How do I stay sane while I try to conceive after a miscarriage?

March 11, 2006 3:45 PM

How do I stay sane while I try to conceive after a miscarriage?

I was pregnant for the first time and it was great. I'm 27 now (was 26 when I conceived), and I got pregnant the second month after I stopped using birth control. 11 weeks into the pregnancy, I miscarried (naturally, no d&c required). The week after was pretty black, then I was swept into new house, new puppy, job, etc and managed to carry on with life without thinking about it too much.

Now this is my second period after the miscarriage and I'm starting to lose it. Today was the third day I spent an hour crying. I was starting to think I was pregnant again, and now this. I feel like my body has cheated me. Two of my sisters-in-law are pregnant, lots of women at work are pregnant, and I am not. My husband, who is otherwise great, does not really understand how to be supportive. He'll hold me while I cry and then he'll say things like "maybe the martini killed the baby" and that just sets me off again. I don't want to talk about the miscarriage at all. My mother-in-law and sister-in-law would say how sorry they are, how hard it must be, and how they are praying for luck next time, and I just want to dissolve into tears on the spot.

To complicate, I am diagnosed as bipolar 2. I am being treated with 200 mg lamictal and I have generally been feeling better with this treatment. My shrink is aware of both the miscarriage and the fact that I am trying to get pregnant again.

So here are my questions: is this normal? Am I just suffering from hormone overload? Should I visit my shrink to tell her that I'm feeling miserable about this? Is this just delayed grief about the baby that I lost? If you or your wife/gf/so/surrogate suffered through this (and for that I am truly sorry), what kept you sane as you tried to conceive again the second time? Are there any decent resources out there that helped to reassure you/make you feel better? How do I keep myself from paying hyper-attention to any possible symptom of pregnancy and then becoming disappointed if I don't get the expected result? And when (if) I do get pregnant again, is that going to help or will that just cause another round of paranoia until the baby actually comes out healthy?

I swore up and down I would not become "one of those women" who obsessed over pregnancy and babies but now I have inadvertantly become one of them. That's part of the shame. I also feel ashamed of being such a wreck. At the same time, I'm saddened because it seems like everybody that suffers through miscarriage feels this pain and shame ...

posted by anonymous to health & fitness (31 comments total)

I have not been in this situation, but if it helps, everything you're talking about sounds *completely* normal to me, even for someone not dealing with the added complication of being bipolar.

I did lose my mother in the past year, and that death still affects me greatly (breaking down in the street crying on occasion). You suffered a real loss -- it has nothing to do with being "obsessed with babies" or in any way abnormal.

I do think you should talk to your shrink, not because you're acting badly or abnormally but because it sounds like you need someone considerate to talk to -- and you need to find strategies for explaining what you're going through to your husband and how he can actually help, because if what you're saying about his reactions are accurate, he's being really inappropriate and thoughtless. I'm sure he's doing his best, but he needs to understand why what he's saying is coming across as hurtful. (Really, if I heard that from a partner, I'd be on my way out the door. Again, you're not abnormal or baby-obsessed for find that reaction inappropriate.)
posted by occhiblu at 3:59 PM on March 11, 2006

You have nothing to feel ashamed of. Your feelings are your own. Denying them doesn't make them go away.

Visit your shrink? Holy shit, yes. This, anonymous, is a profound event, something I wouldn't wish on my worst enemy, and your disorder only amplifies its impact. Talk to your shrink as soon as you can.

I'm so very sorry. But you will pull through this, and you will have beautiful children.
posted by middleclasstool at 3:59 PM on March 11, 2006

Also, if I'm reading your question correctly, the miscarriage just happened two months ago? What you're feeling isn't really delayed grief, it's just... grief. It just happened! You're completely allowed to be upset about it, even if it didn't really "hit you" right away. Often, I think, all the practical considerations of daily life and loss can almost help us get through those first few weeks without breaking down, and then when there's a bit of a break the real feelings well up, because now there's time and space to deal with them.

