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PAILS of Hope

Coping with Fear During Subsequent Pregnancy
by Deborah L. Davis, Ph.D.
After struggling with infertility or after a baby dies, a subsequent pregnancy can feel tainted. Even as you are grateful to carry new life, you may feel overwhelmed by strong emotions not usually associated with expecting a baby-emotions like anger, sadness, confusion, failure, guilt, anxiety, and terror. If you have experienced infertility, feelings of failure may be exacerbated by any problems or unusual events during your pregnancy. You may feel guilty every time you're tempted to complain about nausea or sleepless nights since you swore you'd gladly endure these trials. If you are bereaved, you may feel angry that you have to pay your dues again and endure the discomforts or risks or another pregnancy. You may feel sad that you are not pregnant with the dear baby you miss and long for. Across the board, fear is the overriding feeling for many mothers-fear of losing the pregnancy, fear of something going wrong that will harm the baby, fear of being an inadequate mother, even fear of worrying too much.

Coping with any of these painful feelings can be hard, but for many mothers, it is the fear that colors every aspect of pregnancy. While banishing your fears may prove to be impossible, you can learn to cope with them, and lessen their emotional impact on you during a subsequent pregnancy. The following list of suggestions focuses on the emotion of fear, but you can try applying them to any feeling that is troubling you.

  1. Recognize the source of your fears. You are afraid, not because there is something wrong with you, but because you feel vulnerable. You feel vulnerable because you are personally acquainted with tragedy and you can no longer trust that only good things happen to good people. You realize that you are not in complete control of the outcome. But remember, when a fear is a remnant of past experience, it isn't necessarily a predictor of future events. Your worries are not foolproof evidence that something terrible is actually going to happen. How can you tell? Try to separate out which fears are arising from your imagination and memories of what happened before, and which fears are arising from cues you are actually observing or tuned into. If a fear is coming out of imagination or memory, discount it. It's not real. Instead, put your energy toward being alert to what's really going on with your pregnancy. Without the noisy interference of your imagination, you'll be better able to relax when all is well, and likewise respond appropriately to any actual signs or symptoms that may require medical attention.

  2. Read about what scares you. One way to master fears is to combat ignorance. The more you can learn about a topic that scares you, the less you'll be generally and randomly worried about it. While you may believe that reading about SIDS, premature labor, stillbirth, miscarriage, cord accidents, birth defects, or Beta Strep will only heighten your anxieties, to the contrary, you can feel more in control. Perhaps you can take action to lessen your risks. Maybe you'll discover that some of your fears don't stand up to specific and complete information. Talking to your doctor or midwife can be an excellent source of information and reassurance. Ask them, as well as other bereaved parents and your librarian to help you find materials to read or videos to watch. Ignorance victimizes you; information empowers you.

  3. Deal with your feelings of grief. Accompanying your fears may be emotions of grief. You may feel angry or feelings of failure about your earlier struggles and losses, guilt that you are to blame, or pessimism about your future. Grief also can contribute to underlying fears that you are a bad mother or that you deserve terrible outcomes because of past indiscretions. Any of these feelings of grief can add fuel to worries about your baby's health and safety. If you can acknowledge, separate out and deal with these other painful feelings, you may find your worries fading or easier to manage. And by facing your feelings, you can learn to cope and adjust, and eventually they won't loom so large in your life.

  4. Talk about your fears. By talking about your fears, you are bringing them out into daylight where you can really examine them and put them into perspective. This lessens their power to scare you and run your life. Enlist people who can listen sympathetically so that you feel free to explore and unload your worries, and even reach some sort of resolution. And remember, openly discussing your fears with your health care providers can help you get the kind of reassurance or monitoring you want and deserve.

  5. Write about your fears. Like talking, writing can be therapeutic. By putting your fears and feelings on paper, you can move them from inside to outside and clarify what may be a confusing mixture of pain. In this way, writing can reduce the pressure and power of your fears. The advantage of writing over talking is that you can be brutally honest or morbid without concern that you might offend your listener. When you don't censor your thoughts and feelings, you can deal with them more effectively. You might also try writing a nasty letter to what scares you, and have it out. Or draw, paint, sculpt, or cut and paste a picture of your fears, yet another way to expose them.

  6. Talk back to your fears. Fears can feel overwhelming if you let them convince you that your situation is hopeless. Even when your symptoms and aches are normal rites of pregnancy, your fears can bombard your mind with catastrophic thoughts of doom. You will feel more resilient and hopeful if you can counter discouraging thoughts. Instead of "I'll never carry a pregnancy to term," try "This is a different pregnancy, and I can hope for a different outcome." Instead of "My body is a failure," try "Right now, my body is successfully carrying a baby, and I will do all I can to have a healthy pregnancy." Instead of "My worries are an annoying imposition on my doctor," try "I'm going to consult with a high-risk doctor who is used to addressing the concerns of vigilant parents."

  7. Reassure yourself with optimistic thoughts. Optimism is an antidote to fear. You may find it easier to embrace or conjure up optimistic thoughts after your pregnancy has gotten past a certain point, perhaps after the first trimester when the risk of miscarriage drops, or near the end, when premature birth wouldn't be such a burden to your baby, or when you're past the point when complications arose the last time. Whenever and however you come upon them, holding onto any positive inklings can help you weather your worries. Banish the superstition that if you have high hopes, you will jinx your future. Instead, take to heart the positive signs you observe, and your intuitions that things will turn out for the best. If you have any deep down intuition that in the end, everything will be okay, trust it, believe it, dwell on it. Remember that the vast majority of pregnancies result in a healthy baby, and yours can too. While your optimistic thoughts may not change the bottom line of your baby's outcome, they may very well affect your emotional well-being. Instead of holding back with pessimism, you can invest in your journey with optimism. And your attitude can certainly affect whether you take the high road or the low road. In the face of uncertainty, positive thoughts are free-it's the negative ones that can cost you dearly.

  8. Reassure yourself that your fears are normal. Having fears is a natural part of a subsequent pregnancy. In fact, recognizing that you are vulnerable to tragedy is a healthy step toward coming to terms with your losses and working through your grief. You can acknowledge that life sometimes throws you a curve, as you also recognize your resilience in the face of adversity. As you learn to balance your fears with optimism for the future, see this as a normal and healthy process. And of course, take advantage of your heightened vigilance to get the best prenatal care possible!

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; 2002), 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, 2003).

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