I am sharing my story of anxiety after pregnancy loss for Baby Loss Awareness Week, 9-15 October 2020 because I do not think this aspect of miscarriage or pregnancy loss is talked about widely enough. However, if 1 in 4 women have experienced miscarriage, there must be many also experiencing a mental health fall-out similar to the one I did during pregnancies following pregnancy loss.
The extra brutal thing about pregnancy loss - as if the loss in itself were not enough - is its ability to taint future pregnancies. Joy and excitement are switched for fear and worry. Whereas before, a positive test meant 'BABY!', after it means CHANCE OF LOSS. In my experience, that chance of loss can sit there, heavily, in the forefront of your mind. Every single hour of every single day. It can be lonely, frightening and overwhelming.
My first pregnancy was in 2012. It was a not-exactly-planned, honeymoon pregnancy. It was a pregnancy filled with the innocence and excitement of someone who had never experienced pregnancy loss. My first trimester went smoothly. We had an early scan at around 7 weeks, but because I was eager to see my baby rather than because of any apprehension that something might be wrong. Everything looked good. After that, I was eager to reach my 12 week scan but again that was an eagerness driven by excitement rather than fear. My daughter was born in January 2013.
My second pregnancy was planned, in early 2014. Having already had one straightforward pregnancy, after getting a positive test result I assumed all would progress smoothly from there. Wrong. I started experiencing some brown bleeding at around 5 weeks of pregnancy. At an early scan in a private unit the sonographer queried my dates, as the measurements of the baby (yes, I am using the word baby) were smaller than they should have been, though there was a strong heartbeat. I knew my dates were right. Sense of doom. The brown blood continued, off and on. Sense of doom. I was a barrister back then, and I strongly recall being in a hearing and popping to the toilets at every possible opportunity to check on whether there was blood, how much, what colour. Was I cramping? Or was I imagining it? I had a further scan at the hospital at 8 weeks, because the bleeding was continuing sporadically. Strong heartbeat! My next scan would be my 12 week one. We ate pizza opposite the hospital to celebrate. That evening, on 8 February 2014, I went to the loo and when I wiped there was bright red blood. I was miscarrying. My relief had been misplaced. I can’t remember ever crying as much as I did that night, and in the days that followed.
I wanted to start trying to conceive again as soon as possible. I desperately wanted to be pregnant again. I was lucky to conceive quickly. I was feeling worried about how this pregnancy would progress, given my recent loss, right from the start. There was a brief excitement upon seeing a positive test, followed immediately by worry and fear. At around 5 weeks into my third pregnancy my fears seemed to come true when, again, I spotted blood when I wiped after going to the loo. I would always check when I wiped. Sense of doom. I remember a particularly large amount of blood which I was convinced was the start of a miscarriage at around 8 weeks. I went in the bath and waited for the miscarriage to happen. And waited. But nothing. The next day, a scan showed that all was as would be expected for my dates. But nobody can tell you, "you will not lose this pregnancy. It is safe." and so my worry continued. This bleeding carried on, on and off, through to 16 weeks into the pregnancy, before stopping. I grew less anxious after my 20 week scan, but continued to pay for private scans, for reassurance. My first son was born in December 2014. I am going to talk about how my anxiety spiralled and presented in a couple of paragraphs, because I had a very similar experience four years later during my fourth and most recent pregnancy, with Rafe.
I had hoped that the passage of time and a pregnancy to term following my miscarriage would have served to settle my anxiety about further pregnancy loss. When I tested positive, I was overwhelmingly happy, but immediately experienced another familiar feeling: the sense of doom. Not long after getting a positive test, at about 5 weeks' pregnant, I noticed bright red blood on the tissue when I wiped. I had been on the look out for it, of course. And there it was. But rather than thinking "I had this in my last pregnancy and it all ended OK", my brain went back to my previous miscarriage and I was utterly convinced the same thing was going to happen again. Sense of doom. The bleeding continued, sporadically, through to 13 weeks. Sense of doom. Again, the 20 week scan brought relief, but I continued to feel on higher alert until Rafe was safely in my arms.
Only now, looking back, do I realise that in both my third and fourth pregnancies, my anxiety was out of control, my mental health was in decline and I needed support. Nobody knew the full extent of my behaviours; I had told my husband and a close friend how worried I was, but I did not let on how all-consuming these feelings were.
I would search the internet for hours trying to find an answer for what was going to happen in my pregnancies. I would search things like "red blood 5 weeks pregnant miscarriage" and then dive into an abyss of forums, frantically scrolling through chats, sometimes many years old, to try to find out how other women's stories ended, to try to understand what would happen with mine.
I would go for scan after scan for reassurance, but the reassurance would only last for as long as I was in the ultrasound room. Once I left, the sense of doom and worry would again kick in.
During scans I would grill the sonographers on their findings. Why aren’t you measuring the heart rate? What is the crown-rump length? What is the yolk sac measuring? I was constantly on the hunt for information that would give me answers, and would search the internet after each scan to try to interpret what the figures recorded meant for our outlook.
I would visit the loo obsessively, not because I needed it, but because I wanted to check for blood. Seeing it would send me into a frenzy of panic. But not seeing it would never fully lift the sense of doom.
I would do a pregnancy test most days, as I desperately looked for signs that my hormone levels were or were not dropping. (NB: this is not a way to predict whether pregnancy loss will occur.)
I would feel bleeding only to find there had been none. I remember vividly being in M&S Richmond with my mum while pregnant with Rafe and being convinced I had felt a gush of blood. Sense of doom. I rushed to the loos in tears. There was nothing there.
I believe my behaviours through this time were exacerbated by the fact that the first trimester remains, largely, shrouded in secrecy. Culturally, the fact we are in the early stages of pregnancy is not something we share. This is because the first trimester carries the greatest chance of loss. So, society says, we keep the pregnancy to ourselves. And all those big feelings we are navigating - physical and emotional - we keep those to ourselves too. We carry on, growing life inside us, as if nothing unusual is happening. We suffer a loss? Well, nobody knew we were pregnant, so we keep it to ourselves. We grieve alone. And, then, if we are lucky to conceive again, the same process begins again, this time with all the added anxiety of what went before.
If you feel your mental health might be suffering because of pregnancy loss, please reach out to someone for help: a friend, a relative, your GP or an organisation like The Miscarriage Association. You don’t have to go through this on your own.