Sunday, September 22, 2013

Trying to Conceive After a Loss

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TTC After a Loss

There is no greater tragedy for a parent than losing a child. It is the loss of a dream and the vision of a perfect family. When the dream ends, the need/hunger to be pregnant again is overwhelming, and sometimes all consuming … not to replace the baby who was lost, but to fill an aching void … with the hope of finding peace and purpose.

According to Dr. John Sussman, co-author of Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth and Infant Loss (Taylor Publications), a woman’s wait to get pregnant again really depends on the nature of the loss. Although medical professionals offer varying time frames – which could be anywhere from three months to a year, Sussman and others advise waiting until menstrual periods have returned, blood counts have normalized and that the doctor has given their approval.

Medically speaking – this advice makes perfect sense – waiting until the body heals from this unspeakable tragedy. Emotionally, though, the burning desire to have that full-term healthy baby in our arms leads us angel moms to a near obsession with getting pregnant again – and quickly.

“Our OB came to see us the morning after our daughter was born, and my question after what I was to do about my engorged boobs was when could we try again,” said Lauren Wilson of Hawaii, whose daughter was born at 30 weeks, 6 days because of preterm labor. “The drive was so intense. Every cell in my body knew it was supposed to be caring for a baby. My entire being needed to hold and care for a baby – that I couldn't physically (do this) felt wrong to the core. I thought having another baby would at least make my life feel more back on track.”

Stacy Schulz of Oklahoma lost her twin daughters, Emilyn and Hailey, at 20 weeks, 5 days. Although her doctor recommended a two-month wait post loss, she and her husband wanted to try again as soon as possible – after being diagnosed with polycystic ovarian syndrome (PCOS) while trying to conceive her daughters and needing Clomid to conceive after 18 months of trying, she knew it would probably take awhile. Wilson’s doctor also recommended the same length of time before trying again, but he also he told them that emotionally, no one could determine when they’d truly be ready but them.

Time Therapy: Healing the Wounded Heart and Body

When a pregnancy is lost, angel parents find themselves on a roller coaster of emotions that span the depths of anger, depression and deep sadness. Some want to begin trying again immediately, as Wilson and Schulz did, while others want a break to grieve and focus on other things. Although the next steps are truly personal decisions, the heart, mind and body need adequate time to heal.

Wilson thought she was ready right away. She wanted so badly to be pregnant again. But her body and mind said otherwise.

“I had in my mind that I needed to be pregnant by her expected due date (EDD),” she said. “My husband and I joked that we just looked at each other and conceived our daughter. But with her sibling – it was not so easy. My cycles never returned to normal without medication and shots. It felt like insult to injury. At the time, I hated that time … waiting and wondering. It was emotional – a roller coaster. When my EDD passed, and then months and months more – I felt lost. However, in hindsight, I wish we hadn't begun trying so soon, especially with the secondary infertility diagnosis. When we ultimately did get pregnant again a few days after our daughter’s first birthday, I realized how thankful I was that I had that time to be a mom to her. I was able to do so much in her honor that year. It was our special time.”

For Lindsay Vazquez of Arizona, a mom to two preemie sons and an angel son, healing from her loss three and one-half years ago was – and still is – a sometimes all-encompassing mind/body exercise. Her angel Naethyn was born at 30 weeks because of placental abruption coupled with a blood clot, undiagnosed preeclampsia, as well as an incompetent OB, who, Vazquez said, ignored her concerns of severe swelling just weeks prior to Naethyn’s passing.

“When I got pregnant with Naethyn, the deal was – three and done. But I never imagined my life without my baby. In the delivery room, alone, I chose to have a tubal ligation – one that was never meant to be a temporary birth control fix. I didn't even have time to discuss it with my husband. I lost 60 percent of my blood that night and there was no time to consider anything else. I think my OB wanted to do everything she could so she respected my decision to have the procedure. I was not in the right frame of mind to be making those life-altering choices then – and I even had second thoughts as I was wheeled into the OR and the mask was being placed over my face. A part of me hoped to not wake up.”

Once Vazquez and her husband emerged from the initial stages of grief, they began investigating another pregnancy – either through IVF or surrogacy – desperate, she says, to right the wrong that she was feeling. But with her physical pregnancy history and the cost to reverse a tubal ligation, the chance to fill her arms with another child may be a distant dream. Until then, she continues the healing process of taking care of herself physically and never giving up the hope of welcoming another miracle.

“We've been living without our angel for three and a half years. It’s been very difficult, but we are doing it,” she said. “I have not accepted the choice I made that horrible night, and I know it will take a miracle to achieve the miracle we so desperately want. It's strange, but after going through something like that, I think it either makes you or breaks you. I'm a fighter and so are my kiddos. We would just like the opportunity to have a chance again. I'm not sure whose hands we'll be in, but one has to believe.”

Managing Post-Loss Pregnancy Fears

Achieving pregnancy after a loss is nerve-wracking. There are no naive, happy thoughts – an angel mom is wise to the world. Seeing double pink lines or a plus sign on a pregnancy test does not mean a full-term, healthy baby.

One of the best first steps is connecting with a maternal fetal medicine (MFM) doctor who can review your history and then set a plan for this pregnancy – one that clearly spells out such things as testing, shots to prevent pre-term labor, ultrasounds – when and how often, as well as accounts for the pregnant mom’s worries along the way.

“My MFM allowed me to be seen weekly from my loss date until I reached viability to assure me that everything was OK,” said Schulz. “As soon as I found out I was having a boy, I went and bought a blanket for him. Not to wrap him in when he was a newborn, but to wrap him in so I would have something special just in case he came early and died too. I didn't want to have nothing special like with the girls. I was scared up until the end. I just took it one day at a time, and kept track of his chances for each gestation, breathing a little sigh of relief with each week that passed.”

Wilson handpicked her doctors for the best chance at success. “I went into my subsequent pregnancy 110 percent sure that everything that caused my daughter to come early was a fluke. It had to be; what risk factors did we have for anything? That being said, I still rounded up the best team of doctors that I could find and that I trusted completely. Knowing that I had people I could call and who knew our story made a huge difference. I didn't have to worry about feeling like a burden calling or emailing with my questions or concerns. I also knew that I needed to find peace, and have a peaceful delivery, so I saw a psychologist who specialized in medical trauma. This made a world of difference to me.

“I was caught completely off guard when we ran into complications with our subsequent pregnancy, but having set up such a great support system with our team of doctors, family and friends who had already navigated a subsequent pregnancy – I felt safe.”

A Post-Script: the Rainbow Babies

"And when it rains on your parade, look up rather than down. Without the rain, there would be no rainbow." – G.K. Chesterton, English writer/philosopher

Wilson and Schulz both achieved their dreams of a rainbow baby. Wilson and her husband welcomed a son in February 2010 and a little sister in July 2012. Schulz’ son, Elim Henry-Otto, was born full-term in February 2011. She and her husband hope to begin working on another little sibling later this year.

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