Again and again and again, you are well within your rights to feel the way you're feeling, and you should do everything you can to find someone to talk about it with -- not to make it disappear or go away but just to get some support for what you're going through.
posted by occhiblu at 4:03 PM on March 11, 2006

Talk to your doctor. You may want to ask if there is a Reproductive Mental Health program at your hospital -- they'd have a specialized approach to your situation and could work in combination with your existing doctors. They can also look after you at any stage of the reproductive cycle -- after a miscarriage, prenatal, perinatal, post-partum, etc.
posted by acoutu at 4:05 PM on March 11, 2006

My mother miscarried what would have been my older sister a year before I was conceived. Don't worry, things will work out soon enough.
posted by mhuckaba at 4:07 PM on March 11, 2006

i'm sure it will work out, these things happen ... but you're right about your husband not being supportive ... "maybe the martini killed the baby" is not the kind of thing you need to hear from him

perhaps he should talk to your shrink about how to be more supportive of you and more understanding of your problem ... it disturbs me that he said something like that
posted by pyramid termite at 4:32 PM on March 11, 2006

If it makes you feel any better, I'm not diagnosed with anything, and today I cried for a half hour because I got my period and we're trying to conceive. It's easy to get more wrapped up in than you originally plan to be; hormones and lots of cultural cues set us up to get deeply attached to the idea of parenthood pretty early on in the process of trying to conceive. Plus - babies are freakin EVERYWHERE. The catch is that high stress levels in the first few weeks make implantation less likely.

My solace is in sites like Fertility Friend and other lesbian mommy blog friends, people who are also trying to conceive and having success (or not.) They're good reminders that a lot of us are in the same boat.
posted by pomegranate at 4:40 PM on March 11, 2006

most of my friends who have become pregnant have miscarried. right now the count is about 8 babies in my circle of women friends out of about 20 pregnancies. most of the women i know who have miscarried have gone on to have healthy babies, but i've really changed my own thinking in terms of what to expect - that despite the sort of smiley baby gap commercials all around us, many many many pregnancies don't result in happy healthy babies, and that our culture doesn't really acknowledge this in any meaningful way that provides women (and men) with outlets for and acceptance of the grief that accompanies this.

the grief is normal and healthy and appropriate, but you might find therapy will help you let go of the blame and shame parts. you might also try some gentle anti-anxiety tactics (either pharmaceutical or natural (omega 3, yoga, meditation, etc)) to help calm you as you try to conceive again. best of luck.
posted by judith at 4:40 PM on March 11, 2006

Go see your pdoc. The strong emotions and the hormones more likely than not will affect the bipolar, and it would be wise to stay on top of that. (I'm bp type 2 and take lamictal myself.)

Miscarriages are heartbreakingly common, as you may start finding out once you talk to more of your friends. It might help if you can find someone to talk to who has gone through it herself. From what I can gather, it is a lot tougher than people who have never had one can understand. (I only had a threatened one, years ago, and altho the pregnancy turned out to be successful I was shocked at how upset I was at the very possibility, when before it all I felt rather cavalier about it.)
posted by konolia at 4:52 PM on March 11, 2006

is this normal?

Absolutely par for the course.

Am I just suffering from hormone overload?

Yes. That's a big part of how grieving works. The main hormones involved are cortisol, adrenaline and friends.

Should I visit my shrink to tell her that I'm feeling miserable about this?

Yes, if what you expect is reassurance and emotional support from somebody you trust to have your best interests at heart. No, if you're expecting fast results.

Is this just delayed grief about the baby that I lost?

No, it's undelayed grief. It would take most people at least a year to get over something that huge.

If you or your wife/gf/so/surrogate suffered through this (and for that I am truly sorry), what kept you sane as you tried to conceive again the second time?

Not rushing it.

Are there any decent resources out there that helped to reassure you/make you feel better?

We all do our best :)

How do I keep myself from paying hyper-attention to any possible symptom of pregnancy and then becoming disappointed if I don't get the expected result?

You could start by acknowledging that this is absolutely likely to happen frequently, and resolving to forgive yourself every time it does. It's only to be expected that you'll feel this way for a good while yet. The rollercoaster ride should get less violent as time goes by, though.

And when (if) I do get pregnant again, is that going to help or will that just cause another round of paranoia until the baby actually comes out healthy?

Expect and prepare for fear to revisit you. Just keep reminding yourself that it's perfectly OK to be fearful about the possibility of important things going wrong; because when you whip on yourself for feeling that fear, you only pile misery on top of it.

