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Planning another pregnancy A booklet for parents whose baby has died and are now considering subsequent pregnancy www.sands.org.au 1300 0 sands (1300 072 637)


Table of Contents Introduction.................................................................................................................................................3 Is it time to try again?.................................................................................................................................4 What else should we consider?................................................................................................................4 During the pregnancy ...............................................................................................................................5 When the baby comes...............................................................................................................................6 Where to go for more help........................................................................................................................ 7 Planning another pregnancy: a summary.............................................................................................. 7

Acknowledgements This booklet was written in consultation with parents who have been bereaved through the death of a baby, and who have also gone on to experience subsequent pregnancies. Sands is grateful to these families for the courage and generosity they have shown through sharing their stories and providing feedback. We also acknowledge previous state-based Sands literature, from which this new booklet has evolved. Thank you also to Dr Gino Pecoraro for his help in the development of this resource. Disclaimer In this booklet we describe experiences that are common for parents whose babies have died. The information and suggestions offered here are guided by our research and experience in helping parents and others after the death of a baby. Sands acknowledges that values and beliefs surrounding death vary across cultures, religions and personal backgrounds. Reactions after a baby dies are unique. Some responses may not be included in this booklet, while some of the offered suggestions may not suit everyone. However, Sands offers information and support without judgement. Professionals have reviewed the information contained in this booklet. It is provided in goodwill, as a public service. However, Sands makes no representation or warranty as to the accuracy, completeness or appropriateness of the information, in respect of which readers should make their own enquiries. To the maximum extent permitted by law, Sands disclaims all liability and responsibility for any direct or indirect loss, damage or injury which may be suffered by any person in connection with this booklet, including any person relying on anything contained in or omitted from this booklet. Should you have further questions or concerns, Sands can assist – please go to the ‘About Sands’ section at the back of this booklet.

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Introduction Pregnancy should be an exciting time in the life of expectant parents − but when a baby has died during a previous pregnancy or shortly after birth, the prospect of having another baby can bring many intense and varied emotions. You may feel excited at the thought of conceiving again but at the same time feel grief for the baby who died, and anxiety about the likelihood of a successful pregnancy. This is normal. Perhaps you also hope that becoming pregnant again will help you get over your baby who died. Many parents feel desperate to get on with having another baby quickly in a sense to fill the void of their loss. In reality, however, another pregnancy rarely takes away the pain of grief.

“I wanted to try straight away, but my partner wasn’t ready yet. It put our relationship under a lot of stress.” – Danielle “When our daughter Rosalie was stillborn, one of the many things I was unprepared for was the fierce intensity of wanting to try again. I wanted the baby I had lost so much that I doubled up with the pain of grief and howled, but I also wanted another chance. A chance to bring a baby home, a reason to get out my big lovely pram, to plan and anticipate, to hope and not have those hopes dashed.” – Bev

*In this booklet we often use the word ‘baby’ although we acknowledge you may have had multiple babies who have died, whether as part of a multiple pregnancy or previous pregnancy losses. Sometimes the words we use might not fit your particular circumstance – we hope you will understand. If you would like individualised support, please call our national bereavement support line on 1300 0 sands (1300 072 637) – see the back of this booklet for more details.

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Is it time to try again? The time it takes to adjust to a baby’s death varies from person to person; there is no ‘standard’ timeframe. For mothers, giving yourself enough time to recover physically and emotionally can help you build more strength and confidence to manage the next pregnancy. For some, getting pregnant again straight after the death of a baby may lead to difficulties coping emotionally. This is because the grieving process can sometimes be put ‘on hold’ as your thoughts focus on the new pregnancy. If this grief is not processed appropriately, a resurgence of grief can accompany the birth of another child. Waiting until both parents have healed emotionally can smooth the transition and assist in the formation of healthy bonding with their new baby. This can also help you both to see them as a unique and wonderful person in his/her own right.

