Pregnant after a stillbirth or late term loss

The experience of losing a baby can sometimes make it impossible for parents to think of pregnancy as a happy time that results in a healthy baby. Instead, it can become a very anxious time full of fear and worry. Most health professionals are aware of this and will be able to offer you extra care, monitoring and reassurance in your next pregnancy.

Being pregnant again after a loss can bring up lots of overwhelming emotions and can sometimes bring a new wave of grief. Remember that it’s ok if you’re not feeling ok and need some more support. Please speak to your healthcare team if you’re feeling like this as they will be able to support you. 

Lots of parents have told us that it’s important to remember that a rainbow baby, or a baby after a loss, is not a replacement for their brother or sister who came before. It can be helpful for some families to try to include them in this pregnancy and think of them as a big sister or brother. But it’s important to do what’s right for you and your situation. 

"No one understands. You have a people magnet protruding out in front of you all the time and you are asked again and again, “Aww, is it your first?" You try to stop further questions with a curt "No" but then the next, "So how old is your other child?" which means you have to explain to a stranger something so intimate and heavy. Even when you talk to family or friends, they all say "Oh it won't happen this time. They are taking proper care of you now, dismissing your genuine concern and anxiety.'"
Sarah, who lost her son Tristan. Read Sarah's story.

Many parents who have experienced the loss of a baby find it helpful to talk to other people who have been through a similar experience. This is why we set up a Pregnancy After Loss support group on Facebook where parents can talk to other people who have been through similar experiences. Many parents say this helps them to feel less alone.  

Extra care during pregnancy

In your pregnancy(ies) following a stillbirth you should be put into a ‘high risk’ group because you had a previous stillbirth. This usually means that you will get extra care and extra scans to carefully monitor your baby’s growth and development. Although this does not get rid of the anxiety, most parents find it very reassuring. You are also likely to be under the care of a consultant instead of a midwife.

The number of extra scans and appointments you get will depend on your doctor and the cause (if known) of your baby’s death. If you would like more scans or appointments to the number offered, you can ask for more.

"We saw [Doctor] Alex about once a month until my third trimester when it became fortnightly, mostly for my peace of mind. I refused to see a midwife for antenatal appointments as I had lost faith in the tape measure and listening in for a heartbeat." 
Sarah, who lost her son Tristan. Read Sarah's story.

As your due date approaches, you may be offered an induction of labour or a caesarean section for your peace of mind, even if your pregnancy has been uncomplicated. If this is something that might help you cope, speak to your consultant about the timing and type of birth you want.

Tommy's Rainbow Clinic

If you feel that you want to be cared for at a different hospital, or with a different medical team, talk to your GP about how to get a referral. Tommy’s runs a specialist clinic for families who are pregnant again after a stillbirth. The first Rainbow Clinic is at St Mary’s Hospital in Manchester, where families can access specialist care from anywhere in the UK. 

Over the past few years, more Rainbow Clinics have been set up at other hospitals in England and Wales so there might be one in your area too. Check with your local NHS Trust if there is one you can access locally.

Am I at higher risk of another stillbirth?

Studies have shown that if you've had a stillbirth, you are at an increased risk of complications in a future pregnancy. This is why the extra care is so important. The chance of having complications depends upon the cause for your baby’s stillbirth. This is one reason it is important to understand why your baby died and what treatment (if any) you need in your next pregnancy. Ideally, it is good to have a plan of care in place before starting on your next pregnancy. 

You will to be monitored much more closely, and potential problems should be found earlier and managed, for example, with an earlier delivery date.

If there was a specific problem, such as growth restriction, diabetes, pre-eclampsia or other medical conditions, then there may be an increased risk that is associated with the condition reoccurring. Depending on the cause of your previous stillbirth, you may be advised to take certain medication in the next pregnancy.

For your own reassurance, always ask if you are concerned about anything any point during the pregnancy. 

Flu vaccines in pregnancy after a stillbirth

Some parents who weren’t given a cause of death for their child worry that the flu vaccine may have caused it. This can make some people anxious about having the vaccine in a following pregnancy.

However, studies have shown that it's safe to have the flu vaccine during any stage of pregnancy, from the first few weeks up to your expected due date.

A systematic review (very reliable research evidence) of all the current research into the flu vaccine and pregnancy outcomes has reported that the flu vaccine does not cause stillbirth. In fact, there is some research to show that getting the flu in pregnancy increases your risk of stillbirth. 

