10 Permissions for Pregnancy After Loss

10 Permissions for Pregnancy After Loss

It is my hope that this blog post will offer validation, solace, and hope to the strong, resilient women who find themselves pregnant after experiencing the devastating loss of a baby due to miscarriage or stillbirth.

Unfortunately, the conversation regarding pregnancy loss is still taboo in our culture. Despite the fact that up to twenty percent of known pregnancies end in miscarriage, women and their partners often feel isolated in their grief, suffering immeasurable pain in silence. These feelings may become even more complicated during a subsequent pregnancy.

Pregnancy after miscarriage or stillbirth can be painful and frightening. You may alternate between conflicting feelings of joy and sadness as you expect new life while mourning another. You may be overwhelmed with worry that you will lose again, finding it difficult to connect with your pregnancy. All of these feelings are normal. Adapted from Lindsey Henke’s ideas, see below, I offer the following ‘permissions’ to women experiencing pregnancy after loss:

10 Permissions for Pregnancy After Loss

  1. It is okay to feel detached from this pregnancy. This is your way of maintaining a safe emotional distance. The idea of becoming attached and losing again is unbearable.
  2. Be kind to yourself. Offer yourself the same compassion and nurturance you would to someone else who just lost a loved one.
  3. Surround yourself with an empathic support system including family, friends, other bereaved mothers, mental health providers, and your pregnancy care team.
  4. Choose to announce and celebrate this pregnancy or not. Trust your intuition when deciding whether or not a celebration is right for you.
  5. If you need, decline invitations to baby showers, birthday parties, or other events that may be triggering to you. It is not rude; it is a form of self-care.
  6. If you need, take a break from social media. It can be incredibly painful to see photo after photo of pregnant friends and babies.
  7. Give yourself permission to grieve and connect with feelings of sadness, anger, and fear.
  8. Allow yourself to feel joy and hope for the new life you carry. Connecting with this baby does not mean you have to forget about the one you lost.
  9. Do whatever YOU have to do to seek healing. This may mean honoring your loss through a ritual—such as planting a tree, writing a letter, or lighting a candle—or choosing to do nothing. For some, a ritual might be too painful. Do what is right for you.
  10. Remember this is a different pregnancy, with a different baby, and a different outcome.

You have experienced unimaginable pain, and it has likely left you raw and vulnerable. Yet in this tender, opened-up state, you will connect with those who offer love and support in a profoundly healing way. Furthermore, you have gained empathy for others who have known suffering and loss. This openness and understanding will prepare you for parenthood and the vulnerability involved in wholeheartedly loving your child.

In Dr. Elisabeth Kübler-Ross’ words: “The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern.”


I was recently honored to connect with Lindsey Henke and Kiley Hanish, both of whom founded organizations to help reduce the stigma of pregnancy loss and stillbirth while raising awareness and instilling hope in bereaved mothers. Below I have provided links to their resources for healing after loss.

Lindsey Henke is the founder and Executive Director of Pregnancy After Loss Support (PALS). After giving birth to her stillborn daughter, Nora, she founded PALS in order to support women during the painful and complex experience of pregnancy after loss. She is also the author of Stillborn and Still Breathing, a blog about her journey through grief after child loss.

Kiley Hanish is the founder of the Return to Zero Center for Healing, which provides outreach, education, and research to instill hope and initiate healing after the death of a baby. Kiley and her husband Sean created the Emmy-nominated film, Return to Zero, based on their personal experience of giving birth to their stillborn son, Norbert. Kiley also developed the Pregnancy Loss and Infant Death Directory, which connects bereaved families with local resources.

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Five Stages of Postpartum Depression

Five Stages of Postpartum Depression

I recently read an article likening the experience of postpartum depression to that of grief. Katherine Stone, who won a Media Award from Mental Health America for her blog post, applied Kübler-Ross’ five stages of grief to PPD. As a therapist who treats mothers struggling with postpartum depression, it is also my experience that the process is met in stages, similar to grief. Each phase unearths new feelings and different struggles.

