“One day, you will tell your story of overcoming what you’re going through now, and it will become part of someone’s survival guide.” ~ Anonymous

Finding hope can be scary, complicated, and elusive when you’re pregnant after loss. The innocence of pregnancy has been shattered. You’ve experienced the worst possible scenario, so you no longer can be lost in the excitement of how a positive pregnancy test equals a baby. Because it doesn’t. The desire to become pregnant again can conflict with the fear of becoming pregnant and facing another loss.

My road to parenthood has been long.

I had spent years trying to have a baby while counseling others who desired the same as a reproductive therapist. I helped clients prepare for treatments, manage disappointments, and mourn their losses. I did all of this in the face of staggering and surprising statistics about fertility and pregnancy loss. While infertility and loss impact everyone, they do not affect people equally. For example, studies show that Black women are twice as likely to experience fertility issues and 1 ½ times more likely to experience pregnancy loss than our White counterparts.

In 2020, I knew my fertility journey was close to the end, but my husband and I agreed to try one more round of IVF before deciding to remain childless. So, after seven years of loss and heartache that included one missed miscarriage, one Termination For Medical Reason (TFMR), five rounds of IVF, a failed IVF cycle, and two chemical pregnancies, I prepared for the next chapter of my life knowing that I had done everything I could to realize my dream.

Dr. Loree Johnson and her husband pregnant with their quadruple rainbow baby

Author’s Personal Collection/Dr. Loree Johnson

Miraculously, this transfer worked. However, pregnancy after loss is brutal.

I had already endured four previous losses, the crushing mix of measured hope and optimism, and then despair. The anxiety of each subsequent pregnancy was worse than the last, which meant the anxiety that shrouded this pregnancy overwhelmed me.

The loss of innocence around pregnancy means you’re holding your breath until you reach the next milestone. Except you’re never fully able to exhale until you’re holding your baby – before the next set of worries sets in. As a therapist, I was keenly aware of the health disparities in Black maternal health, so I had to navigate my fears of developing one of the countless complications that I would be twice as likely to develop, such as high blood pressure, pre-eclampsia, gestational diabetes, or dying during childbirth. Managing this pregnancy would be exponentially more challenging for me, not solely based on my age but also my identity.

Loved ones were told about my pregnancy on an as-needed basis, stemming from my need to create a small circle of trusted individuals who demonstrated an ability to support me in ways that I found helpful. Usually, loved ones want to express excitement and happiness about each stage of pregnancy. However, I couldn’t take that in because I knew that pregnancy could shift at any moment, even while I tried to find reassurance in any pregnancy symptom that things were progressing normally.

As I cautiously made my way through my second trimester, leisurely walks helped my mental health as my morning sickness waned. The long-awaited 20-week scan was the next major milestone. I breathed a sigh of relief as the doctor went through the scan noting how everything looked good. Until the end of the exam, she grew silent as she took measurements, and then I heard her say, “Let me help you up; there’s something we should discuss.” My heart sank. Memories of when my doctor had delivered devastating news to me in previous pregnancies came rushing back – “I’m sorry there’s no heartbeat,” “I’m sorry, there’s something wrong with your baby.”

I thought, “Surely, I can’t be going through this again.”

Dr. Loree Johnson and her husband pregnant with their quadruple rainbow baby

Author’s Personal Collection/Dr. Loree Johnson

My doctor diagnosed me as having a short cervix. As I heard her list all the potential complications and the treatment plan for my condition at my stage of pregnancy, her words became a blur, especially as her voice softened when she mentioned, “pre-term labor, viability, the end of pregnancy.” I’m not sure how I made it through the next few weeks, but as my monitoring appointments ramped up. I soon learned that my cervix had started to dilate. I was directed to Labor and Delivery to be assessed for an emergency cerclage.

I remember my husband’s face while driving to the hospital (worried but trying to stay calm for my sake), waiting in line to check in at the hospital, and then approaching the nurse’s station – alone due to COVID – and breaking out in tears when I was asked my name. The kindness of the nurse reassuring me that they would take good care of me helped ease my spirit slightly, but I knew there was still no guarantee that my baby would make it.

On the unit, interns, residents, and attendings examined and monitored me while we discussed my options. I was briefed about the benefits and risks of an emergency cerclage and steeled myself for a tenuous remainder of my pregnancy – not the sigh of relief that often accompanies this stage. Instead of looking forward to a baby shower, setting up a nursery, or shopping for anything baby-related, I counted the weeks until our son reached viability and each subsequent week after that, which equated to less time in the NICU. The stress and fear continued…

Elevated blood pressure readings and a diagnosis of chronic hypertension in pregnancy added insult to injury. Twice weekly stress tests and two high blood pressure readings that sent me to L&D marked the remainder of my pregnancy. I couldn’t catch a break.

By week 34, I exhaled somewhat. I was three weeks away from my scheduled cesarean section. However, on the morning of my 36th week, I woke up to an excruciating pain that would not go away. The pain wasn’t a normal contraction. I knew because I had had them before during a previous loss, although never this strong. After speaking with the doctor on call, my husband and I trekked 45 minutes to the hospital in traffic. Luckily, the baby was fine, but when the pain would not subside, the doctor decided I needed to deliver early.

On July 23rd, my quadruple rainbow baby was born, and his cry unleashed a well of emotion eight years in the making.

Tears of joy were mixed with disbelief. Our miracle was finally here. Getting lost in the sweet sound of his cry made me somewhat oblivious to what would happen next. The NICU team evaluated him, but he passed their tests with flying colors. I, on the other hand, learned that my uterus had ruptured, something that happens once in approximately every 10,000 births and most likely at the incision site of one of my two previous uterine surgeries.

It has taken me months to process what my body and spirit have endured, even as I write my story 18 months postpartum. I sit in disbelief as I continue to process my birth story, my son’s presence as a long-awaited miracle, and the long and arduous journey it took to get him earthside. Yet, the struggle to allow myself to embrace the joy and happiness I feel when I look at him is not uncommon for those of us in the community. Chalk it up to months and years of “waiting for the other shoe to drop,” but each day gets easier as I honor my feelings about how I got here thus allowing me to move forward.

Dr. Loree Johnson and her family

Author’s Personal Collection/Dr. Loree Johnson

I am eternally grateful to the community of individuals who have helped me navigate this pregnancy–from my medical team, who listened to my fears, and honored my loss trauma with their compassion and guidance, to my colleagues who had undergone complicated loss journeys and were now on the “other side” who provided professional support as I balanced the intensity of my work with the intensity of my emotional experience – to my husband, family, and friends who quietly supported me in the simplest yet most meaningful of ways.

I felt held and loved in ways I still can’t put into words. Each person became an integral piece of my guide for making it to the other side and embracing my miracle. I hope that by sharing my story, I can also be part of your guide.

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