To make the ride a little less bumpy, learn and practise some relaxation techniques. Hatha yoga has plenty of those, among other things, and would be a good place to start.

But the main things are learning to forgive yourself for having feelings you don't want, and giving yourself the time you need to let them subside to tolerable levels.

Best of luck.
posted by flabdablet at 5:02 PM on March 11, 2006

This is pretty much on the money, too.
posted by flabdablet at 5:06 PM on March 11, 2006

My mother miscarried several times before she had me (and then my two brothers). I know she was miserable about it, but she followed doctors' orders and took it easy and, well, here I am, and I grew up feeling very much loved and wanted (I didn't find about about the miscarriages for years). You'll be fine; let yourself grieve and give yourself time to recover.

"maybe the martini killed the baby"

!!!

Seriously, I'm sure he's a great guy, but hit him over the head with a two-by-four for me, willya?
posted by languagehat at 5:10 PM on March 11, 2006

I cry and then he'll say things like "maybe the martini killed the baby" and that just sets me off again.

Well, get him to stop saying crap like that. Geez.
posted by delmoi at 5:11 PM on March 11, 2006

First of all, I am so sorry. {{hug}} The first 12 weeks of a pregnancy is sooo hard and to have gone that far, only to lose it - man, that's rough. The good news is that from everything that I've read, the odds of this happening the next time are very small. I don't know that this is much comfort to you right now, though. Again, I am so sorry.

My concern for you is that you might be rushing into trying again when you should really be working at making peace with the loss of your first pregnancy. I think that you are dead on when you say that you might be having a delayed reaction to the loss. Oftentimes after such a major loss you're a little numb for a month of two, then it hits you like a Mack truck.

You're young and waiting a few months more before trying again might give you enough time and healing to proceed without so much fear and anxiety. Also, talk to your obsterician about grief support groups in your area for women who have miscarried. Being with others who are going through what you are might be just what you need right now.

Try not to judge your husband too harshly. Some people deal with grief by trying to come up with reasons why the loss occured, as if knowing the cause would give you the power to change the outcome. It may be his way of trying not to feel so powerless over what happened. If, for example, the fetus had Trisomy 13 or Trisomy 18 it's highly unlikely that you would have been able to carry to full term - both of those are pretty much "luck of the draw" 1 in 1,000 type things that could happen to anyone and nothing you did or didn't do could cause or change the outcome. The pregnancy just wasn't meant to be. For him though, the thought that something so horrible could just happen for no reason, might just be too painful to contemplate right now.

And I am also Bipolar Type II and on Lamical. It might not hurt to add something to the mix for a couple of months, but I think a short course of counseling to deal with this specific issue might be just as helpful.
posted by echolalia67 at 5:36 PM on March 11, 2006

Uh, make sure that your obviously clueless husband speaks to a doctor as well. If he's saying blindingly absurd things like "maybe the martini killed the baby" then it's quite clear he could use some education as well.

A miscarriage (or 'spontaneous abortion') at a mere 11 weeks is absolutely no fault of your own. Unless you were massively abusing drugs or doing something horrible (and even then...) this was not your fault at all.
posted by drstein at 5:39 PM on March 11, 2006

Every woman on my mother's side of the family (mom, sister, aunt, grandmother, great-aunt) miscarried their first pregnancy. Every. Single. One. (And all of them went on to have children.) I think about this as we plan to start later this year. It is, as has been said, heartbreakingly common, but the fact that it is so common does nothing to diminish your grief. Be gentle with yourself- two months out is still very fresh to the wound. Give your body and your spirit a little time to heal, and talk to your doctor as well.
posted by ambrosia at 5:54 PM on March 11, 2006

FWIW, my mom miscarried what would have been my older sibling. Then she had me. And then my younger brother.

You'll get through this. Good luck.
posted by jeff-o-matic at 6:15 PM on March 11, 2006

Miscarriage is really hard -- a kind of silent, invisible loss. It's a private thing, and sometimes people expect your grief over it to be private as well. I miscarried my first pregnancy, and it was difficult. The hormonal rollercoaster, the change in my body, the sudden anxiety that I might not be able to conceive again -- and that if I did, this might happen once more... It was overwhelming. (After I miscarried, I felt like I couldn't endure being pregnant again. And yet I did get pregnant again -- twice. And now have two children.)

