In the course of a few years, Meredith Langston* had a miscarriage and an ectopic pregnancy. In her third pregnancy she delivered twins at 21 weeks, who died shortly after birth. Finally, with close monitoring and specialized care, she gave birth to a healthy daughter.
For Langston, the journey to motherhood has been a patchwork of emotions – from grief and fear to joy and hope and back again, a common experience for women with a high-risk pregnancy. But Langston and countless others like her have found ways to cope.
Fortunately, you can find effective strategies for managing your emotions, even during the darkest days of a very difficult pregnancy.
Emotions in a high-risk pregnancy
Psychiatrists and psychotherapists who specialize in prenatal and postpartum therapy say it's common for a woman in a challenging pregnancy to feel like she's been singled out. She may imagine that other pregnant women are wrapped in serenity while she spends her days on bedrest, stressing over the latest test results.
"Women having a high-risk pregnancy can feel that they're being robbed, that the great majority of people are having a positive experience. They may feel anger, envy, a sense of being cheated," says Berkeley, California, psychotherapist Gina Hassan.
Psychotherapist Donna Rothert, whose Oakland, California, practice specializes in high-risk pregnancy and reproductive losses, agrees that expecting moms may grieve because they feel their happiness has been hijacked. "That's a loss." Rothert says. "It's often bitterly disappointing for people who are not going to have this sweet, blissful time."
Some moms-to-be worry that feeling unhappy during pregnancy will damage their baby psychologically or get in the way of bonding. Hassan, whose practice has focused on pregnancy and postpartum issues for over a decade, says that's a common but unfounded fear.
Other common feelings associated with living through a high-risk pregnancy include fear, depression, anxiety, grief (especially if there have been previous losses), and self-blame.
Blaming yourself for a difficult pregnancy
Many women blame themselves when something goes wrong in their pregnancy – even though it's not their fault. They may think that they were too physically active in caring for their other children, that they were too old when they conceived, or that they shouldn't have had sex during pregnancy or gotten on a plane.
Women who blame themselves often come up with irrational but understandable strategies to deal with their situation, Hassan says.
"A woman may think something like, 'I had an abortion when I was 22, and that's why this is happening.' We want control over things. We want things to make sense, so we're thinking, if I was bad before, then maybe if I do everything right this time, I'll have paid my dues."
Hassan says she counsels her clients that complications rarely have anything to do with past behavior and encourages them to find ways to deal with a stressful situation that's out of their control.
Depression and anxiety when you're high-risk
Depression and anxiety are common, especially in women who were prone to those conditions before pregnancy. Psychotherapist Rothert notes that any pregnancy is a time of "great stress." And if the mom-to-be is concerned about her baby's well-being, it's even more stressful.
Even women who don't have a history of anxiety or depression can be at significantly higher risk for those conditions during and after a high-risk pregnancy, says Anna Glezer, a perinatal psychiatrist at University of California San Francisco Medical Center.
Glezer says that can create a vicious circle: Anxiety and depression can affect your ability to function, which in turn can increase the risk of complications, which can make you more anxious or depressed.
Expectant moms on bedrest, especially in the hospital, are extra prone to high stress levels, says Glezer.
They may be hours away from home and missing the daily support of friends and family. They're in a hospital, which is associated with being sick, and the machinery and noise add to the stress. And although adequate sleep is an essential part of pregnancy, sleeping in a hospital is difficult at best.
Dealing with grief
After the loss of her premature twins from preeclampsia, Meredith Langston found herself wanting to try getting pregnant again. But at the same time, she was mourning the loss of her twins, who died shortly after birth.
"I was dealing with a lot of grief, intense grieving, and then working through that in our marriage." Her husband didn't want to talk about their loss but Langston did, and she sought support from a high school friend who lost a baby at around the same stage she did. "She was wonderfully encouraging," Langston says.
She also saw a counselor at a crisis pregnancy center, starting a month after her twins died and weekly through most of her next pregnancy. She credits her counselor with helping enormously to get her through it.
The support was critical when she had to spend three months living away from home near a university hospital in case she delivered early again or had other complications. "I lived so much in the moment," Langston says. "I just tried to enjoy every flutter, every movement." In the end, she gave birth to a healthy daughter.
When to seek counseling
Knowing when you need to get help from a psychotherapist or psychiatrist is key to getting you through this difficult phase. Watch for symptoms such as panic attacks, insomnia, or significant depression. "If anything is interfering with your general quality of life, it's time to reach out," Rothert says.
Hassan agrees and says the emotional roller coaster isn't something most women feel free to talk about with just anyone. "It's sometimes hard for people to listen, so working with a therapist experienced in this area is important," she says.
What helps you cope
- Don't suffer your feelings alone. Get support from friends, family, a counselor, or other women who are going through the same thing. If there's no one in your immediate area to talk to, you can find strategies for coping and an empathetic ear in online groups for women with high-risk pregnancies.
- Prioritize self-care. Eat well, stay hydrated, and exercise if you can. If you find the anxiety rising, take time to consciously breathe, even in line at the grocery store. Rothert advocates "self-talk with compassion," acknowledging, for example, that you're dealing with an awful lot and it won't last forever.
- Knowledge is power. The more you understand about what's going on in your body and what your doctors are recommending, the less fearful and stressed you may feel.
- Try not to make major life changes during your pregnancy, such as moving to a new house, remodeling, or getting a dog. "That's just an unkind, unfair thing to do to yourself," says Rothert.
- For friends and family, it's not a good idea to try to talk a woman out of her feelings. "It's not helpful to say, 'Don't blame yourself,'" says Glezer. "Don't tell her what she should and shouldn't feel. Give her space to express her emotions and feelings."
* Her name was changed for this article