What to expect when you're expecting (219 page)

Structure the day.
Try to establish a routine—even if the highlight is a soak in a tepid tub followed by a nap, or a morning on the couch followed by an afternoon in bed. You’ll feel a little better if you give the day some sort of structure.

Work from home.
If you’re on modified bed rest and work in a fully wired field, it may be possible to work from home for all or part of the time you are on bed rest. Between conference calls and e-mails, you can actually be very productive as a gestating telecommuter. Speak to both your practitioner and your boss to be sure everyone is on the same page about what your capabilities and your limits are (and if your job is emotionally stressful, you may not get the go-ahead from the obstetric powers that be).

Moms Helping Moms

Every pregnancy comes with some challenges, but a pregnancy that’s high risk (or one that’s been complicated) can come with a whole lot more. Facing those challenges is always easier when you’ve got company—other moms who know exactly what you’re going through because they’re going through it, too (or have already gone through it) themselves. There may be support groups in your area for the specific pregnancy challenge you’re facing (ask your practitioner), but you’re also likely to find that support online.

Get your baby shopping done.
Pretty much anything you can do in a store, you can do online. So use this bed-rest time to get baby-ready on the web. Register for your layette, order your crib, or find your future doula, lactation consultant, and babysitter online. And while you’re at it, order your groceries, too (you’re out of milk again, aren’t you?).

Deliver dinner.
While you’re waiting for your special delivery, tap into your neighborhood network of restaurants that deliver. Keep those menus within arm’s reach, or look for them online.

Try some movie magic.
Sign up with a DVD-by-mail service and catch all those films you didn’t have a chance to see in the theater—and won’t have time to see once you have a baby in the house.

Entertain in bed.
Get your friends together for a bedroom potluck or pizza and a movie. (Best part of this plan: They’ll have to clean up the crumbs, not you.)

Get crafty.
Teach yourself to knit, crochet, or quilt. Better yet, have a talented pal come over and teach you. You’ll be creating sweet treasures for your little one and getting some much-needed companionship, too. Or take up scrapbooking (you’ll soon have more mementos to save than ever before).

Get organized.
Put all those old photos into an album (finally), or enter your address book into a computer database. You’ll be glad you did when you’re able to print out those address labels (for your baby announcements, thank-you notes, party invites, holiday cards …) instead of hand-writing them.

Sit pretty.
Do the things that make you feel good each day, even when it sometimes seems pointless. Brush your hair, put on makeup, slather your tummy in yummy-smelling lotion (your skin will be itchy and dry anyway). If you can afford it, consider having a hairstylist or manicurist make a house call. (Drop the hint to your friends that this would make a great shower gift.) Don’t fall into that “nobody’s going to see me anyway” trap—looking good makes you feel good, whether anyone else sees you or not.

Freshen up.
Charge your spouse with changing the sheets on your well-used bed once a week. Keep baby wipes and hand sanitizers nearby to keep yourself clean and relatively fresh between showers and baths.

Start a journal.
Think of the bright side: Now’s the perfect time to begin recording your thoughts or feelings about pregnancy or bed rest, or writing a few letters to your baby that you can share with him or her in years to come. Check out
The What to Expect Pregnancy Journal and Organizer,
which can help you preserve pregnancy moments. Writing your feelings down is also a great way to vent.

Keep your eyes on the prize.
Frame one of your ultrasound pictures, and keep it by your side—so when the going gets tough, you can remind yourself that you have the best reason in the world not to go anywhere at all.

P
REGNANCY IS SUPPOSED TO BE
a joyous time, filled with excitement, anticipation, and pink-and-blue daydreams about life with your baby-to-be (mixed in with a little normal trepidation and anxiety). And usually, it is all of those things, but it isn’t always. If you’ve experienced the loss of a pregnancy or a newborn, you know firsthand that the depth of your pain can be beyond words. This chapter is dedicated to helping you handle that pain and cope with one of life’s most difficult losses.

Just because it often takes place very early in pregnancy doesn’t mean that miscarriage isn’t painful for expectant parents. The grief that can come with a miscarriage is real, no matter how early in pregnancy you lost your baby. Even though you never saw your baby, except perhaps on ultrasound, you knew that he or she was growing inside of you, and you may have already formed a bond, however abstract. From the moment you found out you were pregnant, you may have daydreamed about your baby and imagined yourself a mother. And then, all the excitement of months (and years, and decades) to come abruptly came to a stop. Understandably, you may feel a range of emotions: sad and disheartened over the loss; angry and resentful that it happened to you; possibly withdrawn from friends and family (especially those who are pregnant or just had babies). You may have trouble sleeping and eating at first and accepting the finality of it all. You may cry a lot, or you may not cry at all. These are among the many natural, healthy responses to a pregnancy loss. (Remember that your reaction is what’s normal for you.)

In fact, for some couples, coping with early pregnancy loss may be, at least in certain ways, just as difficult as coping with a loss later on. Why? First of all, because so many couples hold off on spreading the word about their pregnancy until the third month has passed, even close friends and family may not have been told yet, which can mean that support may be hard to come by. Even those who knew about the pregnancy and/or are told about the miscarriage may offer less support than they would have if the pregnancy had been further along. They may try to minimize the significance of the loss with a “Don’t worry, you can try again,” not realizing that the loss of a baby, no matter how early in pregnancy it occurs, can be devastating. Second, the fact that there is no possibility of holding the baby, taking a photo, having a funeral and burial—rituals of grieving that can all help offer some closure for parents of stillborn infants—may complicate the recovery process.

