Pregnancy, Interrupted - A Journey Towards Healing and Hope
Posted on May 20, 2011
"I'm sorry; we don't have good news. Your pregnancy test from the IVF is negative."
"Please call regarding your Amnio results. There's a problem we need to discuss"
"The doctor needs to speak with you about the Nuchal Ultrasound."
"Sounds like you're miscarrying"
"We've been trying to become parents and going through infertility treatments for so long. We've undergone, experienced so many setbacks, false positives, negative test results, IVF attempts with failures."
"Somehow we stayed the course and we got pregnant. YES!! Reproductive technology worked for us! We were on our way to parenthood. But now, let-down, big-time..The big tease" I don't deserve this; my body has betrayed me.
After initially hearing these comments, there is often more we can't fully comprehend. Devastation, frustration, shock, paralysis followed by tears, partner hugs, much sadness, mixed with anger. No, it's not fair!!
Miscarriage affects about 25% of women who become pregnant during their lifetime.
Of all pregnancies, between 15% and 20% end in miscarriage during the first five months. Although devastating, the majority of women become pregnant again soon after the loss. After months of medications, procedures, anxiety and emotional upheaval an INFERTILE woman who finally achieves pregnancy success followed by loss, may endure a period of alternative treatments with emotional challenges prior to another success. For thousands of women the agony of infertility is not that they cannot conceive but they can't keep their babies beyond the first weeks of pregnancy. Women feel alone and isolated, betrayed by their bodies, and silently suffer their invisible pain. They have a connection to this unborn child and experience profound loss and grieving.
Some couples are told that the Nuchal translucency ultrasound, CVS or Amnio, reveals a chromosomal abnormality as Down's syndrome, Trisomie 13 or 18. They can elect to terminate the pregnancy before 24 weeks if they choose to do so.
"Hold on!! Did you say "choice?" We've been tying to conceive for years. How can we possibly choose to end this much wanted pregnancy? Is it our choice to be selfless or selfish?" This is an incredibly difficult decision fraught with unbearable, emotional pain, heartache, and guilt. Genetic counselors can offer clarity of the diagnosis explaining medical facts with the dim prognosis. Then the couple must gather information, statistics and search their souls and hearts to determine what's right for them and their baby. They may need to consult with pediatric specialists (cardiology, orthopedics, neurologists, etc). They are encouraged to talk with family members, counselors or pastors, explore religious and cultural ties, and consider existing or potential siblings, financial issues, work roles, employment, and re-location necessity to determine what's possible. Family, friends and co-workers know she is pregnant. Should she now share the truth with all, a few, or do they have a right and need for privacy? Counselors and therapists who understand loss will be helpful with the decision-making and "telling" process.
Whether it's a miscarriage, termination, fetal demise, stillbirth…there's tragic, unpredictable loss resulting in shock, pain and sadness. Hopes and dreams began to form and the person of the child began to develop. Plans and future were discussed. COUPLE was morphing into FAMILY. "Why me? Why us?" The question is forever haunting, and the punishment relentless.
You will experience a whole range of emotions with varying degrees of intensity. The mourning period is unpredictable; two weeks to several month with triggers kicking in without warning causing more grief just when you thought you were finally moving on. Emptiness for what was; your body can't accept the void. Anger, irritability, confusion, inability to concentrate, loneliness, indecisiveness, and sadness are common and expected reactions. Return to work, responsibilities, and routines prior to the pregnancy seem impossible. Family and friends will be there for support but they can't understand the impact on your life. As they begin to forget and expect you to be OK again, you will always remember the loss and the due date. The loss of a child is the deepest loss one can experience…"When you parent dies, you've lost your past but when your child dies, you've lost your future."
Grieving has a purpose. It permits you to detach appropriately from the relationship you have formed with your baby over the months. The grieving period will provide you with time to accept, understand, and let go.
Couples are often surprised but always grateful for the overwhelming family support when sharing their loss. It's helpful to tell others what you NEED and when they can pitch-in, without expecting them to guess what works. You may receive more advice than you'd like or can manage but keep in mind the offerings are out of love and concern. Whom to tell and what to say in regard to your loss is a concern for many; a group e-mail may be the easiest and clearest communication to family, co-workers and friends. A termination due to a genetic abnormality is more complicated. Stating "We lost the baby" implies miscarriage or possibly a fetal demise where the decision is made for you. One needs to assess the need for protection and privacy without the judgment of others.
