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PAILS of Hope

AGAIN OR NOT? ~ Making Decisions About Whether to Attempt Yet Another Pregnancy
by Deborah L. Davis, Ph.D.
When you've been burned, it is difficult to step up to the plate without a sense of foreboding. If you've been through the infertility mill, high risk pregnancies, or experienced the death of one or more babies, you may wonder which is less painful--trying again or moving on. Trying again after one or two bad experiences might be a given. But if bad luck continues to haunt you, or if there are clear reasons that add to your risk, or if your experiences devastated you to your limits, you may cringe at the roller coaster you know too well: high hopes and rich expectations followed by feelings of grief, disappointment, failure, inadequacy, frustration, and defeat. Or if you've finally succeeded and have one healthy baby, you might look at your history or other factors and decide that maybe it would be best to quit while you're ahead and spare yourself the heartache.

But, if you move on, there is heartache there too. You have to deal with your grief and the finality of giving up those dreams for a(nother) baby. Which would be easier? Moving on to certain grief and eventual healing, or trying again the torturous roller coaster riding where the outcome is uncertain? It may be awful, or it may be the joyous realization of your wishes and dreams. It is a tough call, and one only you can make.

While just the thought of making such an important, life-altering decision can feel overwhelming, here are a few perspectives, which might help you find some answers you are looking for.

  1. Recognize that the urge to get pregnant and have babies has a primal, biological basis. You are wired to want to be fruitful and multiply. Of course, the biological you desires a baby, and you picture the joy of cradling a cuddly, snoozy newborn in your arms. But there is also an intellectual you, and unlike (as far as we know) most other animals, you can call into question all the aspects, goals, motives and outcomes of your desire. Look at the financial and logistical realities. What is the probable physical and emotional toll, given what you've been through and what you are likely to go through? Are there marital, familial, social or cultural pressures that you can choose to embrace or ignore? Your decision can be more than biologically driven. Perhaps after looking at all the issues involved, the "correct" decision will become clear. Maybe trying again seems right in so many ways. Or maybe you can see that even while you feel a deep desire to have a baby, you can still decide not to try for one.

  2. When making important life pathway decisions, try to decide with your heart and your gut as well as your head (e.g. #1 above features the head, predominately). Sayings such as "gut feeling", "following your heart", "putting your heart into it", and "having your heart set on something" are all ways in which we recognize that we don't just make intellectual decisions. Sometimes it can be especially meaningful to honor your feelings about various options. With regard to childbearing, you may find it particularly telling to look at your hopes and fears. Consider the following:

    1. What is the best thing that could happen if we try again?

    2. What is the worst thing that could happen if we try again?

    3. What are some other good and bad things that might happen if we try again?

    4. What is the best thing that could happen if we don't try again?

    5. What is the worst thing that could happen if we don't try again?

    6. What are some other good and bad things that might happen if we don't try again?

    Set aside 10 minutes and make a list. Don't censor or filter your responses. Write everything down, however trivial or embarrassing it may seem to you. Your list may illuminate what is holding you back from, or pushing you toward either direction. Looking at your bests & worsts, goods & bads may help you settle on what your heart is telling you. More importantly, it can help you make peace with the path you travel.

    You can also flip a coin. While this might seem simplistic or disparaging, it is an effective way to get at your gut reaction. Heads you try again, Tails you stop. Flip it. Heads? Okay, let's go for pregnancy.

    How do you feel? Optimistic? Scared? Relieved? Anxious? Dread? Anticipation?

    Flip it again. Tails? Okay, that means you don't try to get pregnant.

    How do you feel? Relieved? Sad? Content? Defeated? Uplifted?

    Really try it and see what your gut says. Naturally, listening to your heart and gut are valuable parts of making heartfelt decisions.

  3. When you're undecided, birth control can be a tricky issue, whether you have struggled to become pregnant or you've had a baby die. If you don't use birth control, every month your hopes get raised in spite of your attempts to ignore them. Or perhaps you feel exposed to possibilities that torment you. You may need to use birth control just to keep yourself from going crazy. If you feel cautious, raw, vulnerable or overwhelmed, then actively avoiding pregnancy is a reasonable decision, at least for now. Even if you really like the idea of having a baby, you can still hold onto the idea, but put off the reality. On the other hand, if you are undecided but can't stand the thought of using any type of birth control, or you keep "forgetting" to use it, then you might as well quit agonizing and accept that you may be willing to throw caution to the wind. If this que sera, sera, go-with-the-flow attitude suits you, you can decide simply to toss the birth control and let fate decide whether or when.

  4. Remember that you probably do not have to decide "the rest of your life" today. If you are struggling to make choices, or if you change your mind every hour, then apparently, today is not the day to decide. If you ovulate monthly, you might try to take things one month at a time. Is this the month to try again? If not, wait until next month. When the time is right to take the plunge, you'll know. But what if time seems to be slipping away, and your biological clock is ticking more loudly? Perhaps the ticking will spur you into a different decision. Or maybe it won't. If the time never seems right and eventually you decide that "now I'm too old", then the decision to forego pregnancy may feel a little more obvious, and you might feel more resigned. At first glance, taking it a month at a time may seem like a passive or lazy way to make a decision, but really, you are making firm decisions every step of the way.

  5. Remember, there is no absolutely "right" or "wrong" decision here. While that can make the "right" choice frustratingly unclear, you can't make a "wrong" choice either.

  6. If and whenever or however you decide "no more", you'll probably feel the need to grieve, but then most women grieve the end of their childbearing days, whatever their circumstances. Your grief does not mean you made a bad decision-it's just going to be sad when you know that your baby days are gone. After all, there's nothing so precious as warm baby fuzzies.

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  7. Many mothers talk about "the courage to try again" as if not trying again is the wimpy way out. Indeed, if you've struggled with infertility and/ or the death of one or more babies, you may feel like you've been on a battlefield, where retreat is traditionally considered dishonorable. But if the analogy of "baby wars" doesn't appeal to you, try to question the assumption that bearing a healthy baby makes you a winner, and walking away makes you a loser. Recognize that while it takes courage to try again, it also takes courage to stop.

This article first appeared as "Looking Toward New Beginnings," published in the Pregnancy and Infant Loss Center's newsletter "Loving Arms."

Deborah L. Davis, Ph.D. is a developmental psychologist who specializes in perinatal and neonatal crisis, medical ethics, parental bereavement and adjustment, parent education and child development. Dr. Davis is the author of four books for bereaved parents, Empty Cradle, Broken Heart (Fulcrum, 1991; 1996), Loving and Letting Go (Centering, 1993), Fly Away Home (Centering, 2000) and Stillbirth, Yet Still Born (PILC, 2000). With Mara Tesler Stein, Psy.D., she is the coauthor of The Emotional Journey of Parenting Your Premature Baby: A Book of Hope and Healing (NICU Ink, 2002).

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