Right now you need to be gentle with yourself. Talk to your doctor/therapist, and yes, by all means, have your husband to talk to someone too. He may think that making light of the situation helps ease things, but it's pretty clear that he's missing the mark on this.

I wrote about my experience with an early miscarriage in my first book, Mother Shock, but I expanded that essay for an anthology coming out later this year by Jessica Berger Gross titled "About What Was Lost." I wish this book was available now, because I know that when I miscarried, one of the things that really helped me feel better was reading about other women's experiences. In my essay (in Mother Shock and in the expanded piece in About What Was Lost) I write about visiting online bulletin boards and websites and finding that secret community of women who had experienced loss. It was comforting to read about how other people dealt with it -- and sobering, too. It happens to so many women, and it happens so often, at all different stages of pregnancy, and yet it's not something that many of us talk about.

Yet when it happened to me, and I did talk to people about it, I learned that everyone seemed to have a story -- my mother, my grandmother, my boss, a friend, a friend of a friend... so many women knew what I was going through, even though it felt like it was only happening to me. Hearing other people's stories was a real comfort.

To that end, feel free to contact me. I'd be happy to share with you the piece I wrote for the miscarriage anthology. And in the meantime, I'll try to collect some links to blogs that tackle this subject with compassion.
posted by mothershock at 7:20 PM on March 11, 2006

I support your feelings unconditionally. They are normal. The loss of a much-wanted pregnancy is huge. You don't need to try to minimize it or try to explain why it's such a big deal - it *is* a big deal. I know it's a big deal, your husband knows, your shrink knows. Be gentle with yourself as you recover; you can't rush that process, which is a process of grieving your loss.

Other than to give you that support and that understanding, I don't suppose there's much to add from that perspective.

On another tack: I'm concerned that your psychiatrist has chosen lamotrigine for you, knowing that you're trying to conceive. There's good evidence that it causes birth defects, even in women who are taking 4 mg (4000 mcg) of folic acid per day. (You are taking at least that much, aren't you?) It is also next to impossible to maintain a therapeutic level of Lamictal during pregnancy. During pregnancy, your liver changes in a way that causes it to metabolize Lamictal much, much more rapidly than it did before you were pregnant. That means that you can expect to have your liver rapidly withdraw you from Lamictal sometime around your 6th month of pregnancy; not when you really want that to happen. I would like to believe that your shrink has already discussed these issues with you.

I hate to second guess a doctor and I hate to bring up other stressful things in this thread. I hope you can have a good conversation at your next shrink visit that helps to sort some of these things out.
posted by ikkyu2 at 7:46 PM on March 11, 2006

ikkyu2, I am currently 21 weeks pregnant and on Lamictal. I did some research before going ahead and trying to concieve. What I read indicated that the normal probability of birth defects in the general population is 2 - 4% and that there was a 3% probablity of birth defects with woman who took Lamictal, meaning that the increased risk is very slight at best. I'm trying not to snarl at you about using anti-psych med scare tactics because I'm sure that you mean well. I just don't think Anon need yet another person making her feel guilt and shame about something she had no control over.
posted by echolalia67 at 8:00 PM on March 11, 2006

My wife miscarried our second child in the 13th week and it was pretty crushing for both of us. We had just heard the heartbeat. I don't know if it'll help you move on, or at least have some closure, but here's what we did.

We wrote seperate letters to our deceased baby. Everything we were losing out on, our family was losing out on, every feeling and regret we had. She had passed the remains of the baby in our bathroom, so we bought a special box for the baby's remains. We went to a special spot, just the 2 of us. We read the letters out loud, through tears, placed the baby in the box, placed the letters in that box, then buried it. It was incredibly sad and painful -- but it was very nice actually. A special moment that brought us closer together.

There is no way around it, a miscarriage turns subsequent pregnancies and conceptions into events that now have an element of worry where they were only about joy before. My wife did get pregnant again, but then some bleeding started and I remember feeling like I was in slow motion, like it was happening again, and there was nothing I could do to stop it.

I remember looking at our first daughter and thinking she was just this miracle child, like how in the world did she survive this gauntlet known as pregnancy, thinking we would never be fortunate enough to have another.

But the bleeding subsided and we had a boy, completely healthy.