“I felt like I had lost something so precious, and I desperately wanted to get it back. But I wasn’t entirely sure how I would cope with the highs and lows of pregnancy. Despite my doubts, we got pregnant straight away, and for the pure joy we got at the end of it, I don’t regret our decision at all.” – Jody “When I was handed my baby, I remember thinking, ‘Which baby am I holding?’ It was confusing, I remember feeling quite conflicted.” – Alana

What else should we consider? If you are having medical or genetic investigations related to the loss of your baby, you may want or be advised to wait a little while before trying to conceive. This is because there may be recommendations made regarding treatment or procedures. If you are older parents or you have experienced fertility issues, you may be concerned about leaving another pregnancy too long. You may also feel pressure from family, friends or colleagues about trying to have another baby. No matter how well meaning they may be, and how much you value their opinions, it’s important that you give yourself time to grieve. If you have other children, it is also important to consider their emotional needs. They may also need time to recover from the loss of their sibling. If you do decide to try again, be aware that a new pregnancy will often generate discussion about your previous pregnancy loss. Prepare yourself to have those conversations with your child/ren and try to employ honest, age-appropriate explanations. Remember to care for yourselves and each other as partners. It may take some time to conceive again, and each menstrual cycle that goes by without a pregnancy may intensify your emotions of failure and disappointment. Recognise that each of you will respond to these intense emotions differently. Try to be accepting, understanding and supportive. There are also several practical steps you can take to maximise your chances of conceiving again and carrying a healthy baby to term. You may like to ask your healthcare professional for nutritional and lifestyle advice.

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“Everybody said that we should wait at least a few months, because otherwise it was like we were trying to replace Bianca. I resented people for telling us what to do. They had no idea what it was like.” – Bradley “I had to wait for two periods before trying again, but then at my follow-up appointment I was told to wait for three. I was inconsolable.” – Nadia “We weighed up our options, and came to the decision that another baby wasn't right for us. The pain was just too much and our life situation had changed.” – Rob

During the pregnancy Pregnancy can be challenging for many parents, but this can be magnified when you’ve already experienced the loss a baby. Once becoming pregnant, continue to make a conscious effort to look after yourselves and each other both physically and emotionally. For mothers especially, the sense of anticipation about the baby growing inside her may be darkened by anxiety about things that could go wrong. Even if there’s no medical reason why the new pregnancy should not successfully continue to full-term, you may still be very apprehensive. Developing a good relationship with your maternity health care professional can also help you deal with the physical and emotional aspects of your new pregnancy. Quite frequently parents in this situation will require additional visits with their doctor to alleviate anxiety during the pregnancy. In some cases extra scans to demonstrate the baby’s growth and wellbeing may be helpful.

“I remember thinking, what happens if I lose this pregnancy? I just didn’t think I could stand the heartbreak. I was petrified.“ – Kim It is normal not to feel 100 per cent emotionally invested in a subsequent pregnancy. This is considered a defence mechanism to protect oneself from grief associated with another loss, even if these feelings seem irrational. Family and friends may be delighted for you both, and may offer their love and support. Some of them may not fully understand that, although you are pleased and excited about the new pregnancy, you are experiencing mixed emotions. If you are having trouble explaining your mixed feelings to the people who care about you, a Sands parent supporter or professional counsellor may be able to offer suggestions about how to approach things. Milestones that correspond with challenging periods during your previous pregnancy (such as not feeling your new baby’s movements yet or being scheduled for routine tests to check your new baby’s health) can bring back painful memories about your baby who died, and increase your anxiety. A full-term pregnancy can seem like a lifetime, so it can help to set the smaller milestones to focus on; and not just related to your pregnancy. Make an effort to spend time with your family and friends and do things that you really enjoy.

"Just because I had a subsequent pregnancy and a healthy baby, that didn't make the next pregnancy 'normal'. I still felt the same anxiety and apprehension as the last time." – Kate “On my due date I couldn't handle the waiting anymore, I wasn't coping. My obstetrician agreed to an induction. I just wanted her out alive.“ – Betty

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When the baby comes Sometimes the joy of the birth of a healthy baby is mixed with sad memories of the baby who died. Parents may experience a heightened sense of grief, regardless of how long they waited before getting pregnant again. These mixed emotions, while normal, may be misunderstood by others. However, allow yourself to recognise and accept these feelings.

