The first trimester of pregnancy is known for its own set of difficulties such as nausea, vomiting, and fatigue. Managing the first trimester when you are expecting a baby after pregnancy, infant, or child loss can come with an additional set of challenges. Some of the challenges that individuals and couples may face beginning as early as the first trimester are described below.
1. Fears of Miscarriage
Statistically speaking, pregnancy loss is more likely to happen in the first trimester than later on in pregnancy. While these statistics may mean little to reassure bereaved parents who have been on the wrong side of the statistics before, it is hard to ignore that the risks are higher earlier on. The fears of miscarriage are incredibly valid. People who have experienced first trimester losses before will fear experiencing another loss in this same time period. However, even for loss parents who have never experienced a first-trimester loss, no time of pregnancy feels like a guarantee. Hypervigilance and fear about spontaneous or missed miscarriage are common during this time.
2. To Share or Not to Share
There can be a lot of pressure to decide whether you want to share your pregnancy with others. What before loss may have felt like a secret that was fun to keep or news that you were excited to share with others likely feels different now. You will have to decide if, when, and how, to make a more public announcement, but you also may decide to share more privately earlier on.
My partner and I have shared differently with each of our pregnancies after loss, mostly based on what felt right to us at the moment. Although there still can be a stigma for sharing early, we have each time known that if we experienced another loss (as we did in our first and second pregnancies), we would need support from others. We wanted people to share in the joy rather than just hear the news if we had a loss, and we needed the support of others from early on up until the milestones of our losses at 20 weeks.
One of the biggest struggles that we have experienced in sharing news of a pregnancy is that others often respond with such excitement. It is hard to imagine how else they should respond, and at the same time when others respond with so much joy, it is difficult that it does not match the level of anxiety that we have especially so early in a pregnancy. I feel like I have to give the caveat that “it’s still early” to not make it seem as though I am counting my eggs before they hatch. Other’s emotions to you sharing may influence who you share with and when you share. Even just hearing the word congratulations can be difficult if you feel like you won’t be able to celebrate until you know you will be bringing home a living child.
3. The Lack of Information
Dependent on your history, your care team, and how you conceived your child, the timing of early appointments may differ. Some people have early ultrasounds, which can be reassuring. Others may not get much information until somewhere between 8 and 12 weeks. These periods of waiting for appointments can feel so long. You will likely find yourself obsessing over symptoms, as this is about the only information you get early on. You may even find nausea or vomiting reassuring.
As I am nearing the end of the first trimester of my fourth pregnancy, I have come to understand that the “silence” of the first trimester is triggering for me. In my first two pregnancies, I never felt a whole lot of movement. This was likely connected with the genetic condition that affected my sons, it is also completely normal to not have reliable movement before 20 weeks, when we found out we lost them. When I was pregnant with my rainbow baby, feeling her move gave me a lot of reassurance, and as the pregnancy continued I tried (and struggled) to trust my intuition more. While it is entirely normal to not feel movement at 12 weeks of pregnancy, the lack of movement and the silence in my uterus are hard to not worry about. I have the knowledge that a baby is growing in there, but it doesn’t feel real without that constant reminder. I have to keep reminding myself about the baby I saw multiple times on the ultrasound screen and assume that things are going fine as long as I get no indication otherwise. For anyone who has experienced stillbirths or missed miscarriages where the baby passed in utero with no indication, the lack of internal cues and length of time between appointments can be a bit torturous.
Before loss, pregnancy was likely not a triggering thing to you. It wasn’t connected with a previous traumatic incident in your life. Now it is. So just being pregnant, in and of itself, can remind you of this trauma. If you had a first-trimester loss, you may pass milestones of your previous loss or losses, and this can be incredibly difficult. If you experienced a stillbirth or loss of an infant or child, being pregnant may trigger guilt about having another baby. The worries about whether you are replacing the child you lost may surface. The rest of us loss parents will reassure you that you are not doing anything wrong, but I also know that the guilt and fear that you are somehow betraying your child’s memory may still nag at you.
Attending appointments can be incredibly triggering. The previous trauma you have experienced of course results in fear when it comes to attending appointments. My partner and I recently had our first appointment at the Maternal Fetal Medicine office where we found out about both of our losses and where we received all of our prenatal care with our daughter. I was shocked at how anxious I was driving to this appointment and walking into the hospital. I had just had my last visit at the fertility clinic 5 days before. I was confident things were fine with the pregnancy. I have had so many more positive visits to this office than negative ones, and my most recent memories of being there include the day I was induced and bringing my 6 week old with me to my final postpartum visit. Despite these more recent positive memories, the traumatic memories are just so much stronger. They trigger anxiety in ways that can still surprise me, a mental health provider, 4 and 5 years out from my losses. The triggers of the first appointments may be especially difficult as the reality of what it means to be pregnant again hits during the first trimester.
5. The Dilemma of Connection
You may be hesitant to connect with this pregnancy. It is normal to feel like you will protect yourself by staying distant. It is also incredibly normal to just have difficulty connecting because your fear is so much stronger. As loss parents, we often feel guilty for not being connected. We know on some level that it won’t hurt any less if we aren’t connected. It is just a lie that we tell ourselves to try to guard ourselves against again experiencing a pain we have already lived. Regardless, it is normal to feel less connected. It is normal to not feel excited. It is also normal to feel excited and joyful. Whatever you are feeling is completely okay. Try not to judge yourself for however you are navigating this time. If you are embracing the pregnancy by telling others and taking bump photos, let yourself enjoy it. If you are still holding back and trying to stay distant or struggling to connect, be gentle with yourself. The connection and joy will come in time, and whenever or however it comes, you are not negatively impacting your pregnancy or your baby.
Beginning the journey of pregnancy again when it has injured you so badly before can feel nearly impossible. The lack of control you have over something that is happening inside of your body can be terrifying. It is also incredibly amazing. This duality in pregnancy after loss can help us manage the difficulty. The hope and fear, the joy and grief walk hand in hand each step of the way. Be gentle with yourself, take care of yourself, and reach out to your community for support when you need it.
- Why fear should not keep you from announcing a baby on the way, even in early pregnancy
- When to Call Your Provider in the First, Second, and Third Trimesters of Pregnancy After Loss
- What You Need to Know about First-Trimester Loss
- How to prepare for your first doctor’s visit when pregnant after a loss
- 6 Ways to Bond With Your Baby Before Birth