Still, if you’ve suffered a miscarriage (or an ectopic or molar pregnancy), it’s important to remember that you have the right to grieve as much—or as little—as you need to. Do this in any way that helps you heal and eventually move on.

Perhaps you’ll find closure in a private ceremony with close family members or just you and your spouse. Or by sharing your feelings—individually, through a support group, or online—with others who experienced early miscarriage. Since so many women suffer a miscarriage at least once during their reproductive years, you may be surprised to find how many others you know have had the same experience as you but never talked about it with you, or maybe even talked about it at all. (If you don’t feel like sharing your feelings—or don’t feel you need to—don’t. Do only what’s right for you.) Some of the tips for those who have later pregnancy losses may be helpful for you, too. You may also want to read about the Stages of Grief (see box on
page 585
), which may or may not apply to you.

A Personal Process

When it comes to dealing with a miscarriage or other pregnancy loss, no one emotional formula must be followed. Different couples confront, cope with, and process their feelings in completely different ways. You may find yourself deeply saddened, even devastated by the loss—and discover that healing comes surprisingly slowly. Or you may handle the loss more matter-of-factly, seeing it as a bump in the road to having a baby. You may find that after some momentary sadness, you’re able to put the experience behind you more quickly than you might have expected—instead of lingering over the loss, you may choose to look ahead to trying again. Just remember: The normal reaction to a pregnancy loss is the reaction that’s normal for you. Feel whatever you need to feel in order to heal and move ahead.

Accept that you may always have a place in your heart for the pregnancy you lost, and you may feel sad or down on the anniversary of the due date of your lost baby or on the anniversary of the miscarriage itself, even years later. If you find it helps, plan on doing something special at that time—at least for the first year or so—that will be cheering yet allows you to remember: planting some new flowers or a tree, having a quiet picnic in the park, sharing a commemorative dinner with your spouse.

Coping with Repeat Miscarriages

Suffering one pregnancy loss can be hard enough to cope with. But if you’ve suffered more than one, you may find it infinitely harder—with each loss hitting you a little harder than the last. You may be discouraged, depressed, angry, irritable, unable to focus on the rest of your life (or on anything beyond your losses). The healing of your psyche may not only take a lot longer than the healing of your body, but the sadness can be literally debilitating. What’s more, the emotional pain may lead to physical symptoms, including headaches, appetite loss or overeating, insomnia, and overwhelming fatigue. (Some couples handle even repeat losses more matter-of-factly, and that’s completely normal, too.)

Time may not heal all, but it will definitely help eventually. In the meantime, patience, knowledge, and support may be your best remedies. Pregnancy loss support groups may be available in your area, so ask your practitioner, or find a support group online, if you think that might help you (some couples prefer to turn to each other for support). Sharing with others who have suffered through pregnancy losses, especially multiple losses, can help you feel less alone, as well as more hopeful. Most of all, don’t let guilt add to your burden. Miscarriage is not your fault. Instead, try to focus on how strong you’ve been (even if you haven’t always felt that strong) and how determined you are to have a baby.

While it’s normal to mourn your loss—and important to come to terms with it your way—you should also start to feel gradually better as time passes. If you don’t, or if you have continued trouble coping with everyday life—you’re not eating or sleeping, you’re not able to focus at work, you’re becoming isolated from family and friends—or if you continue to feel very anxious (anxiety is an even more common sympton following miscarriage than depression is), professional counseling can help you recover.

Try to remind yourself that you can—and most likely will—become pregnant again and give birth to a healthy baby. For the vast majority of women, a miscarriage is a onetime event—and actually, an indication of future fertility.

When you don’t hear from (or feel) your baby for several hours or more, it’s natural to fear the worst. And the worst is that your unborn baby has died.

You are likely to be in a fog of disbelief and grief after being told your baby’s heartbeat can’t be located and that he or she has died in your uterus. It may be difficult or even impossible for you to carry on with any semblance of your usual life while carrying around a fetus that is no longer living, and studies show that a woman is much more likely to suffer severe depression after the delivery of a stillborn if the delivery is delayed more than three days after the death is diagnosed. For this reason, your emotional state will be taken into account while your practitioner decides what to do next. If labor is imminent, or has already started, your stillborn baby will probably be delivered. If labor isn’t clearly about to start, the decision of whether or not to induce labor immediately, or to allow you to return home until it begins spontaneously, will depend on how far you are from your due date, on your physical condition, and on how you’re doing emotionally.

The grieving process you will go through if your fetus has died in utero will probably be very similar to that of parents whose baby has died during or after birth. The same steps will help you begin the long healing process, including, when possible and practical, holding your baby in your arms and having a funeral or memorial service. See below for more.

Sometimes the loss of a baby occurs during labor or delivery, sometimes just after delivery. Either way, your world comes crashing down. You’ve waited for this baby for months—and now you’re going home empty-handed.

There’s probably no greater pain than that inflicted by the loss of a child. And though nothing can completely heal the hurt you’re feeling, there are steps you can take now to lessen the inevitable sadness that follows such a tragedy:

See your baby, hold your baby, name your baby. Grieving is a vital step in accepting and recovering from your loss, and it’s difficult to grieve for a nameless child you’ve never seen. Even if your child has malformations, experts advise that it is better to see him or her than not to because what is imagined is usually worse than the reality. Holding and naming your baby will make the death more real to you and ultimately easier to recover from. So will arranging for a funeral and burial or a memorial service, which will give you another opportunity to say good-bye. If there is a burial, the grave will provide a permanent site where you can visit your baby in future years.