After experiencing pregnancy loss, the joy and excitement of future pregnancies may be overshadowed by feelings of detachment and/or distress due to the possibility of another loss. In fact, research shows that pregnancy after loss is associated with higher levels of stress, depression, and anxiety.

Symptoms of depression may include feelings of sadness, numbness, or emptiness, anger or irritability, loss of interest in things, sleep and/or eating disturbances, feelings of worthlessness or guilt, feelings of hopelessness and even thoughts of suicide. Symptoms of anxiety may include feeling nervous, tense or restless, having a sense of impending danger, dread, or doom, and physical symptoms such as increased heart rate, sweating, trembling, gastrointestinal distress, and so on.

When it comes to coping with pregnancy after a prior loss, I encourage you to:

1.    Allow yourself to handle this pregnancy in a way that feels right to you. After experiencing a loss, it can be difficult to trust that future pregnancies will result in a baby. Because of this, you may be apprehensive about sharing the news of your pregnancy, celebrating it, or making preparations for the arrival in the ways you might have otherwise. Do what you feel comfortable with.

2.    Hold hope along with uncertainty. While no one can tell you the outcome of this pregnancy, know that according to the Mayo Clinic, pregnancy loss is usually a one-time occurrence with most women who miscarry going on to have healthy pregnancies. It may also be helpful to know that researchdemonstrates that once a heartbeat is detected the chances of miscarriage drop to less than 5%.

3.    Focus on what you can control. Knowing that there is little you can do to prevent a loss can be difficult to accept, but it is likely the reality. Focus on what is within your control, mainly taking care of yourself including managing the distress you may be feeling as a result of a prior loss. Maintain a healthy lifestyle by eating nutrient dense foods along with taking your prenatal vitamins, limit caffeine and abstain from alcohol and other drugs. So long as you have the ok from your doctor, stay physically active. And try to prioritize sleep. Practices like prenatal yoga and meditation as well as journaling can help you manage distress. There are meditation apps geared toward pregnancy such as  Expectful, and journals as well, such as WeNatal. You might also consider things like prenatal massage and/or acupuncture.

4.    Consider seeing a specialist and asking for increased monitoring. Having regular prenatal visits is important. After experiencing a pregnancy loss, particularly in light of complications, you may benefit from seeing a specialist such as a perinataologist. In fact, research has demonstrated that seeing a specialist and having increased monitoring can help manage distress.

5.    Seek support. You may benefit from attending a support group, such as Pregnancy after Loss Support offered by Postpartum Support International (PSI) and/or finding a therapist in your area through their online directory, which you can at the PSI website, particularly if you are experiencing symptoms of depression and/or anxiety. There are additional resources including the app Pregnancy After Loss.

PSI has a helpline available at 1-800-944-4773 (4PPD).

The National Maternal Mental Health Hotline is available 24/7 at 1-833-852-6262.

If you are experiencing thoughts of suicide the Lifeline can be reached 24/7 via text or phone at 988. In the event of a mental health emergency call 911 or go to the nearest ER. Please note that this information is intended for informational purposes only. It should not be used as a substitute for psychological or medical care.