Kübler-Ross’ five stages of grief are as follows:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

These stages are not typically passed through linearly; rather, one moves through them in waves, without order or timeline. Like grief, each person experiences postpartum depression differently. This is important (notice the italics). You cannot expect your symptoms of postpartum depression to follow the same course as someone else’s. What worked to alleviate their PPD may not work for you, and visa versa. What initiates your recovery may not have worked for them. We do not put expectations on grief, and in the same way, we cannot put them on postpartum depression. Here is an example of what each stage may look like:

  • Denial: “This is not postpartum depression. Motherhood is just not as easy for me as it is for others. Once I start sleeping more this will improve.”
  • Anger: “Why do other moms look like they’re enjoying every minute with their babies, and I’m miserable? I shouldn’t have to seek treatment for this!”
  • Bargaining: “Maybe if I start scheduling a little more ‘me’ time I’ll start feeling better. Maybe this will pass once my baby turns one or starts sleeping through the night.”
  • Depression: “My family deserves better than what I can give them.” It is extremely difficult to ask for help when you are in this stage. Not only do you feel unworthy of help, but you also don’t have the energy or motivation to seek it. This is the time you may start to question if you’re family would be better off without you or even feel suicidal. Remember, you are not alone, and these symptoms are treatable.
  • Acceptance: “This is temporary. I will not feel this way forever. I don’t have to be miserable!” This stage usually comes once you’ve sought treatment, found relief, and discovered you are not alone in your feelings.

With help, you will reach acceptance, and you will find recovery. As Katherine so eloquently asserts: you will feel the love for your child that was always there, temporarily buried by postpartum depression. The pleasure and enjoyment of motherhood will surface once PPD is effectively treated. A temporary inability to access this joy does not make you a bad mother. It merely means you are one of many who are struggling with postpartum depression—one in five to be exact. You are not alone. What you are feeling is common. What you are feeling is treatable.


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The Baby Blues and Postpartum Depression

Baby Blues & Postpartum Depression

Dearest New Mama,

You have just given birth. In accomplishing this feat, you are empowered, yet exhausted, and now tasked with life’s most important responsibility—caring for your baby. Amidst this sudden change, you may find yourself feeling sad, anxious, or irritable. These feelings can be distressing, as you expected to be basking in the glory of motherhood; however, what you are feeling is normal. Eighty percent of new mothers will experience the Baby Blues, and twenty percent will experience Postpartum Depression. This means you are not alone! After giving birth, levels of estrogen and progesterone plummet. This sudden crash may trigger “blue” symptoms. Baby Blues Connection, an online resource for new moms, suggest women may experience some or all of the following symptoms:

  • Frequent crying
  • Feeling let down
  • Impatience
  • Irritability
  • Restlessness
  • Anxiety

Symptoms usually remit after two weeks as your hormones begin to adjust. If you find your symptoms worsen or continue after a few weeks, you may want to be assessed for Postpartum Depression. PPD is less common than the Baby Blues, but is still experienced by 1 in 5 moms. It can be hard to differentiate between the two, as they share many of the same symptoms. Postpartum Depression, however, is longer lasting and more severe, making it difficult to care for your baby. Postpartum Support International describes the following symptoms:

  • Sadness most of the day and frequent crying
  • Loss of interest or pleasure in daily activities
  • Appetite and sleep disturbance
  • Intense fatigue with low mood
  • Emotional numbness
  • Feelings of helplessness and despair
  • Feelings of inadequacy, guilt, or shame
  • Difficulty concentrating, indecisiveness
  • Frightening feelings
  • Thoughts of death or suicide

Unlike the Baby Blues, Postpartum Depressive symptoms usually do not remit on their own. Therefore it is important to reach out for help if you think you may be struggling with depression following the birth of your baby. If you feel safe, confide in your partner, a family member, or a close friend. You may also choose to work with a therapist who can validate your experience and help you alleviate these symptoms. Seeking help in a time of need is difficult, as we feel exposed and vulnerable. Remember, what you are experiencing is common, treatable, and temporary.

In the mean time, try to find little ways to sneak in self-care. When you have a free moment (albeit they are few), soak in a bubble bath instead of your usual five-minute shower. Enjoy a hot cup of coffee or tea. If you can, get outside and take in fifteen minutes of sunlight. Eat a warm, balanced meal instead of the cold pizza in the fridge. We sacrifice so much for our babies, even at the expense of our own physical and mental health. Now is the time to ask for help if you need it.

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