The vaccine is recommended by the NHS as well as Royal College of Obstetricians and Gynecologists (RCOG) and Royal College of Medicine (RCM) because of the benefits to you and your baby. Getting the flu in pregnancy is serious. As well as increasing your risk of stillbirth, it puts you at risk of:

• developing complications, particularly if you get it in the later stages of pregnancy
• giving birth prematurely
• having a low birthweight baby. 

Read more about the flu vaccine, preventing stillbirth and symptoms and risk factors. 

Managing anxiety in pregnancy after a stillbirth

Many parents describe pregnancy after a stillbirth as a difficult and very anxious time. It is hard not to be overwhelmed with fear of losing another baby and it’s normal to not be able to imagine taking a live baby home.

"In both pregnancies, the anxiety was at a level most probably cannot even begin to imagine. Being pregnant is such a triumph but such a delicate state of being. Every day you would check for bleeding and expect it to be over. Every time the scans began, the pause before you hear you baby's heartbeat you are convinced it just doesn't exist and they have gone again. You worry every moment of those pregnancies."
Sarah, who lost her son Tristan. Read Sarah's story.

If you’re finding it hard to cope day-to-day and anxiety is becoming difficult to manage, talk to your GP, consultant or midwife. It might be possible for you to have some counselling, or talk to someone about coping strategies for managing your anxiety. Your midwife may also be able to refer you to a mental health specialist midwife who can offer additional specialist support.

Be kind to yourself. You have been through a traumatic experience and it is natural to feel overwhelmed by emotions and anxiety. Getting extra support and help with this can make a big difference.

"One day you’re confident and excited but the next day the doubts creep in and you worry the baby isn’t moving. Before you know it you’re feeling as if you are neurotic." 
Amy, who lost her son Jack

Tips for reassurance in pregnancy after a stillbirth

These are some tips from other parents who are going through pregnancy after a stillbirth. Hopefully you find some of them helpful for you and your situation:

• Try not to bottle it up. Let your midwife, doctors or hospital know if you’re worried about something, need an extra scan or want to talk through any concerns. Some people worry about ‘wasting time’ – you’re not and no-one will think that.
• Monitor your baby’s movements and speak to your maternity immediately if you notice any reduction. The hospital is open 24/7 so you can go in at weekends or during the night if you need to. You may find a Kicks Count wristband helpful for tracking your baby’s movements. 
• Find out if your maternity unit runs a clinic or drop-in session for bereaved parents who are pregnant. This can be a place for you to go for reassurance and support where you might meet other local bereaved and pregnant mums.
• Always take a list of questions with you to appointments and a pen to note down important points – or use your phone. This can be helpful because anxiety can make it difficult to remember things on the spot, and might distract you from absorbing all the information.
• Let your midwife know particularly difficult dates for you. For example, around the time that your baby died you might like to request an extra scan or monitoring, for peace of mind. Some parents want to avoid the hospital at this time. If you feel like this, talk to your hospital to see if it is possible. 
• If your maternity notes have not already been highlighted in any way to show that you had a previous stillbirth, ask about marking your maternity notes. Maternity units can mark notes with a sticker so that midwives understand that you’ve lost a baby and you don’t have to keep explaining. Mama Academy sell baby loss alert stickers for your maternity notes or can sometimes be supplied by your midwife.  
• Consider getting in touch with other parents who’ve had a similar experience. It can really help to talk things through with someone who understands. We have a parenting after loss support group on Facebook where you could chat to other parents. 
• Try writing down your thoughts and worries. Lots of people use journaling as a way of releasing their emotions, fears and anxieties.
• Ask for a tour or virtual tour of the place you will be giving birth. Often having a visual picture before the day and being aware of the layout can relieve some anxieties, especially if this is a different hospital.
•  Ask your midwife to help you write a birth plan. You may be able to get extra support, such as a single room after your baby is born, flexibility with visitors and longer visits from the midwife or health visitor once you’re home with a new baby.
• Don’t put yourselves under too much pressure to pack a hospital bag or buy items for your baby. Often people feel that they might be jinxing the birth doing this. There’s no immediate need for most of it. Speak to your midwife. Your hospital may have a supply of clothes and nappies for immediately after the birth, and you can buy anything else you need later.

