the Czajkowskis conceived their son, Jill had lost 57 pounds and felt physically ready for another pregnancy.
Are You Emotionally Prepared?
While a doctor or midwife can assess your physical condition, it’s much more difficult to determine your psychological preparedness for the challenges ahead.
Andrea Arias is a mother from Gilbert, Arizona. Her daughter, Grace, was stillborn in March 2005. In part because Grace was delivered via C-section, Arias’s doctor suggested that the couple wait a while before trying for another baby.
“I am glad that our doctor recommended waiting for a year because it gave me time to grieve for my daughter and to get through the ’empty arms’ feeling I had for several months after giving birth,” shares Arias. “By the time we were able to try to conceive again I came to realize a new baby would be a sibling and not a replacement.”
The grieving process is vital to your well-being; rushing into another pregnancy without processing the loss you experienced could cause emotional trauma when you deliver your new baby.
Douglas and Dr. Sussman suggest asking yourself and your spouse the following questions:
- Have you had a chance to work through some of your grief?
- How would you cope if you were to experience fertility problems?
- How would you cope if you experienced the death of another baby?
- Are you ready to cope with the stress of another pregnancy?
- Do you want another baby—or do you want the baby who died?
It’s vitally important that you and your significant other enter a new pregnancy with realistic expectations. This baby cannot and will not be the infant you lost.
Another concern couples face when deciding to get pregnant is how friends and family will react to the news of another pregnancy. Some misguided relatives assume that a new pregnancy means that you don’t still need to talk about your baby who died, or that you’re “over it.”
Other family members may feel concerned about a subsequent pregnancy. Catriona Harris of Orlando, Florida, shares, “My parents mentioned that they would like to see me wait, but we explained to them that was not the best choice for us, and they were supportive. I think they wanted to see us heal first. What they didn’t know was that having another baby was a major part of the healing for us.”
Pros and Cons of Waiting to Try to Conceive
Some reasons parents decide to wait include:
- Allowing more time to work through grief from your loss.
- Continuing to rely on support of family and friends who might take a new pregnancy as a cue that you’re completely recovered from your loss.
- Looking for the health benefits for mother and baby with more time elapsed between pregnancies (studies by the US Centers for Disease Control and the University of Chicago both found that the chance of delivering a premature or underweight baby are higher for women who become pregnant within six months of a previous full-term or near-term delivery).
Disadvantages to waiting a long time include:
- A longer period for you to worry about infertility and a subsequent loss.
- If you and/or your partner are older, the biological clock is ticking, and fertility drops each year.
Pros and Cons of Trying to Conceive Quickly
Sara Alford, who lives near London, England, says that she wanted to start trying “immediately!” after the death of her first son in November 2002. In hindsight, she thinks that she probably should have waited a bit longer to try for another, “but there was no way anyone could’ve told me that so that I would have listened [at the time],” says Alford.
The desire to have another baby isn’t rational or reasonable. In fact, the word most women use to describe themselves while trying to conceive after a loss is “obsessive,” write Douglas and Dr. Sussman.
Nevertheless, writing out a list can be enlightening for some couples. Here are some pros and cons to consider:
Reasons to try to conceive quickly:
- It gives you something to focus on and take hope from during a difficult time of loss.
- If time isn’t on your side, it might make sense to try again soon to beat the biological clock.
Cons of trying again very soon after a loss include:
- You might simply be brushing aside your grief instead of dealing with it.
- Family and friends may not be as supportive and thoughtful about your loss after you share the news that you’re expecting again.
- Your body might not be ready to support a pregnancy, especially if you were full term or near term, which puts you at an increased risk of experiencing another loss, according to Douglas and Dr. Sussman.
Consensus Is Key
Perhaps, like my husband and me, you and your spouse see eye to eye regarding TTC after loss; or maybe you are miles apart. Either way, it’s important to talk about the decision together. The partner who is more eager than the other needs to recognize that both partners need to feel prepared for the next pregnancy.
“If you find you and your partner are on different timetables when it come to embarking on a subsequent pregnancy, you should make a point to listen—really listen—to one another’s concerns,” write Douglas and Dr. Sussman. “Sometimes all that’s holding the reluctant partner back is the need to have his or her concerns taken seriously and to be given the time he or she needs to resolve those concerns.”
It’s also OK to take a hiatus from talking about the subject. Sometimes the father, in particular, feels overwhelmed by the mother’s drive to have another baby. Taking a break gives each person time to consider his or her feelings and dreams.