HEALING TOGETHER and APART
Individuals grieve and mourn differently from one another. Gender, personality, intensity, sensitivity, emotion, and life stages, plus previous experience with loss are some of the factors impacting on the grieving and healing process. Most of us are unaware of what will be most helpful though all agree that mourning is mending. If we don't share thoughts and feelings with our partners, deny that we're suffering and sad, pretend it's a week like any other….it's likely that we'll move through the process more painstakingly with communication gaps and increased misunderstandings with those we love and need most.
Try to be patient. You may not be expressing nor demonstrating grief in the same way, but that doesn't mean the loss is not being felt as deeply with him or her. Tell each other what you need. Saying "I need a big hug, pronto" goes a long way. Don't be afraid to cry and scream for fear of making the other break down. Being present for one another means that one is cheerleading while other is crashing; it's unlikely that two have the same dispositions at the same moment.
A "surprise", funny card, chocolate, extra phone calls, texts, e-mails just to say I love you. A silly anecdote or maybe sharing a joke. But most important be a good listener even if you've heard it too many times repeated. Pause to listen to your partner and validate what he/she is saying even if you don't agree. "I hear you, I understand". Show respect, sensitivity, and caring. Don't forget physical affection and touch. It's not the sex; it's the intimacy and you can be creative. Respect each other's need for alone time and check-in with one another often…"I'm here; let me know if you'd like to talk."
A few days together and a change in environment w/o unsolicited advice can be helpful. For others the necessary return to motherhood if other children are present, and/or assuming out-of-the-home work roles, engaging in distractions with friends, working-out if physically ready, yoga, a continuing ed course "just because", can all be beneficial.
Read and research how others managed to move on. For example journaling your feelings and reactions, speaking with physicians and counselors, and allowing oneself to mourn and be pampered, all aid in making one's way through this journey. Pay tribute, acknowledge your loss, and be conscious of what feels right in saying good-bye or offering closure. Some couples choose to name their baby and have a reference for talking about him/her, have a memorial service either alone or with family and friends who are invited to share poems and thoughts, plant a tree, have a memory box or drawer, candles or perhaps a poem as rituals. No judging, no right and wrong choices; whatever gives you comfort and solace. Just be aware that due dates coming closer or anniversary ("angelversary") dates, can intensify the sense of loss.
Where do we go from here? Is it possible to have a healthy child? Will the next pregnancy be equally or more difficult? These are realistic concerns. It is helpful to secure information as to why this occurred. Prior to another pregnancy or making future plans, remind yourselves that you have much to give, and you'll be nurturing and loving parents.
Some folks attempt another pregnancy as soon as able while others see it best to take a 3 to 6 month hiatus from baby-making if they have the time to do so. A few are cautious, fearful, and stuck while continuing to have unresolved guilt and pain over their losses.
But thankfully most muster their courage and persevere promising that they will make this happen! "We'll move ahead to have everything we want. We have the ability to be good and nurturing parents."
Familiarize yourself and consult with the many options and choices available in regard to becoming parents. Will it be more infertility treatments, adoption, donor, or surrogacy? Then evaluate the course of action which will be best for both of you and know that making a decision is a process usually taking some time to discuss and review with the help of physicians and counselors. Look at statistics for age and protocols, fees, insurance coverage, location and hours for daily monitoring, medical and support staff at different clinics or agencies. Most importantly before proceeding try to be certain you're on the same page with what path might bring you the best chances for success without compromising your relationship and beliefs. Turn to those whom you know will give you reassurance as well as support. Keep in mind you deserve to be parents and you're not ready to abandon your dream. With determination you'll succeed in having a healthy and happy child.
To get through the hardest journey we need take only one step at a time, but we must keep on stepping.
Emily Laitmon, LCSW is a psychotherapist in private practice in NYC and Westchester specializing in women's issues, couple counseling and family building. She is also a Bereavement counselor and offers support to several NYC hospitals and genetic depts. She has been a group facilitator and coach for Path2Parenthood for more than 25 years. Ms. Laitmon has written articles and led seminars on emotional challenges of infertility, couples and relationships. She has experienced repeated IVFs resulting in a daughter, and adopted a son.