Trying Again After Loss

Trying again after loss can be a very touchy subject, and can add to the taboo as many people around the couple try to avoid the subject as they are worried about upsetting them. When you do mention the possibility of trying again, everyone seems to have an opinion, and you can find yourself doing what you think others want and expect… rather than what you want for you and your family.

When is the right time to try again? Only you can answer this question and the answer will be different for everyone; it will depend on many factors including:

  • What gestation you were when you lost your angel?
  • Have you healed physically?
  • Did you need a caesarean section?
  • How do you and your partner feel about trying again?
  • Are there any genetic tests which need to be done first?

I have known people who try again straight away, and also people who have chosen to wait a while; whatever you choose has to be right for both you and your partner. There is no medical reason to wait if the doctors have cleared you physically, so the only thing that you need to worry about is how you will feel emotionally going into another pregnancy.

When we told people that we were going to try again we had a whole range of comments, it seemed like everyone had an opinion! Some were good…. And some were not so good! Ultimately, it is down to you and your partner and other people really need to either support you in your decision or keep their opinions to themselves!

After we were told that Sophie has passed away we were sent home for two days while awaiting the induction. This was probably the hardest part for me as I could feel that inside things had changed; my stomach was hard and heavy, Sophie was slumped to one side, at the bottom which made it very uncomfortable, and emotionally just knowing that she had passed away but was still inside me and frightened of what was to come was extremely difficult. Emotions can make you react in a way that some people can’t understand.

During our time at the hospital before we were sent home the doctor was discussing the possibility of trying again and at the time I was adamant that it wasn’t going to happen… EVER! Well, you can imagine Paul’s surprise when the following day I turned around to him and said ‘once Sophie is born I want to try again straight away’ he was very shocked by this and thought that I wasn’t thinking clearly… which I now know I wasn’t! My emotional state at the time was, as you can imagine, all over the place. I remember feeling very guilty for admitting that I wanted to try again so soon, but after speaking to the Midwife I realised that actually, those feelings, are very normal.

These are some of the questions I asked myself to decide when the time was right for me. However, this was after a stillbirth, when I had gone through labour and birth, my milk needed to dry up, and I needed time to heal physically and have the post mortem and all the genetic testing done; after our miscarriages we tried straight away… so these questions can be adapted depending on the gestation.

When is it right to try again?

This is something that is personal to each couple, and no one else should try to influence them in any way. I am hoping that this post will help to answer this question.

Are You Physically Prepared?

With the physical aspect of trying again it is best to be guided by what your doctor recommends. My doctor recommended waiting until after my 6-week postnatal check-up, but each doctor will have their own recommendations based on your own personal circumstances, the reason for your loss and the method of delivery. They may also recommend that you take vitamin supplements for a set period of time to replenish the stores which reduced during pregnancy.

Are You Emotionally Prepared?

Your doctor can assess your physical state, but your emotional state is just as, if not more important when trying after a loss. In all honesty, no one knows for certain how they will react when they conceive after a stillbirth, miscarriage or infant death; psychologically it can affect you for the rest of your life, and although you move forward, when you conceive these feelings may come rushing back. However, there are a few questions that you could ask yourself when preparing to try again:

  •  Have you had a chance to work through some of your grief?
  •  How would you cope if you were to experience fertility problems?
  •  Are you ready to cope with the stress of another pregnancy?

Talk about your feelings with your partner

Do you both feel the same? It’s important to discuss and listen to each other. I know Paul was shocked and overwhelmed by my eagerness to try again so soon. Women can sometimes become obsessive and carried away, while very often, for the man, it takes time to want to try again. So, you really need to listen to each other in order to agree on a course of action that you are both comfortable with.

Emotions while Trying Again

Trying to conceive can be torturous and frustrating… even for people who haven’t experienced a loss. Women can easily become obsessive as the months go on (charting, taking temperatures, buying ovulation predictor kits etc). Very often people lose sight of the intimacy and sex becomes robotic… this can make things much harder, not just to conceive, but also your desire to be together. For couples who have experienced a loss this can be even more challenging…. You want things to happen, but at the same time are scared of them happening. It is far better to just relax and let nature take its course; and you will then find that you enjoy the process rather than allowing your emotions to get in the way.

What Others Think

It is a fact that everybody will have their own opinions on whether or not you should try again. However, ultimately that is down to you and your partner. Until I decided to write a post about this there were very few people that knew we were trying again… mainly because I didn’t want, or need to hear their opinion! Of the people we have told, we have had a range of opinions… from the supportive ‘we will stand by whatever you decide’ to ‘we think it’s a complete mistake’ but ultimately it is our decision, and with the doctors promising that I will be closely monitored, I think we may regret it if we don’t ‘try’ once more.

How to Know When You’re Ready

This is a really hard one to answer! You will have days when you are obsessed about trying again and really want it to happen asap, and then you’ll have days when fear takes over and you are terrified about conceiving and losing again. These are both completely normal emotions. Most people who have lost a baby ‘just know’ when the time is right; it’s a gut instinct that takes over. However, I am under no illusion that pregnancy will never be the same again, I will worry about every single thing and will no longer be ‘relaxed’ once I hit the 12-week milestone.