The night Becky Ellis, a mom from Dallas, Texas, delivered her stillborn son, she and her husband had a talk about trying to conceive. “David and I decided that we would not even discuss the topic of trying to have another baby for six to 12 months. We have several friends that have lost babies either within the first year of their lives or because of poor prenatal testing,” says Ellis. “I needed to know that David was still open to trying to have another baby, but I knew we couldn’t have handled it emotionally to jump right back into the entire process.”
Emotions While TTC
Even without experiencing a loss, people who want to become parents face trying to conceive with mixed emotions. For a couple who is praying for a healthy baby after a loss, the days, weeks, and months of temperature charting, meetings with fertility doctors, and endless rounds of ovulation predictor kits and home pregnancy tests can be torturous.
“Trying to conceive was frustrating as I’ve never easily gotten pregnant before,” says Czajkowski. “I felt like there was a large clock ticking and time was quickly running out, even though I’m only 31 years old. I guess it’s because we’ve been trying to have a living child since 2002. [Czajkowski experienced a miscarriage 14 weeks into her first pregnancy prior to conceiving Catherine.] In the meantime we’ve had friends have not one child, but go on to have their second child before we could have one living one.”
Impatience is common. “If you’ve got your heart set on conceiving again quickly, you may find that your entire emotional state hinges on what stage you are at in your menstrual cycle,” write Douglas and Dr. Sussman.
Sharing sexual intimacy is hard for some couples because it reminds them of their recent loss. “It was very emotional for me,” says Harris. “I cried the first time [we made love], because all I could think about was giving birth to Brady, and that my deceased son was the last thing to have touched me.”
It’s also common to feel a sense of guilt, like you’re trying to replace the baby you lost. “I felt guilty, but actually I got obsessed by the whole trying-to-conceive thing,” says Alford. “It blanked out some of the pain of the loss. I got to know all about fertility, which is something I had not investigated before.”
Czajkowski compares her recent road to conception with her previous two: “There was more of a desperation to get pregnant. I wanted to have hope again and I wanted this to happen quickly so I could have something to look forward to. I lost hope when I had Catherine. I wanted hope back.”
What Others Think
Czajkowski was less concerned about her own feelings about Catherine’s little brother than about how others would respond to her pregnancy. “I was concerned that people would think I was trying to ‘replace’ Catherine,” says Czajkowski. “I’ve made it crystal clear that this is a little brother for Catherine—not a replacement.”
My husband and I decided to keep it a secret that we were trying to conceive. Neither of us felt like other people would understand why we wanted to try again so soon.
Ellis and her husband made a similar decision. “We didn’t tell anyone that we were trying again. We waited until our 10-week ultrasound to tell family about the baby and then waited until we were 12 weeks to tell anyone else,” she says.
When they did share the news, everyone was excited for them. The Ellises didn’t talk about trying to conceive because, as they say, “We didn’t want the pressure from anyone just in case things did not go as well or it took us a long time.”
Alford’s mother made it clear that she didn’t want Alford to try again, mainly because of health concerns. “My mum didn’t want me to try again; she was so frightened I would lose my life,” says Alford. “She also hated me being so depressed.”
The bottom line, of course, is that the decision is up to you and your partner, with your doctor or midwife’s input, and no one else.
How to Know When You’re Ready
You might know immediately that you want to try again. Or, it might take months. It’s also possible that there will be days when you can’t stand the thought of waiting, and others when you’re paralyzed by fear about losing another baby. All of these emotions are completely normal.
Heather Murray, a South Carolina mother who lost her son, Nathaniel, in July 2002, recommends that parents who are freshly grieving “always remember the joy that your baby gave you while you had him or her with you,” says Murray. When you are blessed with another baby, you’ll cherish all the experiences with that new baby. “I loved those 3:00 a.m. feedings, and my son Jacob is precious to me even when he is crying at the top of his lungs and I don’t know what is wrong.”
Most moms who have had a stillborn baby insist that knowing when you’re ready to start trying is a gut feeling. “You just know,” states Harris. “I have met women who can’t bear the thought [of being pregnant again yet]. It’s a very painful process, and the pregnancy is entirely different because instead of being naïve, you worry about everything.”
For Jill Czajkowski, it’s a question of risk versus reward: “When you feel that your desire to have a child is greater than your fear of losing another, you are ready.”