"I found the best way to manage and cope with my feelings was to have a chat with people, especially my two friends who were going through something similar. Then we could talk about the children we lost. I also kept a diary during my pregnancy so if I ever felt I needed to air my feelings, I had that." 
Jennifer, who lost her son Alexander

If pregnancy feels very long

For some people, pregnancy can feel like an eternity stretching out in front of them. Here are some tips to help cope with this:

• Take one day at a time. You could even try breaking the day down into segments, perhaps morning, afternoon and evening. Think to yourself, I’m going to get through this morning by going for a walk and getting some fresh air. And then do the same for the afternoon and evening. 
• Look after yourself extra carefully. Grief is tiring, even more so if you are pregnant.
• Give yourself time out to do things you enjoy or make you relax each day.

"I felt very uncomfortable being congratulated on our rainbow pregnancy. As far as I was concerned there was nothing to congratulate until I brought a live baby home from hospital. We chose not to tell family until 17 weeks, and close friends at 19 weeks. If I could have gone through the whole pregnancy without telling anyone and then brought a baby a home, that’s what I would have done. It felt that people thought that we were OK because we were pregnant again, that we had accepted what had happened, that we weren’t grieving any more, none of which was true of course." 
Ellen

Some people found reading books around managing pregnancy after loss helpful. For example, Pregnancy After Loss by Zoe Clark-Coates has been recommended by some parents.

Parenting children after a stillbirth

Parenting children who are born after the loss of a baby can bring extra anxiety. Babies seem so fragile, and the conflicting care advice from parenting books can add confusion and worry.

“We talk about grief after people die, but when you lose a baby, it’s so important to talk about that loss too, especially as you continue into another pregnancy. When anyone said to me, is this your first, I would say no it’s not and explain the situation. We need to be careful about the questions we ask people. I wish the world was just a bit more vocal about these things, so nobody feels they need to go through their grief alone.”
Maisie. Read Maisie’s full story. 

Having experienced death makes it much more difficult to assume that things are fine. Do what you feel is needed to ease your anxiety and get through the early months. Keep your baby sleeping close by you in your room, use baby monitors or check on them frequently during the night. If possible, explain your fears to those close to you and ask them to help out and be vigilant for you so you can get some sleep.

We have more information on safe sleep for babies. 

"I think it’s also completely underestimated and not really documented how stillbirth can affect you as a parent. Despite my constant reminders to myself to be ‘in the moment’, the first six months of my rainbow baby’s life are a bit of a blur. Midwives and health visitors kept telling us to sleep, but my husband and I wanted to take it in turns to watch him breathe. It felt like they just didn't understand, the stakes were so high and he was so precious. I am still very dependent on a breathing monitor in his room, something that I never needed with my first son. Once one of your children has died, you realise bad things can happen to anyone, and it's hard not to think the worst.Good friends who have been with me through this entire journey told me just to do whatever could get me through." 
Ellen

You might find our parenting after loss information useful.

When your rainbow baby is older

‘Andrew’s Rainbow’ is a book available from The Scottish Cot Death Trust. This is a good resource for children who have been born after the death of a sibling.

Kicks Count also has a storybook book called ‘I Am Your Rainbow’ which may help you explain what has happened. 

Pregnancy loss community

A very supportive community has built up over the last few years around pregnancy loss. We have put together a list of blogs, online communities and social media accounts from people who have suffered pregnancy loss or preterm birth. All write movingly about their experiences of loss, life after loss and, in some cases, pregnancy and pregnancy/parenting after loss.

"When my son was stillborn, I couldn’t find anything to read about the mum’s personal experiences and what to expect... I needed something real, something I could relate to." 
Hannah 

Getting more support 

Going through a pregnancy after a previous loss can be incredibly hard. You can talk to our Tommy’s midwives about what you’re going through for free on 0800 0147 800. Or you can email them at [email protected] We are open 9am to 5pm, Monday to Friday. 

Other helpful organisations

• Kicks Count is the UK's leading baby movement resource and awareness campaign.
• Mama Academy is a charity that aims to empower all maternity professionals and expectant parents on stillbirth prevention methods to help more babies arrive safely.
• Sands is a charity that provides support to anyone affected by the death of a baby. 
• Twins Trust is the Twins and Multiple Births Association for support with losing a multiple birth baby.