It's not easy, and people who think that you should just move on and get over it don't really understand. It's a real death, a huge blow, and 2 months isn't enough time to properly deal with it. You'll be alright. Just keep trying, and know that your feelings are normal.

My mom had 2 miscarrages before me. These are much more common than you probably think.
posted by visual mechanic at 9:05 PM on March 11, 2006

echolalia:

1. I don't know where you found that 3% figure, but it certainly wasn't in the American Epilepsy Society's 2005 abstracts. That study cited a major malformation rate of 8% with lamotrigine when the medication was adjusted properly to keep levels constant. That's worse than valproic acid, and it is certainly statistically well off the baseline.
   
   
2. Adding to the stigma of illness is not one of my major goals in life.
   
   
3. Most psychiatrists who prescribe lamotrigine aren't aware of the way its metabolism changes in pregnancy. I think you missed that point: by month 6 of the pregnancy, if the dose isn't changed, levels can fall by up to 90%. That means the medication isn't working any more, even though you're taking the same dose. Wouldn't your shrink think it important if you suddenly went off the medicine? Well, if being pregnant essentially does the same thing, wouldn't a person need to know about that and discuss it with their shrink?
   
   
4. Anti-psych-med scare tactics is a ridiculous accusation to level at me. I prescribe more lamotrigine in a week than the average psychiatrist does in a year. I may, in fact, even know more about lamotrigine than the average contributor to these threads.

posted by ikkyu2 at 9:33 PM on March 11, 2006

20% of all known pregnancies end up in a spontaneous abortion (according to the class on it that I just took)

So pleaes, remember that it's not your fault. :)
posted by drstein at 9:52 PM on March 11, 2006

ikkyu2 , after I responded I looked at your profile and realized that you're smarter than the average mefi bear, anti-epileptics med-wise and probably weren't coming at this with a huge anti-psych axe to grind. Living with the type of illness I have means you have to hear alot of bullshit about how there's no such thing as mental illness, that all you need is exercise, moral fortitiude, and a positive attitude, blah, blah, blah. Being pregnant, I get to hear about all of the millions of ways I can cause irrepairable harm to my future child - I've even heard lately that using regular old bathroom soap while pregnant can cause birth defects. Seriously. So I'll admit to having a bit of a chip on my shoulder and apologize if the tone of my reply sounded hostile and snotty.

That being said, I had heard through my psychiatrist and then read in a reuters health news article that analysis of 10+ year of Lamotrigine pregnancy registry data came up with the figure of 3%. Vaproic acid, if I remember, was at about 11%. This site seems to reflect similar numbers:

" However, there is a growing body of information the reproductive safety of lamotrigine (Lamictal), and this may be a useful alternative for some women. The manufacturer of Lamictal (GlaxoSmithKline) maintains a pregnancy registry for lamotrigine and has presented preliminary data regarding outcomes of children exposed to lamotrigine in utero. Out of 200 children exposed to lamotrigine alone during the first trimester, four had major birth defects, representing a 2.0% risk of major malformation, which is within the range of 2 to 4% observed in the general population absent exposure to any known teratogen. Lamotrigine polytherapy, however, seems to carry a more significant risk, with a 6.5% risk of major malformation observed in a total of 184 cases."

The info about way lamotrigine is metabolized at the 6th month of pregnancy is interesting information, however, and I will have to discuss this with my doctor. My symptoms have been getting worse and if this is a possible cause, it's good to know. Having a study to cite would be helpful, so if you could provide it, I'd appreciate it.
posted by echolalia67 at 10:16 PM on March 11, 2006

My apologies to the original poster for hijacking her thread. I'll take this to email.
posted by ikkyu2 at 11:51 PM on March 11, 2006

My ex and I went through the loss of pregnancy not once, but twice, back to back. Very dark period.

First, absopostivelutely bring your therapist up to speed. Yes, I know, it's been said + said + said (and will be a whole lot more in this thread.)

I mention this, because while Med therapy is good, talk therapy helps significantly as well. Perhaps your on too slight of a dosage, etc. Perhaps it's time to reevaluate what you're taking. I don't know and you don't know but there is someone competent in your life. You're just not 'troubling' them.

Second...just a word of thought.