Final and Most Important Question

Do the rewards outweigh the risks? This is a personal question that only the couple can answer! Once you feel that the answer is yes, then you are ready to try again

How to Know When It’s Time to Try Again

This is something that I have been asked a few times recently. ‘How do I know when the time is right to try again?’ This is a very personal question, and the answer is going to be different for everyone. So, with this post I am going to give a very general answer based on conversations that I’ve had with various bereaved parents.

You are the only person who knows how you feel about trying again, and therefore you are the only one who knows when the time is right. However, there are some things to take into consideration.

• How does your partner feel?
• Have you had all the tests available so that you know any risks in future pregnancies?
• Are you happy with your care team?
• Are you confident that you will be well looked after?
• Do you feel ready, emotionally, for another pregnancy?
• Are you physically healed from your last pregnancy?
• Are you taking any suggested medication?

The main thing is that you, and your partner, feel ready. Rainbow pregnancies are not easy; you are no longer naïve about things that can happen, and this can be very stressful. I would urge you to work with your doctor to make sure that you are fit and healthy, and that any concerns are taken seriously; as this will help to ease your mind.

Some people feel ready immediately, others want to wait a while. What I will say (and I’m being a complete hypocrite here as I wanted to try straight away after Sophie!), is that it is best to wait for tests, especially genetic tests, to come back first; this way you can be sure that the care plan your doctor puts in place for you, is tailored to your individual needs.

I wish you the best of luck when you do decide to try again, and I’m keeping everything crossed for you!

Research into Loss

Tommy’s conduct research into miscarriage, stillbirth and premature birth; they have four research centres (London, Manchester, Edinburgh, and the National Research Centre which is the largest in Europe). Hundreds of doctors and midwives work together across the Tommy’s research centre network to improve pregnancy outcomes for both mother and baby.

There are specialist clinics within the centres for women at risk of pregnancy complications, they also have the opportunity for people to join in research trials.

London

The Tommy’s Preterm Surveillance Clinic – This is held at Guy’s and St. Thomas’ hospital, and they have been providing care for over 10 years. Tommy’s states that ‘In 2017, the total number of referrals from women at high risk of giving birth too early doubled compared to 2016. We are now seeing an average of 200 referrals each month’.

The hypertension in pregnancy clinic – This is based in St. Thomas’ Hospital and helps women with high blood pressure. They have helped 150 women since 2015.

The diabetes clinic – This is based at Guy’s and St. Thomas’ Foundation Trust, the clinic helps women with diabetes, women suffering from endocrine disease and other disorders like cholestasis. ‘The research carried out in the clinic has been a driving force for the adoption of universal screening for gestational diabetes’ Tommy’s

Manchester

The Placenta Clinic – This is the UK’s first placenta clinic and was opened in 2009; they work with women whose babies have growth restriction, and study the placenta carefully to reduce the risk of stillbirth.

The Rainbow Clinic – This is based at St. Mary’s and they provide care to women who have suffered a previous stillbirth or neonatal death.

The Lupus in Pregnancy Clinic –Tommy’s is supporting this clinic which helps women with the autoimmune disorder Systemic Lupus Erythematous and related diseases. Tommy’s supports the clinic through access to our research midwives.

The Manchester Antenatal Vascular Service – This is based at St. Mary’s hospital in Manchester, and offers extra monitoring and pregnancy care to women with a history of high blood pressure, and those at risk of related complications. Tommy’s states that ‘MAViS is currently home to exciting research funded by the National Institute for Health Research’. Tommy’s supports the clinic through access to our research midwives.

Edinburgh

Tommy’s Metabolic Antenatal Clinic – This clinic helps women with severe obesity, they have specialists in pregnancy care and diabetes, as well as midwives and a specialist dietician. 25-30 women each week are seen in this clinic. Last year women attending this clinic were 8 times less likely to have a stillbirth than women attending clinics not specialised in helping obese women.

Tommy’s Lothian Preterm Birth Clinic – This clinic aims to continue reducing preterm birth and late miscarriage rates, to improve the quality of care for women and to develop expertise in managing complex cases.

Miscarriage centre clinics

Tommy’s National Centre for Miscarriage Research has recurrent miscarriage clinics in three different sites in the UK. All of these offer close monitoring and care during the early stages of pregnancy to women who have previously suffered miscarriages. They are also able to take part in Tommy’s clinical trials, which hope to provide women with reasons for their loss. The clinics are based in:
• Birmingham Women’s Hospital
• University Hospital Coventry
• St. Mary’s Hospital London

If you would like to be referred for one of these clinics, then please visit: https://www.tommys.org/our-organisation/help-and-support/clinical-trials

If you would like to take part in one of the trials, then please visit: https://www.tommys.org/our-organisation/help-and-support/i-would-take-part-tommys-trial

To sign a petition I made to cut the stillbirth rate in the UK, please visit: https://you.38degrees.org.uk/petitions/cut-stillbirth-rates-by-half