“I couldn’t stop crying when I held Amelia for the first time. I think the staff must have thought I was crazy. I had so much joy for her birth, but also acute grief at her sister's death. In a way, I think I was saying goodbye. I felt guilty and uplifted at the same time.“ – Christina “Our son's birth didn't make everything better; but he is helping us to heal in a beautiful, life-affirming way.” – Ignatius “After two years we finally got what many don't get − answers as to what happened with our first baby. This helped us fall pregnant again and we now have a happy and healthy 4 month old boy.” – Danielle

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Where to go for more help Many parents find it helpful to discuss their own situation and feelings about another pregnancy with a hospital social worker, a grief counsellor or a pre-pregnancy counselling service. Bereaved parents also find that talking with other parents who have had a baby die is very helpful. If you want to talk to someone who has had a similar experience, Sands has parent supporters available through phone or online support. See the back of this booklet for more details. If you would like a mental health clinician to support you during this time, Sands can provide details of professionals practising in your area.

“I spoke to a Sands parent supporter. At first I felt silly, because this baby hadn‘t died − she was alive and kicking inside of me. But they reassured me that all my strange and sometimes scary emotions were normal.“ – Alice

Planning another pregnancy: a summary • After the death of a baby, parents are often eager to get pregnant straight away. • Before 'trying again', parents should consider waiting until they have had enough time to grieve the death of their previous baby. • It is common for parents to feel mixed emotions during subsequent pregnancy. The prospect of a new baby gives hope, but there are strong fears about further loss and heartbreak. • When considering subsequent pregnancy, couples should consider their options and come to a decision together. • It is normal for mothers to be extremely anxious about the well-being of their new baby, both during the pregnancy and even after birth. • Seeking support from family, friends, professionals or a Sands parent supporter can help you to get through this anxious time.

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About Sands Sands is a national not-for-profit organisation that offers support when a baby dies before, during or soon after birth. Sands can put people in contact with a volunteer parent supporter who has also suffered the death of their baby. Each parent supporter is specially trained to provide caring, non-judgemental and ongoing support to anyone affected by the death of a baby. Sands also offers monthly meetings, member newsletters, annual memorial services and resource libraries. Our collection of booklets, listed below, can be mailed direct to individuals or downloaded from www.sands.org.au. • About Sands (brochure)

• Your baby has died (in-depth book)

• Early pregnancy loss

• Creating memories

• A father’s grief

• For family and friends

• For grandparents

• Caring for your other children

• Planning another pregnancy

• If your baby died many years ago

• Easy English/multilingual • Making a difficult decision (for parents who have received a diagnosis of an abnormality in their unborn baby) • Caring for bereaved parents (for health professionals)

National bereavement support Telephone support – 1300 0 sands (1300 072 637) Volunteer parent supporters are on call 24/7. Email support − support@sands.org.au Contact a local Sands office Sands Victoria 201/901 Whitehorse Road Box Hill Victoria 3128 t (03) 9899 0217 f (03) 9899 0219 e info@sandsvic.org.au w www.sandsvic.org.au Sands Queensland 505 Bowen Terrace PO Box 934 New Farm Queensland 4005 t (07) 3254 3422 f (07) 3358 2533 e admin@sandsqld.com e support@sandsqld.com w www.sandsqld.com

Sands South Australia PO Box 380 Park Holme South Australia 5043 t (08) 8277 0304 e info@sandssa.org w www.sandssa.org Sands Tasmania t 0415 127 464 e info@sandstas.sands.org.au w www.sandstas.org.au Sands Australia (National Council) 201/901 Whitehorse Road Box Hill Victoria 3128 t (03) 9899 9414 e info@sands.org.au w www.sands.org.au

This brochure was funded by the Australian Government Department of Health and Ageing. © Sands Australia National Council Inc. 2012. ABN 47 437 480 296


Planning another pregnancy