Your body didn't betray you. I know it feels that way - you're trying hard to have a child, there is all this social pressure (my peers are having babies! Babies everywhere!)

To reframe some of this for you:
What your body did, is stop the reproduction of a child with a some sort of developmental problem in it's formative cycle. Not a pleasant way to say it...but...
Your body is trying to produce a healthy offspring. Don't blame it.
Yes, there are buckets of hormones to make the experience worse in this regard. Yes, there is social pressue out the wazoo.

Most first time parents are estatic (and breathe deeply in relief) that their child is born with all its fingers and toes.

Loss is a powerful force in life. It makes you appreciate what you have. Sit down this sunday afternoon and make a short list of things like: how much your husband loves you (and you him), some of the good you've done on this planet, and how nice it is that you can live a life where strangers are trying to actively help you. Having trouble with the list? Ask your spouse to help. Put this on your mirror, near your bedside or in your purse. Next time you feel down, look back at this list.

How do you stop being hyper aware and deal with your fears? I don't know if any of us can answer that.

But I can tell you that there is one possibly positive note. How much fun the act of conception is. Didn't happen this month? You'll just have to go back to having sex.
posted by filmgeek at 6:22 AM on March 12, 2006

My mother miscarried what would have been my older sister a year before I was conceived. Don't worry, things will work out soon enough.

That happened to me too. . . .and I did not find out until my mom drew up a will.

And I have a younger sibling also. . .

I have no advice, but also, there is a LOT of time for you to have a child. . . .and the world is full of people who give up and adopt, only to conceive after that. .

I wish you and your husband the best.
posted by Danf at 8:51 AM on March 12, 2006

If there's one thing I took away from my embryology course, it's this: miscarriage is often your body's way of saying "there was something wrong with this baby." It may be cold comfort, but if you think of it as a mechanism for weeding out unhealthy fetuses, it may set your mind at ease.
posted by greatgefilte at 8:51 AM on March 12, 2006

Dear Anon,

Like many others who have responded to you, I miscarried my first pregnancy at about 11 weeks. (This was last May, actually, less than a year ago.) First it is perfectly and completely normal to miscarry your first pregnancy. For me, I was devistated for a week, then sort of "shook it off" (or so I thought), only to discover that seeing babies in the Grocery store would reduce me to tears about 2-3 months later. Everything you're going through is normal. (Except -- frankly -- the totally unfeeling and irresponsible comments from your partner: but then again, not everyone knows how to deal with a death; I'd suggest that you have him go in and speak with your doctor about why miscarriages occur. Sheesh.)

At the time of my miscarriage, the best advice that I got was from my midwife, who recommended that we go back to using condoms for a full three cycles before we began to try again. She told me the reason for this was that your period can be messed up for a few months afterwards, and that giving the body time to heal completely would be an important part of being able to concieve again. But, in retrospect, I also think that she told me this in order to give my mind time to heal as much as my body.

I would pass her advice on to you: stop trying for about three months. Let your mind and body both do the work they have to do.

I am, right now, less than a year after my miscarriage, carrying a child at 21 weeks. The baby is healthy, moving, and big!

I know that right now you feel like you've somehow failed, but you haven't. You Did Not Fail. If it would help you to talk to someone else about this, then by all means do so. But always remember this: a member of your family died. Mourning a death of this kind properly takes months. Don't try to rush the process.

**HUGS FOR YOU**
Everything will turn out fine. Don't worry.
posted by anastasiav at 9:36 AM on March 12, 2006

[removed a few comments (well, just one and the ones responding to it) please address the question that is being asked, or take it to email or metatalk]
posted by jessamyn at 1:20 PM on March 12, 2006

I just got a letter from Glaxo Smith-Kline yesterday. It started with "Dear Doctor," and went on to explain that, in the GSK sponsored registry for babies exposed to lamotrigine in the first trimester, there was a 2.7% excess incidence of cleft palate. That means that lamotrigine was causing 3 of every 100 embryos to develop *just cleft palate*. Other major malformations weren't mentioned.

I don't think we're looking at "thalidomide II" here, but I am now certain that the idea of lamotrigine as a medicine that's considered "generally pretty safe in pregnancy" is definitively exploded.

Ask your doctor.
posted by ikkyu2 at 3:39 PM on June 23, 2006