• Ali Ferrara

GUEST POST: Pregnancy After Loss Struggles

Updated: Mar 28

Last weekend, my husband (Joe) and I got the chance to go somewhere for the first time since the pandemic began a year ago. We spent the weekend with his parents at their home near the beach. It was such a nice time to get finally get away for a bit to relax, but still stay COVID safe. We had the chance to walk on the beach and see the ocean, even though it was cold. We loved taking a few pictures on the beach of my big 28-week pregnant belly, as we told our son, Lucca, about the beach.

The weekend came to an end, and as we were driving home, we chatted about how fun it was to show Lucca the beach before he was even born and how we hoped to take him often through his childhood. It was one of those fun, joyous, ‘daydreaming about the future,’ moments in pregnancy. However, pretty quickly, tears came to my eyes as I said, “But we never got to take Mira to the beach.”


This was just one of those many moments in pregnancy after loss (PAL) where you are suddenly reminded how different this is from the pregnancies of women who have never experienced loss. In PAL, joy of


this new life, can suddenly change to grief of what you missed out on with your loss. Happiness at finding the perfect décor for the nursey, can suddenly turn to gut wrenching fear that the baby will never see the nursery. Confidence that you can now handle looking at the baby clothes in Target, can suddenly turn to regret for even walking in when you see that cute big sister dress, that his big sister will never get to wear.


Pregnancy is always an emotional roller coaster. Between hormones and typical anxiety surrounding giving birth and raising a tiny vulnerable baby, that is expected. In pregnancy after loss, you feel like you are walking on eggshells, waiting for the bad news to drop. Your emotions about pregnancy are so tied to your grief from your loss, that separating them is so difficult.


I do not think I could ever list anywhere near all the reasons the PAL is hard and complicated, but I would like to address the ones that have been most glaring for me. As PAL Month (March) starts to come to an end I hope my thoughts can add to the conversation that needs to be happening on this topic.


I hope that those of you reading who are pregnant after loss find comfort in knowing others feel similar. I hope those that are wanting to one day be pregnant again after losing a baby find these words helpful to be prepared and not feel alone if you have a similar experience. I hope those who have not experienced loss can read these words and better understand the PAL mom in their life. Please remember as you read these, they are from my perspective as Mom, but I know my husband and other PAL Dads feel most (or all) of this too.

Struggles of the PAL Mom:


Fear of losing this baby, and knowing full well exactly how hard it would be. Innocence is completely gone in PAL. After carrying my daughter to term with fatal birth defects and watching her take her last breaths in my arms just an hour after birth, I know that anything can go wrong in pregnancy. In learning how to process your grief, you hear the stories of others and learn about that many, many ways babies can die. PAL Moms have been a part the minority percent before that means their baby does not come home, so knowing something has only a 1% chance of happening gives no comfort. This makes fear is a constant companion. I have found as time goes on and I see more and more wonderful signs of health in Lucca, that fear is often just in the back of my mind. But so many triggers still bring it front and center, rather often.

Guilt over normal pregnancy complaints and knowing the same guilt will be there on rough parenting days. Everyone has the right to get frustrated with the discomfort of being pregnant. Logically, I know that. But after experiencing infant loss, and then secondary infertility, it seems so wrong to have any compliant about carrying this baby I begged for. PAL Moms, please know that hating morning sickness, or complaining because a pulled ligament makes it hard to walk, does NOTHING to diminish your gratefulness of carrying this life. I feel guilty for any pain or ache I mention and must remind myself of this often. Pregnancy is physically uncomfortable and acknowledging that is okay and even healthy. I know that this guilt will also show up when the baby kept me up all night and I just want sleep. I also know, not venting about the struggles of parenthood increases the risk for postpartum depression. Remember, frustration and gratefulness often occur together. One does not erase the other.


Fear of others forgetting the baby (or babies) that were lost or others seeing this baby as more important than the baby that died. I am a mother of two children. I correct anyone who says that I will be a Mom soon, or that I am having my first child. Lucca is my second child. Mira did not come home from the hospital with me, but she lived both in my womb and the world. If you lost a child before or after birth (at ANY gestation) you have the right to ensure they are recognized. As any mother, I love my children equally. I will parent them in vastly different ways. Obviously, Lucca will need much more active and hands on parenting, but I still parent Mira in many ways as she waits for me in Heaven. Showing that the baby that died is remembered and is just as important as the living child(ren) is such an important way to support a PAL Mom. I often fear that with Lucca’s arrival, others will begin to dismiss Mira’s role in our family. This is terrifying.

Knowing how challenging it will be to parent after loss in some ways. I don’t think any adult goes into parenting thinking it would be a piece of cake. However, parenting after loss presents some unique difficulties. It is hard to not be overly anxious about your child’s health and safety when you have lost a baby. Watching this child grow up can be a painful reminder of all you missed out on with the baby that died. Watching a child grow up that should have an older sibling can be heartbreaking wondering how that relationship would have looked. Another challenge, is ensuring that Lucca is never defined by Mira’s loss, but balancing that with acknowledging and treasuring Mira’s role in our family.

Panic attacks, flashbacks, or nightmares that come with the many triggers of pregnancy. Many loss Moms have PTSD or other mental health concerns. Even if the concerns do not rise to the level of a diagnosis, there are still many triggers to cause anxiety and panic in PAL Moms. For me, anything that happens too similarly to an event during my previous pregnancy is a trigger. Ultrasounds are always a trigger too and are for many other PAL Moms. During my anatomy scan for Lucca we received all good news. However, as the tech highlighted each part of Lucca’s body and told us how perfect it was, I could so clearly here the doctor at Mira’s anatomy scan telling us the issues with each and every organ and body part. Simple things that I don’t expect can be triggers too. Such as, taking a breastfeed class and hearing about what to do about engorgement, leading to a full flashback of standing in the shower crying as my breasts were swollen with milk that would never be used. Triggers are so very hard, and PAL is FULL of them.

Messages from others implying that a new pregnancy should magically erase your grief. Those with no experience in PAL often think, “Oh, she is pregnant again! I am so happy her grief and pain are gone!” This is so far from the truth. In fact, PAL brings on a whole new type of grief to walk through and process. The grief from losing Mira will never end. It changes, it matures, it grows, it flows in different ways, but it is there forever. Having anyone think that a new baby erases that pain is hurtful and rather insulting. When a mother who never experienced loss has her second child, she does not stop loving the first child. She does not “move on” from that child to focus solely on the new baby. So why would anyone expect a loss Mom to forget their baby due to having another?

Pregnancy after loss is hard and complicated, and a beautiful miracle. It can be all at once, and it is. I feel I could literally write a hundred more pages about how it has felt. Before I even was pregnant with Lucca I knew PAL carried its challenges. I was aware of what the books said and had heard other women’s experiences. However, it was about 8 weeks into this pregnancy when I “graduated” from my infertility specialist to regular OB (and straight to MFM due to my history) that it hit me hard.


Moms that need reproductive technology to conceive receive tons of extra attention, tests, and scans in those first few weeks, but then they graduate to OB for “normal” pregnancy care. I didn’t get to do that. This was a high-risk pregnancy from the beginning. Any future pregnancies would be too. I would face challenges other moms did not. I would need care other moms did not. Despite the comfort all the extra care gives me, it was also heartbreaking the moment it hit me: I will never have a normal pregnancy. Mira was my first pregnancy, and that will affect any others I have. This role of loss Mom is life long and impacts so much. Thankfully, my love for Mira is also life long and brings a great blessing to balance the pain. Soon Lucca will be here in my arms and my role and purpose will grow and evolve with him. Just as it has with Mira.


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