WebMD Chat Transcript: Pregnancy after a Loss with Carol Cirulli Lanham

Transcribed by WebMD staff

We were joined by Carol Cirulli Lanham to discuss pregnancy after a loss.

moderator Welcome! Today we are talking with Carol Cirulli Lanham on the topic, "Pregnancy After a Loss." Carol is the author of "Pregnancy After a Loss: A Guide to Pregnancy After a Miscarriage, Stillbirth, or Infant Death." Carol Cirulli Lanham has been a journalist for the Associated Press, Reuters, Newsweek, and Vatican Radio. She suffered a pregnancy loss in 1994, and has since given birth to two healthy sons. Thank you for joining us today, Carol!

moderator Why did you decide to write your book, "Pregnancy After a Loss: A Guide to Pregnancy After a Miscarriage, Stillbirth, or Infant Death"?

speaker Five years ago, I experienced a late loss in my first pregnancy. As you can imagine I was devastated and spent many weeks grieving my son. But eventually I began to think about getting pregnant again and found that there were very few resources available to help me make some very difficult decisions, and I also found very little information that help me know what to expect in the next pregnancy. Since I had worked for many years as a journalist I decided that I would be the one to write a book that could help women through a pregnancy after a loss.

moderator Is there such a thing as "being on the rebound" when it comes to choosing to get pregnant again immediately after a pregnancy loss? How can someone identify such a period, and is it recommended to immediately try to have another child after a pregnancy loss?

speaker The decision of when to get pregnant again is a very personal one. Your health care provider is in the best position to advise when a woman is physically ready to try again. But when it comes to emotional readiness it is possible to be on the rebound so to speak. In other words, a woman might think that if she gets pregnant again right away, that will somehow help compensate for the baby she lost. I believe that if she is still crying most of the day, having trouble sleeping and not eating right, she probably is not ready to face another pregnancy. But there are factors like fertility problems or the biological clock which may prompt someone to try again sooner rather than later.

moderator What advice can you give to someone who is considering pregnancy after a loss but is worried about experiencing another loss or are experiencing feelings of guilt?

speaker It is very important to talk with your health care provider about the chance of another pregnancy loss. Many women are at no greater risk of having another loss than anyone else in the population. For example, my loss was the result of a very rare condition so my doctor chose to label me "high concern" rather than "high risk." As for any feelings of guilt, I think most women should know that it is very unlikely that they did anything to cause the loss.

moderator If a woman has experienced a pregnancy loss, are her subsequent pregnancies considered "high-risk," and what sort of precautions should she take if it is?

speaker She is not necessarily considered high risk although that definition is used in different ways by different people. As I mention, I was not considered high-risk despite my late loss, and many women will not be considered high risk either. Those who are among the high-risk group are those with a chronic medical condition such as an insulin-dependant diabetic or someone with a history of preterm labor or delivery. Other reasons for a high-risk status include someone with a history of placental problems, such as placental abruption or someone who has had two or more miscarriages already.

moderator Can you walk us through some feelings, stages, and experiences that may be unique to someone who is going through pregnancy again after a loss?

speaker Fear, of course, is one of the most pervasive feelings in a pregnancy after a loss. Some people like to say that ignorance is bliss. Well, that bliss is gone for a woman who has lost a baby. She knows that nine months of pregnancy do not always end with the birth of a healthy baby. But I think that mixed in with that fear is hope. If we didn't have hope, we probably would not even contemplate another pregnancy. Of course, all of a woman's grief does not go away just because she is pregnant again. So in many cases, there is continued sadness over the loss. At times, there can also be resentment about having to go through another pregnancy at a time when you expected to be enjoying your healthy baby.

moderator In your book, you offer tips for easing anxiety. Can you please share some of these with us?

speaker There are many things that a woman can do to ease her anxiety. One of the most helpful is to write in a journal during the pregnancy. That is not something she needs to do everyday, but only when she feels like venting her feelings. Sometimes putting a problem down on paper can provide a new perspective on things. I also suggest that women take a proactive role in their medical care. I think that if she is not afraid to ask questions or insist on frequent monitoring her health care provider can go a long way toward easing her anxiety. Some of the other tips include taking care of yourself. If you know that you are doing everything possible for your baby, there is not as much for you to worry about. If a woman has been seeing a counselor, it can be helpful to continue to do so during the pregnancy. Support groups are helpful too. Many hospitals now have "pregnant again" support groups for women who are pregnant again after a loss. I think it's important to find success stories too. And my book is full of them. I had two healthy boys after my loss and every woman quoted in my book had a healthy baby. So as devastated as you may feel after the loss, it is important to hang on to the hope that a healthy pregnancy is possible.

maria_54 I don't feel like my doctor was responsible for my loss but am wondering if I should consult a specialist in high risk pregnancies before I try again.

