Pregnancy after loss

The beginnings of processing pregnancy after loss

I feel that this will be the first of a series of posts, since if I write about it all now, it could take days to read.  There is so much swimming around in my head about my nine months of pregnancy after loss, and I want to give it the time and space it deserves.  This is therefore a bit of an introduction for myself really – getting me in the headspace to pick apart what is ‘normal’ and expected and what I maybe need a bit more help with making sense of.  And I find getting it out on paper (or virtual electronic paper) is the best way….
This diagram was something I sketched out at 4am on the day I went to hospital to be induced.  Knowing that it was likely to be a long process, I had planned to spend the day writing a blog post on my reflections of pregnancy after loss, the sense I made of it from a mental health perspective, and how I had managed the relentless 37 weeks to that point.  However, I ended up spending the day huffing, puffing and moaning about how slow induction was this time around, pounding the streets around Camberwell, climbing and descending the stairs of Kings College Hospital, bouncing on a ball, sniffing clarey sage and lavender, before finally flopping down with a book and a less than appetising hospital dinner.  I am not very patient as my face below shows:
Fast forward almost 14 weeks, and I am only just ready to sit down and write this post.  It has of course been a huge whirlwind since the 5th April, and Esme has consumed almost every waking moment (of which there have been a lot!).  However, I wonder if I am only just mentally ready to begin the process of understanding pregnancy after loss.  In some ways, it feels like a distant memory, or in a detached way, almost as though it happened to another person in another lifetime.  However, it also feels like a dark cloud that has cast a shadow over these first few weeks of parenting.  I don’t think it would be an exaggeration to say that I feel somewhat traumatised by the process: the constant fear, the worry and second guessing of everything, the mistrust of my own judgement and the overwhelming sense of responsibility for our unborn child.  But there was also the meta-worry: the worry about the worry and what impact it might be having on our baby.  Being a psychologist can give you an awful lot of information to beat yourself up with.
Anyone who is a psychologist, or has seen one, probably uses the ‘stress bucket’ analogy all of the time. The premise being that we all have a limited capacity for stress (be that trauma, mental health difficulties or general day to day stuff) and that at some point, this bucket will overflow, spring a leak, or just completely tip over.  This will look different for every individual; for some, the leaks may be tears, anger or withdrawal, for others, it might be drug or alcohol use or self-harm.  But the important thing is that we all have our own tipping point, and keeping a check on that is key.
At the time of drawing this, my bucket was filled with lots of intense thoughts, feelings and experiences.  I was at the end of pregnancy and the finish line was in sight; we had just passed the day in pregnancy (37 weeks) that Orla had died and I had survived the final weekend of pregnancy, a time of the week I found very difficult due to finding out about Orla’s death on a Sunday.  Emotions were at an all-time high and my capacity for managing any additional stressors was very low.  In fact, just managing general day to day tasks was challenging, since everything was focused on ‘getting ready’ for a baby that I still couldn’t quite believe would be coming home with us.  In addition, we were rapidly heading towards the anniversary of Orla’s death and her first birthday.  I knew that this would be tough, but I was also fearful of not having the time or mental space to dedicate to this significant date.  Second time mum guilt I guess, just not in the way that most people experience.
For me, this last year has had three main themes: grieving for Orla, processing the trauma of losing her and managing the complex thoughts and emotions of pregnancy after loss.  My feelings and inner experiences were not mutually exclusive to any one of these themes, but these were the main factors responsible for my distress.  However, if I had drawn this diagram a few months ago, although there would be similar themes, the amount of space taken up by each may have been different.  The toll of pregnancy after loss – and the subsequent trauma that I feel has resulted from this – has been cumulative, and has heightened as pregnancy progressed.  There is no ‘safe zone’ when you have lost your baby at full term, so the stress increased rather than decreased.

At the time I went back to work in November, the capacity I had left for coping with general ‘life’ had been greater; I felt grateful for the normality of work – the clear tasks, the goals and focus and the satisfaction and reward at being able to achieve something.  However, as time progressed, and my bucket filled with more pregnancy related anxiety and stress, the balance between managing that and everyday life shifted.  One week, I had a packed diary at work with interviews and other recruitment tasks, and I just panicked – the sense of responsibility and feeling that I couldn’t take a day off if I needed to was just overwhelming.  I constantly felt that I needed a space in my diary to go to the hospital ‘just in case’.  Most days I didn’t need it in reality – but mentally, I just needed that safety net.  When that was taken away, I could feel my ability to cope rapidly deteriorate.
Something that I didn’t include in this diagram, was the stuff that the bottom of the bucket – the ‘emotional silt’ so to speak.  We all have some of our own baggage that we carry around with us as a result of our life experience and personality traits: perfectionism, the need to be in control, difficulty trusting others, traumatic life experiences and their subsequent impact – and these will start to fill up our own buckets.  This is what makes our capacity for managing stress so individual.  It’s funny that this wasn’t something in my mind at the time of scribbling this out, but it is certainly something I have reflected on since bringing Esme home.  I’ve mentioned before about my propensity for feeling overly responsible for others happiness and also my need for control, and these traits have certainly played a huge role in my parenting experience to date.  However, that’s a whole essay in itself…
One thing for sure is that this is just the beginning for me of starting to make sense of pregnancy after loss.  Although the acute feelings of anxiety and fear have subsided, I feel that the hangover of these intense feelings have lingered: the need for control, the overwhelming responsibility and the sense of inadequacy.  These feelings certainly aren’t in the foreground, but hum away as background noise, sometimes turning up the volume to remind me that they are still there.  I know that much of this is a ‘normal’ and expected aspect of parenting a live child, but I am sure that coming from a starting point that has been so traumatic is certainly different.  And as much as possible, I want to buffer the impact of these on parenting after loss.

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  • Reply LanaSalt July 13, 2017 at 11:06 am

    I love your ‘stress bucket’, such a good visual to demonstrate just how complex a PAL is. I may in fact be asking your permission to use it in a PAL workshop I’m hoping to do as part of my Tommy’s half marathon fundraising!! I have a PAL blogpost that has been lurking half written on my blog for over a year now and I doubt it will ever get completed! I’m still just so happy that time is over and I don’t want to revisit it!!!!

    • Reply dearorla August 7, 2017 at 9:04 pm

      Please do feel free to use away! And are you doing the London Landmarks? I have signed up too (what was I thinking?!) I knew if I didn’t write this up now, I’m not sure I ever would…have a few more to get out of my head, then a bit of therapy and then maybe I would feel able to go through it again one day….

      • Reply LanaSalt August 8, 2017 at 12:33 pm

        Yes Simon and I have both signed up! Maybe we could do a wee get together before or after – am sure we’ll make a few days of our trip x

        • Reply dearorla August 9, 2017 at 9:15 am

          That would be really lovely! We’ll be around the whole weekend of course, so let us know what works for you closer to the time and we can arrange something xx

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