speaker I am a strong proponent of second opinions. I too trusted my doctor implicitly but decided to seek a second opinion anyway. In my case, the second opinion was confirmation that my doctor did not do anything wrong. I suspect the same may be true for you. But just in case there is something that was overlooked, it is better to know so before going into another pregnancy. So yes, I would recommend consulting with a high-risk specialist.

moderator What should a couple keep in mind when choosing a new doctor?

speaker I have included a list of questions in my book, and I recommend asking those even if you decide to stay with the same doctor in the next pregnancy because your needs will be different the next time around. For example, I suggest that they ask whether they can go in for unscheduled visits. By that I mean, can you go in to check the baby's heartbeat with the Doppler if you are feeling particularly anxious some day. Will you have more frequent appointments with the doctor than you had the last time? If there are many doctors in the practice, can you arrange to always see the same doctor. This will avoid the problem of meeting with a doctor who is not familiar with your history. Does your doctor set aside time for non-emergency phone calls? Usually, a nurse is available to answer questions, but there may be times when you want to talk with the doctor. I also recommend that couples find out whether their doctor is affiliated with a major hospital. None of us likes to think that our next baby might need a Neonatal Intensive Care Unit. But in case they do, it is so much better if that is available on site immediately after delivery. My third baby had a little trouble breathing when he was born, and I was so glad that he was in the NICU down the hall rather than across town.

moderator Should couples buy new baby accessories and clothing?

speaker That is a very personal decision. Since I had prepared everything for my first baby, and never got the chance to use it, I decided that I would not under any circumstances get ready for the next baby until he was home safe and sound. If your loss came earlier in the pregnancy, you may reach a point where you are past the date that you experienced your loss and may see it as a whole new pregnancy. In other words, there may come a time when you want to be just like any other pregnant mom-to-be and make loving preparations for the baby that is on the way. There is no right or wrong thing to do. Just follow your heart.

maria_54 How can I find a support group in my area?

speaker Abbott Northwestern Hospital in Minneapolis has a training program for caregivers who want to organize a pregnant again group. Try calling 612-863-4427 for help finding a group in your area. SHARE Pregnancy and Infant Loss Support also has knows of many support groups that have organized a "pregnant again" group. That number is 800-821-6819. You also might try calling your local hospital, especially if they have a support group for couples who have experienced a pregnancy loss.

moderator How can a couple relate the fact that they are or are not going to try to have another baby to family and friends?

speaker Some people prefer to wait and not share the information until they are fairly far long in the pregnancy. My husband and I were among that group and I'll explain why. I got pregnant again only 4 months after losing my baby and I was not ready for the focus to shift to the new baby. I was still grieving my son and wanted people to remember that he had existed. Maybe I also was a little worried that people would think bad of me for getting pregnant again so soon. Others prefer to share the news right away because they want the prayers and support of those closest to them. They also want them to share in their joy over the next pregnancy.

moderator What advice to you give to the husband who has experienced a loss and is having another baby?

speaker Many men pride themselves in being "like a rock." In other words, they feel like they are too strong to show any emotion. But it may help them to know that it is very natural for them to feel sad, and afraid, and overwhelmed. In other words, they are likely to feel very much like the mother-to-be. The difference is that people tend not to worry about the father. Usually, alll of the focus is on her. I suggest in my book that a woman do her part to ease her partner's anxiety and in so doing she will be helping herself. I suggest that a couple search for ways to communicate with each other. I also recommend that the partner be involved in the pregnancy so that he can feel more in control of the situation. It's also a good idea for a woman to let her partner know how he can help her because many times a man wants to help but is not sure what to do.

moderator What kind of feelings should the couple expect to experience after the baby is born?

speaker I actually was surprised by the feelings I had after the birth of my healthy child and I suspect many others are too. It is easy to believe that all our problems are over once the pregnancy ends happily. But what I found through my own experience and when talking to others is that the fear continues to a certain extent after the next baby is born. There is fear of SIDS or other illnesses, at least at first. That can lead in some cases to overprotective parenting. Over time, however, many couples find that they become just like any other parent. But of course, the most overwhelming feeling that couples have after the birth of a healthy child is happiness.

moderator We are reaching the end of our hour. Do you have any last comments or advice for our members, Carol?

speaker I would just like to say that this book is a book of hope. I was able to have two healthy children after the devastation of my loss and hopefully so can you. That doesn't mean there won't be setbacks along the way or that it will be easy. But working together with your health care provider you may be able to have your heart's desire: a healthy baby. I wish you all the best.

moderator We have been talking with Carol Cirulli Lanham. Carol is the author of "Pregnancy After a Loss: A Guide to Pregnancy After a Miscarriage, Stillbirth, or Infant Death." This book is available at your local bookstore or online.

moderator Thank you, Carol, for joining us today to talk about this sensitive issue.

speaker Thank you.